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sauconyrunner

sauconyrunner

Emergency
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sauconyrunner has 11 years experience and specializes in Emergency.

sauconyrunner's Latest Activity

  1. sauconyrunner

    When will being an RN stop sucking?

    I think too many people have a great desire to "LOVE" their job. I was an Emergency Dept Nurse for 12 years and then moved into another office type field. I don't adore either job, but I do recognize that I am lucky to earn a good living, which allows me to do things I want to do. I've been quoted as saying, "I'm just here for the money" Sounds crass, but once you remember, you are getting paid to deal with all the BS we deal with...well, it gets easier. I realized that those awful patients were not trying to ruin my day on purpose, they were just the patient that ended up in my room. I did get a fair share of them too, as my Charge nurses told me, "you don't complain as much as xyz nurse." For the money, I gave my patients great attention and care, but I also did not work OT, stay late etc... I also freely admit, I don't take stuff home with me. I focus on what I want to do in my life, and work my nursing schedule around it, not the other way around. It has worked out. Some of nursing sucks, but then again, so does some of being a school teacher, or a janitor, or a physician, or an air traffic controller...
  2. sauconyrunner

    What would you say to this shocking patient statement?

    I have to say, in a true Crisis for a loved one, i would have forgiven this entirely. It's not really a statement made out of complete intolerance, but one made of true gut wrenching fear. It isn't very nice, but I can totally see where they were coming from.
  3. sauconyrunner

    Is it ever ok to stand up to a doctor?

    You say you aren't bitter, and I am sure you don't think you are, but you come across as bitter and frustrated. If you come across that way just writing, you probably come across similarly in real life. I have halted many many procedures at many "Big Name" medical centers. I'm there for the patient, not for a physicians ego. If you do not halt procedures when devices are contaminated, etc, you are taking part in harming a patient, and that is not acceptable. To me, I think you could seek employment elsewhere, asking many many questions regarding how physicians and nurses work together. the other option would be to try to bring in a cusp project: Using a Comprehensive Unit-based Safety Program to Prevent Healthcare-Associated Infections They have had excellent success at Johns Hopkins and other places...
  4. sauconyrunner

    Is it ever ok to stand up to a doctor?

    You must MUST correct physicians. BUT, just as you would expect them to not dress you down at the nurses station for something, you shouldn't either. What you said in quotes was actually very rude. Imagine, you are floating to a floor, and you need to put a foley in. You don't know where the foley stuff is, so you ask one of the CNA's to help you get it, and she responds "no I'm busy, get it yourself" Lots of ways to handle this have been discussed. It is only September, so its seems you have some still new residents/interns. They don't know much. I would have either discussed it with them in a polite way, "I'm sure Dr Smarty pants you didn't mean to leave that patient way high in the bed like that, and I'm sure you are going to clean up the room, since it looks like a tornado blew through!" If they still behave badly, I would bring it up with my manager and the attending if you have access to the attending/chief resident. They can not fix what they don't know about. You, by creating a scene at the nurses station have lost all bargaining chips because you were actually rude. They were wrong, but probably did that out of ignorance, and greenness. You on the other hand, can't really claim that. And of course, they won't be able to either in a few more months.
  5. sauconyrunner

    Things interviewees have said...

    I do some peer interviewing. Although we appreciate wit and sarcasm in our unit, somehow when the job candidate becomes "too personal" or too sarcastic it doesn't come across well. Example: We all have Frequent Flyers in ED's across the country, people that make us roll our eyes heavenwards. For some reason, even though we moan about them, as a candidate moaning about them has always been a next please for us. I do think we may have been hypocritical, but...
  6. sauconyrunner

    I just can't find a job.

    Florida is supposed to be one of the states that is still hiring... I am in Florida. I agree that googling Critical Access Hospitals may give you an idea of where to look. I would also make sure that you have an application in to ALL of the big systems. And refresh the application each time you see a job you qualify for. This and I think you may also need to look outside of Florida. Though I am surprised, because I see positions open in Fl all the time...its the No new grad thing thats awful. good luck.
  7. I have worked with LPNs in many different hospitals. In fact I was oriented to the Fast Track area of a Level One Trauma Center by one. Depending on which hospital it was at, some LPN's functioned fairly independently, some didn't. My bigger frustration was not with the title or the people, but the fact that LPN's in our state can not give IV push medications. Well, in an Emergency Dept....we give a lot of them. At one hospital which gave LPN's their own assignments, I spent a ton of time giving their meds, signing off on assessments and documenting the meds I gave. I decided that while they were awesome people, the ED was not the best place for that role.
  8. sauconyrunner

    Discrimination Against Ethnic/Minority Names

    Trying to figure out how this - non English Speaking Nurses- has any bearing on anyone's name.
  9. sauconyrunner

    Disgusted - wipes for bathing

    I wish more nurses would allow their younger, stable, ambulatory patients to shower- and to encourage it. Someone in their 40's in for a variety of diagnosis are able to shower quite safely. Now, Grandma in her 90's may be in the hospital because of her inability to shower safely. The recommendation if bath basins are to be used is this. Basin used only for bathing. Not for storage of tools for bathing like peri-care wash, various creams, shaving cream etc. After bathing, rinse basin and dry it, then wipe it with a patient safe antimicrobial wipe (ie NOT sani-wipes, cavi-wipes etc). Basins themselves are cheap cheap on contract we get them for our commodes for 0.24 cents a basin. But we also have to consider the environmental impact of a new basin for a patient daily. We would easily fill a landfill with bath basins. THink 800 bed hospital full to capacity. 800 times 365 = 292,000 basins.... It also depends on the wipes used. The ones we use are not at all like baby wipes- they are really thick and more like a regular wash cloth. The water becomes contaminated by the Basin which has been contaminated.
  10. sauconyrunner

