HurleyRN

BEFORE I get lambasted, let me preface this by saying my experience with unions is limited to my hospital only. I am aware that just like anything, there are good and there are bad. With that being said....let my rant begin. I am fully supportive of the "Right to Work" for the above mentioned reasons. I have no qualms with unionization in general (although I do think there are some inherent flaws). Actually, from what I understand, our dues are not as high as many. My problem is with our particular union and steward. He has been in the position for a few years now and has accomplished NOTHING. Any pay increases with contracts are general standard of living increases that I would probably get anyway. We consistently have lost benefit days, have stricter sick day process, questionable overtime pay scales, etc. When we lose, our Union claims a victory and tells us to be grateful, that we could have lost a lot more! Many times I have suspected that he was "in bed" with administration and a recent e-mail confirmed my suspicions. He directly stated that he is paid by our hospital, which I don't know if that is usual, but seems like a HUGE conflict of interest! Our staffing is terrible, we are mandated ALL the time. One year, I had 76 hours in mandation only. That did not include voluntary. Not too far back, we were running up to 5 nurses short in a critical care unit. Many have stopped filing greivances because it goes nowhere. A while back, we had a pretty high profile lawsuit against the hospital that may have been avoided if the union had intervened and protected a nurse as they claim to do. The whole issue could have been settled quietly, avoiding some negative press. When the unit called the union, they were told not to bother filing a greivance, that management had taken care of it. Now, as we have become a right to work state, we have recieved e-mails that take a very threatening tone. Instead of respecting why some would choose to opt out, He refers to them as "freeloaders" that will be reaping the benefits without paying. I'm sorry, but I would say the burden of proof is on him to show that I am benefitting from it at all! I consider myself a hard worker, and diligent at what I do. I do not appreciate his insinuation that I am so inept or the hospital is so evil that I would be out on my ear for no good reason at all. But the scare tactics work with a lot of people apparently. I actually feel I could have more opportunity without our union. It is very frustrating. I am very active in hospital a safety issues. I looked to our union for help with safe staffing and got an ear full of empty promises. I have since gotten involved in that independantly. In one conversation, our steward was trying to make a point as to how hard he works and what he has to "put up with". He mentioned that he was currently defending a nurse that was on probation for drunk driving. I really don't see why our union dues would go toward something like that. And if he was complaining about all the "whiners" to me, I can only imagine how he talks about us as a group. So again, my intent is to not offend anyone. I wanted to illustrate the point that it should be OPTIONAL. Maybe having the choice will force ours and other poorly run unions into stepping up to the plate and effectively looking out for our best interests, and thus, those of our patients.

I am completely against being required to be vaccinated as a term of my employment. The arguement that I have the option of finding a new job is irrelevant. Injecting a foreign substance into my body is a little different than nail length or whether you have the right to wear piercings or tattoos. This issue has implications to my health and my ability to provide for my family. Not only is the efficacy of the flu vaccine not proven, but there is no way to prove what is IN the vaccine itself. Contaminated injections have drawn plenty of media attention lately. I understand that as a HCW it is my obligation to protect my patient.....within reason. We scrub, we observe standard precautions, we use PPE's. Administration claims that this is for the protection of the patient, right? How about using some common sense and creating stricter visitation policies? It is a hospital after all. What is our focus? Getting people healthy and home or keeping the patient happy by allowing the masses to infect the hospital? In the past month, my closed unit has had isolation for MRSA, Norweigan scabies and RSV. None of the STAFF brought these things into our unit. Here's another one.....flu is but a season. Mandation is year round. How about not threatening my job if I refuse to work a double when I say I am too tired to safely care for my patient? How about safe staffing instead of saving a buck? Or what about REASONABLE sick day policies? I don't understand how we can earn sick days but are not allowed to use more than four a year without being put into a disciplinary process. Sick staff come to work because they HAVE to, or potentially lose their jobs.....or is that another "choice"? Just because I have chosen to care for people and have chosen to work in a hospital DOES NOT mean that I should be expected to sacrifice my personal rights. I think that it is a bit of a contridiction to say that my health and my family don't matter until I am on the other side of the bedpan. So, no, I don't think I am willing to give up the rights to my own physical being, and I don't think anyone should be asked to. It scares me to think of what could come next!

:confused:Hey everyone, I would love some input! At the end of last year, our unit was told that we were going to start putting comment codes into our glucometers if they were outside parameters. This change in policy was immediate and anyone failing to comply would be disciplined. Unfortunately, at that time I admitted my new primary, a 23 weeker. She was very unstable and had a lot of abnormal labs. Needless to say, I missed entering the code. As a background, our one touch shuts off after 10 minutes and you CANNOT go back in later and enter a code once it has been off. They made arrangements with lab that we can send a slip with a patient label, the time and value and they will reconcile it. This can be so difficult to remember, especially when I am managing so many other, important issues with the baby! I ALWAYS report the sugars, follow orders AND chart it all in my nursing notes. I dont understand why lab needs to be aware of what interventions I am doing for my patient? Are they supposed to call the floor if they feel it is inappropriate? I am concerned that in an effort to reconcile the gluc, that other care will be de-prioritzed! Are other facilities being so strict with discipline? Is this part of the JCAHO requirement or is it hospital/unit discretion?

