steven007

Workers compensation rights aside, this nurse has a clear case of negligence against the hospital and this is the bigger fish to fry. The hospital administration implemented this new equipment without formally training the staff. The administration sent an e-mail detailing the efficacy of the equipment but ADMITTING that the staff did not have training. I do not have the full e-mail, but if the hospital did not explicitly state "DO NOT USE THIS EQUIPMENT UNLESS YOU HAVE RECEIVED TRAINING" and/or failed to make training available, the hospital is grossly negligent in this case. The hospital's risk management department must have done their math, clearly they felt that this nurse was more of a liability to keep than to just fire, because I am sure they realize that they are going to have to pay her out a settlement if and when she sues. They likely are anticipating a lawsuit but hoping that she does not sue and at the first moment she does sue, they will throw a settlement (likely half of what she would be entitled to should she go through a court case) and hope she settles out of convenience and desperation for an income of some sort, seeing as she is too injured to work and thus will not have the financial means to drag out a long court battle.

Hallo Mein Freund! So, disclaimer in advance, I am not an American nurse and can't really speak to the particulars of the type of nursing you do in the USA, BUT I hope to address your insecurities about not feeling like a "nurse" because you haven't done IVs and such in a long time. The type of area you work in currently is recognized as a specialty area of nursing (in Canada at least). The area here (Canada) is called Dual Diagnosis Psychiatric Mental Health Nursing (Dual diagnosis for short). Now, a quick look on google shows that this area exists as well in some states of the USA. So, you would technically be classified as a psychiatric nurse. Your skills are highly specialized to this area. You may not think this is psychiatric nursing, but believe me, this is psychiatric nursing. It is normal for you to feel "out of place" in an area such as ICU when you have practiced for the last many years in an area that is unrelated to ICU. But trust me, your skills are very useful, valid and important in this day and age with mental health getting more recognition. If you are considering changing to ICU and more acute care nursing, perhaps you can take a re-orientation course or a specality course that prepares you for this area of nursing. These exist in Canada and would almost bet they must exist in the USA (as the USA tends to have better educational initiatives for nurses). Hope this answers some of your questions and addresses some of your insecurities! ?

Thanks TriciaJ for the comments! And interesting to hear from a previous member of the SRNA!! I just wanted to correct you on one thing that I don't want people to be confused by, Canada DOES have a constitution. If we didn't, we wouldn't exist as a country (and my law school course load would be MUCH MUCH easier without the "Canadian Constitutional law" and "Advanced Constituitonal Law" courses hahaha). While some countries don't have a formal "constitution", such as the UK and New Zealand who has an "unwritten constitution" that exists only in case law and legal mores, Canada does have a written constitution that was founded in 1867 (termed the BNA Act). The Charter of Rights and Freedoms which you speak of is codified within the Canadian Constitution. It is an extension of the constitution and exists as a constitutional guarantee. And Rionoir is correct, Freedom of Speech extends beyond just "not going to jail". It means you are free to express your opinions without recourse by Government agencies. The SRNA is a government agency. But otherwise, yes, there may be social consequences to your speech and even employment consequences. But when your employer is part of the government, there can be no recourse (unless you are a public servant). Hope this clarifies and thanks again for your opinions :).

That is so interesting! Canadian courts have found that kind of thing to be unconstitutional. Any statute that talks about moral values or religion is not considered constitutional in Canada. Its so curious how two neighboring countries that share so much in common can be so different. I find that super fascinating, I would like to read one of these statutes!!

Yes, I wasn't necessarily referring to the sexually explicit material, I was referring to the discussion as a whole of how regulatory bodies have stated, in the USA, that your off duty conduct can merit discipline. The one that stood out the most, at least to me, was the nurse that pulled the gun on a random person who started to charge at her in a parking garage. She didn't fire or anything, and there were no charges laid, but she was called to answer to her conduct with her BON, for self defence! I agree that things like theft and other criminal activity would merit disciplinary action or pure revocation of your license, but these things such as acting in self-defence while off duty, or the case of the teacher who was disciplining her son, I think regulatory bodies go too far to dictate our conduct off duty. I think Hoosier_RN, MSN makes a good point, regulatory bodies are attempting to prescribe their own moral views on their members.

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.

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 SpeechThe 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 LawWhile 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. ImplicationsWe 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.

