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JKL33's Latest Activity

  1. JKL33

    New Nurse Struggling With Doctor Calls

    Can you recall a close approximation of what you said? That would be helpful here.
  2. JKL33

    Knock knock. Who's there? HIPAA. HIPAA who?

    Having attended numerous employer presentations of HIPAA I have never encountered a presentation where the presenters seemed to concern themselves with any degree of nuance. They are there to scare everyone, which they accomplish by dumbing it all down so much (improperly oversimplifying) that people are practically afraid to take care of patients. Read this question I recently answered elsewhere on this forum for an example of my assertion. In my experience questions and concerns like this are very common. I see. That is noble on some level but I can't help you understand deviance other than to say I reserve my nursing judgment and believe there probably are situations out there where I would deviate if I had weighed out the ethical conundrum and felt that deviating was the lesser of two evils. I don't know what they do after they leave but sometimes yes they do make quite a scene about matters such as that one or others at that level of importance, if you will. I am not sure if it's an overreaction or just a completely inappropriate attempt to scare, threaten and manipulate others under the guise of one's "rights." When it happens, it is usually some sort of public performance (waiting area, nurse's station, hallway, etc) so that other patients can be led to believe some major crime has been committed. This is on the level of people who scream about how someone will be hearing from their lawyer. I was curious about your interests because one of the examples was patients placed in cubicles that were deemed to be unnecessarily near each other--which is an act that would have been done by a harried RN or assistive personnel, not a physician or high level admin. By the way, I don't know why they did that and I am usually aware of those types of things as a nurse. However, I believe many things like this have at least some roots that go beyond the staff level. For example, occasionally when seated in a restaurant I have been seated near another table when there were many open tables. I sat there and asked myself why anyone would do that, and then recognized that it probably had to do with efficiency and workflow or something like "this" group was "that" waiter's assigned tables so that's where "his" customers were seated. The same could be true in an ED or clinic. Nurse A has these cubicles and Nurse B has those ones over there. I don't know, but I am sensitive to perceived criticism from anyone not intimately involved--for these types of reasons, and because of the incredible amount of inane, like utterly ludicrous stuff that admin is capable of coming up with and then the staff is just there looking like uncaring idiots because of it. I think there are. I think our whole system overlooks obvious opportunities for abuse, pretends they won't happen, makes a few examples here and there (that are either outrageous or in some other way noteworthy) and calls it good. For starters I have a hard time understanding how there is actual confidentiality and privacy when one corporation is allowed to own tons of healthcare facilities in a region, own the largest insurance provider, employ 30K or 40K people throughout the region who are also patients and have health insurance provided by the employer who also provides the health care and pays for it (not specifics, just the situation in a nutshell). So my perspective is that I don't care about who sits near me in a cubicle or who wants to shadow for a reasonably valid reason, I care about things like ^ this. I can appreciate your work. But there are things that concern me much more than the examples you have given. Were I to investigate gaps between ideal and reality I would be interested almost exclusively in the executive/administrative piece of the picture in hopes of filling in some of the gaps of how they have abused so many laws, regulations and guidelines to serve their interests while destroying those around them. Here's another example of abusing the idea of "healthcare operations." I know of another situation in a bunch of outpatient specialty clinics where nurses are now supposed to call patients not even under the guise of healthcare but just making a social call solely under the pretense that it would be good for business. It is specifically not to be a health-related phone call. Just "Wanted to say hi" I guess (??). So in my humble opinion you should look into these kinds of things. 😉
  3. JKL33

    Short Staffed: An Epidemic

    😮 Some journalist actually tried to find out some things! (Although they hold the refrigerator decorations in too high regard and don't seem to understand that's just another dog and pony show). Pretty well done, though! Confirmed.
  4. Yep, pleasantly assertive, not acerbic. Just visibly going about your day instead of being scared/bullied into backing away from them (and the things you are supposed to be learning) step by step. I definitely agree with the spirit of this. But, then, I make a significant distinction between pandering and killing w/ kindness. My recipe is to just be genuinely kind in a way that...well, others will look like real jerks if they keep up their bully routine. But I would not be caught dead doing anything that could be taken as trying too hard for approval. No snacks and definitely no organizing potlucks when one is supposed to be learning important stuff. That is straight up pandering (IMVHO 😉). Just me.
  5. JKL33

    Achieve Test Prep for CNA to RN

    LPT: Don't pay a premium to get into nursing. 💡
  6. JKL33

    How should I move forward?

    No, not regarding your concerns per se. I wouldn't mention your personal obligations; the manager can't be expected to have much concern for helping an applicant with their personal obligations so it runs the risk of just seeming needy (I.e. needier than some other applicant perhaps). It is perfectly reasonable to ask about the specific call requirements, though. "On call every week..." = how many days, how are sign ups handled (or are OC days assigned), will your call shifts be the shift you normally work, how is OC paid? Etc. Then you make your decision based on what they are offering/requesting. Good luck. (I wish I.e. would stop capitalizing the I.)
  7. JKL33

    Would Flo Have Used a Segway?