    Disgusted - wipes for bathing

    The bath basins are actually a HUGE infection risk. We've cultured bath basins where I work. All of them grew out pathogens, and a good deal of them grew out MDRO's, and alarmingly the patients that belonged to the basins did not have MDRO's. (though I was able to then trace the MRSA in the bath basin to a pts new MRSA status, talk about GROSS.) It's not about the linens from an infection control standpoint, it's about the stupid plastic basins. If they were stored properly and DRIED, rather than being used as storage for a wide variety of things, we would have better success. What we recommend at our facility is that if a pt has incontinence, we use a towel, wet or dry soap or not to clean the patient first, then we use the wipe. It's actually more expensive for us to have the wipes, but we decided it was good for infection control. But we didn't get rid of washcloths, or towels. and use of them has not gone down. It's not the soap or water, it is the basin. Funny thing is we also did a pilot study with patients, and about 98% of them preferred the warmed bath wipes to a basin bath. And our nurses really like using them as well, we haven't really had any of the issues described here. I wonder though, if they would have been if we had tried to lower the linen par or take away linen.
  11. sauconyrunner

    DNR bracelet with DNR written on it. HIPAA???

    I did not read all 9 pages, but just like posting isolation signs, posting a DNR sign bracelet etc in no way identifies the patient with any identifying information, and if it is attached to them...
  12. sauconyrunner

    Pregnancy Discrimination - Interview

    There are so many if's and's and Buts about pregnancy that I can see that there might be some reservations about hiring in pregnancy. It is unfortunate that we are there, but...I can see the uncertainty, especially as I have seen many, not all, but many nurses decide to take 6 months off, after having been out for 2...and then some who leave entirely. Even though you say you would not, and you would not...some people end up doing that, and if a manager has been burned with providing training and what not...I can see where they would be leary. Good luck to you!
  13. sauconyrunner

    Bleach and C diff

    All of these MDRO organisms should scare the bejaseesus out of us all. Cavi wipes do nothing for C diff. Even the CDC recommendations are currently for Bleach...
  14. sauconyrunner

    Female Catheterization and UTI

    good tips. and a pregnant lady going for a C section should not be so dehydrated that there is no urine, though I guess it could happen...
  15. sauconyrunner

    Female Catheterization and UTI

    Well, if you break sterile technique yes, it's a problem. Especially if you have trouble with the gloves in a situation where the patient is not moving etc. Once you get a patient who is moving around, and you are trying to see- and the meatus of a real female may often more resemble a cantaloupe than what you might think it would look it...maintaining sterile technique is going to be harder, so if you can not do it on a dummy...going to be much harder on a real person... People get UTI's in the hospital for a variety of reasons. But one of them is having a catheter in for some time, germs easily can enter the urinary badder by simply crawling on the catheter...Proteus mirabilis is one that can actually kind of change shape to move up the catheter more easily. Obviously any person sitting in feces is at higher risk for the same problem... I am the person at my hospital who investigates hospital acquired UTI...clearly if the UTI is e.coli it is an issue of possible not being cleaned properly, and a nice passageway into the bladder. If it is a different organism not normally found in feces, then it is probably the introduction of bacteria from the catheter either by allowing the bacteria to travel there, or by introduction on the catheter when first being put in. Have you had microbiology yet? You seem to not understand the amount of bugs that proliferate and can crawl right up a foley. So to answer your question: Is a break in sterile technique a big deal when putting in a catheter? Yup. If sterile technique were not tthat important, would hospitals bother? It costs a lot more to get a sterile kit than to work with unsterile equipment. It might seem like a small detail to you, but when you think about all the small details that go into a procedure with sterile technique... which one is it ok to break? Which one would you want your nurse to break and decide "it wasn't a big deal"? I would like to add that placing a catheter in a female is not that difficult, I am surprised at the amount of people you know who say they have not been able to do this. I don't know anyone who says they can't....now some days and some patients, yes, bit not never...
  16. sauconyrunner

    Flu Vaccinations

    Agree with Ashley. Does this really have to do with patients? It seems to me that more people are concerned as the flu season starts, with the stickers that many hospitals are using to identify staff members who have not been vaccinated. As of January 2013, hospitals that want FULL reimbursement from CMS will be reporting the Health Care Worker Vaccination rates. Our hospital has stickers on Employees badges that let us know who has and has not had the vaccine. Those with no sticker, need a mask and there are signs that inform visitors etc that "No sticker=mask" And our No sticker staff are often called out by the patient to put on a mask. I think the patients have a right to know if their health care worker is vaccinated or not during flu season. If this is really about patients- We already Post isolation signs on doors and charts. They are not HIPAA violations, so a sticker identifying vaccination status would fall under the same rules. If we put a poster in our cafeteria stating that patients who have isolation signs on the doors, are in isolation, well that would be silly, but not a HIPAA violation.