Great article! It really does touch an a huge issue in healthcare as a whole. The idea of huddles is great! The reality of huddles, not so much. Huddles should incorporate all members of the healthcare team, pharmacy and other allied health, nurses and physicians/NPs. The reality of the situation is there are too many units and too many hurdles for these pertinent people to attend, and therefore it ends up being nursing and physician heavy, with very few members of other significant professions (i.e. pharmacy, social work, etc.). Competing demands and the general lack of resources (hospitals are more frequently turning to fewer pharmacists and allied workers) makes allocating time for huddles impossible if these professionals are to get their primary duties done. The other issue with huddles is the lack of structure. Many times, huddles become toxic ranting parties that become more about venting and less about patient care. I think proposing a model for huddles and for effective communication strategies is absolutely pertinent in healthcare today, as well as proper allocation of resources. But it all comes down to money in the end.

I have to admit, as a nurse manager, I have done this before with candidates I have interviewed. At my hospital, we usually interview candidates with a couple of managers from different units (in the same general discipline, for me its psychiatry but I will have the manager for the, say, addictions unit interview with me as well). We will interview and if we like the candidate, we sometimes match the candidate with the unit they are best suited for based on their strengths in the interview and their previous work history. We won't refer them for a follow up interview, we will just tell the manage rof the unit "hey, we interviewed this person and we think they would be a good fit" and then hire them accordingly. But this is done when people don't really stress their desire to work in a SPECIFIC area. So, in the interview, if the person didn't stress "I really want to work in ADDICTIONS" or "I really want to work in adult mental health", then we generally just consider them available for whatever their area of expertise is. I would just reach out to the interviewers and stress your interest in working in that specific area, asking if they would have preferred to see any additional education or anything you could do to improve your chances of landing a position in that department. Don't take it personally. When we do this, we generally feel like we are doing someone a favor, matching their skills with a unit they would be most comfortable with. But not always! Sometimes people come forward and say "well, I would really have preferred to work here instead" and then we see what we can do to move them and apologize for the misunderstanding. I don't think it is malicious and I think they are doing it thinking they are being supportive. They probably just didn't realize that you really wanted to try something different! Reach out to them and see how it goes! Keep us posted!!

This is unrelated to your topic and I'm afraid I can't offer insight into the questions you are asking, but this is a question I have always wondered; what is the salary like in los angeles? And places like Silicon Valley? These are considered among the most expensive cities to live in and I would assume that they would have to stay competitive to keep nurses employed and fed in the area, so I am curious? Need nurses to keep those tech geniuses at google and youtube alive and healthy.

I agree and this is a very valid point! However, where I disagree is that it is actually a valid defense in court. Its called undue duress and has been argued quite successfully in cases here in Canada. If your employer places you under undue duress, you can absolutely get off the hook. I'm a law student and I volunteer for a nursing union to gain first-hand legal experience. I have used this argument before with great success, albeit with an arbitrator (not a judge). All the nurse has to prove is: 1. Others who spoke up were disciplined, reallocated or fired to the point where the culture was "just go with it" 2. They had extenuating circumstances that did not give them an option to leave (i.e. supporting a family, children, etc.). 3. They attempted to mediate the situation (i.e. by finding other employment). If those 3 factors are met, you have undue duress and a valid defense. Obviously, I don't know the whole story and I am sure some of the nurses involved likely wouldn't meet this defense and willingly participated in this nonsense. But I am sure, there is probably one poor soul, one inexperienced graduate nurse, that really felt that there was no other option. And for that person, my heart goes out to him/her.

