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JKL33

Content by JKL33

  1. JKL33

    Night Shift at a Rehab

    Knowing that you aren't going to change what's going on, what are you going to do about it? Venting is one thing, but getting angry and doing nothing is nonsensical. Get OUT of there before something terrible happens.
  2. JKL33

    Can’t a nurse be fired?

    Source link: https://ahajournals.org/doi/full/10.1161/circ.102.suppl_1.i-12
  3. JKL33

    Ethics question

    What would she report? That her sister works as a companion helping people with things that would otherwise be self-care/ADLs? And tells them that she has experience working for a dentist as a "scrub nurse" in Germany? The OP makes no charge that her sister is doing this. No one knows the truth of the situation. People with swallowing struggles are not required to hire someone with a college degree to feed them properly, and even if they were that would not mean that they would never have difficulties with aspiration or with pneumonia or with aspiration pneumonia--or that the person they hired would necessarily be guilty of inflicting harm should the person develop a problem. I'm sure you know people can develop aspiration pneumonia/pneumonitis due to even such things as GERD or their altered ability to handle their own secretions. The bottom line is that people are free to hire lay persons to assist them with ADLs if they wish to. Likewise the OP's family is free to seek advice from this lay-person family member even though they know darn well that she is not a licensed nurse--and that they do. There are plenty of poor choices that aren't illegal. If she is representing herself as a licensed nurse that is a different matter.
  4. JKL33

    Back and foot pain- can I be a nurse?

    Quick correction, not to detract from the overall advice: Low glycemic.
  5. JKL33

    Recognition

    Glad you're back.
  6. JKL33

    Add short work experience from orientation or not

    Almost posted last night using that word, awkward. OP if you leave it off your resume you will need to be prepared to address the discrepancy. But if you leave it off your application you will need to be prepared for termination (for cause) at some date any time in the future that someone wishes to make an issue of it. Typically when submitting application info you attest to the information being true and complete to the best of your knowledge or some such wording.
  7. JKL33

    OB Unit for Male Student

    I suspect that is a problem for the school one way or another. If the "male OB student" thing is really on the hospitals (and is not related to anything that school themselves is or isn't doing--which I don't think is completely clear at this point), then the school still has a problem because they are not able to provide members of the cohort with similar services, solely based on sex of the student. And, even if there's nothing illegal there, then it would seem reasonable that they should have to disclose that information up-front before you decide whether or not to engage their services/pay them tuition. ?
  8. JKL33

    OB Unit for Male Student

    Are instructors out there really individually responsible for trying to secure clinical placements for each student? How would this possibly fall to an individual clinical instructor? How does the school not have this ironed out? This cannot be the first time this has happened. Doesn't it seem like someone isn't telling the truth somewhere (or doesn't have all the information)? [I'm thinking of the instructor, not the OP]. I mean, assuming this has happened before the school would know that local hospitals have this issue (right or wrong) and that the far away place is the go-to place. How does that end up with an individual instructor supposedly calling around and pleading the case?
  9. JKL33

    New Ohio law would let families put cameras in nursing home rooms

    I don't have any fake privacy concerns at all. I also didn't claim that any aide of any stripe has any privacy rights while on duty. I am asking if you believe that good, conscientious, well-meaning people who have something to lose in life will enjoy being subject to the unguided individual scrutiny you are talking about. Remember, it doesn't matter whether you care if they like it or not, it only matters whether they will choose to be employed in such as scenario if they can help it. We could simply proclaim, "Well, if they don't like it, they don't have to work there!" Typical response. Has anyone actually followed that thought through all the way?
  10. JKL33

    New Ohio law would let families put cameras in nursing home rooms

    You sound like a reasonable caring person and I am not trying to make this difficult. But if you truly believe that your camera is preventing your grandmother from lying on the floor unchecked for hours after a fall, then you do not have her in a facility where appropriate care is being provided.
  11. JKL33

    New Ohio law would let families put cameras in nursing home rooms

    I just want to make sure I understand the pro-camera (in patient care areas) theory: 1. Good, conscientious caregivers are all going to proclaim, "Please let me be filmed all day by multiple different families with their own motivations, in this resource-restricted environment where the entire business plan is to not spend too much money on these old people." and 2. Abusers are going to stay away and/or stop abusing because they have a lot of job options and a lot of self control.
  12. JKL33

    Such thing as too late to negotiate?

