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rncountry

rncountry

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  1. Detroit Medical Center is closing three hundred beds, and laying off one thousand employees, in the Detroit paper's today. DMC is part of Detroit Regional. From the articles some trauma victims may end up being turfed all the way to Ann Arbor to U of M hospital. DMC is the only area Detroit hospital with a level one trauma center. It is interesting to note that Regional just put Dr. John Swartz on it's board. Dr. Swartz was a Michigan Senator until this year, and could not run for reelection because of term limits here. He was the one who put together nursing scholorships for Michigan that just passed last year and are in grave danger of being scrapped this year because of budget shortfalls. The best thing I can say about Swartz is that he is grand at talking out of both sides of his mouth, and makes a grand politician because of it. One thing he said that was worthwhile, DMC is seeking money from the state to help, but last year they had a fund with $222 Million in it and now only $36 million. He says that unless they are willing to open their books and practices to the public, they should not be allowed any state hence public money. It's also worth remembering that DMC is part of a 8 hospital systemt that had the Hunter Group go through it about 4 or so years ago, and they made horrid cuts to staffing and resources. One nurse from Regional was arrested after being found in a dumpster stealing discarded IV poles from another facility because Regional was so low on them. The issues have a great deal to do with how many uninsured and patients that the system is not being reimbursed for, but some of it has to do with poor business practices as well. While nurses and ancillary staff were being laid off, top management pay was increased and the millions were paid to the Hunter Group in less than 30 days for their consulting work. As it stands now Detroit is underbedded, but now they will lose another 300 beds out from the only facility that is a level one trauma center. I wish I could say that wouldn't affect care, but unfortunately for Detroit it most certainly will. The whole fabric of Detroit is unraveling. The state is in court to take over the school system, the Major is in political trouble, under investigation by the state attorney general. In truth Detroit has never recovered truly, from the riots in the late 60's, massive layoffs from the car industry in the 70's, and repeated graft and corruption of public officials. Having gotten lost in the bowels of Detroit once several years ago I can testify to the fact that there were burned out, rusting hulks of cars that had been there since the riots of the 60's. As a very small town girl I can't tell you how shocking it was to see some of the things I saw there. Since then I have made a point of not going to Detroit unless I was flying out of there, or going to Windsor. Speaking of which, probably a good third of the nurses in Detroit are from Windsor. To see this happening at DMC is heart breaking. At one time, they dealt with so many gun shot wounds that the military sent their docs there to learn how to deal with gunshots. Even 9 years ago when I worked at Sparrow in Lansing I had an agency nurse tell me that it was not uncommon to have vented patients in the ER for days because they didn't have enough beds at DMC, and now they are closing more. Healthcare should not simply be a business, I find this kind of thing morally repugnant.
  2. rncountry

    Good Night, Florence

    By the way Roxanne, nicely written article!
  3. rncountry

    Good Night, Florence

    If you look not only a FN, but other early nurses in the US as well as other countries, really read about them, you will find that the majority if not all, stepped out of the norm for women and what society expected from women. The truth is that if we as nurses get back to the early roots of what the early nurses believed could be accomplished by sheer will and a deep belief that women could and should do things that lead their societies to better and more equatable situations, then today's nurses would be leading charges on many different levels and more publicly than we do now. They spoke up and were willing to put everything on the line for what they believed in. Can we do less? One of the gals that I work with did her Master's thesis on nursing history. This week she did a terrific board about many of the early nurses that really puts into perspective what nursing has accomplished not only for the profession, but for society as a whole. I personally take Lavinia Dock as a terrific role model. She was one fiesty lady! Not to mention very bright. And you know what? Even if FN was bipolor who cares? Does that negate the accomplishments she had? To make a statement that she was bipolor does little more than play into the stereotypes of mental illness. It was not FN that wrapped a mussle around nurses mouths, that was done later and in many ways we have done it to ourselves. I would say take a look back and really SEE what the early nurses accomplished and use it as a role model for what nursing how nursing could and should lead.
  4. rncountry

