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hyllisR MSN, RN

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Musings with A Cardiac and Informatics Nurse

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  1. hyllisR

    This Forum is Quiet

    Thank you! Will do !!
  2. Thanks for he follow !!!!

  3. hyllisR

    I Hope This is Not the Latest Trend

    Staff Nurses are not responsible for writing orders for wound care. Period.
  4. hyllisR

    I Hope This is Not the Latest Trend

    I hope this is not the latest trend to be putting nurses in jail. (CNN)Current and former employees of an Ohio nursing facility are accused of mistreating two patients in their care, including one who died as a result of the nurses' actions, Attorney General Dave Yost said Thursday. A Franklin County grand jury indicted seven people who worked as nurses in 2017 at Whetstone Gardens and Care Center in Columbus, Yost said in a news conference. The defendants face 34 charges, including involuntary manslaughter and patient neglect, Yost's office said. One patient "literally rotted to death" as a direct result of the nurses' neglect, Yost said, adding that another suffered physical harm because nurses falsified her medical records and forged signatures. "This is gut-wrenching for anyone who has entrusted a care facility with the well-being and safety of a loved one," Yost said. The accused include six current and former employees. https://www-m.cnn.com/2019/02/14/health/ohio-nursing-home-patient-neglect-accusations-bn/index.html?r=https%3A%2F%2Fapple.news%2FAoPN6WYqqT6Otez_aEF9qCA
  5. hyllisR

    Nurse Charged With Homicide

    I am sure the hospital will fix it after throwing this nurse under the bus.
  6. hyllisR

    Nurse Charged With Homicide

    Where is the report, please? I can't find it online?
  7. hyllisR

    Nurse Charged With Homicide

    Exactly- that is why I am ready to hang this nurse.
  8. hyllisR

    Nurse Charged With Homicide

    I think she should be reprimanded, but not lose her license. According to CMS, there are 100,000 deaths due to medical errors each year. Are all of these doctors losing their license? I promise you, whenever an incident like this happens, it is never one person at fault. It is a system process error. I am just not ready to put all of the blame on this nurse. For example, how is a paralytic readily "available"? What pharmacy does that? In my facility because a paralytic is only used to intubate, or when a patient is intubated, paralytics are only available in critical care areas and they are in a "kit" for intubation drugs. We just do not have all of the information available to us. I fear we are only hearing about this because she is a nurse.
  9. hyllisR

    Nurse Charged With Homicide

    In my facility, Versed is only given to monitored patients.
  10. hyllisR

    Nurse Charged With Homicide

    Also, Versed is a procedural drug. Why in the world did the doctor order Versed instead of Ativan or Haldol? It sounds like there was plenty of standard protocol deviations going on.
  11. hyllisR

    Nurse Charged With Homicide

    I’m sure Vanderbilt has an Omnicell or Pyxis. Why is the nurse allowed to override a paralytic? I would be willing to bet if someone did a root cause analysis of this unfortunate incident, there would be a breakdown on many levels. When Incidents like this happen, very rarely is there one person/ department to blame.
  12. hyllisR

    Nurse Charged With Homicide

    This is absolutely wrong on many levels. Pharmacy and medicine should also share the “blame”. Why is this nurse able to override a paralytic? The article does not say if the hospital had BCMA- I’m sure most medical centers have. Did the nurse not scan the drug? Did the nurse not have a computer to scan the drug? Was the MRI department in a hurry and insisted that the nurse give the drug? I think this hospital has hung this nurse out to dry.
  13. hyllisR

