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steven007

steven007

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steven007's Latest Activity

  1. This has already happened in America! https://www.statesman.com/article/20130210/NEWS/302109767 The theme is concerning for sure and I think nurses internationally need to take notice and speak up about this kind of thing.
  2. Just over a year ago, in April of 2018, RN Carolyn Strom lost her court appeal contesting disciplinary action that was taken by her regulatory body (the Saskatchewan Registered Nurses Association “SRNA”) for a comment she posted on Facebook about the care her dying grandfather received in a hospital. Strom’s Facebook post read as follows: “My Grandfather spent a week in “Palliative Care” before he died and after hearing about his and my family’s experience there (@ St. Joseph’s Health Facility in Macklin, SK) it is evident that Not Everyone is “up to speed” on how to approach end of life care ... Or how to help maintain an Ageing Senior’s Dignity (among other things!) So ... I challenge the people involved in decision making with that facility, to please get All Your Staff a refresher on the topic AND More. Don’t get me wrong, “some” people have provided excellent care so I thank you so very much for YOUR efforts, but to those who made Grandpa’s last years less than desirable, Please Do Better Next Time! My Grandmother has chosen to stay in your facility, so here is your chance to treat her “like you would want your own family member to be treated”. That’s All I Ask! And a caution to anyone that has loved ones at the facility mentioned above: keep an eye on things and report anything you Do Not Like! That’s the only way to get some things to change. (I’m glad the column reference below surfaced, because it has given me a way to segway into this topic.) The fact that I have to ask people, who work in health care, to take a step back and be more compassionate, saddens me more than you know” While Strom was not employed by the facility and was, in fact, not practicing nursing at all (she was on maternity leave), the nurses at the care facility took notice to these comments and filed a formal complaint against Strom with the SRNA. The SRNA launched an investigation and found Strom guilty of professional misconduct, namely that Strom engaged in “conduct that is contrary to the best interests of the public or nurses or tends to harm the standing of the profession of nursing” and “not following the proper channels”. Strom appealed this decision to the Court of Queen’s Bench for Saskatchewan where Currie, J. upheld the administrative decision of the SRNA. In his judgement, Currie, J. holds that the judgement by the SRNA was “reasonable” and ordered Strom to pay the costs of the investigation, as well as a disciplinary penalty totaling $26,000 CAD. It is likely that Strom will appeal this decision; however, as it stands now, this rests as valid case law and sets a precedent for nurses to be charged and disciplined for “off-duty” misconducts. Removing our Constitutional Rights to Freedom of Speech The precedent set in this case permits a regulatory body (such as a BON) to limit one’s constitutional right to freedom of expression. In his judgement, Currie, J. acknowledges that this was a breach of Strom’s constitutional rights to freedom of expression, but holds that, so long as a regulatory body “proportionately balanced the right to freedom of expression with the objectives of the [Nursing Act], in the context of Ms. Strom’s circumstances”, it is acceptable to limit freedom of expression. Currie, J. goes on to state that “The [SRNA’s] balancing of the rights and objectives is not required to be correct. It is required to be reasonable.” So what makes it reasonable? Currie, J. holds that the decision was reasonable because Ms. Strom was granted other avenues of expression, namely, she was able to report the nurses providing inadequate care to the SRNA or the hospital administration. This is in fact what is recommended in the code put forth by the SRNA. Omitting Pivotal Case Law While Currie, J. holds that Ms. Strom was able to express herself in other avenues, he ignores holdings from previous case law where the form of expression (or the avenue chosen for expression) can only be limited if the location or method of expression removes the protection of freedom of expression (see: Montréal (City) v. 2952-1366 Québec Inc., [2005] 3 S.C.R. 141;). While Currie, J. and the SRNA holds that Ms. Strom should have followed the methods outlined in the Code, Currie, J. and the SRNA did not apply the test as outlined in the case of Montreal v 2952-1366, where the method or location of expression can only be limited if it conflicts with one of the three values of freedom of expression (i.e. Self-fulfillment, truth-finding and/or democratic discourse). Currie, J. and the SRNA omitting this vital aspect of freedom of expression analysis has paved the way for bad precedent. Therefore, Currie, J. did not address whether the SRNA could in fact limit one's freedom of expression by law, as this step of the analysis was overlooked. Implications We now have this precedent standing that will for sure give a carte blanche to regulatory bodies to arbitrarily discipline their members for expressing anything that the regulatory body opposes. This will only hamper the ability of professionals (the ones arguably best suited to advocate for change in a system they are fluent in) to advocate for change and to speak out against bad public policy and other ill-doings, for risk of being reprimanded by their regulatory bodies.
  3. steven007

