Jory

They will not cover you. The only cover from the day the policy is implemented forward; claims are not retroactive. I have never had a complaint, but twice have had the threat of one...one I wasn't worried about, the other...I couldn't sleep for weeks and nothing came of it. Should you get a complaint, I used to have a friend that was on the BON in another state...I'll review worse case scenario and assume you made a huge mistake. What the BON looks for is A) Did you perform due diligence...did you know the policy, did you follow policy, were there barriers that kept you from following policy, did you escalate to the MD, house supervisor, administration, etc. B) Do you even recognize what went wrong? If it was your fault, are you taking responsibility? What are you going to do different to make sure _______ doesn't happen again? How are you going to protect that patient? The BON is there to protect the PUBLIC. Remember that they don't care about hospital or clinic politics or actions that could cost you your job. So you can't say, "I didn't call Dr. Smith at 3 am because he always bites everyone's head off if you call him that late". They don't care about that...their only question...did you call? Most of the time, what they ding nurse's for is WILLFUL failure to follow policy, refusing to take responsibility, and failure to advocate for the patient. Also, don't post anything about the case on social media, no matter how "private" you think it is...don't put on Facebook or Instagram even something vague, "Very sad day today" because they can and do search social media. If you have your employer listed REMOVE IT and remove the city/state as well. If you have already done this, delete them. Oh..and look up the laws in your state to see if it is a one-party or two party state. If it is a one-party state I would record any conversation, save all emails, etc. I sincerely hope this works out for you. Any of us can mess up.

Nope...all you are doing is documenting. Employment records will show you work in quality and not bedside and never examined the patient. Yes, you are over-thinking it ❤️

A feeding tube defeats the purpose of hospice and is an artificial sustainment of life unless, the patient had a medical reason, can ask for it, etc. Our hunger naturally goes away as we move through the process towards the end of life. Your body, also has reduced efficacy in digesting and absorbing nutrients optimally and peristalsis declines. Patients are typically told if the patient can ask for something to eat or drink and can safely swallow it, give it to them. If they are not asking, don't.

Sorry if this is harsh, but you felt your patients was safer with LESS staff than with you there? How did that benefit the patient? If they report it to the state, you could be in trouble.

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.

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.

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.

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 member or scrotum, a urologist would have been consulted, but this is another example of providers dismissing a gynecological complaint because it was a female.

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.

I have never measured a PICC line ever removal when I was a floor nurse. Never. That is why there is a tip.

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

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.

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.

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?

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.