    The Family

    It is not a crime to ask a family member to leave the bedside. I have done it rarely in my career, but when I have done this it is because of what the patient needs. There are times that no matter how much you have explained to the family what is happening, how many questions you have answered or how much time you have spent with them, the family is not absorbing what is being said to them. And frankly there are many, many times that the family have not managed to realize that ultimately it is the patient who has to have their needs meant, not them. When I worked in the neuro ICU years ago I had an 18 year old kid who had been in a bar on a false ID, who managed to pick a fight with the wrong set of people. He ended up with a severe head trauma. Family flew in from Chicago, mom and dad divorced. They would go to the nurse with, "tell my ex-husband this", "tell my ex-wife that" these two parents could not even manage to be decent when their son was hovering near death. The ultimate problem they simply could not manage to put aside their own needs to take a look at their son's needs. The mother would come into the room and rub his legs, and his arms. Crying or talking to him constantly. I would watch his ICP's hit 100 or more. For those of you who don't understand this, any intercanial pressure above 50 is causing damage to the brain. I repeatedly explained to her that she needed to be quiet, that she needed to please not rub his body at all. Educated her that she could sit quietly at the bedside and hold his hand as long as she wasn't rubbing his hand or making any type of repetative movement. But she just couldn't manage to do this. After a number of hours of dealing with this, I asked her to leave, and explained that her repeated disregard for the instructions I had given her was causing harm to her son. She refused. I called security and had her removed. Did this mean I could not understand that this woman was had fear? Or that I didn't understand that she simply needed to have a physical connection to her child? Or course not, I understood that well, I have children myself. But when it comes down to allowing a family member to do something that is obviously contraindicated for the PATIENT'S health regardless of the reasons or what the family member is feeling I fully believe it is up to the nurse who is EDUCATED to know what the patient needs and who has the ultimate responsiblity to protect that patient, to request that family members need to remove themselves away from the patient. Talino, I am sorry about your own mom. Having lost my dad 2 and a half years ago after some terrible care and some things that should have been done that weren't, I think I understand your upset. Saying that however, what I see here is what in school we learned was transference. You feel that the family members were looked at as only a pain, perhaps the way you felt when no one was there for you when your mom was in ICU. Perhaps because of your experience in the ICU you are able to empathisize with family members in a way that other nurses do not. I know that because of the way things happened with my own dad I get angry pretty quickly when I see nurses who are not through with their own assessments on patients, it also led me to become vocal about what nurses need in order to do our job's appropriately. It may be that you have yet to run into a situation where you had to make a choice between the patient and the family needs, I don't know. I do however, know that this bb exists in part to allow a place for nurses to come in and vent, to ask advice, to ask for support etc... and while one can most certainly disagree with one another, it need not be done rudely. All of us learned how important family and the family dynamics for a patient is, and there are times I'm betting that each of us have dealt with families that we just don't understand where they are coming from. As long as what they are doing does not interfere with the ultimate responsiblity of taking care of the patient then there never needs to be a problem. But when that line is crossed, it is the nurses duty to step in and ensure that the patient is the center of care, not the family. Disagreeing with this is certainly your right, but again I say it need not be done rudely. And when a nurse is neglecting another patient in favor of spending time with a family that is not even the family of the neglected patient, than priorities need to be set. I agree with another poster, there are times when pastoral care should be brought in or social services to deal with these situations. As nurses we can't do it all, should not be expected to do it all. And no matter what our ultimate responsibilty is to the person who is ill and in our care. The ultimate responsibility is not to the family.
  5. rncountry

    I need your input on this!

    LoisJean, Great for you! After speaking with you on the phone I hope you know that I think the idea that only an RN is a nurse is a bunch of bunk. Several times I have been all ready to join the ANA through the Michigan Nurse Association, but everytime I end up not doing it. Two reasons. First I just do not feel they are using the political influence that they should have, and secondly because the ANA will not represent LPN's. Considering LPNs are dealing with the same issues that RNs are I see this as foolish. It maintains a rift in nursing that should instead be healed. It is difficult at best to be able to impact healthcare as nurses when there are people out there that do things that split nurses among ourselves. In many ways it is an inability to not see the resources right in front of you. Imagine what a force nurses could be if all nurses were united. As someone said, Mr. James has the unfortunate inability to see the forest for the trees. I took a look at that site too, and this was my take. The only way I could much information was to join, but how do I know that this is a worthwhile association if I can't get the information first? I felt like this guy was more interested in what money he could get than in actually helping nurses become independent. Decided it was not worth my time. The National Nurses in Business Association on the other hand was a wealth of information. Wrote to Pat Bemis, received a prompt reply and information that should prove to be worthwhile. And currently I am not a member, though have every intention on becoming one. As my dad used to say, Onward and Upward!
  6. rncountry

    How do you deal with your anger at work?