    Aspen University

    I had looked into Aspen a little while ago for their masters program. They were one of the only schools in North America I found that offered a masters with a forensic specialty in nursing. Additionally, they were the ONLY school in the USA I could find that would accept my Canadian nursing license and not make me register my license in the USA (I did my license before Canada adopted the NCLEX, so I would have to re-write which was a no no for me). The reviews are generally positive from students. I am not really sure how well recieved a degree from Aspen is. In Canada, if you are a nurse with a masters, it is generally expected that you have done it at some offshore US or Australian school online and no one really cares about the quality or reputation of the school. They just care that you have the piece of paper that says you have a masters. I am not sure about how well received it would be in the USA and for a BSN (which would be your foundational degree to nursing practice, unlike a masters which is just supplementary and more a novelty for nurses, IMO). I ended up going to a Canadian school after all. It was cheaper but required more of a time investment than Aspen would have. I think in general it would be a good choice. They were helpful for me when I was on the fence about applying and they also have an enticing tuition payment program where you just make installment payments instead of paying the full amount in one lump sum. It is also accredited. Therefore, I think it would be a safe choice! My 2 cents.
  4. steven007

    Is Nursing Dangerous?

    I laughed so hard at this comment. I just pictured a hospital, with a bunch of nurses in old Western uniforms, dodging bullets and running down halls with guns. But on a serious note, I think the area of nursing you work will dictate the level of danger you are exposed to. I personally work in a forensic facility and have had staff stabbed with pens, punched, had their hair pulled out, hit with doors, beaten in the hall, etc. However, I understand the risks, I understand how to keep myself safe and I NEVER cut corners in terms of my own personal safety. This has worked fairly well for me thus far *knocks on wood*. Not to say that the staff that have had these horrific events are to blame, that is not at all true! But, just being aware of your surroundings can definitely help! And the employers tend to try their hardest to provide you with the resources and training you need to stay safe. Be sure to use all that they give you and pay attention to all of the training. That said, I have personally found less violent forms of nursing to be more traumatic. I remember my first code blue in ER. The patient past away and i had nightmares for weeks about my family members and friends dying and not being able to resuscitate them. 2BS Nurse talked about PTSD and I believe that is very real in nursing. But many nurses who don't feel like these areas are good fits will move on to other areas such as public health nursing, policy or management nursing. I think the question you need to ask yourself is, do you want to be a nurse? Because chances are, if you want to be a nurse and you are passionate about a specific area of nursing, you will learn to mitigate the risks and practice smartly and safely. If you completely avoid nursing because it is so "dangerous" I find it hard to believe that you were ever serious about nursing to begin with. Not to be condescending or rude, I say this empathetically and with great understanding. There are many things I have done that are super dagnerous. Sky diving for example, cliff jumping, speeding down the highway doing 120 for example. I understood that these things were dangerous. But the danger did not outweigh the fact that I WANTED to do them. I was passionate about it and I did it, despite the risks. So ask yourself, are any of the potential risks worth you wanting to do nursing? Or is nursing just a pasing phase? If so, that is no problem. Nursing is not for everyone and I hope, regardless of what you decide, you are happy with what you chose :).
  5. steven007

