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cleback

cleback

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Reputation Activity by cleback

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Like 21

Reactions Received

Like 40
Haha 1

  1. Like
    cleback got a reaction from CommunityRNBSN in Another Tragedy at Vanderbilt   
    Yeah, this is why I was not a fan of the nurse charges. Now every screw up can be criminal. 
  2. Like
    cleback got a reaction from WorldEscapes in Feeling incompetent as a student nurse...   
    Nursing school is equal parts learning how to be a nurse and learning how to be a nursing student. Nursing school requires a different approach than, say, a mathematics major. No calculus professor would ever dock you for nor being their kind of personable... a clinical instructor might. Whereas other fields only care if you know the material, nurses care how you show that you know the material. It's frustrating. You'll get through it.
    For forgetfullness, come up with a way to better retrieve knowledge. Meet with the professor to discuss your strategy. By seeing you use it, hopefully she see you care. Also through continued interactions, she'll warm up to your way of expressing yourself.
    However, I will say it doesn't really matter if you're not outgoing. The best professor I had told me that nurses need all types because we take care of all types. As you work, you will find it to be true. The most outgoing nurse may click with some, while a more reserved nurse clicks with amother patient. 
    Anyway, chin up!
  3. Like
    cleback got a reaction from WorldEscapes in Feeling incompetent as a student nurse...   
    Nursing school is equal parts learning how to be a nurse and learning how to be a nursing student. Nursing school requires a different approach than, say, a mathematics major. No calculus professor would ever dock you for nor being their kind of personable... a clinical instructor might. Whereas other fields only care if you know the material, nurses care how you show that you know the material. It's frustrating. You'll get through it.
    For forgetfullness, come up with a way to better retrieve knowledge. Meet with the professor to discuss your strategy. By seeing you use it, hopefully she see you care. Also through continued interactions, she'll warm up to your way of expressing yourself.
    However, I will say it doesn't really matter if you're not outgoing. The best professor I had told me that nurses need all types because we take care of all types. As you work, you will find it to be true. The most outgoing nurse may click with some, while a more reserved nurse clicks with amother patient. 
    Anyway, chin up!
  4. Like
    cleback got a reaction from CommunityRNBSN in Another Tragedy at Vanderbilt   
    Yeah, this is why I was not a fan of the nurse charges. Now every screw up can be criminal. 
  5. Like
    cleback got a reaction from CommunityRNBSN in Another Tragedy at Vanderbilt   
    Yeah, this is why I was not a fan of the nurse charges. Now every screw up can be criminal. 
  6. Like
    cleback reacted to Nurse Beth, MSN in Another Tragedy at Vanderbilt   
    Vanderbilt is having a rough patch. First the lethal Vecuronium error and now a "never event".
    A woman at Vanderbilt undergoing kidney surgery suffered a wrong-site surgery to her kidney- a "never event". She filed a 25 million dollar lawsuit due to extensive damage and is now dependent on dialysis. Neither here nor there, but one news report said the woman was a certified nursing assistant (CNA).
    In the first case, the RN was arrested and charged with reckless homicide. Should the surgeon likewise be arrested and face charges? 
     