    I know that I am different than most, but I usually tackle problems head on. I would not change my schedule, if it worked for my life I would keep it. I would however tell this nurse she was inappropriate when that happened. I would also write an incident report and also go above the NM head since she is not taking her responsiblity to ensure appropriate care for patients is being done. Have I been in this situation? Yes. About two years ago we had a fairly new grad put in as charge nurse. She irritated me on a regular basis, at the time I was working as a primary floor nurse and absolutely would not put up with someone with less experience expecting me to do what I knew was not right. The worst it ever got was a shouting match in the breakroom, got mighty nasty and within seconds the breakroom cleared leaving me and the charge alone. I let her know EXACTLY where I stood and EXACTLY where she stood with me. After that I not only had no further trouble, other nurses started standing up to her. Eventually this nurse opted to leave our facility and I for one, was not sorry to see her go. My MN also would not do anything, she handles any type of confrontation poorly, be it disciplining someone or not. I like where I work very much, I like more coworkers very much and was not about to let one person on a power trip mess that up. The place I work at is great with teamworking and getting along and one ding dong could not be allowed to turn a wonderful working environment into hell. Confronting someone can be done very professionally and directly. When that did not work with this person, the shouting match did ensue, but I was not about to do something with my patient that I did not feel was appropriate no matter who was telling me to do so. I know not everyone would agree with me, nor feel comfortable doing this, but it simply is not in my personality to put up with crap for anyone.
  7. rncountry

    Ready to give up....

    Glad to be of assistance Julie. And just for the sake of more ammuniation per se, it is not recommended to do any regular flushing of foley's. All that information can be found on the CDC website. Next just because it is a physician order does not mean it is appropriate, any DON worth their salt would know that, and be sure that physicians are actually following the guidelines. After numerous studies it is found that the more often a closed system is messed with, the higher the number of nosocomial infections. Then there are the further guidelines in LTC. What is the reason this patient has a foley, there has to be a definative dx and it can't be simply for incontinence. As deb wrote, has she been seen by a urologist? Has every avenue been explored to get the foley out? State inspectors fully expect to see it has. It also should be pointed out that the nurse who noted the order to change the foley should have been the one to do so, if they could not for whatever reason it needs to be placed on a tx sheet and passed on in report. If the nurse noting the order did not put it in the appropriate place the write up belongs to that nurse not you. That is nursing 101, the responsiblity is on the nurse who noted the order. You also might just throw in the CDC guidelines on changing foley's have been in place for at least 9 years now. Maybe they should catch up with times, or have someone in infection control who knows what the hell they are doing. Of course a DON who knows what the hell their doing would be nice too. To me it is apparent the DON does not. Let us know when you get another job. This place is not worth your license.
  8. rncountry

    Ready to give up....

    Also the CDC does not recommend changing foley's unless there is a specific reason, it is not to be done on a regular basis, that promotes more infection potential not less. Tell that to the RN. Your facility is way behind times. Run away fast.
  9. rncountry

    Ready to give up....

    Julie, I concur with everything everyone else has said, I just need you to know that the write up you received was bunk though. Insulin does not need to be refrigerated anymore. If it is a written policy for it to be that is one thing, but if there is no WRITTEN policy then it is perfectly acceptable to leave insulin in the cart.
  10. rncountry

    Oooohhhh, Now I feel cosmopoliten, do you ALL wear scrubs?

    Britstudent, you were an hour north of where I live. By the way it is spelled M-i-c-h-i-g-a-n! Now the big question. Did you have the grand opportunity of experiencing lake effect snow? Once upon a time I was going to work in the neuro ICU at Blodgett hospital, now Spectrum Health, but decided I just did not want to deal with the winter driving and declined the job. So what brought you to the great white north? How long ago where you here? Karen, I believe you are experiencing the same thing with Beverly Malone that American Nurses experienced when she was head of the ANA. If I recall correctly it was under her that the ANA started the labor arm of the association. The United American Nurses, problem was this. It is a labor association that is connected to an association that has nurses that are management nurses, and also nurses that work with the American Hospital Association. The AHA is the one who has come up with all the grand plans of having aides do tasks that were also the province of Nurses, like IV insertion, dropping NG's, inserting foley's etc... Many people, not all, but many, feel there is a definate conflict of interest there. Plus most southern and western state association were not keen on having to have a labor arm to their association in states that have traditionally been hostile to labor unions, so the solution was to put in a work place advocacy program in those states. This program has no teeth, and is basicly ineffective. I may wrong but I believe she was the head of the ANA when California disaffliated from the ANA. If she wasn't then it was around the same time frame. California left the association because they felt the ANA was not addressing the real problems, and that they were not addressing the actual needs of the bedside nurse. I don't understand why the RNC would pay for her flights home? Or other perks. She opted to take a job there, if she wants to come home it should be on her dime. She's been there about 2 years right? I recall at the time I was corresponding with someone involved with Unison and he emailed wondering what she had accomplished here. While she has an impressive resume, I just don't recall her leading the ANA as a group that most nurses here felt was effective to what was happening to us at the bedside. At the time I was quite shocked that an American nurse was hired to lead British nurses, and I was given to understand she did not take a RN license in Britian. Though that may have changed. I know that if the shoe was on the other foot, I would not be happy with the situation. Now if there were dynamic results happening, that may be one thing, but if there are not I'd vote her out.
  11. rncountry

    Oooohhhh, Now I feel cosmopoliten, do you ALL wear scrubs?

