Irving

I was wondering if some of the smart and deep-thinking members of this site would share their thoughts on being video taped by a patient/family member. (Patient [pt] or family member [fm] ). I understand that in public, a person cannot have the expectation of privacy, and a person has a 1st amendment right to film, in public. It is not that I have an issue with people watching my work - I was told early on, if you cannot start and IV with ppl watching then don't be a nurse. Even if the pt gives consent to be filmed, I feel I should have the right to refuse to be filmed. I have no control over what they will do with the video, post it, sale it...anything. This is the same if they filmed me in public, yet it feels different for some reason. While I have nothing to hide, I believe if I do not want to be filmed in the discharging of my duties, that should be my right. Or is it? Has anyone here been told they have to allow pt/pt's fm to film them? Is everyone here O.K being filmed? I am trying to decide my final opinion on this and would appreciate you giving me input and thoughts. About 10 years ago, a pt tried to film me while I was assisting another nurse in their room. I said I declined to be filmed, and I left the room. In the time since, much has changed. Filming in most places is protected as 'freedom of speech." (This despite what many police agencies would have you believe.) I know I need to get a copy of my hospitals policies on this subject, but still, in general, I am interested to hear your thoughts and opinions. Also, in my area, we have hospitals that fall under Federal ( I THINK) jurisdiction. We have a few military bases and a Veterans hospital. Would the laws/policies be the same there or difference since they are Federal. Your thoughts/opinions matter to me. Thank you much ID

I was wondering how you handle being mandated to work 18.5 or more hours on a shift. Or even if this is required of you. Here is how this went down last time. 19OO time to give report and I am called to the side by the charge nurse and informed I am being mandated to stay until 233O which probably would mean OO3O. I work on a Med Surg floor and I do direct patient care. I work mostly 12.5 hour shifts and when I come home I shower and I go to bed because I am wiped out. I have been nursing for >3O years and after 12(.5( hours, I hurt. My body and my brian are both tired. On a good day I will have had a chance to use the BR and on a bad day, I will not have. {As an aside, it drives me crazy to hear a pt c/o about not getting something with their meal - their 3rd for the day plus snacks, while I have not and will not eat until the morning. sorry, couldn't be helped} The last time I was mandated, I was also sent to a different Floor to work and took report from a nurse going home at 153O which made no sense to me. My employer uses "Mandating" to shore up their inability to hire new or retain current employees. If I get mandated and told to work 12 hours on a day where I was scheduled for 8, I can suck it up and do it. But I feel physically unable to work another 18 or 19 hour shift. No mention was made of this on my hire but I probably signed something saying I thought this was a superb idea. I plan to notify management that I will not be available for any shifts over my agreed 12.5 hour ones. I am concerned for my pt's safety. I am concerned for my safety and I am sure if anything untoward actually occurred, I would receive the full blame for not saying anything. I have medical issues and my MD may or may not be willing to fill out something saying it is not good for me to work that long. I hate not being a team player but I am to the point where I am careing a lot less about what many ppl think. Not you guys of course! Well OK, only some of you. The trolls. And to be clear, this is not like a once a year thing, but is rotated through all the nurses until it is your turn again - takes about 2 months. I would be interested in hearing some thoughtful opinions on this subject. Any trolls that feel the need to attack me because I can't work 24 hours a day for a week , or feel I am less of a nurse bc I need to eat and go to the BR - I promise to do my best to ignore you. Thank you for taking the time to read this.

Hello. While I was in HS I worked a few night shifts a month to get money and always felt ill afterwards. I swore never to work night shifts again. My first nursing job was night shift and I did it for 21 years. It took me a while to understand my body but I would need SLEEP and I would need REST and the two were not always the same. I also had to commute an hour each way so I lived in fear of falling asleep. Sometimes I would go for days without sleep between shifts then crash eventually. If I was home, even after a day of sleep, I would fall asleep as soon as I was warm and comfortable in a chair or on a couch. I had to stop going to plays and movies bc of this. I have not worked nights in several years and I am happy and feel much better. I used to feel like I was hung over all the time. I still have problems with my sleep but it is getting better. I still have work dreams. My advice would be to try to acclimatize to nights if you can. But foremost, listen to your body. It may be telling you that nights are not for you and while you can chose not to listen to it, you will pay if you ignore it. It probably didn't but I do hope this kind of helped you. As I said, I still have sleep issues because of working NS. And if you find yourself in need of sleep meds, where you never needed them before, you should really think long and hard about it.

