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Content by JKL33

  1. JKL33

    Case discussion for Patho

    Holy . Whyyye are nursing-type people so painful; such "creativity." If you haven't otherwise been given any kind of order guideline for this assignment, you could consider using a format for report-giving, if you have been taught that (in another class). If neither of those two things apply, you could try a common reporting format: SBAR. Situation, Background, Assessment, Recommendations Disclaimer: the only "right" way to do this assignment is whatever way your instructor says. There is no universal standard to this kind of malarkey. Is a grading rubric provided?
  2. JKL33

    novel coronavirus

    CDC website is open to the general public; they are referring to health care providers as in, the entity, the places where the patients are going to come and all the associated people/employees with whom they are going to interact at that place. They are not solely referring to licensed medical providers. Have you been told that your idea is inappropriate/unnecessary at your place of work? If so, what rationale was given?
  3. JKL33

    novel coronavirus

    They should be asked immediately upon arrival if they have the common sx and have just returned from China or have a concern about exposure. If so, utilize masks, isolate them (without causing additional exposures in the process), and call your chain of command for additional guidance. [Off-the-cuff basics not official advice]. You can always call your HD to see if they have additional specific instructions. But right now they have the symptoms +/- a reasonable concern for actual exposure (travel to area or contact with someone). As the situation changes the CDC will issue additional statements. Here is a current statement (emphasis added): https://wwwnc.cdc.gov/travel/notices/warning/novel-coronavirus-wuhan-china
  4. JKL33

    Mieux de vie

    In that case are you sure it isn't lieux de vie? lieux = place/places vie = life = places to live. Ex: Random website that came up from searching the terms + elderly https://www.onex.ch/fr/onex-au-quotidien/pour-les-seniors/lieux-de-vie-388-1438 Translate heading and 1st paragraph: =
  5. JKL33

    Tips for dealing with techs/pct’s as a new grad

    Take this as straightforward talk, not chastisement: Ignore. Don't take the bait. Ignore. Ignore. Ignore. Wrong. This is a big NEVER. She doesn't decide your priorities. Period. You absolutely do not engage on the inappropriateness they have going on in patient care areas. Under any circumstances. Keep your cool. Make no retorts and do not engage them regarding this. Try to very neutrally and privately bring up the topic w/ your preceptor. "What is the best way for me to handle this?" Let her know that you are being subjected to numerous snide comments suggesting you have upset someone, and it has something to do with the miscommunication last week but you aren't sure what, or what to do about it. If there is no solution and it doesn't die down in the next...? couple of days, go talk to your manager and concisely describe what is going on and ask how you should handle it.
  6. JKL33

    Profanity filter on overdrive?

    Don't mean to make light of the problems with the site, I'm sure it's frustrating (and thanks to those working on it). But...I guess I just needed something to laugh about today because that (cl***) made me laugh. @Sour Lemon better clean up her act a little.
  7. JKL33

    9 Types of Manipulative Patients

    All of this is less common and less problematic overall when the nurse's personal self esteem and nurse-identity don't hinge upon constant reassurance and/or being approved and adored by anyone/everyone. Instead, let kindness, professional prudence and fairness/neutrality be the things that reinforce one's self-esteem. Encountering these situations in patient care should not bring on a personal existential or self-esteem crisis. If you know that you are acting with competence and genuine kindness then you will not feel validated (manipulated) by things like fawning, and will not be intimidated (manipulated) by belittling, splitting, filibustering and the like. Threats of complaints are easily handled: Immediately refer the complaint or threat to a member of administration. Get a witness with some authority. Threats of physical contact or violence of any kind are also to be dealt with immediately by security and admin. Basically the nurse's job is simply to practice in a competent/prudent, and kind manner. It is possible to build a decent and genuine professional rapport with difficult people--but all of it begins with understanding oneself. Avoid what I call emotional flailing, which leads to grasping around for acceptance and reassurance from any source as if these are some sort of effective lifeline--which they are not; they are flimsy and not anchored to anything. Another useful picture is that of the tumbleweed being blown this way or that by the direction and force of the wind. Don't be that. Instead, do what is kind and right and when difficulty arises handle it as kindly, neutrally and efficiently as possible. -My unsolicited $.02 which I think is useful for many areas of life, not just nursing.
  8. JKL33

    Alarm Fatigue Design Feedback

    1) Would this be a device marketed to hospitals/health care entity? As in, if they want to use it they will keep 30, 40, 50 of them on a unit just like whatever number of staff phones they need? I wouldn't want any patient info transmitted to the personal device for which I paid hundreds for my own personal use/enjoyment. 2) I do think it'll be distracting enough that people will have to learn to disregard it at least some of the time as a matter of getting anything done and/or concentrating on other important matters. Is there an expectation that people will be less likely to learn to ignore/disregard/tune out the flashing and buzzing on a wrist device than beeping, ringing and vibrating in a pocket device?
  9. JKL33

