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Rob72 ASN, RN

Infectious Disease, Neuro, Research
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Rob72 is a ASN, RN and specializes in Infectious Disease, Neuro, Research.

Former EMT, Corrections Officer, Phleb, lab tech, current Research RN

Rob72's Latest Activity

  1. Rob72

    Blood Glucose of zero

    I'm a Type I DM x41 years, and I haven't seen a zero. Not saying it couldn't happen, but I would be concerned with the meter, if the pt wasn't seizing/post-seizure, and/or hasn't suffered a hypoglycemic stroke.
  2. "Violence is not part of the job." I strongly disagree. It is an inherent part of the job. The problem is that nurses are not taught how to recognize, verbalize, or document inappropriate verbal or physical behavior. Attempting to create a "violence-free" zone ensures that someone, at some point, will use violence. Why? Because all the "nice" people wag their fingers and tongues and there is no immediate, overwhelming, response. The idea that violent behavior is corralled or modified by verbiage is a failed concept, as demonstrated by the efforts in Corrections Science, from ~1960-1980. Unfortunately, the idealists, with their student loans to pay off, and their ideals to sustain, have moved into Public Education and Healthcare. Press-Gainey is a huge problem, as their overall model is based on sensation and reality-denial. If a patient is presented with the (real) choice of restraining their impulse, or receiving care at County (jail), or being tazed, they generally choose to conform to the stated standard. Truly violent people, with limited impulse-control understand that a minor assault charge is nothing to fear and they are likely to get what they want by threats and modest expressions of force.
  3. Okay, is that all of the story? Raising your voice only gets you in trouble in a frilly-lace undies facility that has no desire to resolve issues, only pay their MBAs to take a trowel and spread a nice warm layer of BS over everything. "We all talk alike. We all like the same things. If you say a Member of the Collective is WRONG, you are a violator. We will not tolerate YOU." If it was a scream-down, that's a bit more of a problem, but as long as it wasn't a disciplinary action with/to the BoN, it should not be a significant issue. I may be a variance of the collective here, but I have little patience for the concepts of "verbal violence", "bullying", etc.. Do they exist? Yes, but they are "Unprofessional conduct" or "Insubordination". Creating a special concept of violence is mental wanking for folks who can't deal with reality. Anyhow, if you're seeking assistance in new coping methods, and assuming your performance otherwise is good/excellent, it should not be a problem. Your main issue will be receiving constructive criticism constructively and changing something of your self-concept after termination.
  4. Rob72

    BSN Only? Give me a break!!

    Please don't misunderstand, I'm not spouting "BSN Hate". I am noting the significant financial and political incentives that have been brought about by "dumbing down" that educational system. If someone who can barely read at a 10th grade level can be accepted into a 4 year college, there is no "superiority" in the "level" of education. I would also note the SES inequality inherent in the model. Lower SES may gain entrance but have significantly higher drop-out rates and higher career change rates for those that do complete a program. Higher SES is an overall indicator of higher capacity for learning, in, "time for development purchased", if in no other way.
  5. Rob72

    BSN Only? Give me a break!!

    If you re-read my post, I did not say that; you have inferred meaning. I have worked on a University affiliated campus for just under 20 years. Having worked with 2 and 4 year students, the BSNs have more theoretical base, but generally less practical base. Individuals vary, etc., etc., and outcomes will vary regionally depending on the number of non-traditional students and ADN/ASNs completing the BSN program. Yes, there is substantial lit on the "better outcomes" associated with BSN staff. Having worked in research for 10 of my years, I would note that I am unable to find substantial literature indicating bias-weight r/study population and pre-BSN levels of practice, years in practice before obtaining BSN and independence of BSN-level ed vs. institutional outcome-measure improvement initiatives in the previous xx number of years prior to the study(i.e., the hospital emphasizes reduction of MRSA transmission and institutes a training policy, vs. MRSA transmission among BSN and non-BSN RNs.)
  6. Rob72

    Are handguns allowed at work?

    I think this is a fairly accurate summary. Not many people have a functional understanding of handling weapons as tools and not as "the Magic Wand"(including Mil and LE). Security is present to confine the non-intentioned offender and/or to talk down the offender lacking a clear expressive plan. "Swift and Certain" is a foundational Corrections theory that fell out of favor in the 60s. It does, however, seem to have the most consistently repeatable and generalizable outcomes (vs. "rehabilitaion" or "re-socialization"). Its present iteration: "Swift and Certain" Sanctions in Probation Are Highly Effective: Evaluation of the HOPE Program | National Institute of Justice
  7. "I have insurance." Translation: the tax base has been broadened because if you work, you will pay. So-called "increased access to care" is still a very much unknown quantity, as outstanding deductibles and co-pays have not yet reached critical-mass in debt-under-collection. I work with a Ryan White program, I have a pretty functional understanding of the funds-shift and the practical consequences.
  8. Rob72

    BSN Only? Give me a break!!