    Judging from all the recent school essays or hopeful-writer columns that have been posted here it seems Flo probably wouldn't have done what the essayist doesn't currently approve of. When I saw your post title I thought, "Oh, no....he spelled segue wrong!" Cause I thought maybe you were going to comment on some of the interesting segues in these essays. Hmmmm. So did you post about the Segway because of the segues?
  8. Seems like there are two basic choices: Speak up/change this up or leave. If you're going to stay I'd (visibly) stop feeling bad about needing to learn. Take the assertive track; don't approach people timidly but use a pleasantly assertive manner as if you just expect that they would respond positively. If they don't that's on them. If you can't turn the tide in another couple of weeks consider telling the manager point blank that there is a problem and you're disappointed and are not going to be treated this way. It sounds like they are having a heyday making yet another new person feel very uncomfortable. So the solution is to stop feeling uncomfortable and in a pleasantly assertive manner get in their faces a little bit. This is the kind of situation where you call them out a little. Like if they are going to sit right next to you complaining about how they hate precepting you might say, "What would need to change in order for this not to be so miserable for you?" They'll probably say "nothing" or "if I didn't have to do it." Or in which case you say, "Well, I can't do anything about that but I do need to learn." That's all I've got for solutions here besides finding a different job. I don't do the whole, "When you say ______ it makes me feel ______" and all of that malarkey; you're not there to soothe everyone and boost their egos further by walking on eggshells due to their mere presence. You have a year of experience. You know which end is up. Whether you tackle this situation or leave is a matter of personal preference. Good luck
  9. JKL33

    Question about patient abandonment

    I don't know, but I wouldn't work in a place where those I am supervising get off scot-free when they leave the facility for hours. I can almost guarantee you there is more badness you just don't know about yet. Any place where someone caring for patients feels free to just walk off the job for however long they want is a place that has BIG problems.
  10. JKL33

    Possible Accidental HIPAA Violation

    Doubtful any need to panic. Think of ways to be conversational without saying anything in particular for situations like this. There are lots of comments. You can't talk about other patients' situations--I know you know this, but if you want to not have random slip-ups then develop a plan how you will respond next time. I usually just make neutral statements to show I am listening ("Oh, wow..." or "well I hope s/he feels better soon..." etc. etc), then redirect back to the matter at hand. If people ask you directly if you know of someone else's situation just tell them point blank that you can't comment on other patients' care. Not picking on this poster, but I strongly advise you NOT do ^ this. The H police are people who have nothing important to fill up their days unless they are working on the investigation of a crime they've managed to find out about. The worst they can do is make a big stinking deal out of it.
  11. She is a miserable person. She doesn't feel good about herself. I think there is a way to make good on this unfortunate experience by gaining insight to be able to recognize this in the future. These people are clearly miserable, as evidenced by their need, even as a so-called professional, to prove that they know more than a student. Right? That's kind of sad/lame isn't it? They only feel good when they can convince themselves that they are better or know more than at least one other person (in this case, you, a student). I know we are all different but this kind of thing can't be allowed to wreak such havoc in one's life. I mean this in a tough love kind of way: There were two problems here: Her behavior and your internalization of it. Keep moving forward. 👍🏽
  12. JKL33

    Calculating Intake and Output

    - Wouldn't be surprised if the popsicles are less than oz listed, kind of like ice chips. - You wouldn't do 100 * 12 for the NS; they told you it was only running for 3 hrs.; = 300. That said, with those adjustments I get 2854 ml, which still isn't one of their choices. Surely they don't want you to account for liquids used to hydrate grains like oatmeal and grits; that would be a little out in the weeds unless that were a facility's policy and the exact amount used were provided by dietary services. Too bad they don't give a rationale for their answer. *** #2 - Agree, check the lipids.
  13. JKL33

    Knock knock. Who's there? HIPAA. HIPAA who?