    Nurse doing JD: Advice

    Hi everyone! So, I am reaching out to my fellow nursing brethren for advice, as I feel this topic is best addressed by them. So I have recently been accepted and confirmed my acceptance to a JD (Juris Doctor or Law Degree) program. What I want to do with this is irrelevant to my question, so I will spare you the details on that. But what I want to share is my attempts to land employment. This law school is located 16 hours from my current city and located very remotely, with not a lot of surrounding cities. It is a metropolitan city, but the fact is it is metropolitan in the midst of desolate nothingness. I currently have a really nice, full time job as a nurse manager in a large hospital. I don't want to give this up, move to this city and hope to find employment; because, I am paying cash for this degree. I already still have student loans from my BSN and MSN that I am paying off, I don't want to incur more debt from this JD. I can afford to pay cash for it (with working my butt off and a little help from my parents) and that's what I want to do. So I can't just make a rash decision to quit my job, move there and hope to land a job. I have looked in the area and, while there are TONS of nursing jobs, there are little to no jobs in my clinical area of expertise (psychiatry). But there are various other positions, such as med surg, ICU, ER, float, etc. I have applied for 2 positions as the two hospitals in the area. But I feel like I have maybe jumped the gun. I want to be judicious in my applications for employment because I don't want to be denied because of my location or my not having relocated yet, but I also don't want to put myself in a position where I need to apply for a job as soon as I arrive and hope to god I find something before the school year starts. I have given notice for my home (I rent thankfully) and am moving into my RV within the months to save some extra money and give me a little more freedom should I be offered some form of employment in my area. But I am also worried about indicating that I am going to law school. I don't want my future employer to think "he's not going to have any time for us being a law student". Because the truth of the matter is, I have no choice but to make time for the employer, I am not living off of student loans. This I can clearly explain to them but they have to call and be interested in me first. I considered not indicating that I am going to law school but then it makes it look weird and abnormal (why someone would wanna move there from where I currently live, with the type of job I currently have for the type of job I would be applying for). In my cover letter I explain that I will be relocating to do the law degree and that I am planning to relocate in August but willing to sooner on finding employment. SO my questions to you are: 1) My desired time for relocation is in August. Is it too early now (end of April) to be applying for jobs? 2) Should I be indicating that I am a future law student? Or should I indicate something about further my academic career or something more vague? 3) Should I include anything else in my cover letter? Like that I am motivated/needing to work part time and not just planning to work 1 shift here and there? 4) Any other suggestions you would give to me finding employment? Perhaps I should have put this under a nursing career post. Not sure though, its been a long time since I used this site. But I am feeling kind of isolated/alone during this process. its really hard and scary going from one profession/career to another, and being one of very few people who make this transition. So it is really comforting to reach out to fellow nurses for advice :)! Thank you in advance
  6. steven007

    Redefining "Abuse"

    Hi Invitale, Thanks for your feedback. I wish to address one thing first; unfortunately current research on respite care isn't so promising in terms of enhancing caregiver outcomes . I am not sure which research you are referring to, but I have read a few recent studies and they really didn't show any qualitative or quantitative results that were statistically significant in terms of positive outcomes for caregivers. I feel like any positive outcomes from respite care is the result of placebo effect. Healthcare providers view respite care as a godsend and this transcends onto users of respite care. Thus, because healthcare professionals recommend and praise it, patients and caregivers see only good that can come for it. And I feel your analysis of the term abuse is very cold, unforgiving and not compassionate. For someone who seems to be heavily advocating compassion, it does not reflect in your use of the term abuse. In fact, your entire comment seems kind of vitriolic. And I am not sure the moral of your comment in the first place? So... what, a caregiver being physically and verbally abused by a demented parent or spouse should suck it up and remain compassionate? Let the spouse or parent continue to violently beat them but the minute that this caregiver does not show compassionate, they are an "over-worked monster"? Also, you're focusing too heavily on dementia. Dementia does not always equate abuse. Some people are just nasty people, whether mentally cognizant or not.
  7. steven007

    Redefining "Abuse"

    Hey heron, These are great questions you've posed! And I wish I could give you an answer to them, but unfortunately I can't. I wish to raise awareness. The first part of addressing a problem is recognizing it and I feel that the abuse some caregivers received is not recognized. I would be interested in hearing other people's ideas regarding these questions though! Thanks for all your comments!
  8. steven007

    Redefining "Abuse"

    Hi CapeCodMermaid, Actually, intent is not a requirement for abuse outside of legal situations. The only time intent matters is if you take an abuse case to court, the courts must prove "criminal intent" or "intent of harm". All of the terms used in this article are the current standard terms applied to abuse from various sources including the Merriam Webster Dictionary. Also, the article isn't only about people with dementia (and dementia doesn't always equate abuse!) but also those who are cognizant of what they are doing. I suggest you read the article more thoroughly :). Thanks for your interest and reading nonetheless!
  9. steven007

    Redefining "Abuse"