I do believe I did hear about HIPAA at some point in my education and I am in fact familiar with it. However I was asking for some clarification on the subject. I usually get pretty good advice here but there always seems to be someone that wants to attack someone asking a question. And I have encountered a lot of this during my time in the nursing profession. I was always told that you could find at least 1 nurse to help you but most "eat their young." To be clear: I don't post anything job related on Social Media. I am not allowed to do so. My question was just that, a question. And to be even more clear, you make a lot of assumptions about me in your many posts flaming me. I hope you don't make such assumptions in your job. And I'm not sure your sexist comment has a place in this conversation. I don't believe my gender was mentioned, nor is it relevant to this conversation. Was your ORIGINAL goal to help and or educate someone that posted a question, or to belittle and mock the asker. If the latter I feel sorry for anyone that has to precept under you. And yes, patients are a great source of entertainment. Being a professional doesn't change that fact. How we react, maybe, but not the fact. But, if you post makes even 1 nurse hesitate to ask a question, then I feel you have done your job, what ever that may be. And if you are helping with this Covid 19 issue, feel good about yourself. That is OK also.

Protecting my family is my number one worry about the Covid virus. I am worried I could catch it, which would be bad, but I made the decision to help people and to risk my life at times to do so. My family never made this agreement. As bad as the news media is blowing this out of proportion, the hospital that employees me seems to be doing the opposite. ALL of out N95 masks have vanished and rumor has it they are under lock and key somewhere. They will issue you 1 N95 mask (you have to sign for it) and it will be your masks for the foreseeable future. However, you will only get your n95 mask after the pt has been worked up and everything else has been ruled out. This includes a negative A/B Flu test. Then they will "give" you a mask. All the bottle of hand sanitize at my hospital have also gone missing....no I blame ppl not the hospital for this. I asked to see what our policy was for treating pt's with Covid or suspected of Covid and was told I would be notified when I needed the info. Apparently we have converted a single person ER room into a multi person (ie 6 person) room. They have some catchy acronym for Vertical Care Stations, but it just means a hard chair. I was told that the loss of privacy and HIPAA was acceptable due to the current pandemic. I am not sure what frightens me most, how easily we disregard privacy or the virus itself. I am not saying I am 100% correct on this, just that for me this is a concerning issue. And then we send pt's home to "self quarantine." 50 years ago, this would have worked with no problem. Today? Yeah, some people with morals and concerns for the greater good will follow these recommendations. But I don't think most people will. People don't even seem to want to bother getting dressed to go shop at Wal Mart. And now you ask them to stay home and delay their need for instant gratification? I can't see that happening. And what is a person is positive for Covid and they know they are suppose to isolate themselves but they go out shopping? Or to a movie or church? Will we do anything? You probably will not be able to tell this person for a well person. I am sorry this is a bit of a rant. I worry that "my" hospital is not doing all it can to keep me informed or to keep me protected. The new rules come down from "on high", ie, Management type that do no pt care and the only way they would catch the Covid is from the person delivering their coffee. And as I said, as much as I worry about my own life, my family's lives are my most pressing concern. At the lest, I would like to thank anyone reading this for allowing me to vent a bit. Seriously, thank you. I know so many people worry about this, but as nurses, we are the front line fighters in this battle and we seem to be some of the most unprepared in this war. And, IMHO, the USA always seems lax in being proactive, once you wake her up, changes will happen. Probably not today or tomorrow. However, I couldn't even guess on what laws and practices will go into effect at the start of the next flu season. I even wonder if the Flu Vac will become compulsory. I understand that doing that will not "fix" anything but logic flies out the window in times like these.