    Yes. The applicable laws and the spirit of the applicable laws. That's what I try to do. I can't comment further. As I already mentioned I have not personally witnessed any shadows of the nature you're discussing for (?) probably 10 years or more. Zero. That is to say, not only have I not seen any situations where there was a shadow present and I knew that patient permission had not been sought; I just mean no shadows, period. Despite the irony, that is what I as an individual health care provider can do about this on a daily basis, in addition to advocating for my patients in these and related matters. We are trading personal experiences. I haven't at all felt that people are only concerned with the portion covered by the law. In fact as a graduate student who has participated in clinical rotations with all proper trainings in place, signed agreements, legal agreements between my university and clinical sites and the whole nine yards, I have not approached any patient without their express permission for my presence having already been given. I don't know the demographics of those who were shadowing but I would not have thought this a simple question for lay people at all. Right. And even if they did the way it is named doesn't clearly signal that it has anything to do with privacy or confidentiality anyway. Maybe the reason so many people make the double-P mistake is because somehow it just might have made sense if privacy was accounted for somewhere in the title. 🤷🏽‍♀️ I don't see it that way. I did purposely describe sort of a superlative of the situation, but I did so because I think it is relevant, not so that I could attack an idea that doesn't exist or is off-topic or that is easy to blow apart. I am trying to understand what you want to see or have happen. I am telling you that with very few exceptions I see people (workers) trying to comply with the law (letter/spirit) and with their facility's individual privacy practices. That is my experience. So when I hear that it isn't good enough or that trying to do our best is merely ironic, I am not sure exactly what more looks like. The posited exaggeration is my attempt to pose that question to you. If you now say that you are not expecting perfect and that perfect is absurd and/or a strawman, I would be interested to know where and how you would draw your lines. No. My point has to do with my own perception of reasonable vs unreasonable (and I stipulate that is an individual opinion). Preoccupation is preoccupation and that's what I was referring to. I am making a distinction between a scenario where a healthcare provider walks out to a waiting room and starts interviewing a patient about something or announcing test results (clearly inappropriate), vs. a situation where someone is going to report everyone because their name was used when they were called from the waiting room (under usual circumstances would seem a strange thing to get bent out of shape about). Meanwhile, nearly everyone is carrying a cell phone on their person. 🤷🏽‍♀️😂 That's pretty close to what I was thinking, although I'm not sure that it is their actual privacy they are most worried about. I believe some of it is a preoccupation with whether rights (or "rights") might have been violated in some way. Well, we say that, but here we are living half of our lives online, banking online, using our SSNs in ways that apparently previous generations were promised they wouldn't be used, carrying cell phones wherever we go, and more. Example already given. I have read some things, yes, but most have been direct observations. I don't disagree. However the workers are not the healthcare facilities. If you want to get into the disingenuous and self-serving nature of healthcare facilities (corporations) this conversation could go on indefinitely. Agreed. Aware. See aforementioned attempt at explanation. I'm making a distinction between those with the autonomy to unilaterally make a decision about what will or will not be allowed (I.e. what a facility's various policies and privacy practices will include); for example, whether or not a non-healthcare student will be allowed to shadow. The majority of those you listed do not have that autonomy. It bothers me that there is no autonomy at those levels but there is much scrutiny. The main reason I am interacting with you is because I do find this conversation somewhat intriguing but mostly I want to know what you want to see. What is it that you want from those punching a clock or working for a large healthcare corporation and trying to do their best in a system that nearly everybody seems fed up with? Your post was very, very long and although well-stated you have to understand that it's only fair to get to the point. What is it that you want to see here. I am not sure but it sounds like you are at least somewhat concerned with the system and what big players can get away with. I won't argue against that being concerning. It's just that this is a nursing forum. As far as I can tell the business execs drove our train off the tracks some time ago. I think you should go way bigger with your concerns. Way, WAY up the food chain.
  14. JKL33

    Setting my orientee up for failure?

    I think it sounds like you have tried really hard on your end of things! 🙂 In case my comments read as a critique of what you have tried to do, I want to clarify that they were specifically about management accepting an active (but minimally time-consuming) role from the outset; maintaining awareness of how the situation is going and hosting a forum where people are encouraged and built up and where it is ensured that everyone's on the same page about where things stand. Maybe an idea you can put forward for future consideration. Well, at this point don't be afraid to be straight forward. As far as that aspect goes you have the ideal situation because you have been kind to her; you haven't been ignoring her or sabotaging her or playing disingenuous games. So, with confidence you can state things like, "There are some elements that we need to pull together; these will limit you from being able to be on your own - for instance, remembering to check lab work" (etc.). That is not unkind. It is a fact, and her job is going to depend upon her doing these things. Good luck!!
  15. JKL33

    Setting my orientee up for failure?

    PS - another benefit of regular meetings is that on the rare occasion when things are actually going quite poorly and the new grad may not be able to successfully come off orientation, it can be said that people really tried. Rather than some of the stories on here about how the preceptor or manager really started getting pissy at the 11th hour and the grad was left with a week to change everything/prove themselves or else be fired. I don't like situations where someone is going to have to be disappointed, especially when they haven't really been treated fairly throughout the process.
  16. JKL33

    Setting my orientee up for failure?

    I have always advocated that all orientees should be given the benefit of regular, pre-planned meetings held in a format for open discussion of how the orientation is going with manager (or educator or whomever will ultimately decide the orientee's fate), preceptor and orientee. For instance, we will plan to meet together every 2 weeks, give or take. All meetings involve discussing things that are going well and things to work on. There is ample opportunity for the orientee to state what is working or could be done differently and how they feel they are progressing. As the orientation moves along things that aren't going well (as determined by sufficient time but insufficient progress) need to be discussed in a straightforward manner. This shouldn't be about that. Basic kindness should be maintained no matter how the orientee is doing. Rather, perhaps the problem, worded differently, is a failure to convey the situation as it stands. These things should be conveyed in a straightforward manner while out on the floor (at appropriate times) and then monitored and revisited in the meeting, especially if sufficient progress hasn't taken place. I have on occasion heard that all of this is just too much trouble, but I'm talking about 10 minutes several different times during the orientation. I think we owe that to all parties, especially the new grad. It isn't too much to ask. I believe that if hospitals want new grads to serve their needs, they have some responsibility to actually help them lay down a solid foundation rather than just churning through people.