TechieNurse

Hi Everyone Brigham nurse here, I thought I'd comment on a few things. Brigham is one of the best paying facilities in Boston. In my opinion, the decision to strike had nothing to do with pay. I think it centered on a few points: 1) removing charge nurses from the union by calling them managers (related to a recent NLRB decision). 2) not assigning newly licensed nurses (licensed Massnurses.org will have more details. We vote on whether to accept the new agreement on Dec. 12.

per wikepedia: the arm of the condemned is swabbed with alcohol before the needle is inserted. along with its antiseptic use, the alcohol also causes the blood vessels to rise to the skin's surface, making it easier to insert the needle. the needles and equipment used are also sterilized. one reason for this is because the needles are standard medical products that are sterilized during manufacturing. also, there is a chance that the prisoner could receive a stay of execution after the needles have been inserted as happened in the case of james autry in october 1983 (he was executed eventually on 14 march 1984). finally, it would also be a hazard for those handling unsterile equipment.

Hi Everyone, In Boston, in a union hospital (under our current contract), new grads. start at $26/hr Remember though, it is EXPENSIVE to live in the Boston area (where studio apartments start around $1,200/month) As part of our benefits though , our union has sucessfully negotiated a pension plan! Sweet!

Hi Pam Housing costs here are going to scare you. :chair: A lot of people live in N.H. and commute to northern Ma. or Boston They don't call it 'TAX - achusetts' for nothing! Long commutes are the norm here, with the average being 50 min. one way. Most of the Boston hospitals are unionized and the pay is tops. You should have no trouble finding a job around here. Most of the hospitals in the state have a good (if not great) reputation. Do a little digging before accepting any position and you'll be fine. Good Luck and Welcome to Massachusetts!:welcome:

ok, i have to comment on the turn the discussion is taking... do you see what's happening here? initially, the discussion focused on what a great thing organ/tissue donation is, how it saves lives yadda, yadda, yadda. now, it's turned to making judgement calls: would you want 'tainted organs' (from convitcted felons) and how we feel about drug abusers or suicide attempters getting organs.... don't you see? it's a slippery slope! where do you draw the line? who gets to make ethical, moral and value judgements and why? was it right for the illegal immigrant child a few years back to get a heart/lung before an american citizen? if someone overdoses on tylenol (thus destroying their liver), do they "deserve" a new one over an alcoholic? what about the case of the sheik in california that paid to be bumped up the list (non us citizen) ~ which is bad enough ~ but also the hospital employees that forged documentation and indicated that someone else actually got the organ, thus removing the sicker patients eligibility! (http://www.latimes.com/news/local/la...home-headlines hospital halts organ program * st. vincent center in l.a. says a patient, 52nd on liver transplant list, got improper priority and the action was covered up.) any system where human intervention is required is inherently flawed. just like the u.s. justice system, the organ donor network attempts to be fair, but sometimes the 'guilty' go free (they get multiple organs/chances) and the 'innocent' suffer (they die while waiting for an organ). so, i'm sorry to say that i just don't have enough faith in the goodness of humanity to always do the right thing, especially when we have documentation (newspapers, legal pleadings, first hand accounts) that underscore that this is a system rife with problems...

i think as nurses, we are, in general optimists and tend to view issues like this as black or white, not realizing - or wanting to acknowledge - all the shades of gray and the 'dark side' of this issue... while directed donation (among family/friends) seems to be ok, general organ donation to an organ bank has it's issues. any process with human involvement is subject to human error. what comes to mind is: > donations made with incompatible tissue types, complicating the already compromised patient and perhaps hastening their demise. > in my area, we had donations made from a patient who died of an glioblastoma, with most of the recipients now diagnosed with the same type of cancer, some have already died from it. ***(when i posted previously, i had links to these stories, but now they're old and gone, sorry) the hospital knew about the donor, but did not inform the recipients or families. a quote from the doctors mentioned in the article (speaking to one of the recipients): "'the donor we got your organ from -- he was dying of brain cancer. so, we are 90 percent positive that your liver has cancer, too,'" and (from one of the recipients families) "i kept on questioning the doctors why weren't we told and one of the comments was 'livers don't come on silver platters' and 'there are a lot of people waiting for livers,'" there is a mistrust of doctors and hospitals. i recently read a news article that cited a study in the feb. 2002 journal medical care that echoes that... this may be a contributing factor as to why organ donation is not more popular in the u.s. > the family of a teenaged boy in a golf cart crash, donated his organs, however, none of the organs were used. his body was used for practice of harvesting different tissues (eyes, bones etc.). the family was not told that his organs were not usable, although the organ bank knew it before they asked the family due to the medications given to him in the er, and once they agreed to donate his organs, they had no way to stop the dissection. the family is suing because: a) the organ bank misrepresented what happened, saying his corneas were tranplanted when they were not b) all of his organs and tissues were harvested, even though the organ bank knew that they couldn't use any of them , then destroyed them without the family's knowlege in my career, i worked closely with a nurse who was responsible for organ procurement. she told me that i was naive to think that the most worthy (i.e. sickest) patients always got available organs first. she said sometimes, they like to 'bump' high profile cases as a way to bring positive publicity to the cause. with the feeling that they are hurting few (those with a higher priority) but helping many (other people who would die without increased awareness and donation). i'm not in favor of bending the rules to further the cause. if the cause were just and un-impeachable, it wouldn't need good publicity... lastly, there is the bureacracy: there are differences in waiting times on the unos list in various geographic locations; there is a lack of transparency in the system; if you have the money you can register in several different regions (thus potentially decreasing your wait time); the fees charged by unos, even to be registered on the waiting list are outrageous. now they are charging new fees to find living donors, unos/opo protocals don't provide fully informed consent to the families of prospective cadaveric donor families; unos and the opo don't inform the public the organs are not donated but sold by unos. in summary, the concept of organ donation seems altruistic, but in practice, like everything else humans do, it's not that simple, easy or fair....