And if I didn't make it clear, sorry if this is mean, but I have been on this site longer then you by 3 years. So I was on this site probably before you obtained your nursing degree. And, I don't think you are sorry at all for sounding mean.

Aug 10 by JBMmom, MSN JBMmom has 6 years experience as a MSN and specializes in Long term care; med-surg; critical care. I apologize for my rant with the other "nurse." If you look at my account info you can see I have had an account here since 2009. Probably longer then the flamer that was sorry for being mean has been a nurse. Since I will probably now lose this account this is what I wanted to tell someone. I heard a resident tell an attending about a pt. He said "He is an elderly male, approx 50, 51 years old and................." That was all I heard. I found it pretty funny that this resident that was all of 20 years old (well he looked 20) was telling the doctor who was easily in his 60's that 50 was "elderly." I didn't know the doctors, didn't know the pt. It was not something I would think to post to FB but may repeat when telling nursing stories. I do keep my mouth shut but this struck me a funny. And to be clear, I also said in my comment : 1) I didn't know the MD 2.) I didn't know the pt 3.) I couldn't ID either one if I was forced to try. I do appreciate you response, an a much kinder one, but not exactly what I was looking for. Unless the measure of if it is not a violation is "Can you ID the pt from the info given." Honestly I should have, as you suggest, have just kept my mouth shut and not posted here in the first place. I wasn't trying to start a flame war and I probably responded to a troll, but I was under the impress from other posts I have read that this was a site where nurses could educate themselves. I am well educated enough to know I didn't learn half of what I needed to know to be a nurse in nursing school. I would say I will not post here again, but most of the ppl have been helpful in their replied. But to take falk from some "nurse" because I wondered if "He was an elderly pt, 50 or 51" violated confidentiality.......well, wasn't worth it. Again, thank you for your reply. Please look at my account info and see I have been here for 10 years.

Aug 10 by Jory, MSN, APRN, CNM Jory has 10 years experience as a MSN, APRN, CNM. 1,189 Likes; 1 Follower; 1,338 Posts; 11,905 Profile Views Well, sorry if this sounds mean, but I doubt you are a nurse at all. If you had attended nursing school and had finished orientation at any healthcare facility, you would know the answers to these questions. This question screams made-up question with a new made-up account. Actually I am laughing reading YOUR comment. I am always hesitant to post a question because of the responses like this that I get. If you look a little deeper into my account you will see I AM NOT in fact new to this site, I just don't feel the need to voice my every thought, either here or on facebook. Let me see prove I am a nurse? My first thought is to say no but, and I am sorry if this sounds mean, I am a nurse. In fact I probably work for you. I work for a lot of people that have so many letters after their name, so much education and yet they have no real life experience. I love working for ppl , perhaps like you, that have gone to school and went from HS to a college program that gives you a BSN and then an MSN and yet you never worked a day in your life as an RN. People that want to spout evidence based care without ever giving care. Oh, I do apologize. For all I know you are the troll. I asked a simple question, basically what is the litmus test for maintaining pt's confidentiality? If you didn't know, why bother to answer? And, sorry to repeat myself, this is why I am marked as a new poster. So many people seeking to pop off. I may as a question about "X" med and I get (ppl like you) ppl that turn it into a personal attack for using "X" med. Omg! I deal with ppl like you daily. I guess my biggest mistake was asking nurses for help and assuming anyone that was on this nice site would be helpful. Yes, I now see it does say "New Member" but I am not a new member here.

I am not a new nurse. I don't usually repeat anything I hear at work but I still have some questions re confidentiality. If you heard something while on duty and wanted to repeat it, how do you make sure you are covered with respect to confidentiality. For instance I heard an MD make a comment about a pt. I don't know the doctor's name, I don't know the pt's name. Would it be safe to repeat this? And would it be ok in any forum, say even Face Book? (My thought being if you could say it there you could say it anywhere.) I hear educational stuff, I hear funny stuff and the truth be told, I couldn't tell anyone who said it, when it was said or who it was about. Not if even if it was tell or go to jail. I am sure the least said the best said but still....Is there a litmus test for confidentiality? I have seen confidentiality broken many times over the course of my career but I don't want to be the one doing it. Thanks for any feedback. I love, love!, the range of comments I garner. So thanks to anyone taking the time to read this, looking past my poor written communication skills, figuring out what I mean, and taking the time to reply to my query.