  7. Like
    cleback got a reaction from LoriFLA, BSN, RN in Changing directions at age 46   
    I'd personally wait until your kids are grown and then see if you still like acute care. You likely won't be able to get a prn acute care position as prn since orientation is usually during the week, likely full time. I'd maybe keep your cardiac rehab job prn of you decide acute care isn't for you. It's a big change, with nights, weekends, and holidays... something that I wouldn't want with school aged children.
    Once you get into acute care, then you can evaluate going back to school. For an acute care np or crna, you'd need acute care experience... and honestly for primary care, you may need acute care to accommodate clinical rotations.
    Good luck to you.
  8. Like
    cleback got a reaction from shauntil07 in Flushing potentially infected PICC line   
    Suspected infected picc lines are not to be used, including flushing. Exception example... If the patient has a fever but no s/sx of infection at picc otherwise, the doc may order a culture off the line as a precaution and opt to keep the line. Then you just use it as usual.
  9. Like
    cleback got a reaction from shauntil07 in Flushing potentially infected PICC line   
    Suspected infected picc lines are not to be used, including flushing. Exception example... If the patient has a fever but no s/sx of infection at picc otherwise, the doc may order a culture off the line as a precaution and opt to keep the line. Then you just use it as usual.
  10. Like
    cleback got a reaction from CommunityRNBSN in Giving up PA school acceptance to pursue ASN?   
    You're not in PA school yet, so you're not giving up anything. That aside, I think you answered your own question. You seem to value a more balanced family life right now, which is a legit life choice. If you end up regretting your decision, you can go back to school for a PA or NP while working as a nurse. You can't really go back and erase student debt or go back in years to be a young mom.
  11. Like
    cleback got a reaction from CommunityRNBSN in Giving up PA school acceptance to pursue ASN?   
    You're not in PA school yet, so you're not giving up anything. That aside, I think you answered your own question. You seem to value a more balanced family life right now, which is a legit life choice. If you end up regretting your decision, you can go back to school for a PA or NP while working as a nurse. You can't really go back and erase student debt or go back in years to be a young mom.
  12. Like
    cleback got a reaction from CommunityRNBSN in Giving up PA school acceptance to pursue ASN?   
    You're not in PA school yet, so you're not giving up anything. That aside, I think you answered your own question. You seem to value a more balanced family life right now, which is a legit life choice. If you end up regretting your decision, you can go back to school for a PA or NP while working as a nurse. You can't really go back and erase student debt or go back in years to be a young mom.
  13. Like
    cleback reacted to Jedrnurse, BSN, RN in Giving up PA school acceptance to pursue ASN?   
    The jobs are like apples and oranges, so I wouldn't look at it like a choice between similars. Are you more interested in hands on care or a diagnostic/treatment role?
  14. Like
    cleback got a reaction from Elaine M in Should 40 year old mom become a psych NP?   
    I'd go for it. Having it paid for takes an incredible amount of stress off. And youd be able to work less (theoretically) than if you had to pay for it out of pocket. 
    That said, it is a time commitment. Be prepared to miss some time with family. But it's only temporary... and you may be able to be done in two years, which will go by in a flash.
  15. Like
    cleback got a reaction from DextersDisciple in Tennessee Nurse RaDonda Vaught - Legal Perspectives of Fatal Medication Error   
    Not sure if I agree with all of your post or understand your point behind pointing out #2. If the nurse knew it was a lower dose for anxiety, not sedation, she would likely not be closely monitoring, so wouldn't the fact that it was an anxiolytic dose make her offenses less egregious, less fitting of a reckless homicide charge?  I'd be curious to see the Vandy policy on it. 
    Anyway, I am going to be completely honest... I would love to join in and say this could never happen to me... but I've made a med error (gave the wrong eye drops). I've technically made a monitoring error (gave low dose iv fentanyl for analgesia without realizing the instituional policy for ANY iv fent was akin to conscious sedation). If the stars had horribly aligned with different circumstances, I could've had a patient tragedy too.  
    Personally, I find the "no, not never me" reaction to be human nature as well. In horrible circumstances, people want to believe that bad things only happen to bad people. My two cents, at least...
  16. Like
    cleback got a reaction from elephantlover in Any RNs considering medical school?   
    This is not an apology. You were being rude. No one is being judgmental to you about wanting to be a doctor. You just don't know how to talk to people without being insulting. You might as well learn now, as you will still need some bedside manners as a physician.
  17. Like
    cleback got a reaction from MBar1 in I've had enough.   
    I don't know if you have clinical depression or would be helped by medication, but I do notice maladaptive thought processes in your post. At the very least, counseling should be able to address those with you. There's no reason to continue being unhappy, OP.
  18. Like
    cleback reacted to Iheartwoundcare, BSN in Nurse Charged With Homicide   
    What is the legal precedent to charge a med error as reckless homicide? Do we all need to now prepare ourselves for the same fate if we make a mistake in the future? Frightening. 
    Revoke her license. Community service. She’s already going to live in some sort of hell the rest of her life. 
  19. Like
    cleback reacted to EllaBella1 in Nurse Charged With Homicide   
    Eh. Homebound, I disagree. I don't think anyone is suggesting that she get a pass here just because she's a nurse. The reason I have an issue with this is because although she clearly bypassed several safety checks, there are still components of a system failure here. I read the CMS report which said that pharmacy had verified the versed nearly 10 minutes before she tried to pull it. If that's the case then why wasn't it profiled? Why wasn't there a computer available in radiology for her to scan the medication? Why wasn't the vec in a RSI kit? And since it wasn't, why didn't it require an override? 
    There have been many sentinel events in the past involving medications- this one is no different. It should be seen as an opportunity to prevent something like this from ever happening again through change. Prosecuting the nurse, especially when the family isn't pursuing legal action, undermines the system improvement process.
    I know for sure the nurse did not intentionally cause harm to this patient, and this just opens the door for more nurses being prosecuted in the future.
    A hypothetical example- A patient is admitted with sepsis and is on Vancomycin. The nurse misses the order for a scheduled vanc trough and hangs the next dose as ordered. The trough would have been high prior to the dose, and is now critical and is through the roof. The patient's kidneys take a hit and do not recover. They're in acute renal failure, on pressors, end up fluid overloaded, intubated with ARDS and on CRRT. Eventually the family decides the prognosis is so grim that they withdraw and the patient dies. Can this nurse be prosecuted for missing the Vanc trough and administering the dose, kicking off this cascade? Because it's a nursing med error too that ultimately led to a patient's death.
    This is a scary precedent to set. 
     