I don't want to be the cynical one here, but I am having a hard time seeing how this really meaningfully impacts new nurses? Part of the issue is that I am a Canadian nurse, but Canada now uses the NCLEX as well. I have taught the nursing program and most of the students had no idea what the nursing process even was! The emphasis of the particular program I taught in was Henderson's theory. No attention was paid to ADPIE. Now, I am a strong proponent of ADPIE. I use it in my daily life. It is how I chart my end of shifts documentation notes, I use them as headings. But I don't think that it is the ONLY valid and applicable framework to use. Also, while I agree with most of what BrentRN, PhD says, I disagree in the emphasis on validation. The nursing process, while heavily used and discussed in the research, is not a "validated tool". There is no metric to validate. It is a subjective FRAMEWORK used for a subjective ASSESSMENT. It is by no means a valid scale that is measuring any meaningful data. There is really no research that I could find on the nursing process being any more effective than just using common sense. There is nothing about the nursing process that can be operationalized into a numeric scale that can be statistically tested. So the argument of validation is completely irrelevant. Furthermore, most senior nurses and even new nurses I ask don't even know what the nursing process is! They have no idea what ADPIE is. I think, at least in Canada, most schools just pick a nursing philosophy they like (i.e. henderson, oren, etc) and go with that. There is no real emphasis placed on using a framework. On that note, I do find the nursing process very intuitive. It is basically just common sense, you assess, diagnose, plan, implement and evaluate. It couldn't be any more straight forward! I think replacing it with a more convoluted theory/framework is counter-intuitive and unnecessary and serves no real purpose. If it isn't broken, don't fix it. I'm curious as to the rationale of why they are doing this now? Bearing in mind that times change, culture changes and society changes. I find that, at least in medicine and nursing, they try to find new ways to conceptualize old theories and it is just pointless and a waste of resources that would be better spent on theorizing on more meaningful and pertinent topics.

You remind me of when I first started nursing! haha The mistakes you are making are common sense mistakes. You are completely ignoring common sense and over-thinking every situation. This is almost certainly because you a) lack confidence and b) are still very inexperienced. The interactions you are having with your preceptor and not feeling welcome are only compounding your feelings of lack of confidence and insecurity which are perpetuating these types of errors. Fortunately, these errors will improve in time. As you gain more confidence you will become better at not making these small mistakes. However, it is really hard not to gain confidence when you have a hostile preceptor or work environment. Unfortunately, not much can be done about that except for you to ignore it, and try the best you can! If there is really a perceived conflict between you and your preceptor, I would address it head on. Pull him or her aside and address it there, in a non-judgemental, non-confrontational and open manner. Once you feel supported, I am sure you will see a huge reduction in these small mistakes. The other reality of the situation is, you are going to make mistakes regardless of how long you have been practicing nursing. Its just a given. Don't sweat it. Admit when you have made an error and ask for assistance when you are unsure. Don't let other people bring you down and always go in knowing you did the best you could! You will find you will improve with time!

This is ridiculous! "Now that they don't want any life saving measures, let's just off them so we don't have to waste a bed on them", is the thinking that comes to mind. And I am sure that this was supported by the hospital administrators. Sick. What I also find sick is how quick they were to fire and blame the RNs and RPNs/LPNs that administered the medication. I hope that these nurses sue the hospital, too. I am sure the ones that protested the high dose of medication were either let go, reallocated or disciplined for "insubordination", yet the ones that chose to give in to the pressure and administer as ordered and save their job to support themselves and their families are the ones to be reported to the BON and have their whole lives destroyed because of this angel of death? Its ridiculous. Not to perpetuate ideas of victimization, but nurses always seem to get the short end of the stick. Dammed if you do, dammed if you don't. These nurses that were let go should sue this hospital too for their blatant negligence and recklessness. The firing of staff was simply a PR tactic to make it look like they were taking this seriously and these fired staff were scapegoats in the tactic to save the reputation of the hospital. Its sick.

No problem! Just wanted to provide any info I can. Best of luck! It is a really interesting job!

When I was a high school student, I worked at a pharmacy that did the methadone program. As a nurse manager, I managed unit that had a methadone treatment program built-in. I would research methadone treatment, in terms of the pharmacology and use. But from a practical standpoint, how a methadone treatment program works is: 1. You prepare the methadone per order. You don't let the patient see the dose, they aren't generally privy to the dose they are getting. It is mixed with a high concentration/strong tasting base such as orange juice to mask the taste. It is supposed to remain confidential and unknown to the patient what dose they are getting (at least in Canada). 2. You administer the medication in full view. You ensure that they are swallowing it and not diverting it. You do a mouth check and generally make them wait 15 to 20 minutes before leaving, giving the meidcation enough time to be absorbed. Expert diverters will puke this stuff up afterwards to sell (and people buy it! Its disgusting!!!) 3. Liaise with the pharmacist and physician/nurse practitioner about how the patient is doing and any side effects. Monitor for withdrawl and you can use a validated withdrawl scale on the patient. Generally at your first point of contact with the patient at each treatment session you will be evaluating for signs and symptoms of withdrawl. 4. Health teach and assess to see if there is a change in their condition. This may signal a change in their response to the meidcation, a general change in their health or that they are still abusing other illict drugs. You need to be vigilant in ensuring that they are following the treatment regimen and not diverting or abusing other drugs on the side. That's all I can think of right now. Best of luck!

