mariebailey

I just want to make 1 more comment; the reality is I could talk about vaccines until I'm blue in the face b/c, gosh darn it, I love what they have done for humankind. As a Public Health Nurse, I received a lot of good training on the topic at hand, so, when in doubt, I recommend going to your local public health clinic. I was a Team Lead for immunizations & had the opportunity to write a grant & start a travel immunization clinic, so I would audit records, including my own. If I spotted a missed opportunity to vaccinate or an administration error, I was allowed to contact the patient, apologize, & offer a convenient time for them to come back to the clinic for services. How often does that happen in the private sector? Also, we were a resource for private providers, keeping them up to date of ACIP recommendations. This started b/c of the frequency with which we observed administration errors in the state registry. If someone ends up with a wrong-site injection, they may need to be re-vaccinated, depending on the site & vaccine. immunize.org & CDC.gov/vaccines have info on this. My point is, when in doubt, reach out to your local or state health department, whether for a patient or yourself. I also contacted the CDC on several occasions with questions prior to immunizing patients with complicated situations (e.g., recently finished chemo/wants live vaccine/how long should I wait, liver failure patients/Should I use Twinrix or standard HepA/B vaccine, etc.). I always received a prompt, thorough response too. Quality matters, & I think we all agree there is much more to vaccines than sticking a needle in an arm. Just wanted to share my thoughts. Enjoyed reading yours.

I've had positive experiences at Walgreens & CVS getting vaccines for travel, flu, etc. I stepped away from public health nursing for a while, so it is news to me that an egg-free option exists. This news rocks my world.

https://www.immunize.org/catg.d/p2020.pdfhttps://www.CDC.gov/vaccines/hcp/admin/administer-vaccines.html I think the CDC's 2-3 finger breadths recommendation is a more realistic rule of thumb than attempting to measure in centimeters, & it gives you enough wiggle room to tailor it to your specific patient. Imagine us all at mass vaccination sites trying to literally measure a specific set of centimeters prior to administration. Probably not so realistic or even necessary.

The ventrogluteal is NOT a recommended site for IM VACCINE administration. Immune Globulin = yes. Vaccines = no

For IM VACCINES, the deltoid muscle & anterolateral thigh (vastus lateralis) are the only acceptable injection sites. Administering an IM VACCINE anywhere else, including the ventrogluteal regions, may result in reduced serum antibodies (I.e., a less robust immune response). That's why it's important for nurses to realize this. I don't think it's common knowledge for people who don't routinely administer vaccines though.

WOW. I completely agree with your concerns. I don't know for sure, but the CDC seems like a good place to start: General CDC Info Contact Form: https://wwwn.CDC.gov/dcs/contactus/form CDC Office of Financial Resources (OFR) email: [email protected] US Government Accountability Office: https://gao-fais.entellitrak.com/etk-gao-fais-prod/page.request.do?page=page.efileConfidentialNoRestrictionComplainantForm EDIT: I think my 3rd link is actually the best place to start. "COVID-19 Update: Federal agencies will be responsible for ensuring that all the funds from the record $2 trillion stimulus package end up where they’re supposed to. GAO has been tasked with tracking that money. If you suspect waste, fraud, or abuse of stimulus funds, you can help us out by using FraudNet to report your concerns." https://blog.gao.gov/2020/04/14/as-aid-for-covid-19-arrives-so-might-fraud-heres-how-you-can-report-it/

OP: I have been to hell & back going through all of this. I blogged about it; it's therapeutic. The resources at the bottom of the article offer more information on the spectrum of disruptive behavior & actually delineate words like incivility vs. bullying. The ANA position paper is particularly useful. https://eclecticideations.blogspot.com/2021/03/nurse-managers-who-is-really-running.html EDIT: These two are really the pioneers who brought the issue to the surface: http://jsbmcnj.weebly.com/uploads/1/0/8/6/10866812/the_downward_spiral.pdf ANA Position Statement: https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/incivility-bullying-and-workplace-violence/

My suggestion: make yourself stand out.

I loathe the responsibilities that are delegated to nurses that do not require a nursing license to be carried out: -ordering jello or whatever else a patient suddenly craves when you have a million other things to do -administrative work for another employee, like making copies, printing labs, etc. when they are perfectly capable of doing it themselves -answering the phone/call buttons while the nurse techs sit on their behind watching -putting in maintenance requests It's not that I think I'm above doing these tasks, but sometimes you're just to busy to deal with the "just let the staff nurse do it" kind of attitude.

https://www.amsn.org/practice-resources/care-term-reference/staffing/question-what-suggested-nursepatient-ratio-andIt was a 1:6 ratio for days & nights for Med Surg where I work, & I'm located in the Southeast.

After several months of day shift in med-surg, I'm a/b to start working nights on a psych unit. I'm in a part-time Psych NP program, & I feel this will help me build a stronger foundation in Psych. However, as with anyone, I feel that adequate, regular sleep is crucial to be alert on the job, mentally healthy, & content. For someone who works nights or has made a similar transition, what can I do to ensure a smooth transition & routinely & peacefully sleep during the day? Any tips are appreciated! Thanks!

Happened on my shift a couple of times too!

I don't have an accounting degree or a CPA license, bit I strongly encourage you to let me do your taxes.