Stearnsy

The OP brings a curious point to light in that communicating PHI to this third party organ-procurement organization (Univ. of Miami Tissue Bank or Lifelink here in my locale) there may be HIPAA violations. If I am ordered to request medical records from another facility, a patient or their representative must sign a release of information form. Why is this not true when I share information with these organ procurement-related third parties, as I have done so many times in the past? I have never once stopped to think that I am sharing PHI without the knowledge of the patient or their representative, but now it seems I have done so quite a few times. Anyone?

I've been a nurse for coming up on seven years, always in an acute care hospital. Other, more veteran nurses always warned me to keep an eye on my "ears," as they've had many a pair stolen themselves. About two months ago I left mine at work over the weekend and sure enough, upon my return it was missing. Finally, it had happened to me. I work in a teaching hospital, so residents are continuously circulating. I'm friends with many of them on social media, and made a polite post about "keep your eyes peeled" for my stethoscope, which also happens to have my NAME ENGRAVED IN THE TUBING. Still, it was never found. I imagine a physician had to come see his one patient in our unit, couldn't find a stethoscope to do his half-assed exam, grabbed mine, used it for 3 seconds, tossed it around his neck, and then onto the floorboard of his S-Class as he left the parking lot. Screw you, dude. My stethoscope was given to me for X-Mas 2008 from my grandparents. I was in school and promised them I'd use it for my entire career. I'll never have the heart to tell them someone stole it.

I work 4-6 shifts per week while my female counterparts work 3, sometimes 4. Yeah, I make a lot more.

I am an associate's degree CCRN back for BSN so I can open some new doors. Totally online, 17months, and at the state college I received my ADN from. Prompt is "list the advantages and disadvantages of using nursing theory to guide nursing practice." I am totally stumped, not by the "advantages" part, as this seems obvious to me; nursing theories provide nurses with a framework and structure on which to base their practice. Before the 1950's or so, nursing education was based primarily in hospital-kept procedure manuals and seen as an auxiliary component to the medical profession before entering academia and developing into an independent profession. The major disadvantage to nursing theory, as I am finding, is that many of them are very complex and abstract, causing many students (like me!!!) to have an aversion to them. I want to explain how theories are not applicable to all walks of nursing practice, like same day surgery, pacu, etc. where nurses see their patients for a very limited amount of time--but I am having difficulty in "backing it up" with references. What are disadvantages?. My thinking is too focused--I love math and science..concrete, provable things..theory causes me major brain constipation. Please help if you would be so generous to share some nursing brainpower with me! I have the 2008-9 Catalano textbook, which to me, is completely useless really. I have access to EBSCO and CINAHL, also have used nursingcenter but search has not been working for me lately. TIA, Stearnsy, RN

Well... If the pt. is sedated, the nurse will definitely need help turning for purposes of skin integrity, pulmonary toilet, and peri/foley care. Radiology usually appreciates help with getting the board underneath these pts. for bedside xrays as well..sometimes even traveling to ct and other areas of radiology with the nurse because of how much equipment there is to manage throughout the trip and during the transfers involved. Hourly or q2hr duties may include gathering objective observations like temperatures and urine outputs and reporting them to the nurse. Oral care can be performed by a pct using tools such as the q2 kit, but don't touch the vent circuit if you aren't comfortable with what to do should it become disconnected. Procuring a stool or urine sample might also be a task performed by the pct. Manipulating surgical drains is at the discretion of the nurse based on their complexity and risk for infection, etc. Some pcts draw blood both by needle and sometimes even via the art line if they are certified within their facility to do so. Be proficient with bls in areas like these as you are liable to be at the bedside in the event of an arrest!

Thanks for all of the great replies everyone! Seeing some replies reaffirm my stance on the subject, others help to humble me! Thank you, thank you, thank you for taking your time to read through this thread and share your $0.02 with me. Still no resolution however! This is 2010. RNs don't make $13/hr anymore. As for my wage as a PCT, not only did I fulfill CNA duties, but I was able to initiate OGTs (yes, even w/ an ETT in place), NGTs, foley catheters, IVs (18-24G + TwinCaths -- couldn't access anyone under 10y/o per policy & no EJs!), I was part of the rapid response team, code team, EKG recognition (spent many an hour in the telemetry room after a nursing supervisor figured out that I had the required competencies!), and I could access art lines! Not your avg. CNA/PCT...just sayin' -- maybe the extra dollars were justified? Who knows, who cares, I'm an RN now :) Much love to you guys, and thanks again. :redbeathe TS

Well, if this is the case--I shall go elsewhere. Do you want to be paid $13/hr as an RN? In the ICU? Who's sometimes tripled? No thanks dude. Had to edit this because I sound arrogant and I hate the generational stigma that those from my cohort have an unrealistic sense of entitlement. Put yourself in my shoes for a minute--a second: Your employer tells you they're going to knock you down from your current wage to $13 for 4 months. What're YOU going to do about this? $13 is nothing. It was nice to a 20-year-old kid and I certainly worked my ass off for it, but now I am entitled to more. I worked full time as a tech while becoming educated as a registered nurse, now I just work my ass off and get fu*ked every other Friday. I simply can't afford it anymore. Nowhere did I sign or give verbal consent to be paid 50% of my true wage for 4 months. It's not fair to me, man.

