IKnowYouRider

I know the quality isn't consistent, but it seems much simpler to just score on the street than to mess with stuff at work

I have this idea in my head that I can't shake -- the best way to explain it is an integrated, partially self-sustained living community. Some features include a 'town hall' area for small live music and guest speakers where residents would have preferred seating, but tickets would be sold as well. Also, a garden/farm to provide quality foods for the residents (and maybe nursing staff could log hours doing this type of work to prevent burnout and feel connected to the whole 'operation' and a residents library, which would also include recorded autobiographies of current and previous residents (like Story Corp)...the list goes on -- Currently in an FNP program after being a IMCU nurse for 8 years and have spent some time thinking about how I could actually be happy going to work, while still working in healthcare. The purpose of the thread was to start diagnosing the problem I guess? Would love to hear any additional thoughts.

Can you explain the "percent of profit allowed to be earned?" Does this mean that nurses, CNA, etcs don't receive fair compensation based on the amount of money brought in?

I think the title speaks for itself...but I'll try to elaborate. It would be difficult to find any nurse who would argue against the notion that the status quo of doing business in SNF/ALF facilities needs a huge overhaul. That being said, what are the issues that need addressed? Staff burnout, poor regulation, and care models that prioritize profit are a few that come to mind. If you work in one of these facilities what would you change?

Hahaha, you'd be right. I have not been very active over the years. You say 'the military doesn't need you'...okay, like I agree, they don't need me as an individual, but as a whole, they require the support of tax payers, civilians, etc. What the military actually needs -- at least to grow and thrive and continue receiving nearly 3/4 of a trillion dollar budget -- is a scared public to justify their job. They need a vast majority of Americans to be complicit in co-signing the fake narrative that the US is the arbiter of conflict around the world, and unquestionably the 'good guy'. I happen to not be one of these people. I quickly raise my hand to increase the chances that I'm blown to bits by a terrorist, in replace of my country continually dropping bombs on poor countries while failing to care for those at home.

I'd also feel differently after I realized that the reasoning behind bombing and invading such people is complete fiction. I'd wonder, "Why have I signed up to participate in sanctioned murder perpetuated by a government that doesn't care for me once I return home?"

I'd also feel differently after I realized that the reasoning behind bombing and invading such people is complete fiction. I'd wonder, "Why have I signed up to participate in sanctioned murder perpetuated by a government that doesn't care for me once I return home?"

I think it's difficult to assess students while on drugs, especially when the amphetamine causes my penlight to shake. Wait...what are we assessing for again?

Whoa, whoa, whoa... You have to take it easy there! You mentioned "even though the most patients I've had is 5"...do you understand how crazy it is you're even able to do that? Taking care of five acute patients for 12 hours is badass, no matter how well you pull it off. Like other posters have said, sometimes you won't deliver the care you want, but who cares? The system is set up against nurses, and set up against providing good care -- we do our best and remain proud of what we're able to accomplish. It took a solid year, but probably more like 2 years to feel completely confident about walking into any at day work. It'll happen for you, you just gotta pay the entry fee. Hang it there, keep it real.

Then don't give out OTC to co-workers if you don't want to. Are you being harassed for not giving out OTC meds? If not I really don't understand the issue here.

I've been a nurse for 6 years. Three years LTAC, three years IMCU. I have a strong work ethic, and really commit myself to serving my patients for the 12.5 hours I'm at work. When I start my day, I ask, "How can I best help my patient progress towards a safe and healthy discharge?" This being said, I checked my email this evening and there's a message addressed to all RN staff about how we need to solve people staying over late. He expresses in the email that this is not a matter of staffing shortages. The hospital has cut positions left and right since I started 3 years ago. It IS a staffing issue and I'm simply done with being a pawn to these hospital systems. I love my work, and do it well, but I love myself and my life more. //rant

@wtbcrna: You're right, only the nurses who have been to Guantanamo are able to question the ethical nature of force feeding prisoners. Also, civilians who have chose not to serve in the military should never question its actions because it's an infallible institution. Thanks for the update. @nurse2033: Again, I appreciate your post. I wish more intelligent responses could have followed. Edit: "Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially" (Declaration of Tokyo, 1975).

Unlike the poetic post below by ckh23, I can respect your answer even though I disagree on a few points. First, I misspoke by stating that 'they haven't been convicted'. What I meant was that many have not been charged, which is even more appalling. But, anyway, that doesn't really relate too much to the subject at hand. What I don't understand is that you seem to equate involuntarily detainment of mentally ill patients with prisoners at Guantanamo Bay. The only relevant similarity between these two populations is that they are both being held against their will. What really matters when speaking of patient autonomy is mental capacity. Clearly, patients in psychiatric units don’t have mental capacity, but I would argue that the prisoners of Guantanamo do. How do we know they have mental capacity? Well, they make understandably sound arguments as to why they’re participating in their hunger strike, and their reasoning remains consistent on a day-to-day basis despite being persuaded to change their behavior. Due to their present mental capacity, I think a better comparison would be the hospice patient who decides to stop eating due to unresolved pain, hopelessness, etc. What does the medical profession do in this situation? Well, typically, we let them die. Therefore, I believe we should allow the prisoners at Guantanamo to do the same.

Is this torture? I would have to think so, especially since many of the prisoners being held there have not been convicted of a crime. Every time the media covers this story, it's always a nurse administering the feeding. What is this doing to the integrity of our profession? If the military wishes to move forward with these practices, they should leave nurses out of the picture. And of course, military nurses should refuse to take part in such behavior.

I just started working at an LTAC facility and have a lot of patients on vents, so I'll probably have a lot of posts in this section for a while. Yesterday I had a patient on a trach collar, SaO2 95% on 4-6L of O2 (I don't remember exactly). He had recent bacterial pneumonia infection. LOC probably x1, restless, agitated. So, he was expelling a lot of secretions through his trach by coughing all throughout the day. I would clean around his trach frequently. Still, he sounded pretty coorifice and I asked my orientating nurse if I should maybe deep suction him a few times to help him out. She told me not to because he was expelling a lot on his own and his SaO2 was normal. Is this what your recommendation would have been, or would you have deep suctioned? I regret going against my best judgement and not suctioning because I now feel maybe his agitation/restlessness was somewhat low Pa02. He was also getting a lot of opiates/benzos, but still....