I agree that it needs to be evaluated on how each baby is doing, but I was particularly interested in the umbilical line issue due to the fact that they can migrate and perf....

Thanks! It does help! I think everyone on the unit is more than happy to encourage kangaroo care, but like you said, when appropriate. I do find myself, however, feeling that the micropreemie, or kids with bleeds are better off with minimal stimulation. Even if haing a "good" day, I wonder if we are risking too much and potentially setting them up for a "bad" day. I was surprised to hear that you guys do umbilical lines for term kids. Generally we try to avoid them unless its for the bitty ones that are on vents and needing pressors. We try to get PICC's in them ASAP.

Just another thread to pick everyones brain.. We have recently had some issues with parents on the unit complaining that the nurses will not let them hold their babies. The RN has explained each time that the baby is too unstable, too small, temp unstable and in some cases has umbilical lines. In one case, we were told by nursing office that we HAD to take the baby out for the parents to hold. Alot of us felt that this was taking "family centered care" too far! We are in a critical care unit and I feel that we have an obligation to the patient, first and foremost to promote a safe environment. I really felt that management had no place over-riding our nursing judgement and especially not backing us with the parent. It did not look very professional in my opinion. Back to the original point... I would like to know what the policies are at different facilities about taking babies out with lines. We all know how touchy they are. Our policy has now changed saying that we CAN take them out. I feel like it goes against common sense. If a baby is that small and that sick, they should have as litle stimulation as possible to prevent bleeds, loss of temp, etc, etc. I also am surprised that any parent would demand to hold their baby when they are clearly sick or small enough to be in our unit. As a parent, I want what is best for my child!

Thanks guys! I have been seeing different schools of thought on the subject. The nurse educator on my unit had oriented us and said it is not needed for salines and dextrose. We called pharmacy and they verified this. It still seems alot of places filter everything though. Where could I find the most current standards? Or are there just some issues that will vary facility to facility?

Hey guys- I was just wondering what your unit policies are regarding the use of in-line filters. When I came to my unit I was surprised to see that ALL IV fluids were filtered here. My previous experience was that mainly hyperal gets filtered. Any input?

You and I are in the same boat. I was on a renal med/surg unit, filled to the brim with psych, geriatric and withdrawl patients. I did that for about a year and a half before recently transfering to NICU. NICU was the whole reason I went to school. I just got off orientation and I am still very intimidated. I love it, but I have much more anxiety, maybe because of who our patients are. It IS a difficult adjustment...cut yourself some slack. If you know its where you want to be, give yourself some time. You did not mention if you are still on orientation or how long you have been there. It's easy to forget that "I have no clue" eeling when you start a new area, but over time you WILL get your confidence back. It sounds like you are a good nurse. It's the ones who are over confident that scare the crap out of me.....

We always use a new syringe, and if extension tubing is used, we replace that, too. How do you all feel about puting syringe pumps in an isolette?

When I was in my last semester of clinicals I heard a couple doozies! Nosmo King -pronounced Nahz moe (No smoking) Queen Earth - First name Queen, Last Name Earth...NOTE: Neither parent had the last name Earth! and last but not least... Formica Dinette!

Our unit also does the 30 minutes before a gas rule, although I am not sure I agree with it. Especially since we seem to get kids that need frequent gases. We also use VAPguard. We use it before repositioning or any procedure. We have seen a decrease in VAP by using it, but on really touchy babies I have wondered if it can have the same negative effects as ETT suctioning (risk for IVH, etc).

I think she has some psych issues, too. I will be curious, given the fact that she has no way to care for these kids, if CPS gets involved. It's so high profile they are going to HAVE to do an investigation to make sure the kids can be cared for.

Just need to vent a little. It seems like my unit has some pretty jaded staff. I get very frustrated with women who use during their pregnancy and it breaks my heart to see the effects on the baby, but I still try to be compassionate with the family when they visit. I have seen staff essentially snub a mom that has tested positive for drugs. I saw one mom in tears, sitting alone with her baby. Even parents that are on methadone and seeking help seem to be treated poorly. Some mothers that use never seem to come to visit, while many others come on a regular basis. Regardless, they are fighting their own demons. I doubt they are happy about the impact on their babies and I think at some point they may carry tremendous guilt. It does not seem ethical for us to judge them, especially not knowing what has led them to make the choices they have.

We have done the pump method in cases where the baby does not tolerate a fast gavage. Then we may run it over a half hour or so. I never thought about the "mistaken identity" with lipids factor! That is scary!