"...I LIKE the smell of perfumes..." One more comment: So...if everyone liked the smell of your perfume Jerico, they'd only be that particular brand on the market, right? I agree, sensitivity is relative, but so is the amount of perfume to wear...there is no way that everyone could agree on what is 'moderate'. There is also the consideration of perfume type...florals are usually 'light', a person can get away with wearing more. Musks and woodsy scents are 'heavy' and a little goes a long way. Overall, isn't it just simpler to forego perfume/cologne at work out of concern for patients & to avoid hearing complaints?

GR8RNPJT, could she have singled you and the other woman out because you and the other woman wore scents that bothered her and everyone else in the office that wore perfume/colonge that didn't bother her? My experience is that not ALL perfume/cologne trigger a response, it's the type (e.g. Channel) and/or the amount worn.

gr8rnpjt ~ not being confrontational here, but I have to ask you this: Even though you were a perfume that you think works well with your body chemistry and that you have received a number of compliments on, why wouldn't you refrain from wearing it at work if someone was telling you that it bothered them? Wouldn't that have been an easier solution then avoiding stairwells and bathrooms near her? If she continued to hound you, you would know that it had nothing to do with your fragrance and had everything to do with the 'alpha female thing'....

my 2 cents: i suffer from migraines and certain scents can be the trigger. i may even like the scent, but there's something in it that causes the reaction; my stomach rolls, my head explodes. we have a 'no scent' policy at my hospital, but it's nearly impossible to exclude all scents from your household: deodorant, hair spray, soap, shampoo/conditioner, laundry detergent, fabric softener, dryer sheets etc. if i tell someone that they're causing me a reaction, i have a right to refuse them to enter my room & treat me. i would find it insulting if i refused someone entering my room based on their 'loud perfume' and my perceived reaction to it (asthma attack) and i was offerend an ativan. i might even refuse that nurse if my perception was that she was unconcerned with my issue i find it supremely interesting that some people here are attributing 'sensitivity' to 'being all in your head' and it is perceived that women have a higher incidence of these 'sensitivities' and women are the ones who most often have to fight against the labels of 'hypochondria' or 'dramatic'.

http://www.thebostonchannel.com/health/5029562/detail.html?treets=bos&tml=bos_health&ts=T&tmi=bos_health_1_12150309282005

hi missboo, good luck on your paper! i thought i'd give you my 2 cents worth, i fully expect to be flamed regarding this viewpoint, but, i thought i'd share it anyway.... just because we have technology doesn't mean we should always use it. for example, just because we know how to clone, doesn't mean we should be doing it. with that being said, i am not in favor of organ donation. while directed donation (among family/friends) seems to be ok, general organ donation to an organ bank has it's issues. any process with human involvement is subject to human error. what comes to mind is: donations made with incompatible tissue types, complicating the already compromised patient and perhaps hastening their demise. donations made from a patient who died of an glioblastoma, with most of the recipients now diagnosed with the same type of cancer, some have already died from it. (http://www.seacoastonline.com/news/02052005/south_of/63075.htm) donations made from the family of a teenaged boy, however, none of the organs were used. his body was used for practice of harvesting different tissues (eyes, bones etc.). the family was not told that his organs were not usable, although the organ bank knew it before they asked the family due to the medications given to him in the er, and once they agreed to donate his organs, they had no way to stop the dissection. (i can't find a link to this story right now, but i'm looking and will provide for interested persons, meanwhile, i did find this:(http://pressherald.mainetoday.com/specialrpts/braindonors/050130brain.shtml) in my career, i worked closely with a nurse who was responsible for organ procurement. she told me that i was naive to think that the most worthy (i.e. sickest) patients always got available organs first. she said sometimes, they like to 'bump' high profile cases as a way to bring positive publicity to the cause. with the feeling that they are hurting few (those with a higher priority) but helping many (other people who would die without increased awareness and donation). lastly, there is the bureacracy: there are differences in waiting times on the unos list in various geographic locations; there is a lack of transparency in the system; if you have the money you can register in several different regions (thus potentially decreasing your wait time); the fees charged by unos, even to be registered on the waiting list are outrageous. now they are charging new fees to find living donors, unos/opo protocals don't provide fully informed consent to the families of prospective cadaveric donor families; unos and the opo don't inform the public the organs are not donated but sold by unos. jmho....

