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Katillac RN

That's not a pic of me. That's Nurse Ratched from One Flew Over The Cuckoos Nest for you young pups.

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Katillac has 18 years experience as a RN.

Comedienne Brett Butler says of her devotion to her second husband, "You let one dog get away, you're gonna build a taller fence and put better food out."  Translated to nursing, that means employers need to provide attractive opportunities including some combination of compensation, benefits, scheduling, training, and workplace environment and culture. Then, equally importantly, they need to prioritize retaining the staff they hire by actively showing they respect and value the commitment, knowledge, caring and experience of their staff, both seasoned and newer.

It's kind of that simple. There is no nursing shortage, there's a shortage of attractive opportunities for nurses.

Katillac's Latest Activity

  1. No. If they ask you to take an assignment in a unit you're not trained for (ICU, peds, L&D) and you refuse and they fire you, you can likely collect UI. In that case they would be firing you without appropriate cause. If you refuse to take a bedside position (say, med/surg or COVID unit without vented patients) simply because you don't want to, and you get fired for it, it's unlikely you can collect UI. See the difference? And yes. Without union protections and/or unless you are a member of a protected class and are fired for being a member of said class, you can be fired for pretty much anything.
  2. Katillac

    How to deal with Nosy Co-Workers?

    Here are my two favorite ways of responding in these situations, when someone doesn't get polite hints that I am not sharing personal information. 1) When asked something you don't want to get into, get a super quizzical look on your face and say, "Hmmmm. . . " as if you are pondering something. Then after a few seconds smile VERY brightly, and cheerfully say, "Nope. I don't have anything to say about that. But how are you?" 2) With an equally blinding smile, ask, "What makes you ask?" Whatever they respond with, you reply, "Ohhhh, I see," and then change the subject. If they persist, see #1.
  3. Katillac

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    Thank you so much for this! I looked into it, and by God Oregon actually has a plan ! The following is from Oregon Crisis Care Guidance: "The professional “duty to serve” must be balanced with the ethical principle of reciprocity, as healthcare workers should be assured of the safety resources they need to do their jobs." Can you tell me where it says that procedure masks are sufficient? I'm not being argumentative, I really want to know where that comes from in light of what they say in their crisis plan. Edited to say: Never mind, I found it. Minimum PPE for evaluating COVID-19 patients is face mask. AGPs require minimum N95. Minimum PPE necessary to evaluate patients with respiratory illness, suspected COVID-19, or confirmed COVID-19:•Face mask (I.e., surgical or procedural mask)•Eye protection (face shield or goggles)•Gown•Gloves Some procedures warrant a higher level of protection. See “Aerosol-Generating Procedures in Hospitals”. Aerosol-GeneratingProcedures (AGPs) in HospitalsAGPs (Appendix I) are much more commonin ED and hospital settings.When conducting AGPs for patientswith fever or respiratory symptoms, or with known or suspect COVID-19, HCP should utilizestandard, contact, and airborne precautions, including:•N95 mask or higher respiratory protection (includes powered air purifying respirators [PAPRs])•Eye protection(face shield or goggles)•Gown•Gloves
  4. Katillac

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    Does anyone have a credible reference to support that any state's BON would take action against a nurse who refused to work because of lack of appropriate PPE? I don't mean they might, or they could, or my cousin said her co-worker. I mean a source from a Nurse Practice Act or your state's BON regulations.
  5. Katillac

    What happens if you quit?

    I did a search in the PDFs of the nurse practice regulations for PA, and didn't find the word mandate, disaster or crisis. They are the folks who would censure your license. PA Act 102 specifies that you can be mandated to work overtime (including complete extra shifts) in times of "unforeseeable national or state emergencies". But that's a Department of Labor thing and allows them to fire you with cause (not take action on your license) for not working when they want during a crisis like this one. Nothing is said in either about penalties for quitting during emergencies, as long as you either have handed off in report or didn't take an assignment to begin with. Maybe it's a union thing?
  6. Katillac

    Refusing Care of a COVID-19 Patient Due to Inappropriate PPE

    The CDC is saying - responsibly, I think - that in the absence of an approved mask a scarf, a bandana or (by inference) a home made mask is better than nothing. The Deaconess post makes it seems there are CDC approved designs. Not so. There's a chart out there showing the % of viral particles various materials filter. HEPA fabric is way up there, but unfortunately you can't breathe through it. The cloth people are making masks out of in there homes filters around the 50% range. In fact non-N95 masks in general are far better for keeping the wearer from spewing droplets into the air than they are for protecting a wearer. I've made a bunch of masks but am only giving them to people I can specifically tell that they won't protect you from COVID-19.
  7. Katillac

    What happens if you quit?