    We've been hearing nothing except how it costs a gazillion dollars to onboard/orient a new grad and get him/her up to speed with the basics. This is the supposed justification for saddling new grads with contracts that must be paid back one way or another (either through retention commitment or cash) so that corporations don't go out of business due to the extreme costs of training the new grads they are forced to hire. The OP has now added that the offered rate is about $1/hr more than a new grad would make in that region. For a FT position that comes out to what? Roughly $1900/yr more than the new grad rate? Someone successfully working under the required license for 1.5 years doesn't have "no experience" no matter how you slice it. No way. And the argument can be made that they don't have "no applicable experience" related to the new position, either. Does the person have a track record of properly completing legal medication administrations as an RN for 1.5 years, for example? Were they interacting with peers, superiors, patients and families for that 1.5 years or just existing in a bubble somewhere? Have they learned basic rules and SOPs? Well...these things are all something if they have been completed/experienced successfully. It's quite a bit actually, given the amount of distress reported during first jobs and first year of nursing.
  13. JKL33

    New Ohio law would let families put cameras in nursing home rooms

    So, @Patricia Nuckols, you first say: And then you say: 1. Do you or don't you have your grandmother in a facility that provides proper and appropriate care, then? 2. Why would you think that a facility that doesn't staff well enough to have someone regularly checking on your grandmother is a place in which employees should feel good about being filmed by 30-50 different families (potentially) for their own purposes? Not maintaining enough staffing is doing something wrong--but the employees aren't the ones responsible for that.
  14. JKL33

    Just Say “YES” to Nurse Staffing Laws

    Well, that's the key IMO--not necessarily the issue of leaving/not leaving precisely on time, but the overall idea of letting people do what they need to do to cover the bases of taking good care of people. If you have that, you're set. I've felt all along that it isn't necessarily the actual workload that has gotten worse, but the despicable hatefulness with which groups of nurses are treated in some places, particularly in recent years. I can do a lot and I can take a lot, but I reject this imposed damned-if-you-do this and damned-if-you-do that business.
  15. A couple of things to keep in mind: If this VP has the slightest idea about what is going on with the nursing service line, they already know about the turnover, the new grads and the poor staffing (and the manager and the poor morale and all the rest of it). People already know about the things that are concerning you and your peers; it's rather likely that the manager is right on track, the turnover is right on track, and the staffing is too. If business wasn't on track it would have changed already. I would meet with this person, thank them for their time, report what your SG council is working on. Beyond that (whether during the formal meeting or the informal after-meeting) I would refuse to mention any opinions regarding the other stuff you posted about. Keep everything pleasant or even cordial...but absolutely business-like. Don't be tempted to alter course even for a second no matter what kind of freedom-to-speak you are offered. Don't do it.
  16. JKL33

    Bad orientation should I leave

    Usually by the time people are told "improve in the next few shifts or else...." it would be very difficult for them to change everyone's opinion even if there were no ongoing problems with their care or they could suddenly do everything perfectly. Minds have already been made up. It might be best to spend some time mulling over this experience and learn what you can from it and look for a place where you can be successful.
  17. JKL33

    Discussion at nurse's station

    Yeah, I don't know either. I made my guess based on the OP having said that the patient came to the hospital because he revoked his hospice status at family's request. It sounds like they exert various pressures upon him (in addition to whatever leeway they gain by the fact that they live together), but whether or not they can independently make decisions on his behalf, I don't know. Kind of doubt it. It sounds, rather, like he just doesn't have a lot of options other than to put up with them and doesn't necessarily have the resources that would be necessary if he wanted to stop being pressured by them. I disagree in principle. For the sake of explaining, let's think about a this situation as if the verbiage being used in the discussion is decidedly not "smack talk," but is still related to the same basic topics and is still of interest to the eavesdropper (who knows that the fact that the family dynamics were being discussed will be an offense all on their own). For example, if the charge nurse had been reporting (to the OP) things like, "They do not allow him speak for himself, they cut him off before he can express his wishes. He told me that he doesn't like their actions but they threaten him and are very aggressive with him so he doesn't feel he can do anything. I am also concerned because they are very rough in their speech and actions towards him. For example, yesterday his granddaughter grabbed his chin and got right in his face and screamed at him, 'I'm sick of fking arguing about this and I don't want to hear another word about it!!'" According to your idea of what constitutes PHI, that isn't PHI. Except that it is...it is all about this gentleman's health as related to his safety, including his psychological/emotional well-being, and including information about his living situation, his vulnerabilities as a individual dependent upon others, and his caregivers. The information is being disclosed by an employee of a covered entity to (presumably) an employee of a different covered entity. The eavesdropper is also an employee of the covered entity and was only anywhere near the discussion d/t her status as an employee of the covered entity. Even if the conversation had been strictly professional in nature, it is still related to the patient's overall health, care, plan of care, etc., etc. and it still may have riled up the patient's family. No outright disclosure of things like name, SSN, address is necessary because all parties involved already know the identity of the patient in question, in other words, whatever the information is, the subject of it is already identified. It is not 'de-identified' information, and it is health-related care information. I think what you are saying is that due to the unprofessionalism of the manner in which information was being conveyed, it is not PHI because it was just plain old gossip. I think sounds like it was conveyed completely unprofessionally (I'm pretty sure that is the OP's opinion, too) but it is quite unlikely that it had absolutely nothing to do with the patient's overall health and care. I do think that employers have been conflating their own privacy practices and PR preferences with HIPAA for so long that our ideas about what constitutes a violation can become skewed, mine included. Yes. His/her correct action is not to run to the family. Any of the parties could lie or exaggerate about what really happened. But the most likely thing is that some extent of the information was indeed health related and "official business." And FTR yes I do think professionalism will have to be stepped up. I'm sure the OP has realized that s/he was not there primarily to affirm the hospital staff's struggles with the family, but primarily to care for the patient. In the future will have to maintain strict professional composure so as to ensure that motives could not be mistaken.
  18. JKL33

