smartynurse

if you have been exposed to tb and have a positive ppd that does not mean you can no longer work in a healthcare facility! You may have to take abx treatment, and will be followed by the health department. So, number three is wrong! TRUE or FALSE 1.It takes about 25 weeks for the skin test to become positive after infection. 2.Symptoms of TB include cough and night sweats. 3.A positive TB skin test means you cannot work in a healthcare facility. 4.If you have TB disease, you will need to take medicine to cure the disease. 5.Reports of delayed reaction, up to 14 days after application, have occurred. 6.A TB skin test is the only way to find out if you have latent TB infection. 7.If you have a positive reaction to the skin test, you will need other tests to see if you have TB disease. 8.A false positive may be caused by recent vaccination. 9.Wear an N95 Respiration when treating a patient with suspected or known TB. 10.If test is not read within 72 hours it will need to be repeated. Answers 1.False 2.True 3.True 4.True 5.True 6.True 7.True 8.False 9.True 10.True

the patient wore a mask up to the floor. Once he was in the room it was removed, the negative pressure was ordered/started. this particular room has an "ante"room, so no cart in the hall. thanks everyone, I have moved on from this, the hospital can kiss my :kiss....!!!!!!!!!!!!!1

cardionics has an electronic stethescope which can be used by hard of hearing and those with cochlear implants. It costs about 400 dollars. You may be able to get help with the cost through the department of rehabilitative services (if there is a department like that in your state). "DORS" helped me pay for school, hearing aids and stethescope when I went through nursing school. I think it would be great if allnurses.com had a forum for nurses with disabilities. I have definitely encountered discrimination due to my hearing impairment at times t/o my career. Both AMPHL and the website "exceptionalnurse.com" are good resources for hearing impaired nurses. I have one suggestion for those nurses experiencing stress or discrimination, look for a workplace that is supportive!

sorry, I knew that!!! and thanks everyone for your kind responses!

hi, I have lost sleep last night worrying about something that happened at work. I am an agency nurse. A few weeks ago I cared for a patient who came up from the ED. The patient was being admitted because he had a cough for one month and the day of admission coughed up blood. I can't remember the patient's admitting dx, however, the patient was ordered for AFB cultures. I did the admission paperwork, and told the charge nurse about the possible tb, she actually got the proper masks for me and others to wear. I also requested that she get maintenance to turn on the negative pressure in the room. I educated the nursing assistant and family about wearing a mask. I wrote a note in the bedside chart about educating the family to wear masks. I gave report to the oncoming nurse that night about the patient, I am absolutely certain that I told him/her that the patient was being worked up for tb. The problem is that my boss told me that they (hospital infection control nurse) have called him because apparently no one knew that the patient might have tb and no one was wearing a mask for the next several days.The one thing I forgot to do was put the droplet isolation sign on the door. I remember this because it hit me later when I thought about it. Although I feel bad that I forgot the sign, the charge nurse was aware, and so was the oncoming nurse. Am I legally responsible for others not wearing a mask? Is this considered negligence, or a public safety issue? Please help, as I have lost sleep over this! I have recently started a new job working monday-friday and won't be going there again. I feel bad and am worried. Thanks for any response.

It depends on the time of day you will be driving...it should not be too bad if it is early or late..meaning if you need to be there at 0700, you will be early enough to beat the traffic. Night shift could be a problem. Randallstown is about midway up 695, right? So, you could run into traffic around Baltimore and D.C. in the early evening rush hour (if you are leaving for work at around 5:30 or 6 pm). Why WHC? Why not try UofMD or JHU? They are closer.. Whatever you do, good luck!

well, there is more agency there than i could believe. the system is antiquated (in my book, i'm used to computerized orders, etc;). The doctors run the roost, you have to call attendings for everything, they have intensivists for their ICUs, I don't know, I am going to keep going and see if I can handle it!

this was a benign error...i have made mistakes too..i also was penalized for it very harshly, even though i did all the right things...just learn from it and pick your battles...if you make a major mistake, own up to it, but i'm sorry, if it was that minor, i think i would not report it, sounds like that facility is antiquated in it's approach to med errors, so be judicious in how you respond to that.. you did do the right thing, and you are human!:)

know your policies and procedures, such as when you are giving an IV drug for any blood pressure or cardiac issue, especially if you are on a med-surg unit. do not let the doctor try and slip something by you. Also, the first thing you do when you start work is check on your patients. Not sit down and organize your day, etc. When a new post op comes to the floor, go and see them immediately....introduce yourself to the patients and their families with a smile, your first and last name, who you are. Ask them if everything is okay, give firm hand shakes, this will instill their confidence in you!!!! If you don't know something, go and ask, as embarrassing as it may be!!!! Good luck!