    Help with topic for capstone project

    Who is your audience?
  10. JKL33

    Need advice on a situation

    Ha. While reading your post that is exactly what I was thinking...then I got to the part where you said it. Direct this type of situation to the manager before it even gets started. That is the best basic policy whenever possible IMO. I would preempt people and tell them that I don't want to know about the matter but that if the information in question involves illegal or highly unethical activities, they have an obligation to use the chain of command. There are exceptions. I just don't tolerate this very well; in general this "seeking alternative counsel" too often just turns into a way for the person to falsely relieve their conscience while doing nothing, or (worst case scenario but all too common) even just becomes a gossip network. In a certain workplace it was known that a certain Susie Q was great friends with the manager and that every "interesting nugget" mentioned in her presence would be going straight to the manager, through her. This became a great way for people to get coworkers in trouble of varying degrees...by casually mentioning untoward or even more accusatory statements about coworkers in Susie's presence, because the manager took everything she said for god's honest truth. Because things like ^ this (and permutations of it) seem to get going with very little effort, I am an advocate of the idea that people need to do their own reporting. Another reason I would advocate people doing their own reporting is because theoretically the second person has even less obligation to report it through proper channels than the first; after all it it factually is nothing but hearsay to them. But if they are told anyway, then the first person is likely to feel at least some relief from their obligation, meanwhile the second person doesn't have the same (first-hand) knowledge, and because of that arguably doesn't have the same degree of obligation. The "whatever reason" is the thing (from your quote) that isn't okay. It is not okay. Think about it, she then informed you of this illegal and wildly inappropriate activity--so she simply had zero business approaching you instead of the proper chain of command. One time a person did report some significantly concerning info to me and I didn't have the opportunity to redirect them before they could do it. So I told them they are obligated to tell so-and-so (manager), and that they needed to do it today and that I was going to check with so-and-so later to "make sure you've had a chance to connect." So, take your pick: Go tell her now, or else later she will know that you chose not to. I don't know. I just don't handle the muddied waters and the various shenanigans that arise around this in general. I hate games and I dislike emotion-based excuses. You don't get off the hook by telling someone who has no authority to attempt to validate your statements. Go tell someone who does. Overall, strict expectations about this are what is theoretically most likely to protect a patient.
  11. JKL33

    How do I become a better nurse?

    I hate to say it but you might have to adjust your expectations. If it were desired (by the employer) that preceptors would be available and able to give orientees an in-depth nursing education, time and resources would be provided for that. As it is told and experienced by many, these things are instead in short supply. General regard for the process is in short supply too, as far as I can tell. Continue to seek out information both on your own and through asking appropriate questions. Try to develop a good rapport with your preceptor, including (through your pleasant actions and words) expecting them to not leave you completely on your own after a few hours or days. Where are you in your career and/or orientation?
  12. JKL33

    If anyone reads this...

    Also, either with a professional or starting on your own, begin to shore up your own self-esteem. You have to start thinking about things differently, including the way you think about yourself. Doing something like signing a form with your signature in your capacity as a professional simply because someone told you to or tried to intimidate you into doing it suggests that you don't even feel good enough about yourself to protect yourself from harm/danger. I am sorry to hear that if it is true. I hope you will begin to see that you have inherent value as a human being. You have to realize and accept that most of the people you are dealing with don't have anything up on you. They are just humans trying to get through life, too, sometimes not taking very ethical or pleasant routes. Don't wait until you are in despair to stand up for yourself. Now you are despairing and so are willing to work at McD's--your mindset always should be that you would rather do X (work at McD's) than some terribly wrong thing, and that you would rather do X than accept the very poor treatment you are currently being dealt. Right now you're in the frame of mind where you believe that if you were to think strong like that, then you are simply fated to end up working at X. But I'm telling you the secret is that when you have the right mindset you will get screwed with a LOT less, and therefore it will be much less likely that you'll have to actually worry about working at X. To some extent the way people treat us is related to the way we tell them they can treat us and the way we allow them to.
  13. JKL33

    If anyone reads this...

    No. Absolutely not. Of course. Don't rely upon employers to make you feel personally valued. When you rely on employers for such things, you're one business decision away from being devastated, all day, every day. Cultivate mutually-caring and mutually-invested personal relationships instead. Employer relationships are not personal relationships. Pick a different bar by which to judge your employer. A good one is "safe" and another good one is "generally fair/ethical" If they are not safe and/or not generally fair and ethical, they are not a good employer.
  14. JKL33

    Is this resident abuse and should be reported?