Hello again kind perusers of this forum, I wholeheartedly wish I was writing you to say "yes! I finally got paid!," but this is not the case. It has been two pay periods with no evidence of a wage adjustment (e.g., bigger paycheck!) thus far. After taking into account ALL of the great feedback I received from everyone with a hand in this thread, I decided to give my employer a "deadline" to pay me before I started taking this matter into my own hands. Two pay periods have elapsed thus far, this Saturday marking the end of the third with that check coming next Friday. This third paycheck is the "deadline" I speak of. I continue to maintain that there is simply no excuse as to why my wage increase was not reflected on my FIRST check, so this third paycheck is really pushing it in my opinion. Today I met with my director to discuss the progress of my development as a critical care nurse since beginning this awesome internship I was so fortunately afforded. She is aware of my situation (not having undergone a wage change) and lamented, "corporate approvals from a few months back are starting to come in so you should have your money just in time for Christmas." I never, ever shoot the messenger. Besides, I love my director and she isn't to blame for this situation. I remained virtuous and didn't comment much, just agreeing and saying "okay." All the while I'm thinking, "what the ****? It's the first week of September. CHRISTMAS?!?!" What really has me ticking this time is the fact that I was told 2-3 pay periods, now I'm being told Christmas. I think they should give me interest if they're gonna back pay me 4 months after I should have seen an increase, for-*******-real. I am so heated about it inside, but I have remained calm thus far. I turned 23 this past weekend and went to Miami beach. Instead of being able to do whatever I wanted I had to budget on my PCAIII wage and was forced to not take part in things that I wanted to do--things I can afford to do per my stated wage, but can't afford to do per the bottom line on my paychecks. If that check isn't correct on Friday, I'm calling corporate compliance and then the U.S. Dept. of Labor's wage and hour division. What do you think? Give them more time or call them out via CC and a gov't office?

You guys are great, really. I didn't expect such a rapid and informative response. All of your contributions have helped put me at ease. I am reading every single post and digesting it all. Sounds like I'm not getting screwed, not in the sense of what my annual taxation will be at least. What IS screwy though is that I absolutely positively would like to have that money in my pocket, NOW! ..sounds like a JG Wentworth commercial, sheesh. Again, major thanks to everyone. TS

Are you two sure of this? I'm new at everything still--I'm 22. Tax withholding on a lump sum isn't going to be > than the taxes on a few, smaller checks? Wezzie, thanks :) I'm proud to be a part of the field. Everyone who has chimed in, thanks a lot. You guys are great. TS

I am so mad, I can't even go in there and talk to them right now. What's more, is that I work in the ICU. I have vents w/ drips for a PCAIII rate. Hello, have I died and gone to Mexico? Kind of funny, but really not. Still steamin'

Hello everyone, I have worked at the same facility since August of last year in the capacity of a tech (pca III) while in school. I recently became licensed as an RN and went straight to work in that same facility. Last pay period, I worked 1 week as a tech, had the weekend off, then came back on Monday as an RN and did my 40. When I got my check, ALL of it was at the tech rate. Went to HR for a resolution, was told that corporate needs to approve my new wage and it may take up to 3 pay periods (6wks.). Now here's the funny part--the recruiter was all excited when she told me this--*BUT* you'll get it all (what they owe me--hours worked x diff between old and new wage) in a LUMP SUM! Oh sure lady, that may sound real nice to every other 22 year old guy getting a nice raise, but NO. I am going to get SLAYED on the taxes accrued on that check. I feel like my wage should have been changed and begun accruing at hour ONE of my work as an RN and should have been so reflected on my last check. What to do? Thinking about labor board, corporate compliance, etc. I am ****** and I would hate to have to go bench press everyone on mahogany row to get my money. Trying to keep my cool and my job. TS

We just did a 10-week critical care course at my facility. We took the BKAT 7 in weeks 1 and 10 to gauge the effectiveness of the course. Most participants scored in the 60s-70s on day 1 and many improved by 10 or more points by week 10. I just took my week 10 test yesterday. It was 100 questions. There were many questions pertaining to swans (normal CVP, PAOP, what to do if a continuous PAOP waveform is on the monitor, etc.), rhythm strips (3rd deg. AVB, lethal rhythms), vasoactive meds (I remember one question pertaining to the administration of nitroprusside and dobutrex), neuromuscular blockade, DKA, and DI. I got an 80 in week 1 and an 87 in week 10--both the highest scores in our class of 25. :) GL with the test, it is merely a tool to see where you're at in regards to knowledge of critical care.

Glad to help..always remember safety first

Haha yes that's what I was thinking. Gotta watch out for projectiles! As for your question, did any of it get in your eyes, mouth, or even nose? Your skin is your body's first line of defense, so it should have done it's job so long as it didn't contact any mucosa or breaks in the skin. Personally, I would consult my supervisor. my $.02 -ts