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Mary H.

Mary H.

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Mary H.'s Latest Activity

  1. Mary H.

    work hassles and team spirit

    It is important that problems get documented from the process perspective. Most often when there is a problem, a particular nurse is just there at the time the problem is discovered, but the problem happens because a process breaks down in one or more places. From a quality perspective, you can't track problems with a process to determine where the process is failing without having consistent reporting every time the problem occurs. Your manager or someone should be tracking these process problems to determine where the process is weak, and the information should not be used to blame individuals. It is hard not to be defensive, as we all expect ourselves to be perfect. I know how much I beat myself up over every mistake, no matter how small it is. If certain individuals are using the process to harass individuals, it becomes very clear in the tracking process, then those individuals should be approached by the manager. In many places, night shifts seem to pick up and/or document things they find better . In some places, they are, by policy, responsible for checking everything for the 24 hours, so finding and reporting process problems is inherent in their job responsibilities. If you feel you are having problems with a couple of people, try to approach them quietly in a non-defensive manner and discuss it with them. Some of the older nurses are sometimes intimidated by newer staff, because you bring a fresh perspective, enthusiasm, and engagement into their situation. Try not to get caught up in negativity and don't buy into regressing back into high school behavior.
  2. Mary H.

    Security Issue----Name Tags? What do you do?

    Interestingly enough, the Nevada law says the first and last name must be "clearly visible from at least 3 feet away." I don't know where our Nurses Association was when this was passed, but obviously they think we're immune to stalking and gangs here. The last place I worked (in New Mexico) had first and last name on the badge, but the first name was big and black, the last name small and light gray, so it was essentially not readable. We did this for staff security - even in the rural areas there are gangs and stalkers. [This message has been edited by Mary H. (edited August 28, 2000).]
  3. Mary H.

    nurses' rights or responsibilities to pts.

    If the doctor has ordered Percocet, or any other medication, and the patient meets the criteria specified in the order (q4h prn pain), you will have more trouble defending NOT giving the medication than you would to give the medication. The only time I would not give the medication is if the patient were sufferring severe side effects or adverse drug reactions to the medication. As far as calling the doctor when they don't want to hear about it anymore, after being a night nurse for a while, I started making some of those calls anyway. Sometimes, I'm sure someone heard about it in the daytime, but at 0300, most doctors will just give you what you want so they can go back to sleep. If you are careful with your documentation about why you called, you will be able to defend the call.
  4. Mary H.

    nursing salaries

    In sunny outdoor and good skiing Reno, base pay for RN is $18.16. I just got an offer from a facility in town for $30+/hr for night staff RN. Come on over, there's lots to do and plenty of jobs.
  5. Mary H.

    Anyone work at a magnet hospital?

    As I read the discussions about working conditions at many facilities, I find myself wondering if the ANA magnet hospital status actually makes a difference at the staff level. I know it did in the late 70s, because I worked at one. It was wonderful. How about it, anyone able to share with the group about staff-level conditions at your hospital with ANA magnet status?
  6. Unfortunately, it is usually a clue when a position is salaried that you will be putting in more than 40 hours/week. I am have had several salaried management/administrative positions and put in a usual week of 50 hours and more much of the time. As a manager, I do not believe in having staff donate time to the facility. First, it is illegal to have hourly people working off the clock, second, I need records of overtime to help justify changes in positions, increases in staffing, etc. I do think that patterns of overtime need to be addressed with individual staff members, but now, much of the problem in most places is the fact that there is too much work to do in the time allowed. I like to have staff groups address issues that impact overtime, i.e., how can we streamline report, where is the point that you are OK leaving work for the next shift. I still have to constantly remind staff nurses to write down their overtime, and I do not capture the majority of the time staff members are working overtime. It is not from lack of trying, however.
  7. Mary H.

    Nursing Uniform Theories.