Hi all, I am feeling a bit insecure about how I handled a situation today. I recently was hired by a per diem agency, have just moved to this area in northern va.. I was told (multiple times, very clearly) by the recruiter, including when I went in for my drug test and finished the hiring process, that my hourly pay at a certain hospital was 40/hour. Well, I just received my first paycheck, and the rate was 38! So, I called the agency and spoke with the recruiter who hired me. She told me that the 40/hour rate was only if I did a contract, otherwise the pay depends on the unit I worked. I will only make 40/hour if I do tele (not my forte, but I will go there in a pinch). I had also called last week before starting to find out if the pay rate of 40/hour was set t/o all shifts or if there was a differential. I was told by a staffing coordinator that it was 40 round the clock. This was not true, apparently there is a differential! Well, I was upset and told them so. It wasn't even the money, which I know is only 1-2 dollars less. It was the principle! I am a new employee! I was pretty firm in telling them I thought I should be paid what I was told initially. By the way, another nurse that I met at the hospital told me they told her the same thing! What do you think of this! I am worried that they will label me as "trouble" and not schedule me. I am so sick of being walked over by people, I just had trouble with the movers with the moving date and also with the charges. I am deflated! Any opinion would be appreciated. thanks

do you think you have an ethical responsibility to report this nurse? is there someone you could above and beyond the managers you have spoken to? I just wonder if you should, as it does affect other patients...if something happened to one of her patients, would you somehow be responsible in some way?

Interesting that you mention that...I guess in my experiences and what I have learned in reading is that the South Korean culture is very closed to mental illness. That was something I thought of right away when it turned out that he was a child of an South Korean family. Of course, I am not trying to stereotype. But read the article, it does shed some light on the problem. They consider mental illness to be a real stigma and sign of weakness. This is now being discussed on the news tonight. I did find an interesting article online discussing this: http://english.ohmynews.com/articleview/article_view.asp?at_code=390145 By the way, I feel that before laws need to change regarding guns, we need to see what really happened with this guy, and the type of surveillance and help he actually received. Apparently, the university police report stated that he was a danger to not only himself, but others as well- but the judge decided to check only the danger to himself box! What I'm saying is, that, combined with the university's ineptness in not expelling him/demanding treatment, is what probably lead to this tragedy. This guy was on a mission, delusional, psychopathic, and I bet he would have used anything in his power to wound others, if he couldn't get a gun.

I agree, that mental health issues in particular are still not addressed well here in the U.S. But I wonder if they are addressed well in other countries and cultures around the world. We are a pretty open society, all considering. Your personal story, and how things were more intrusive back then, reminds me of the movie "one flew over the cuckoo's nest"...Hollywood bashing the intrusiveness of mental health institutions and individual rights...Now I'm sure they will complain that they are not intrusive enough! But I just think that their was a lack of connectedness w/in the university...again, I am really interested in how the university handled Cho after his stay in the health facility, did they follow him, or did he refuse tx.

They didn't fail, because you or I could voluntary commit ourselves to an inpt. psych unit for depression at a low point in our lives. If the law did as you say it should, we then would not be able to buy any gun for ever. Also, the mental health community is very vocal about privacy laws for this very reason. This is not to refute the fact that this is a very unfortunate outcome.