Hi Kelly911, I have some practical suggestions, some tried and true, some just ideas: At a team meeting, or call a meeting, attach a piece of paper to everyone's back, give everyone the same color crayon and spend 10 min. having people writing something nice on the backs of people. Read some out loud. guess who belongs to which baby picture (self explanatory) pot luck days/nights, alternate with themes (i.e. mexican, your specialty etc.). Or have a routine of ordering out from a new place every Friday or something. celebrate birthdays once a month with cake/ice cream. Also, celebrate new homes, babies prn secret santa/holiday gifts. (This helps people get to know each other by finding out what they might like for a gift) get a pin/small ribbon/button (your choice of design) and put it on your bulletin board with instructions that staff are encouraged to give this pin to someone to wear for the remainder of the shift in appreciation for something special they've done. You'll be surprised at how people will start extending themselves to get that pin. You may want to pick up spare pins as some people forget to take it off after their shift... at a team meeting or an after hours get-together, have everyone bring in one trivia question, either about themselves or someone else in the department. Put questions in a hat/bag. Read the questions and have others try to guess who it relates too. We had some with multiple answers, like 'who has a tattoo?' or 'who bought a new car within the last year' That's all I can think of right now. Hope it helps. Keep us posted on how it's going! Linda

quoting from: http://content.nejm.org/cgi/content/full/352/24/2471 new england j. of medicine volume 352:2471-2473 june 16, 2005 number 24 "...as mahatma gandhi said, "in matters of conscience, the law of majority has no place," acts of conscience are usually accompanied by a willingness to pay some price. martin luther king, jr., argued, "an individual who breaks a law that conscience tells him is unjust, and who willingly accepts the penalty of imprisonment in order to arouse the conscience of the community over its injustice, is in reality expressing the highest respect for law." what differentiates the latest round of battles about conscience clauses from those fought by gandhi and king is the claim of entitlement to what newspaper columnist ellen goodman has called "conscience without consequence." and of course, the professionals involved seek to protect only themselves from the consequences of their actions-not their patients. one is the emerging norm of patient autonomy, which has contributed to the erosion of the professional stature of medicine. insofar as they are reduced to mere purveyors of medical technology, doctors no longer have extraordinary privileges, and so their notions of extraordinary duty-house calls, midnight duties, and charity care-deteriorate as well. in addition, an emphasis on mutual responsibilities has been gradually supplanted by an emphasis on individual rights. with autonomy and rights as the preeminent social values comes a devaluing of relationships and a diminution of the difference between our personal lives and our professional duties. for health care professionals, the question becomes: what does it mean to be a professional in the united states? does professionalism include the rather old-fashioned notion of putting others before oneself? should professionals avoid exploiting their positions to pursue an agenda separate from that of their profession? and perhaps most crucial, to what extent do professionals have a collective duty to ensure that their profession provides nondiscriminatory access to all professional services? some health care providers would counter that they distinguish between medical care and nonmedical care that uses medical services. in this way, they justify their willingness to bind the wounds of the criminal before sending him back to the street or to set the bones of a battering husband that were broken when he struck his wife. birth control, abortion, and in vitro fertilization, they say, are lifestyle choices, not treatments for diseases. and it is here that licensing systems complicate the equation: such a claim would be easier to make if the states did not give these professionals the exclusive right to offer such services. by granting a monopoly, they turn the profession into a kind of public utility, obligated to provide service to all who seek it. claiming an unfettered right to personal autonomy while holding monopolistic control over a public good constitutes an abuse of the public trust-all the worse if it is not in fact a personal act of conscience but, rather, an attempt at cultural conquest. accepting a collective obligation does not mean that all members of the profession are forced to violate their own consciences. it does, however, necessitate ensuring that a genuine system for counseling and referring patients is in place, so that every patient can act according to his or her own conscience just as readily as the professional can." so, believe whatever you want, but don't deny care (or at least a referral)

First, let me say that my heart goes out to you nursejoey. What a terrible thing to happen while you're trying to support your husband, go to school and raise a family! Second, there are some valid reasons that patients get 'fired' that have been previously posted (non-compliance with treatments, drug seeking behavior etc.). But I'm here to give you other, not so valid reasons... Having worked in and around the insurance industry for years, I can tell you that patients get fired for financial and legal issues. I've seen physicians fire patients when they're nearing their insurance cap (by their own estimates) knowing that they won't be able to get reimbursed over Medicare/Medicaid rates once that caps reached. I've also seen it happen when physicians try experimental/unproven treatments, procedures +/or medications to avoid a lawsuit. For example, they have their patients try a new drug (or more commonly, off label use of an existing drug), usually being vague about the newness, potential side effects, efficacy etc., then they later find out about side effects or complications of the drug. Instead of working with the patient, they 'fire' them (usually citing non-compliance) to avoid being sued. Lastly, as in your case nursejoey, I've seen some cowardly physicians fire patients who are terminal either because they can't stand losing a patient or, more likely they are afraid for their reputation. Of course, the situations described above are unethical, but I'm sad to say that I've seen it happen...