This is so unlikely. This is one incident. If it was happening a lot and always with controlled substances, then I would definitely worry and it would definitely raise suspicion. This is a one-off incident and I would assume and hope (as a nurse manager myself) that they understand. Also, don't be afraid of getting reported to the BON because of this. Reporting to the BON requires extensive resources and ground covering on the part of the employer. An employer cannot willy nilly report you to the BON unless they are ABSOLUTELY POSITIVE there is a cause of action. There is insufficient evidence from what you are saying to support a report of "med diversion". To report such a thing, the employer would need to prove a track record of continued incidents of medication discrepancies and/or obvious or suspected impairment while at work. They would need to back this up with documentation which would be achieved after meeting with you, your manager and an HR representative (and union rep if you are unionized). If you have never had a meeting with you manager and an HR representative to discuss concerns about your performance or your competence while at work, then reporting to the BON is the last thing you have to worry about. Instead, I would just invest my energy in learning from the incident and planning how you can prevent it from happening again. Also, if the system use is not intuitive, maybe discussion with your manager about how the system can be changed to be easier to use or more intuitive for nurses (this is unlikely to actually yield any changes, realistically, but it shows to your manager that you are being proactive. Just frame it in a way that is not confrontational and does not come off on trying to shfit the blame, i.e. I would say something like "This was totally my fault and I definetly will won't do it again, but I wonder if we changed blah blah blah, if this may prevent a similar error from happening to others in the future"). Relax, you will be fine! It sounds all positive thus far from the info you are saying about your supervisor!

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.

What did your assistant manager say about the situation? Chances are it was just a user error on your part. You say you scanned the patient and med, I am not sure what system you are using, but usually after you scan a medication you still need to sign it off as given, either with a pin code or some other computer intervention. But this is highly speculative, I don't know which system you are using and its intricacies. But I would suspect that the most likely cause is a simple user error on your part. In which case, don't freakout. I am sure it happens and I am sure you are not the first. It is always scary when these errors happen with a controlled medication, but don't freak out too much about it. My best suggestion would be to follow your institution's policy on a medication error. I know you administered the medication, but because of the error in transcribing it, I would write up an incident report or whichever type of reporting your facility uses, explaining the details of what happened "you got the med, you scanned the patient and the med and you administered the med" and the end result "the med is showing as not given". This will cover your basis. Again, relax. It's one discrepancy. You will be fine!