I have a friend that takes Testosterone injections (ordered by a real MD and all). He has a multi dose vial (3 attempts to spell vial correct) and tells me he has not taken the med for the past year due to trying to rule out other medical issues. However he has the ok to restart the med. The questions is he has not used the vial in 11 months and it has been in his refrigerator. The vial has a exp date of 8/2018 and he has asked me if it was ok to use. It looked ok. Not discolored and nothing floating in it but what do I know. I told him at work we toss opened multi dose vials aft 28 days. But apparently the vial was pricey for my friend who is very cheap (don't tell him I said that ) and he doesn't want to toss it. And speaking of multi dose vials.....what the heck? Who ever thought that was a great idea? I have 10 other people using something before me and I have to bet my pt's life that they did everything to maintain sterile technique. Maybe it is just me but I don't like to do that. Anyway perhaps someone with more knowledge can help me out here. He wants my OK and while I can't see a reason not to use it Im not sure they should either. Thanks ID

My truth also. We like to think we know why something happened......... say a person with oral CA got it because they dipped tobacco but I see just as many tragic events that happen to nice decent undeserving people. Truth 2: Always wear eye protection when using tools. Truth 3: I'm not as smart as I thought.

I'm guessing you meant to ask how to find the J point on a strip to determine ST elevation. The J point is the point at which the ST segment and the QRS meet. . Yes thanks. I'm trying to type on a laptop with a cast and it is difficult for me. On a perfect strip I can easily find the J Point but when the tracing moves about or there is a large amount of ST elevation/depression I just don't clearly see where the J point occurs. Suggestions for this? Thanks ID

Im thinking that in Mobitz II the electrical impulse is at the AV node? And for 3rd degree it is ventricle? With an escape rhythm the p wave is reversed and can come before during or after the qrs? Thanks for the help. Can you tell me how to tell the difference between SVT and Sinus tach ON A RHYTHM Strip? Is it only a matter of rate? Thanks for the assist ID

I am having trouble understanding the difference between Mobitz II and 3rd degree heart blocks. What I have as for the differences is this: As seen on a strip - M2 Atria regular, Ventricle Irregular PR Interval: Prolonged but constant 3rd degree Atria regular, ventricle is regular PR Interval: There is no PR Interval (per our Educator) My problem is the while I realize that in 3rd degree heart block there is no communication between the Atria and ventricles, I can look at the rhythm strip and as day follows night, I can see P waves and at some point they are followed by a QRS complex. Again I realize that one does not cause the other but based on a the definition of a PR Interval it does exist. So if a normal PR Interval is between 0.12-0.20 seconds, long must a PR Interval be before one could say they are not cause and effect? Also any advice for finding the P-Joint on a strip to determine ST Elevation? Any help appreciated Thanks ID

I see the term "endorse" more and more in medical notes and I fail to understand its use. I can infer the meaning when one writes: "The patient endorses having a headache all day." I have never heard it used like this before. I have checked numerous dictionaries and nothing shows an applicable definition. Truly, the above example would mean "The pt thinks it is great to have a headache all day!" I guess in the larger picture this is just a stupid pet peeve but I was wondering if it bothered anyone else, or, if anyone feels it is a perfect reasonable use for the word and why. It just seems odd that I have only noticed this over the last few years and I have never seen it anywhere other then in a nursing note, or the odd MD's note. I don't believe the usage to be correct but would certainly endorse a well reasoned argument or documentation that supports this usage. (Did you see what I did there? That was a correct usage of the word "endorse." You could remove "endorse" and replace it with "support" and the sentence still works. And, hey, if you have noticed anything annoying that people document or say, please tell me here. It will be something else for me to fret over. Say like the use of "Orientated" vs. "Oriented."