    Good faith, yes. If you didn't see something and therefore your imagination is free to conjure up what might have happened and then use your ethical duty as an excuse to wreak havoc on someone, that is not good faith. The (non-) witness in the OP has another option, arguably quite preferable: Advocate for a care conference regarding the resident in question so her care plan can be optimized to minimize these kind of encounters, and so that all staff have a plan for how they are to respond.
  15. JKL33

    Is this resident abuse and should be reported?

    There is a line between actually suspecting abuse and simply wondering if the thing done was wrong due to one's own abject ignorance. In that case the person should find out what they don't know. They should also eliminate their own biases from the general process. There have been a few posts here recently that have impressed me with people's pressing concern about their "ethical duty" and whether or not they should report various things--while at the same time displaying ulterior motives. That's quite the irony. I guess their conscience is only piqued by others' alleged problems, not their own. This OP didn't even see what happened as evidenced by their use of the word "or" to describe the event that has them so concerned. And it was a BIG "or." The OP actually wrote that the staff member in question either moved her arm away from the patient's grip "or" HIT HER. Come on now. NO. Imagining that it is possible that someone could have done something is not the same thing as suspecting abuse/neglect. People can "suspect" anything to the extent their own imaginations will allow. Especially if they are completely ignorant of the facts or simply don't like someone.
  16. Sure you can. No, you don't tell her she's inappropriate but you absolutely say that you won't do it, no excuses. "No, I am not allowed to be involved that way." If you really feel that more information is required, just say, "It is a professional boundary that protects patients and nurses. Nurses are not allowed to be involved in that way." Making excuses is discouraged. First, you have to keep coming up with them and second, your client knows they are excuses/not true--that won't help your rapport with her in the long run. Do NOT capitulate on boundary issues. No you can't buy things for the baby. Stop this. I mean this kindly: Whatever the underlying causes of the situation are, you are effectively helping to hide the situation and enabling it to continue. This is a matter of getting this baby (and mother/family) the help they all need, not a matter of reporting someone from a place of judgment. The reason you are having trouble doing the right thing is because you are thinking about it wrong. Think in terms of getting help for the children. If you go to that home and basic life-sustaining supplies are not available, you have an immediate problem and you need to take care of it immediately by informing your supervisor and following your policies. If you are objectively concerned about neglect, you must report this--you are mandated by law to do so. None of this is to punish this mother but to get the appropriate help in the home. Keep in mind plenty of children have grown up on cup-o-noodles, cereal and the like; use care to be objective in what causes you alarm. But at the same time if there is no formula in the house or the children are being objectively endangered then you have to get help. Again, you're thinking about this wrong. It isn't about whether someone is "one to separate families." Or "one to report." If you are a nurse you had better be "one to report" when the situation calls for it; you are mandated by law to do so! If this family were to be separated it would have to be a fairly extreme situation--and if it is, then what is the excuse for leaving the children a minute longer than they need to be? And if it isn't (an extreme situation) then CPS/DCFS will not remove them and will be looking to see what else is needed to help the family and help them come up with a plan. Do you have questions, or how are you going to handle this?
  17. JKL33

    RN/LVN Ratio Acute Care

    Here is the document: http://www.nurseallianceca.org/files/2012/06/Title-22-Chapter-5.pdf Begin reading on pg 41 at the heading §70217. Nursing Service Staff The following statement: "Licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit, except where registered nurses are required pursuant to the patient classification system or this section" is found in the 5th paragraph of the first section, section (a). Pg 46 contains the other statement to which she is referring, in section (m). It states, "(m)A rural General Acute Care Hospital as defined in Health and Safety Code Section 1250(a), may apply for and be granted program flexibility for the requirements of subsection 70217(i) and for the personnel requirements of subsection (j)(1) above." It certainly isn't clear that pg 46 is referring to section (a) on page 42. Maybe she is allowed to finagle things based on the swing bed status. I couldn't find much information about that, but I wouldn't be the one to bring it up. They either know what they're talking about and can tell you or else they're making it up. **You should carefully read §70215. Planning and Implementing Patient Care (beginning on p 40) to better understand the extent of your duties in this situation. It is significantly more than just hanging the abx.** Good luck w/ your meeting
  18. JKL33

    Need advice on a situation

    I turn these things back to the person who told me (although my first preemptive measure involves not being around to hear gossip if at all possible. It isn't usually too difficult to figure out who always has something to say about others. Avoid these people and don't hang around to give them an audience). Anyway, if something like this is dropped on me I turn it right back to the person from whom it came. In this case I would say, "It sounds like you know something about whether it's true or not. I'm staying out of it." And walk away. I don't act upon hearsay unless there is some exceedingly compelling reason for me to do so; I have a pretty high bar for deciding what meets that qualification. That is all.
  19. JKL33

    Is this resident abuse and should be reported?