You are my doppelganger! I graduated nursing in 2013 and started in a career in med/surg, floating to other units such as emerg and ICU. I lasted roughly 3 months before I left (and I didn't leave on good terms). I accepted a position in LTC and I actually felt that it was manageable! I enjoyed LTC (believe it or not), it paid the bills and I lived a modest life. I began my masters and entered a management position at a large, mental health hospital. I love LOVED mental health! This was surprising because I hated it in undergrad, but something just clicked and I loved it and management! I would occasionally do some "real nursing" on the side, working casually in LTC and hospitals, but I felt like I needed a change. On a whim and after watching legally blonde, I decided to apply to law school (no joke, legally blonde seriously was my motivating factor). I wrote the LSAT and applied and was accepted! When the time come and I got my acceptance I was actually really unhappy! I was torn because I was quite content with my current job (I was working full time as a manager for a nursing unit that suited by expertise to a T), the pay was great, I was on my way to buying my own house and life was pretty good! Did I really want to put this on hold to attend another 3 years of school? Well, at the age of 27, I figured it is now or never! So I decided to go for it and that 30 something thousand I had sitting for a downpayment on a house went in one fell swoop to my tuition for law school. I am now finished my first year of law school and going into my second year in September. While I really struggle grappling with the decision I made (you are literally putting your entire life on hold to attend this type of program, I can't buy a new car because I can't afford to make payments on it while I am in class full time, I can't buy a house because the money I save goes to my tuition and living expenses and I can't settle down because my law school is 16 hours from my home location and I have no intentions of settling down in the location where my school is. On top of that, while i am in law school, I am working casually in an area of nursing that I have absolutely no expertise in and that I am not all that fond of. That said, law school has been invaluable. I am so grateful for the experiences I have gained and for the different world view I am deveoping from it. However, with that said, there are some other things that I think are important to note: 1. Law school (and I assume it would be the same for any non-nursing discipline) has been a real culture shock! I have been a nurse for just over 5 years. I am acclimated to nursing culture. Law students are acclimated to "law" culture and "political" culture. They tend to be more uptight and less humours. They are also more cut throat. Whereas nurses foster collaboration and collectivism, law demands an adversarial and cut throat approach. I frequently find myself missing nursing, especially nursing humour! No self-respecting law student finds it funny when you trip over the IV tubing during a blood transfusion and blood starts spraying everywhere (law students call this negligence by the way)! 2. While I appreciate the experiences and learning that I gain from my current studies, it also has made me realize that I am and will always be a nurse. You can slap a suit on me and stick me in a court room, but in the end, I will stand before the judge and be like "Your honour, you are looking very pale and clammy, do you have any cardiac issues? Does anyone have an asprin?!" But in all seriousness, I like law, I love the opportunities I have with it and I am grateful I decided to do it. But in the end, I know that I will stick with nursing and combine law in whatever way I can, but my primary focus will always be nursing. Nursing has been a good fit for me as a person. Nursing has made me the person that I am and it is nursing that ultimately is paying for my education. And despite the fact that I am not a huge fan of the type of nursing I do while I am in school, I am so grateful to my co-workers there. It was my co-workers who held a birthday party for me, not my classmates. It was my co-workers who held a going away party for me when I moved back home during the summer, not my classmates. It was my co-workers who wished me luck and all my exams, not my classmates (in law, your classmates tend to try and psych you out). It was my coworkers who let me leave an hour early because they knew I had an exam in 2 days, not my classmates. Nursing is the greatest career and nurses are the greatest people I could ask for! And I am forever greatful to be a part of it. I would say, do any additional education you can! Regardless of whether it is nursing or not, it will never be a burden to nursing. Nursing is so multidimensional that you can combine almost any other discipline and make it work with nursing. It is normal to feel contention about the discipline and think you want to leave, and for some they do! But as a curious anecdote, I know of an antoher nurse who went to law school. After practicing law for a couple of years they ended up coming back to the profession! I think nursing is a hard discipline to quit. Sure, there is caddyness and sometimes bullying, but the good always outweighs the bad and for every ***y nurse there are 2 who are holding your hand and offering you guidance. Sorry, this has turned into a long rant! Best of luck with whatever you chose!

It is a pretty surreal situation and I am sure that others have used this excuse in the past (whether legit or not, its not for me or anyone else to say). But my advice to you, to put your mind at ease, would be to talk to whichever person reported to you that this came back positive. I suspect it would be the HR department for whichever agency. Ask them what the next steps are and what action they will be taking? Don't assume the worse. In terms of reporting to the BON, I wouldn't worry too much about it. *DISCLAIMER IN ADVANCE, I AM NOT PROVIDING YOU WITH LEGAL ADVICE AND I WOULD HIGHLY RECOMMEND SPEAKING TO AN ATTORNEY* I'm a nurse and a law student in Canada and not too sure about the American statutes, but the BON would be hard press to do anything against you for this positive, for 2 reasons: 1. This was positive PRIOR TO and NOT DURING employment with the organization. You were not tested positive while you were physically at your place of work. Thus, the BON cannot prove that you endangered the life or safety of any patient. Under the California nursing act, the following is stipulated: "In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following: (b) Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license" 2. I am ASSUMING that you have an otherwise untarnished track record of practice. No previous positive drug tests, no impaired while at work reports, etc. If your track record working as a nurse is clean and untarnished, then the BON would be hard press to prove that this 1 off occurrence reflects on your ability to nurse. Again, follow up with this girl, find out what is going to happen. Assume you won't get the job (best case scenario) and that it will end. Worst-case scenario, they report it to the BON. But you must ask them what they are going to do. If they say they must report this to the BON, then contact an attorney ASAP. Based on the California nursing statute though, I don't think they would report it as there is no provision for a positive drug test, only a provision for using drugs while you are actively practicing and on site as a nurse. But, again, I am not 100% sure as my experience is predominately Canadian. Best of luck to you!

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 :).

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

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.

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!