What type of unit do you work on ? Think of various activities/interventions that you do there: are there any that could benefit from EVB? An example would be: if you work with trach patients, do you use saline irrigation? There is EVB out there that suggests you shouldn't. A great place to review EVB is the Joanna Briggs website: http://www.joannabriggs.edu.au/about/home.php Focusing on nurse-patient education would be great! Or even nurse advocacy issues on your unit...there are many avenues to explore. You could do a survey of whatever it is that you think your unit could use more education, then develop a care plan, then evaluate it somehow. Good luck!

are you a new grad? I am moving to NOVA and decided to sign with an agency-contemporary nursing solutions in springfield,va. They said I can have as many hours as I want at Potomac and the pay is great! If you have experience you may want to call them, to see about per diem and contract work. Unfortunately, I don't have any info on work conditions, etc. But I will soon find out! Good Luck!

I am not so sure this could NOT have been prevented. It will be interesting to see exactly how this ends up. Questions: once Cho was sent to mental health facility and subsequently released, was he followed by university officials? Was there any tie in by the officials when he was removed from the classroom? Why was he allowed to stay when he set something on fire (in dorm) and stalked two women? Doesn't the university have some parameters in place? Also, were the parents ever notified? If a kid displays such serious behavior problems, and refuses participation in classes, could they have suspended him? Hopefully with the task force by Gov.Kaine, we will have some honest inquiry and answers to this tragedy.

Still was being done at the trauma unit I worked in in Baltimore 12 years ago!

I agree, well said. I would like to add that perhaps you could continue to work as a nursing assistant, and meanwhile find a place that assists non-native english speakers with language issues. I know at the school of education at univ.of virginia, they have special tutors for this. I bet if you went to your local community college they might have someone/somewhere to direct you. Good luck!

Well, it doesn't have to be...that is why there is a Center for Nursing Advocacy (nursingadvocacy.org), why nurses need to respond to those comments personally and publicly with thoughtful, intelligent answers! Education!!!

do you need benefits? how about doing float pool or per diem? Then you could make more money and work less hours...or, the chances of you working on days/evenings could be better...what type of work experience do you have? There are other places you might try, depending on that...even if it is not exactly what you want, it might hold you over until you find something better?

This is an interesting thread, because nurses aren't allowed to be irritated with families!!! Why, they are our customers! And customers are always right, right? Anyway, American Chai mentioned something about support systems for families! In my hospital (I should say former hospital, my last day was last Saturday-Hallelujah!) they have patient representatives, they come up and take down all of the families grievances, etc. That is fine. What they realllly need to do is provide some emotional support for the nurses!!! In my research for a management class for my RN to BSN, I found out that Vanderbilt U. Hosp. has classes for health care workers (all-doctors, nurses, etc.) to help them deal with demanding people. They also apparently go up to the unit to meet with the nurse, not make him/her go see them on their days off! According to them, their turnover rate is less than 10% for nursing staff (I think my MAGNET facility is closer to 17%!!!!!!!). Anyway, I am so incredibly sick of nursing and all of the stress/demands/demoralization-they have finally beat me down! I just want to find a way out....I am moving to northern va. and hopefully will get an agency job, so I won't have to work more than 21/2 days a week. Then I can pursue other things in my life, maybe even a new career!!!

Central virginia, large hospital..new grads are making about 19-20/hour....i have a lot of experience, when is came here they offered me 23/hour but i have had over 3/hour raise in base pay in last 3 years.

Well, Thanks everyone for your responses! The funniest thing happened after I posted...I got a call from an agency in NOVA, I saw the 703 area code and thought that maybe it was a recruiter(not!). We talked for a while, at first I was a little resistant, but then I realized, heh- maybe this is a good thing. I actually worked for a per diem agency in Baltimore for over 7 years and made good money, better than staff pay. So, anyway, she told me that she has oodles of shifts in D.C. and some in NOVA (INOVA is apparently diff. to work for, and that is the hospital where the recruiter called me once and then no more). She basically promised me she could get me a contract in 48 hours...she has 10 for Georgetown right now!!! So, I feel much better. As far as I am concerned, it is the hospital(s) loss, not mine. I really hope that it works out, because, well- because. As far as my resume is concerned, I made it very concise and easy to read, professional, but with enough info to get who I am. The lady at the agency says that she has a number of nurses who have also gotten exasperated by the length of time it takes to get call backs, so I am not worrying anymore. I don't think my manager is saying something bad, but I can get other refs so I am not going to worry about it. Right now I just want to get the ball rollin along!!! Again, thanks everybody!!!! I appreciate the support.