Nccity2002

...Wait, What??!!

Wow. This is one of the most ignorant comments I had come across in this discussion. Leave it to nurses to shoot themselves in the foot by resenting those with higher education. Just like in the "old good days", guess I should had been be happy just empting bedpans...

Wow...The "ombudsman" really?? To the OP: Sorry about your bad experience. The situation obviously still bothers you, as others had wisely adviced, get in contact with the hospital ER manager or the custumer service liason person (now in days, every hospital have one of those) and informe them of you bad experience. Hopefully you would be able to get some closure.

Congratulations personally, I joined a professiona organization (try AACN if interested in critical care) and made acquance with several managers and educators around my area. My 1st interview was a bliss since I already knew the manager. I think you have many options if you are flexible and willing to relocate. Best of Lucks.

"The partner hospitals are in Texas. So, you cannot live in Georgia and do the nursing program at UTA." Actually, the above is incorrect. I live in OC, CA and my facility (a teaching hospital) does have a partneship with UTA, for ADN-BSN and BSN-MSN 100% online; and yes, as a employee there is a tuition discount. I would advice you to contact an admission adviser at UTA...they should point you to a facilicy in your area who participate in the program. Best of luck

Why are you expending so much time and energy in an environment that you consider toxic?? If you had exausted all the official channels at your facility to solve the issue, with not results...either get a new job (I know...you hear it before) or consider lawying up.

The rationale for clamping a ventriculostomy device (EVD) is to evoid overdraining of CSF, which may lead to brain herniation. If you place the EVD below the patient, you will normally see an increase of CSF drainage, due to gravity. For this reason, most EVD protocols recommend clamping it with any changes in patient's position that may place the EVD below the patient.

It would be helpful if you provide us with specific and factual situations that you are perceiving as lateral violence. My two cents...you had been a nurse for more than two years, it seems; seek another job. End of problem.

Orange County, CA $38-50... depending on the agency, hospital and your negotiation skills...

I will be the devil's advocate here... To the OP, would you rather her to go directly to your manager with these "issues", rather than address them with you, first? Because, honestly that is probably what will happen if you confront her and she takes it the wrong way. As many noted earlier, respectfully accept the feedback and move on with your day (Obvioulsly some things are being missed, if she keep coming back to you) .

Sounds like you need more assistance transporting patients...are you doing this, by yourself??

Run for the hill...and never look back.

In the future, please read the OP original post, before commenting. There was no reference of that patient being"unstable". She simply did not turrned or "touched" the patient because she became busy with her other patient.

I do agree that nobody should be treated that way, under no circunstances. However, as an ICU nurse, I can't get past the fact that you did not turn/touch an ICU patient under your care for 12 hrs!! I am curious, how did you completed your documetation/charting if you did not assess/touch your patient??

[QUOTE=MomRN0913;6744157]This past 2 weeks, the patients i have opened up cases for in HH speak not a work of English. They have social security numbers, Medicare benefits, and Medicaid benefits. Live in the U.S. But do not speak a word of English. Getting a family member who does or a translator at a certain time, or even to make a simple phone call and to get someone to answer the door is an utmost challenge. I know this topic is controversial, but why am I struggling to hard to understand some Spanish so I can do my job in America? Most are quite lovely patients. Some are just shocked that I don't speak Spanish! My rant of the day. And these days, there are a lot of rants for me in this field, I admit it. Welcome to America. It is what it is and with a growing Hispanic population, I do not see that changing, anytime soon. As nurses, we have a moral and ethical responsibility to check personal biases/agendas at the door. Why do I make this comment? Just based on some of the responses...including the OP post, above(I can't help but wonder how this mentality affect patient care.) Sometimes it is wise to take a step back and evaluate our attitudes and be careful not to short change our patients because of personal beliefs. To the OP: Why no be proactive and take this opportunity to find out what resources are available at your facility to help you and others (staff and patients), in future situations (because trust me...you will find yourself in this situation, again).

Hi There, Went to Australia and New Zealand last year and I can understand why you are having such a hard time choosing between the two!! I spent some time in Queensland and I met two Canadian traveler nurses, while water rafting...they loved it there. According to them, the pay was not the highest, but the low cost of living compemsated for that.There is a great need for nurses in Australia, but be prepare to live in rural ( but beatiful) areas. Australia is a huge country and one region will greatly differ from another. Pin point where you want to live and start your reseach from there. Not sure about New Zealand...but the people are amazing and the country is breath taking. Best of Lucks.

