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Jory MSN, APRN, CNM

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Jory has 10 years experience as a MSN, APRN, CNM.

Jory's Latest Activity

  1. Jory

    Testing Window of FNP Exam

    I am not an FNP, but just wanted to ask this out of curiosity. When you graduate from FNP school, is there a time limit where you can take the exam? Like 1 year, 2 years, 3 years? Or is there no end as long as you can pass it. I know there is a limit to how many attempts per year. I'm just curious as to the testing window.
  2. Jory

    Huge Zoom Mistake....Nurse Instructors Caught!

    This shouldn't even be up for debate. The dean needs to know about it because the professors have made it clear that they have a problem with minority students. I'm sorry, that is racist and there is nothing else that it can be called. They are trying to do damage control and students need to present it as a group to the dean. PLEASE do this for your classmates and the integrity of the program. If you are white (as I am) and you don't stand up to protect your minority classmates that is no different than supporting the behavior.
  3. Jory

    How to chart to protect license

    You don't need a legal expert, all you need is to go to your BON website and see what reasons the BON are sanctioning licenses. In the example you gave, you don't need to go into that much detail b/c if you have a critical lab just check to make sure the lab documented they called you, if they did, that is part of the patient's chart and you don't need to chart it again. But you do need to chart (you don't need a time if it is a couple of minutes of when the event occurred as the charting will capture the time) that you contacted Dr. Smith and you need to chart any follow-up. When I worked the floor, I had managers and co-workers that didn't like my charting b/c they said I wrote too much. That is the one thing hospitals don't have control over--your charting. You chart what you feel like you need to chart, but you don't have to double chart. If it is documented elsewhere you don't need to chart it again. I once had a stupid manager that wanted us to triple chart a few things and I absolutely refused. You should never fear being pulled into court if you have documented what you are supposed to. I have been called into court more than once (nothing I personally did, just giving my personal account for things) and it never bothered me. The nurse that needs to be fearful is the one that charted hardly anything at all. If you didn't chart it, it didn't happen. Period.
  4. Jory

    Contested a Doctor's Order Psych 😬

    As a midwife, hysterectomies are rarely "recommended" for endometriosis anymore. In fact, it's a lazy providers way of dismissing the patient. A hysterectomy doesn't necessarily solve the problem as endometriosis is an inflammatory condition that can impact other organs than just the uterus. The pain can be so bad I have seen patients vomit. The treatment is to shut the cycles down. Stop the cycling = stopping the pain. The problem is there wasn't an appropriate discipline available to help this woman nor was an ovarian cyst (that can lead to ovarian torsion) ruled out. Had this been a man with a swollen penis or scrotum, a urologist would have been consulted, but this is another example of providers dismissing a gynecological complaint because it was a female.
  5. Jory

    What's your opinion on nurses dating doctors?

    It's a dumb move. Yes, it's fun while it lasts, but once things go south you have to still work with that person. Let's say you are the one that got dumped? How would you feel if you had to show back up to work and not only work with that person, but watch them flirt or be with others? Yes, a FEW get married, but far more don't. If you are OK with a very uncomfortable work environment, go for it...but once you get some life experience behind you, you realize that it's always a bad move.
  6. I have never measured a PICC line ever removal when I was a floor nurse. Never. That is why there is a tip.
  7. Jory

    Case Study: An OB Catastrophe

    We have had our differences but you did a great job with this presentation. Well done.
  8. Jory

    Case Study: An OB Catastrophe

    Also....manual removal of the placenta is a huge risk factor for AFE. That's why you don't rush the process unless it's truly retained.
  9. Jory

    Case Study: An OB Catastrophe

    I have a massive question...why was the placenta manually removed at all? That is very important because the overwhelming majority of PPHs are preventable and caused my mismanagement of third stage labor. If the placenta was inappropriately removed (and just because it was manually removed, doesn't mean it was necessary) that provider action could have easily caused the catastrophic cascade that followed because they were too impatient to wait.
  10. Jory

    Vaccine Excursion

    When you say, "You didn't package them properly", HOW did you transport them. Rule #1 in transporting medication is seeing if the medication requires refrigeration. If you took them out of the refrigerator, what made you think they didn't need to be transported in ice? How did you know what the temperature was when you got there?
  11. Jory

    What are they teaching?

    You don't get that choice as a nurse and the law doesn't require you to act as a police investigator. The only requirement for mandated reporting is "reasonable suspicion". The last time this happened there was the group at the nurse's station when I was yet again...told a long, drawn out, dramatic story that was never documented. I told the nurse, "I am disappointed that you didn't chart this when it happened, now I'm going to have to chart this incident for you and make a note that you failed to chart the incident when it happened, I am going to chart that I wasn't notified until today, and I'm also reporting it to your manager. So I highly suggest you go back and do a late entry." We don't report criminal activity to the authorities unless we have direct evidence that it is happening..that is the job of social services to get them involved. There needs to be some serious training in nursing schools on what constitutes mandated reporting and they are obviously not teaching it.
  12. Jory

    Compact license question

    Again...READ YOUR LICENSE. I don't think the OP said anything about doing anything dishonest such as listing a fake address. So let's not add elements to the story that don't exist. This isn't rocket science...her application above made it clear what Florida requirements were for a compact license IN FLORIDA. Florida doesn't control compact the issuance of compact licenses in other states. The individual BONs do.
  13. Jory

    Compact license question

    It's not dangerous advice considering it's written on the license you receive, what type of license you have. Unless you have personally went to every Board of Nursing in every state that is in the compact to personally research it..you have no idea what type of license each nurse has. That is up to the BON of each state.
  14. Jory

    What are they teaching?

    My major beef right now with new graduates is this "trend" not to chart anything. They will say, "Oh, we are supposed to 'chart by exception' " but if you ASK them EXACTLY what that means? You get the deer in the headlines look. They have no idea. Because I work as a midwife, sometimes when I do rounds there are significant social issues that need to be addressed. They will tell me a long, detailed story of this huge argument that happened in the room, mothers that are inappropriate, possible drug use in the room with the baby. I go to pull up the chart? Nothing. Absolutely nothing documented. I have complained about this until I'm blue in the face to management and unfortunately, one day something is going to happen and a nurse's license is going to be sanctioned. We have had social services referrals fall through the crack because of it, placing infants at risk when they go home. It's absolutely ridiculous.
  15. Jory

    Compact license question

    It depends on what kind of license you have. Compact licensure states usually have it indicated on the license if it is single state or multi-state. I think where you live is irrelevant and that is probably state dependent.
  16. Jory

    Multiple vaccine errors.

    If you have made three errors in one year, you are not practicing the five rights of medication. Not trying to be cruel, but if the first incident and the second didn't change your practices, don't blame it on the staffing. When it comes to medications, I wouldn't care if there were 100 people in the waiting room for two hours...that is your license on the line and that patient is counting on you. You need to block out what is going on and make sure it is correct.