    Abuse, within the context of geriatrics and especially long-term care, is a well-documented global phenomenon. Geriatric citizens are already a marginalized and oppressed demographic, so it's not surprising that abuse is interwoven throughout the lives of these individuals. There is a plethora of research available documenting this phenomenon and suggesting and identifying key contributing factors within the context of caregiver abuse towards individuals. However, what is surprising is the lack of research and attention on elder abuse of family and caregivers themselves. Before moving forward, it is important to have a clear understanding of what defines "abuse". The term abuse is used quite frequently when dealing with geriatric clients, especially in a healthcare setting. However, it is unclear as to whether or not the individuals using this term have a very clear understanding of what defines abuse. The Merriam Webster dictionary outlines five definitions of the word abuse. These include: "1) a corrupt practice or custom, 2) improper or excessive use or treatment, 3) a deceitful act, 4) language that condemns or vilifies usually unjustly, intemperately and angrily and 5) physical maltreatment". When people think of abuse, they generally think of physical violence; however, this is the 5th definition of abuse, according to Merriam Webster. So it is clear that abuse is more dynamic and complex than simply "violence". In terms of geriatrics and "elder abuse", The Ontario Network for the Prevention of Elder Abuse uses the WHO's definition, defining elder abuse as a "single or repeated acts, or lack of appropriate action, occurring within a relationship where there is an expectation of trust, which causes harm or distress to an older person." Considering these definitions, one can see the complexity in the term "Abuse". The Ontario Network for Prevention of Elder Abuse also outlines numerous types of abuse, from physical to sexual and financial. However, when examining the numerous definitions and examples of abuse collectively, an overlying group of themes can be seen and thus help paint a complete picture of what really constitutes "Abuse". Using these themes to create a holistic and comprising definition of abuse would give a similar definition to this; "subjective or objective representation of mistreatment (whether verbal, physical or sexual in nature) causing an individual physical, emotional and/or moral distress and discomfort and creating unhealthy relationships between abuser and abused". The term abuse and the idea of abuse itself need to be redefined to be more including of, not only elders, but of those caring for elders. Elders are generally viewed as ones whom which are enduring abuse and never the ones of who inflict the abuse. However, this is not always the case; therefore, it is important to approach the topic of abuse with an open mind and understanding and to not immediately assume the "stereotypical" scenarios. Many times it is the caregiver who suffers, not only abuse, but also emotional and sometimes financial distress, as they are placed in a situation in which they must not only care for, but also support their loved ones. The National Initiative for Care of the Elderly (or NICE) have created a caregiver abuse screening tool for use by healthcare personnel to screen for possible elder abuse; however, there is no initiative in place to screen for the opposite. Furthermore, physical aggression and violence is all too common against those caring for individuals suffering dementia. Dementia is becoming a common diagnosis amongst the elder population, especially those individuals older than 80 years of age (Lobo, et al., 2000) and is becoming a specialist area, requiring added skills and knowledge. The introduction of the Gentle Persuasive Approach (GPA), which is becoming a mandatory course for most caregivers caring for the aged in both institutions and in community, has proven that fact. Though GPA can improved how we care for those suffering dementia and can provide solutions to mitigate common aggressive and non-aggressive dementia behaviours, it does not completely solved the physical (and verbal) violence that can present in some demented people. It is unrealistic to assume that the abusive behaviour associated with certain individuals suffering dementia can be completely solved or "cured" (unless of course a cure for dementia is found!) but recognition of this phenomenon and its significance to caregivers should be considered. That's not to say that support does not exist for caregivers struggling with violent behaviour, but there seems to be insufficient recognition of the psychological and physical impact this has on all caregivers. Respite care is something commonly offered to those caregivers caring for loved ones in the home setting, especially when caregiver "burnout" is suspected. However, this is only a short term solution for a long term problem. Respite care may provide a day (or days) free from abuse and stress, however, the psychological and physical impact will remain and eventually become further exacerbated when respite care ends. Respite care also does not acknowledge the root causes of caregiver "burnout" and is really only a band-aid solution. That said, dementia is not a necessary prerequisite for physical and verbal abuse of family and caregivers. Sometimes, elders may exhibit abuse towards family and caregivers despite being fully competent and cognizant of their actions. The reasons for this are many and vary; for example, it may be that they wish to maintain control of their situation, internally acknowledging their reliance on the caregiver for basic activities and being resentful. These individuals may also be resentful in general of their aging and declining health. Or, it may just be as simple as it is who they are. Not everyone is kind and caring! Furthermore, abuse can stem from the individual utilizing and controlling the caregiver's finances. Sometimes, these individuals have little to no life savings and rely on a family member (who may be their caregiver) in order to provide for them financially. Sometimes, these individuals may take advantage and control the finances of their caregivers. This is sometimes dependent on the caregiver enabling the individual, but it can quickly spiral out of control. There is much progress to be made in the area of defining abuse, identifying abuse and understanding abuse. However, the current trend in abuse, within the context of geriatrics, seems to be placing too much emphasis on elders and their being abused, and neglecting the possibility that it is they who is the abuser. This can be detrimental for healthcare personnel, as they may miss the opportunity to screen and identify caregivers who are being abused. It is already known that abuse can lead to feelings of oppression, isolation and distress; therefore, it is vital that we identify these issues and intervene appropriately. The best way to do this, may be to redefine abuse and how we look at abuse in the healthcare community. Though redefining abuse will not solve all of the problems that exist in terms of geriatric and elder care, it may provide a means to better understand, acknowledge and accept the problems that exist within the care of elders. References Lobo, A., Laurner, L., Fratiglioni, L., Anderson, K., Carlo, A., Breteler, M., . . . Hofman, A. (2000). Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology,54(11). Merriam-Webster Dictionary (n.d.). Retrieved March 24, 2015, from Abuse | Definition of abuse by Merriam-Webster Nicenet - National Initiative for the Care of the Elderly. (n.d.). Retrieved March 24, 2015, from Nicenet - National Initiative for the Care of the Elderly ElderAbuseOntario.com. (n.d.). Retrieved March 25, 2015, fromElderAbuseOntario.com
  10. steven007