If you have the need to give PRN medications ealier (...and I am assuming you are referring to narcotics/sedation), consider contacting the MD and changing the frequency, backing the request by your assessment (increased pain/agitation).

Hi BelgianRN, What you just described is what I am mostly used to. In California, if someone indicates(via DMV records) that they wish to become an organ donor, legally, the organ procurement organization in CA (One Legacy) has the legal right to procure the organs without family authorization...althought they usually try to respect the family wishes, therefore they rarely enforce it (I had only witnessed one case where they actually persue it). As you mentioned, I often find it very helpful when religion is weighted in the decision process and there is someone of religious authority who is able to provide guidance as to what is acceptable when it come to organ donation. Thanks for your reply!!

Hi Esme, Thanks for you insight in the process. We actually only do kidnesy and livers; but I had not been aware of any inpatients receiving organs from one of our donors....usually the organs are shipped out, to other places. I think you are right, for once, a hospital is trying to do the right thing by empowering families and I am proud to work at such a facility...still, sometimes, I wonder if we may be overdoing it, especially when we bend over backward to meet/accomodate them and it never seem to be enough.

Hi Sun0408, Thanks for you input, and hope you got some sleep!! We are very pro-active in identifying and preserving potential organ donors. We have an "organ perfusion protocol" which allow us to implement interventions (such as pressors and aggresive ventilation management) to maintain major organs perfused, when a patient is deemed a potential donor. The nurse can initiate the protocol in collaboration with the medical team. The problem is that sometimes, we are so good at stibilizing these potential donors that it is harder for families to accept the fact that their loved one is really gone (all they see is that their loved one is pink and warm to touch....), therefore making it more difficult for them to make a decision, one way or the other.

Hi There, I am interested in finding out what is the practice of other facilities/states in regard to how much time is given to families to make a decision in regard to organ donation, once a patient is legally declared brain dead. I work in a busy trauma ICU, and in the last three months it seems we are having more situations where brain dead patients (and I mean, legally declared by two MD's, physical exams, and in some case cerebral angiograms), are being kept for long period of times in an ICU bed (twelve days, the longest one, after the patient was declared!!). All those situations involved difficult families dynamics and plain old difficult families; and in many of those situations, they kept changing their minds when they felt that their demands were not being met, such as sponsoring four family members from Mexico...after the hospital already sponsored three other relatives. My undestanding is that insurance/ medicare stop paying for care once a patient is legally declared, I had worked in community/county hospitals where once declared, family are given 48 hrs to make a decision...but my current facility is a teaching hospital. I think my facility is trying to meet the family emotional needs...but from a practical standpoint, what is the practice in other places?? Thanks!!

Hi There, I am interested in finding out what is the practice of other facilities/states in regard to how much time is given to families to make a decision in regard to organ donation, once a patient is legally declared brain dead. I work in a busy trauma ICU, and in the last three months it seems we are having more situations where brain dead patients (and I mean, legally declared by two MD's, physical exams, and in some case cerebral angiograms), are being kept for long period of times in an ICU bed (twelve days, the longest one, after the patient was declared!!). All those situations involved difficult families dynamics and plain old difficult families; and in many of those situations, they kept changing their minds when they felt that their demands were not being met, such as sponsoring four family members from Mexico...after the hospital already sponsored three other relatives. My undestanding is that insurance/ medicare stop paying for care once a patient is legally declared, I had worked in community/county hospitals where once declared, family are given 48 hrs to make a decision...but my current facility is a teaching hospital. I think my facility is trying to meet the family emotional needs...but from a practical standpoint, what is the practice in other places?? Thanks!!

Feb 2 by DookieMeisterRN "I'm sorry I can't give any advice you're post is really difficult to follow with text/abbreviations." I know what you mean...by the 3rd paragraph, my mind went to my happy place...

Hey Michelle, You should consider a Paramedic message board, you may find it more helpful.

Uhhh..., now, that is an interesting correlation between labor laws and clinical ladder programs. I think it all come down to education. If someone is willing to go throught the time comsuming process of going up the ladder, well... they do deserve to be compensated for it (more education= more money...it is a basic concept). Every facility is different, but besides the bedside care responsibilities, there is a bigger picture that you may not be aware of in regard to the role and responsibilities of those up in the ladder. For instance, most facilities around my neck of the wood, do require Clin III to work on projects, in order to maintain their status. Sorry, I do not think your labor law violation theory (in relation to the clinical ladder nurses) has any merit.