    Women and Heart Disease

    Mary hurriedly sat down on her couch in her living room. The symptoms were starting again. Mary had these symptoms on and off for over 4 years. She was constantly in and out of the emergency room. In fact, the emergency room staff knew her by name. The providers had diagnosed her with anxiety. She was already 50 years of age, and the providers knew that she was menopausal. The symptoms that Mary had experienced was acid reflux symptoms, right upper quadrant pain, and nausea. Even though the doctors had diagnosed Mary with anxiety, Mary knew her body and she knew something was wrong. The only anxiety Mary had was when she would go to the emergency department and the doctors would dismiss her symptoms as anxiety. Since Mary was a nurse, she knew these symptoms were abnormal, but she could not figure out what was causing them. She decided to go to another emergency department at a teaching hospital. Mary checked into the new hospital and the doctor evaluated her and came back with a diagnosis of GERD and anxiety. The doctor went to prepare the discharge instructions, and then the nurse came back with a GI cocktail. Mary proceeds to tell the nurse about her ongoing symptoms. The nurse started to think about Mary and her symptoms. The nurse knew that women presented much differently than men for heart disease. The nurse also recognized that Mary had symptoms of heart disease. The nurse went back to the doctor and asked him to do a cardiac workup. The doctor agreed and cancel the discharge and to do a chest x-ray, a troponin level, and an EKG. The nurse did an EKG and recognized it was abnormal because it showed the patient had a prolonged QT interval. At that time, the nurse did a troponin check and the troponin was elevated. The x-ray showed cardiomegaly. The provider then recognized that this patient could have a cardiac event going on. The emergency doctor called for a consult with a cardiologist, and the patient was admitted. A cardiac cath showed three-vessel disease and the patient had to have an emergency bypass. Women, Heart Disease, and Statistics There are a plethora of women who go through what Maria went through. Often time, women present to the emergency department with these symptoms, and they are told it is just anxiety. Heart disease is now the leading cause of death for women in America. According to the Centers for Disease Control, approximately 25% of women in America die from heart disease. Heart disease has traditionally been thought of as a man’s disease. However, statistics show that the same number of women as men die of heart disease. Perhaps this fallacy came from research decades earlier that stated women were protected by estrogen. Therefore, providers had the false assurance that “younger” women were not susceptible to heart disease. More recent research has shown this not to be true. Heart Disease is even more harmful to African- American women. Approximately 8% of African-American women have coronary artery disease. Thirty-three percent of women who die suddenly of heart disease have no symptoms. Even armed with these statistics, women are still not diagnosed as readily as men are with heart disease. A study was performed by the Canadian Medical Association that revealed that women are dying at a faster rate than men of heart disease. Also, hospitalization rates have increased for women and declined for men. Signs and Symptoms of Heart Disease in Women Women have different symptoms than men for heart disease. This is one of the reasons that women are not “easily diagnosed”. Health providers are using the standards identified for men. The symptoms for women are: Fatigue Nausea and vomiting Diarrhea Stomach pain or acid reflux (GERD) symptoms Right upper pain Upper back and mid back pain Neck/jaw/throat pain When women do have chest pain, the chest pain is described as a burning sensation. Often time, there are no symptoms until a woman has a heart attack or stroke. Also, there are such vague symptoms, the diagnosis could be a host of many other disorders. Awareness of Heart Disease and Women The American Heart Association created the Go Red For Women to create awareness of women’s heart disease. This campaign empowers women everywhere to take charge of their heart health. These measures include: Monitoring your blood pressure Maintaining a normal weight Exercising at least 3 times a week Stop smoking Monitor your cholesterol Monitoring your blood pressure Get your annual physical exams Emergency doctors are usually the first doctors that women with heart disease come in contact with. These providers should be armed with the latest research about women and heart disease. Conclusion According to the American Heart Association, 80% of cardiovascular events that women have can pre prevented with the proper lifestyle and adequate treatment. Most women have families, and they tend to put others needs in front of theirs. As women, we need to better take care of ourselves, and make the commitment to better health. Have you had any experiences where women were wrongly diagnosed? Have you been wrongly diagnosed? To join the discussion, leave your comments below. References: Daugherty SL, Masoudi FA, Ellis JL, Ho PM, Schmittdiel JA, Tavel HM, et al. Age-dependent gender differences in hypertension management. Journal of hypertension. 2011;29:1005–1011 www.goredforwomen.org. (2019). Go Red For Women®. [online] Available at: https://www.goredforwomen.org/ [Accessed 2 Feb. 2019].
  14. hyllisR

    HELP New grad job dilemma

    Are you interested in night shift? Ten minutes versus 1.15 hours is a big difference in commute times. Sometimes I think as nurses we take that "loyalty" syndrome too far. Sometimes we have to think about what is best for us. I have been in healthcare for about 30 years. It took me about 20 years to figure about that healthcare is a business; and as nurses, if we don't treat them like a business, you will be lost in the maze. It is not selfish to look out for YOUR best interest. I would wait until the second offer came through as a written offer, and if you still want the job I would put in my two-three weeks notice. Good luck !
  15. hyllisR

    This Forum is Quiet

    I would love to interact with Nurse Entrepreneurs! I have started a nurse blog and I am interested in networking with other nurses. Phyllis
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