    Allowed to quit? Do you mean can you be forced to stay? In my state there is nothing in the Nurse Practice Act that would allow the BON to censure a nurse for quitting during a pandemic. Technically, the lack of PPE would not prevent the BON from censuring you for abandonment IF YOU ALREADY TOOK REPORT on a patient. But these are uncharted waters.
  8. This is from an ad for a dialysis nurse in Syracuse, New York. The pay range quoted is $17 to $31, far from competitive in the market. I mean, maybe given no access to narcotics they will work with someone who has a conditional license, or on monitoring. And their benefits package looks good. But seriously, how can corporate look at what they are requiring for the compensation offered and wonder why there is a "nursing shortage"?
  9. Katillac

    Coronavirus (COVID-19): We Want to Hear from You

    Lube will not be helpful in getting a handle on most things. Makes it harder. 😆
  10. Katillac

    At a crossroads

    Cutting someone off while they are giving report is unprofessional and rude. That's on them. For some reason, you're choosing to make it about you and be personally affronted and hurt by it. You "just want respect," not an unreasonable desire, but are becoming depressed and anxious when you don't get it. I'm not sure the problem is with your co-workers, or your work place. Nor do I think changing jobs is the answer; you'll find disrespectful jerks and a rude co-worker or two just about everywhere. Maybe instead of working on finding a place where everyone is respectful and polite, you could work on not taking disrespect and rudeness personally. In this day and age I'm afraid being treated consistently respectfully and decently is too much to ask if you need it to feel OK about yourself. Sad commentary on today's work environment, but that's what I see everywhere.
  11. My advice is to adjust your expectations. You seem to expect that schedulers, including this team leader, will be considerate, reasonable, fair and/or interested in your priorities. Some may be, but others will simply look at you as a resource, a possible plug-in for a hole that's hard to fill. That's why and how this person did what she did. I agree with others; as a PRN, the most useful response is, "Yes, I'm available," or, "Unfortunately, I am unavailable." Not sorry - you have nothing to apologize for. And when someone says you must come in, see above. No explanation or justification after the first time, if you even elect to give a reason then, which I don't recommend. If you elect to meet with the director, I'd suggest you clarify with her if there is another response from you under the circumstances that would be more effective. In all likelihood she understands that schedulers sometimes exert more pressure than staff would like to get shifts filled. They get to ask. You get to say yes or no; those are the roles of the scheduler and the PRN.
  12. Yep, for sure there's more we don't know than we do. All I've been able to glean from other stories is the student was 14 years old and the school has denied responsibility. It could have gone down so many different ways. It could be that the nurse (and you're right, it isn't stated whether RN, LPN or other) exercised perfect clinical judgment but the parents were approached by a lawyer who smelled money to be made. Or it could be anything else, we don't know. In no way am I suggesting blame. I guess I should have said my point in posting this was I have mad respect for school nurses who need to navigate these waters, which can become life and death matters or be a routine assessment and back to class, every day. I was thinking it's such huge responsibility to manage the well-being of hundreds of kids, especially because you're pretty much a single practitioner.
  13. I feel horrible for everyone involved in this situation. LAKEVILLE, Minn. (FOX 9) - A family says their daughter suffered a traumatic brain injury and is now in a vegetative state after her school nurse in Lakeville, Minnesota didn't treat her asthma. In a lawsuit filed on Thursday, the family's attorneys say the nurse at McGuire Middle School failed to properly evaluate her and sent her to gym class where she lost consciousness and had to be taken to the hospital. Now, they say she will require caretaking services for the rest of her life. Leading up to the date of her medical emergency, the family says their daughter Aaliyah had a long history of asthma with severe exacerbations that required medical intervention. The school district and nurse were aware of the severity of her condition, according to the lawsuit. https://www.fox5ny.com/news/family-minnesota-girl-in-vegetative-state-after-school-nurse-failed-to-treat-her-asthma
  14. Katillac

    Aide Documentation - Rationale?

    I'm not technically tasked with the role, but to protect myself and the organization I feel I need to, as this aide's supervisor at times, direct the aide away from inappropriate charting. I say protect myself because the aide often charts details that are very different from what the nurses are charting about the same interventions. Unfortunately, due to the EHR we use, the aides often don't have appropriate check boxes and data fields to use. The PTB tell them "Just check off what you do and fill in the blanks", but depending on how the case manager has set up the care plan, the aide may or may not have anything to check. So maybe the answer is to just tell the aide not to chart on what the nurses do and when the PTB get around to auditing and giving feedback they will correct what they want to, but I won't be at risk in the meantime. Thanks for helping me work it through!!
  15. If you don't have a prescription for what they found, it's a failed test. It doesn't matter why. Some employers report to the BON, it doesn't appear to be consistent even by state. If you got notified you failed, they already confirmed it positive. If they report to the BON, they may or may not take action, it depends on the state and other factors. I wouldn't reapply for this position, it's poking the bear as far as I'm concerned. I would surely talk to a lawyer. It may be that steps you take now will affect your future. You don't say what state you're in; following is a link about Florida. Also check out the allnurses board Nurses/Recovery https://www.joneshealthlaw.com/failed-pre-employment-drug-test-for-nursing-position/

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