    Discussion at nurse's station

    What do you mean/where do you get that idea? Maybe or maybe not. And an eavesdropper not involved in the care may not know whether they are or aren't. I get what you're saying, but to the extent that any of the so-called "smack talk" relates to the volatile and abusive situation in which the patient is living, it could be dicey trying to claim that it was not protected information related to his care and care plan and arrangements being made for his ongoing care. The OP has no affiliation or relationship with the smack-talking charge nurse as has been noted a couple of times now. The OP visited the facility in which this charge nurse was on duty; the OP was there to see the patient and participate in care-planning on behalf of a government agency. And if the eavesdropping-staff-RN-friend-of-the-family had concerns her appropriate action would have been to report to management, not to contact the family with information that was gleaned through her role as an employee of a covered entity. Also please re-read the scenario. 1) The OP visited this hospital unit d/t her role with a government agency that is working with this abusive family. 2) A charge nurse at the hospital shared her perceptions and complaints of the family's behavior with this gov't worker (the OP). 3) The eavesdropper staff RN (who is the best friend of the most problematic family member) recognized that she could wreak havoc for the gov't agency worker who has an ongoing relationship with and is overseeing the abusive family. That's what this boils down to.
  19. I would get someone else involved. She can't sit on this for 3 months or longer (however long the regular employee's leave might be). They owe you the money, assuming you completed the steps to change over your job status, which it seems like you did because the regular payroll employee did not mention other steps you needed to take when she was involved in rectifying the initial issue. Maybe your direct supervisor and/or HR or ?? can look into it for you. I wouldn't just sit on it and refuse to work though, because the next thing is that they will say you haven't been meeting your PD requirements and goodbye.
  20. JKL33

    Discussion at nurse's station

    As above. A friend of the patient's family was employed at the hospital as an RN. The OP (employed by a government entity that serves vulnerable adults) was at the hospital seeing the patient in an official capacity. While at the hospital nurse's station the OP received a verbal report from the charge nurse at the hospital. The friend of the family who was also a hospital employee eavesdropped and divulged the details of that conversation to the patient's daughter.
  21. Sounds like there has been a decision to have CSTs involved, doubtful that it was a lone-RN decision (based on use of "we"). So I would call this the new and crappy unofficial version of delegation: UAPs and/or non-nursing personnel performing duties as assigned by management and everyone referring to that as "delegation" (supposedly by each individual RN).
  22. I agree with the above advice. There are a lot of time pressures and a lot of tasks. As you are learning all the details, always strive toward an understanding of the big picture...what are the likely things that could be going on with the patient? Although you will have to learn many steps/procedures/processes etc. to care for your patients, don't forget to have an idea about what is going on that goes beyond "need troponin," "needs a CXR," "needs bipap"....etc. Best of luck!
  23. JKL33

    Best Medical App?

    Hello, Can someone confirm whether 5 Minute Clinical Consult by Unbound Medicine is the product being recommended? There are a few similarly-named apps in the App Store. Thank you! JKL
  24. JKL33

    Phenobarbital

    Hello - Here is another thread that might have some pertinent information.
  25. JKL33

    Feeling forced to be the house supervisor

    I would also be prepared for how you are going to handle a situation where you have told them no but you walk in and are the only RN/house-supervisor-by-default anyway...because it seems like it could be high on the list of possibilities.
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