    "Or"--?? I think you should stay out of it, and that's just one of the reasons.
  20. JKL33

    Gloves at all times?

    Agree. I maintain a very tolerant and ready-to-go-with-the-flow mindset when attending loved ones. I say very little other than "thank you" most times. I do not understand nurses who act as if the nurse there to care for their loved one is their sworn enemy and somehow the reason the LO is hospitalized. I have my thoughts about it, in light of the many professional, knowledgeable people who do not act like that despite the stress of the situation. Re: gloves. I probably wear them more often than not. What did you do/say in real time? So awkward... I think I would have said, "I'd be happy to you would like."
  21. JKL33

    Save your back, do powerlifting

    What would be really cool was if you were in good shape (as some others here are as well) but also put your foot down appropriately. You know, kind of an "I'm in good shape but I'm not stupid" sort of thing. I guarantee your job requirements do not say that you need to be able to lift 150, 200 lbs. We should be able to perform according to our job description. Beyond that, that's what machines and extra sets of muscles are for. IANAPM. I am not a people mover. I have never had a back injury at work, but one day when I was holding up a load probably twice my body weight, I just decided that was the last time. And it was. Get your peers involved and change the atmosphere. Go help people when you see they're about to do something they shouldn't be doing and say, "Take care of your back, you need more help for this. Let me get a couple more people; BRB." Etc. Pretty soon people will get on board with not single-handedly lifting, pushing, pulling, dragging and scooting awkward loads 100, 200, 300, 400 lbs. The number of times people are doing these things and there isn't even an emergency of any kind...nah, that is just dumb. It is not okay for a workplace to not have the proper tools to move the loads that need to be moved and to rely upon knowing that we gluttons for punishment will simply martyr on, serving as the people-moving machines that the employer didn't want to spend money on. You could choose to use your strong physique for lots of other people's good, if you wanted to...Be a strong one who demands a change. Then, along with your exercise/health routines, you'll have a chance of your back being good for a long time.
  22. JKL33

    termination :(

    It may not be completely easy to get re-hired at a place from which you have been previously terminated, but what she was telling you is that she is not going to make a specific official recommendation to HR that you not be eligible for re-hire, which is a status HR would retain in your employee file. So the way she left it is that you could continue to work on gaining experience and skills and be eligible to be re-hired at some later time. Still not a pleasant experience but it seems like she tried to be somewhat kind about it? Or at least not kick you while you're down, as they say. How long had you been on orientation? Take a little time to recover and then get back at it; make a new plan for success.
  23. JKL33

    Managers: Remaining Objective with All Employees

    But did you really think that? I'm not trying to be hard on you. I just haven't noticed that kind of truly free time, where all the patients are fluffed and buffed and cared for with the highest excellence possible and there is still time left over. I truly hope I'm wrong, but you might be disappointed in what you find if you go around and start doing checks and looking into charting and the like. I think you need to follow this through. Like, figure out the truth pronto. Some humorous personalities are just all-around great people who are doing a great job and having a great time, too. Others use the humor as a crutch or a tool with which to manipulate people. And, some people with less nicey-nice and funny-fun personalities are conscientious hard workers. It's good that you are aware of this and will admit it. But you have to deal with it. That is not okay. It would be okay if you said, "I have no problems holding staff members accountable." (period). Probably. That doesn't mean you wouldn't do your duty, but at the same time there are a lot of little things that your emotions and opinions can get in the way of, and they will be difficult to neutralize in the heat of the moment unless you start making some mental changes now. Even-handedness is often missing, and often unappreciated when someone possesses it. I find it a very admirable skill/trait. Anyway...good luck to you, I'm sure it'll be a great personal and professional growth opportunity.
  24. JKL33

    CoWorker using a patient's medication

    My disagreement with your position doesn't require me to overlook the ethics of stealing. Stealing is wrong, especially when not utterly necessary for survival. Stealing something meant for a patient's treatment is indeed wrong. If your conscience bothers you about this, use your incident reporting system to report it and it will be followed up as seen fit by your management. But you are appalled and are letting that affect your judgment. You want this person punished by a means that you personally find fitting. For this reason, I say you're getting into glass houses territory, since people can be appalled by a lot of different things, especially if they don't like you. This isn't about your ethical obligation or else you wouldn't have mentioned what's really irking you (who parties with whom, and the like). Is there a reason you wouldn't call the police about this and make a report of what you witnessed? If there is, I'm curious to hear what it is...
  25. JKL33

    How would you feel if a dentist was your boss?

    Aw, don't be that way. Just trying to have a down-to-earth convo.

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