    How to properly wash & disinfect scrubs??!

    Yeah, it sounded weird to me at first too! But it turns out MRSA and VRE are sensitive to it,.which are the bacteria that concern me the most. It's also cheap and readily available. It's good for stains totoo!
  11. steven007

    How to properly wash & disinfect scrubs??!

    I am surprised with some of the comments. This is a topic I am very passionate about, and have considered studying further (currently doing Graduate work in clinical infectious diseases) I personally use 1/2 cup pine sol with laundry detergent and colour safe bleach. There's a plethora of studies on how filthy and bacteria ridden your clothes are after washing AND drying. In fact, there are even a couple of news reports on this! A study in the UK found that there is, on average, about 0.1 g of fecal matter on every item of clothes after it has been washed. And that was studying the average household, I imagine this would be augmented in health care workers who are exposed to much more fecal matter on a daily basis. And really, use common sense. In the hospital, to disinfect and sanitize materials, they need to be autocalved. Autoclaves reach temperatures of 121 degrees celsius, with humidity and pressure!!! The average dryer reaches temps of around 50 - 100 C (depending on how expensive, new and "high tech" your dryer is), which is generally insufficient to kill spores (mind you, new dryers and washers are now having options for steam clean and "sanatize" which would be sufficient to denature spores). So no, "Tide" is not enough to clean your scrubs. And I am really surprised at the ignorance of some of these fellow health care workers. No wonder hospital acquired infections are so prevalent in our society today!
  12. steven007

    What She Couldn't Tell You

    If you were a nurse in Canada than you just wrote a complete post about your professional negligence. At any time domestic violence is suspected and a child is involved, it is the MDs, RNs, NPs, RPNs and/or LPNs DUTY to report this to child services and authorities. Failure to do so can result in a loss of license. And I may be missing something because everyone seems to see things for your perspective but all I am seeing from this post is a nurse judging a woman she knows absolutely nothing about. You do not know her circumstances or the context that this is happening in. Maybe she has no one else? Maybe she has no money? Maybe she has to make the decision to stay and risk being beaten or live on the street with her child, unable to feed him/her? I am slightly disturbed by the amount of judgement and hatred I feel when reading this towards a woman that already experiences so much hate. How about instead of hating and judging, you do what a nurse is suppose to and empathize and try to view things from her point of view.
  13. steven007

    Bachelors in Nursing to Masters in Psychology?

    Did you ever find the information you were looking for? I am interested in the same thing. I have my BSN and want to do MA in Clinical Psych. I contacted the graduate school for psychology and they said that I would have to redo a undergrad which is complete BS. I mean really, who does an undergrad in psych? It's the most useless undergrad of life. Anyway, so I was not impressed with that answer especially considering my mother did her BSN and MSN and then went right to a PhD in psychology without having to do another undergrad.
  14. steven007

    So I Have This Rash... What Do You Think?

    Hahaha donsterRN, I should try that next time! Hilarious!
  15. steven007

    So I Have This Rash... What Do You Think?

    Sorry, it's an article! I put it under the wrong type. But I fixed it :)!
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