    Karen, curious what do you think of Beverly Malone? She is still the head of the RNC then? Britstudent, a dutch porn star....just the thought :roll Where in the states did you spend time?
  12. Tenet has had these issues over and over again, going back over 20 years. They are called Tenet because they changed their name some years ago because the first name, which I can't remember right now, was so associated with fraud and scandel that they needed a "new face." some things never change, and unless the gov't stops them from practicing business it likely never will.
  13. rncountry

    Oooohhhh, Now I feel cosmopoliten, do you ALL wear scrubs?

    Funny that, mine too! But then it helps to get by in the job. You know Brit, I'm thinking your pretty ok.
  14. rncountry

    Question- calling all mothers!!!!!

    My oldest child is very bright, he spoke full complete sentences by 18 months. About age 3 he had times he would stutter, it was frustrating for him, but usually if I told him to slow down a bit it would help. I agree it was a process of his brain being able to go faster than his mouth. Though eventually he overcame that issue and there were times I thought he talked so much he must be breathing out of his ears! The stuttering phase lasted until he was about 5. I would say though, that if you are very concerned it is worth getting it checked out, if nothing else to put your mind at ease.
  15. rncountry

    Oooohhhh, Now I feel cosmopoliten, do you ALL wear scrubs?

    Naw, I don't think it is rude, I think it is funny. Maybe just me though. I think of it this way. Britian is a very small island, but it's impact has been huge. The culture that has been dissimated by the Brits is felt all over the world. The Scots once had THE place to go for learning, particularly as a physician, but the Scottish enlightment would not have likely happened if it were not for the merging of the two kingdoms, it was an economic boom for Scotland, if that had not happened we may never have had John Locke or Adam Smith, two men whose writings heavily impacted the founding fathers of America. Without John Locke and his Rights of Man would we have a US constitution? It's worth considering that we would not. One cannot study the history of my country without studying the history of Britian. I wouldn't even have a church to attend if Queen Elizabeth had not stuck to her guns and continued the Church of England, since the Episcopal church in America takes it roots from there and remains in the Anglican communion. Not to mention the fact that I wouldn't be here if both my mom's and dad's people had not had the foresight to immigrate here to begin with. Of course I find it amusing that we both speak English, but sometimes seem clueless as to what the other is saying too. Maybe I just have a warped sense of humor.
  16. rncountry

    Oooohhhh, Now I feel cosmopoliten, do you ALL wear scrubs?

    Let me know if I have this wrong, but it sounds like the nurse education system in Britian is the same system that we had in place in the states for a number of years. Diploma nursing, there are few Diploma schools around anymore. A Diploma nurse trained through a hospital, and worked at the hospital as well. They were paid very low and some programs no pay at all. That is one of the reasons that the Diploma schools have gone by the wayside here. The American Nurses Association pushed very hard to have all nurses 4 year degree university trained, but we also have a associates degree program through community colleges where it takes most people three years to complete, it can be done in two, but it is quite difficult. I did mine that way and would never do something that stressful again. The way the program works is you start in nursing fundamentals, and while doing the classwork, you also do clinical time at a facility that accepts students. So the class time and the clinical (ward) time go hand and hand. A teacher shadows the students in clinical, meds, treatments etc... can't be done until the instructor is there to watch. I'm curious if the new things in Britian you two are discussing have anything to do with Beverly Malone? I know she became head of the RNC a couple years ago, I do not know if she still is or not, but she was the head of the American Nurse Association a few years back. I may not be understanding exactly the way you described the system being split between nurse and aide, but if I am then it sounds like the way things are done here between aides and nurses. That does not mean that nurses do not do baths etc... it does mean that the bulk of that work falls to the aide. The time crunch that you talk about with nurses is very alive and well here also. I know we do make more money, but I do not know how that equates into the cost of living differences either. Trust me most American nurses do not feel they are being paid what they should be paid. And pay differences from one area of the country to another can be quite different. Nor can you expect to be working in a union facility. Most facilities are not unionized. You will be expected to pay for your own insurance, and how good that insurance is also depends where you work. There are an awful lot of aides that I have worked with over the years who cannot afford to pick up insurance, so if you have an illness it all has to be paid for out of pocket, and that can be extremely expensive. I have one last question, is the states really called the colonies on a regular basis? I know you are also referring to other British started nations, but I have to tell you I think it is a hoot to hear the states called the colonies.