    When I started as a nurse 26+ years ago (Wisconsin), we were wearing variations of white (colored top, white pants), but we had to wear hats - YUK. The hats went away with the advent of male RNs - no one I knew was brave enough to tell them they needed to wear a hat. I don't like white personally, it is not a strong color. I like to wear clothing that compliments me and makes me look as good as I can. IMO, having prescribed colors or types of uniforms takes away from me as a person and makes me feel like a factory worker. Even the "uniform" of corporate America allows for some individuality! I think the reasons for prescribing a particular uniform are mainly to promote conformity and compliance - the same reasons schools keep looking at or going to uniforms.
  8. Mary H.

    just curious

    I have BSN, MBA, and I am manager of a medical unit.
  9. Mary H.

    stethoscopes

    I have had a few different stethescopes. One Sprague-style that I liked was cheap. I still use it for auscultating my horses and dogs. Now that I am older (read don't hear as well as I used to), I spent more money and got a Littman Master Cardiology, and I love it!! I can hear really well, and my assessments go faster because I don't spend time listening again to be sure about what I heard. I got it through the internet and paid about $130. My advice is to borrow from people & listen with different scopes & get the best you can afford at the time.
  10. Mary H.

    Tell us about your computer system

    I was part of several Meditech implementation teams at my prior facilty. LPNs in NM could assist with data collection and deliver care, chart what they do. Our entire paper system and our Meditech was set up to require only RNs to complete portions of the initial assessment and the plan of care. We never had a problem passing survey. There was a Meditech feature that would allow amendments to the Patient Care notes. You could have the RN amend the LPNs notes if you have to show a cosignature for any reason. I have not worked in WI for many years, but I don't remember having to cosign for LPNs when I did.
  11. Mary H.

    First SCARE

    A needlestick is never a comfortable thing to have happen, there are so many unknowns involved and a long time to wait (6 months) before being reasonably certain regarding an exposure. Most of the time things turn out OK. PLEASE do not fall into the trap of judging your patients by their appearance. There were EMTs on an accident scene who treated an elderly (80s) woman they assumed was "safe," so they didn't wear gloves. The woman was HIV positive.
  12. Mary H.

    Spooky Stuff

    I have heard things but never had them happen to me. In one old Catholic hospital, staff and patients reported seeing a nun in full long dress come around and visit patients. The story said that there was one old nun who lived in the building until she died. She would make rounds to see patients. In another hospital, heard stories about patient reports seeing an elderly man standing at the foot of their bed. When asked to describe him, the story goes that he fit the description of a person who had died in a room down the hall quite a while before.
  13. Mary H.

    Socialized Medicine/Nursing

    Talking about the military's healthcare is a valid comparison, but those covered individuals are young, healthy individuals (for the most part), not aging, chronically ill individuals. A one-payor system seems to be better at preventative intervention, which we as nurses usually support. On the other hand, being an American means that the economics automatically involve the free market, the invisible hand, and profits. That's a huge shift in thought for the culture. Just look at the other postings about nurses receiving the pay for the value of the work!!
  14. Mary H.

    Socialized Medicine/Nursing

    This is a really interesting topic. I wonder what legal protections and limits on liability are written into the Canadian or other socialized system. Also, our society is different than the other countries, particularly with regard to us not being able to deal with death very well. Bunky, when you compare the societies and legal protections, how do you visualize a system similar to Canada's working here?
  15. Mary H.

    Nurse's Week. Whadya get?

    On Saturday, we worked with REMSA on a community project with child safety seats. On Monday, we had an ice cream social with 3 sessions, including evenings and nights (served by shared governance council, directors, managers, supervisors, nursing VP). On Tuesday, each nursing unit was "adopted" by another department for the day. On Wednesday, flowers were given to each person working. On Thursday, directors/managers/supervisors delivered cookie trays for all shifts in each department. On Friday, each department does something for their own area. We also received pens. And yes, we did receive at least one gift from a physician - a very large bouquet of exotic flowers. [This message has been edited by Mary H. (edited May 12, 2000).]
  16. Mary H.

    8 hour shift vs. 12 hour shift - your opinion...

    I have been an RN for 26 years. During some times of my career, 8 hour shifts worked better. I worked graveyard, and I had time to be involved with my daughter's school, go to school myself, or just play. During some times of my career, 12 hours worked well. Some 12-hour schedules are like having a week off every 2 weeks!! I feel the continuity of care is the same in most settings, although in units or areas with a 2-3 day average LOS, the continuity may be better with 12s, as the patient could potentially be cared for by fewer staff. The options are one thing that's really nice about nursing as a career. You can usually go anywhere you want to go and find a job, many times with the schedule you want, and at a pay rate that allows you to support a family.