  20. Like
    cleback reacted to HiddencatBSN in Nurse Charged With Homicide   
    I just read about this and headed right on over here to talk about it.
    It sounds like the hospital, faced with losing money, threw her under the bus. How many patients did she have? How many shifts in a row had she worked? Was she on her regular unit? Was she properly trained? How was the vecuronium labeled? What distractions did she face while getting the medication, and do they profile meds to patients there (so you’re selecting from a med-list and not all available meds)? If the hospital was in danger of losing Medicaid money over this why is the nurse taking all the blame legally? Did she have a pattern of risky practice or negligence?
  21. Like
    cleback reacted to JKL33 in Nurse Charged With Homicide   
    For the sake of every other patient in a hospital in this country, I hope CMS and the general public understand that she has not done any one single wrong here that hasn't been done innumerable times. I bet every one of them has happened at V in the past 8 hours.
    - Failure to conscientiously read a label
    - Fail to ensure 5Rs
    - Use override function on pyxis
    - Failure to monitor according to SoC
    ****
    Many, many people have done #1 and/or #2. Usually when they do, we all say, "Don't be so hard on yourself!" Either that or no one ever even knows about it because it didn't lead to an actual mistake or if it did, there was no obvious patient harm If you've been a nurse since before auto-profiling, especially in certain departments, there's a good chance that #3, using "override," is (or fairly recently has been) SoP in your work area. That aspect of this makes me particularly sick because the entity in question is using the override thing to make this look particularly evil. And actually the override wasn't the major problem here. But if you don't claim it was the (utterly reckless) major problem, then eventually you might come around to some of the other factors, like the idea of a newer nurse who clearly was not prepared enough for this role to be familiar with either of these two medications or the required monitoring, being in a role of roving help-all while orienting someone even newer while being sent all over the damn hospital (or to at least two different outpatient departments, in one of which there were no other clinical/nursing staff present and no tools for nursing care), to do these various things, neither of which were urgent or even necessary, so that she could medicate the patient of a nurse who couldn't medicate her own patient because she was busy watching two full assignments' worth of patients in the ICU. You might not think so, but you've probably done #4, too. If you've missed a set of important vitals, if you haven't reassessed as quickly as you should after giving pain medication, if someone took your patient off the monitor and didn't put them back on, if you delegated a monitoring-related task that was then not completed in a timely manner (vitals, blood sugars, etc., etc., etc.) The most unfortunate and egregious thing was not reading the label, and that's the bottom line.
    But what she did NOT do was  "bypass a hospital safety measure *in order to* gain access to the lethal drug used to to execute inmates on death row."
    **
    Oh, and she is also charged with impaired adult abuse. Which I'm guessing, to avoid "inadvertently" sounding like something isn't, would have been better written, "impaired-adult abuse" (IOW, the patient was impaired secondary to the medication).
  22. Like
    cleback reacted to juan de la cruz, MSN, RN, NP in Nurse Charged With Homicide   
    It's not that unusual to order a benzodiazepine drug (Versed or Ativan) to patients undergoing an MRI who are claustrophobic. Hospital procedures and national standards require monitoring of these patients by the nurse who gives the dose. I don't think there is responsibility on the side of the physician. If anything, VUMC should be held liable for not maintaining a system that makes sure patients given a dose of an IV benzodiazepine are monitored by a nurse. 
    I know a colleague who is familiar with the case and tells me the nurse involved bypassed multiple safeguards to prevent this tragedy from happening. VUMC uses vecuronium packaging with a clear warning stating that the drug is a paralytic. She reconstituted vecuronium prior to administration as is usual for that drug yet the fact is Versed never requires reconstitution. 
    Is the treatment she is facing now justified? she is being charged with reckless homicide not cold blooded murder. It's hard to answer that since I don't know her state of mind, what her patient load was, or what her training has been. This is in the hands of lawyers and the courts now. I was told this was an ICU patient (abeit ready for transfer out of the unit) and this was a nurse who has trained in the ICU.
    It is rare for acts of negligence by healthcare professionals to be treated as a criminal case. The physician that gave Michael Jackson propofol faced criminal charges so there has been precedence. My own take home lesson from this is never is the time more right to demand safe nurse staffing, adequate mentorship/training, and Pharmacy checks prior to administration of medications using the override function only in true emergencies. 
    BTW, I answered that she should not have been charged if anyone was wondering.
  23. Like
    cleback reacted to Emergent in Nurse Charged With Homicide   
    I have a feeling that someone with clout, associated with the hospital,  is behind this. Someone who perhaps plays golf with the chief prosecutor?
    How convenient,  to divert attention away from the hospital's deficiencies by vilifying this unfortunate woman.  
  24. Like
    cleback got a reaction from HiddencatBSN in Older Doctor doesn't think nurses should be in charge   
    How is asking a doctor to see a patient over a medication issue acting "above"  doctor?  It's recognizing the doctors expertise in medication ordering... sounds like the doctor didn't like being asked to do something... silly.
  25. Like
    cleback got a reaction from HiddencatBSN in Older Doctor doesn't think nurses should be in charge   
    How is asking a doctor to see a patient over a medication issue acting "above"  doctor?  It's recognizing the doctors expertise in medication ordering... sounds like the doctor didn't like being asked to do something... silly.
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