    I'm always a bit hesitant to post on this topic, but its been awhile, so what the heck... The BSN requirement is an artificial socio-economic barrier created to "thin the herd" because colleges and Universities have a vested financial interest, and hiring facilities have liability limitation incentives. Back 40-odd years ago, with the liberalization of student loan policies, followed by the diminished entrance requirements enacted in the '80s, Higher Ed realized they had a whole new customer base. All they have to do is keep them flowing through and maintain a reasonable pass-rate. Community Colleges were not a part of this market, until fairly recently; ergo, when they start cranking grads out, the job market is flooded, meaning the University programs are in danger of dying (because of the significantly lower cost of the CCs). Along with the entrance of CCs into Nursing Ed, the Diploma Programs began to die off. Why should an institution invest thousands of dollars into an employee likely to leave w/in 5 years(this is also a fairly new phenomenon, IMO r/lack of real depth in Nursing Ed. Whooooole other discussion), not to mention instructors, insurance, etc..(No "?" because this is a rhetorical statement) So (Higher Ed says), how do we deal with this, and not collapse the network of Community Colleges relying on all this loan funding? We network with them! The CCs "prep" for entrance into the Univer$$ity; they split the funds. My experience has been that neither Community Colleges nor Universities turn out notably "superior" grads(i.e., statistically quantifiable). Dilpoma programs do.
  9. Rob72

    Can nurses use medical marijuana?

    No, we have responsible professional judgement. I would second mystcnurse's comment, regarding other theraputic meds used by nurses. Medical MJ is not some mystic, happy panacea. It is impairing(no less so than take-your-pick-of-narcotics) and it is controlled. The DOT and FAA have thresholds (which are actually fairly liberal) and medical MJ will in most cases cause one to exceed the safety standard. Your facility and State BoN may have different standards, but I would not be optimistic. Never confuse "feel-good" with safe practice.
  10. Rob72

    Resume question

    Given the "weight" that your financial/business experience carries in your work history, yes, it should be included. I would remove industry-specific tasks (i.e., if you worked with a wholesale food distributer and loss assessment related to spoilage, for instance) and tone up the generalized experiences that translate well into your overall decision-making, administrative skill-set.
  11. Rob72

    My husband is in nursing school

    Hmm. I did an on-line program, with 5 lovely, charming ladies. I was also the oldest (36). 3 of us had spouses and kids, the other 3 were engaged, and all of us worked full time, in addition to school. Definitely friends, but I think all of us would have found 8 hours in a group a questionable investment of time. So. Overall, it's a maturity issue. I don't know how old the two of you are, but I hope you married with a common-commitment in mind (having raised 3 daughters, I will say being "in loooove" as a reason for marriage is iffy, at best). My wife didn't like my being in school, and we did have conflicts, and if I didn't have the character to deal with that as appropriately as I could, that was certainly not an issue with her. It will definitely be a reality check, and while it may be hard, that's not always a bad thing. God bless you both.
  12. Rob72

    Research Nursing

    The question is: are you planning to be a Research Nurse, or a Specialty Nurse who works in research? There is a difference. Once you have 2-3 years as a Research Nurse/Coordinator, you should be able to run a protocol in essentially any discipline, recognizing that you'll need to do some study on the basics of the specific practice area. After 10 years in research, my frustration was that I could take a protocol from start to finish in any area, but my clinical depth wasn't growing. If you have a passion for a practice area (OB, Transplant, whatever), get your floor-time first. If you have a passion/interest in the new and different, going "straight" research is not a bad way to go.
  13. Rob72

    Are handguns allowed at work?

    Having worked at a trauma center in Wichita, KS, in the early 90s, I've been around for 2 such incidents. Regardless of my environment, I will walk away from trouble at every opportunity. Regardless of the trouble, I will walk away. To the OP: I would say the co-worker was very foolish, and I would have an issue with the behavior as well.
  14. Rob72

    Research Paper

    Here's a clinical study that has been done: African American antiplatel... [J Stroke Cerebrovasc Dis. 1998 Nov-Dec] - PubMed - NCBI My suggestion would be to look at utilizing community centers, churches, etc., to encourage peer-mandated compliance(vs. a more middle/upper-middle SES educational program). One of the issues with "education" is a strong counter-culture (lower vs. higher) SES ethic and limited consequential reasoning. You can tell someone that fresh veggies and lowfat meats are the way to go, but (even with WIC/Medicade/medicare) at the same price point, there is a strong bias towards the familiar junkfood.
  15. Rob72

    Can anyone help me understand patient ratios?

    Okay, generally, Esme and I are on the same page, but I would like to (perhaps) expand on what I read. Yes, patient ratios are "recommended" by Jack-O, Nerds In Hiding, and Morbidity and Mortality, 'scuse me, "Medicare and Medicade". These ratios, however, are subjective, as noted. The ratios under which many practice are determined by overhead/"clients"/nurses. Why? Because there is no ICD billable unit for nursing care, ergo, the physical facility takes precedence over nursing staff. Nurses are a dime-a-dozen and easily replaced. The "customer service" model of tile floors, coffee bars, etc., are used to make up for questionable care-practices. It works, as long as there aren't too many Sentinel Events. If we want to change these standards, "someone" needs to bring a class-action suit, probably against JCAHO, substantiating patient endangerment by incompetent policy direction(i.e., allowing MBAs undue influence in care-delivery).
  16. Rob72

    Oral hypoglycemics Confusion

    An astounding boom of silence... Oral meds should be providing a baseline BS, in conjunction with a regular eating schedule. So, your patient should have his meds- and a "snack" pretty much equivalent to his ordered dinner. Call pharmacy. Call pharmacy. Call pharmacy. Be a PITA...