RoamFreeRN

My check cashed 1/13 & that was also the date on breeze. I got my license yesterday (3/13)! :)

There are some concrete guidelines (like critical values), but this is also something that involves critical thinking & nursing judgement. Is this a new problem or chronic issue? Is the abnormality already known & addressed? If addressed, has enough time passed that you'd expect results? Is it a value that, while may not be critical, may indicate a complication of the pt's problem/condition or a side effect of a new medication? Would a change in this value possibly require a need to re-evaluate a medication dose? This judgement comes with experience, as well as with a practice that is not just about carrying out tasks but is also about understanding physiology/pathology and ​pts response to a diagnosis or condition.

I don't know if this is state specific, but at least here in PA there is also PHRN---pre-hospital RN---certification. The course runs over 6 months & includes both didactic and clinicals.

Call up your hospital's Child Life Specialist (if you have one)...they're great for preparing & supporting kiddos in these situations.

The hospital itself will suffer, sued or not. Talk about a PR nightmare:barf02:

Yep, 4 hours max. Lasix in between units for CHFers. if it has to run really slow then I've had docs order half units...1 unit = 4hrs whereas 2 half units= 8hrs.

Um, if your hands look even remotely close to that pic then you can NOT work! I know, at least at the hospital I'm at, working with open wounds is a NO. I've seen co-workers put on leave by employee health for stitches on areas that could be easily covered ( like upper arm). Your skin is your most effective barrier against microbes. Even those of us without allergies are encouraged to moisturizer in addition to sanitizing...chapped, broken skin should be prevented. Think about the risks to both you and your patients!

Reason? Doc's 'judgement' trumped ACLS protocol.

Just thought I'd come back & update: I started a partial/day program this week, which is about 30hrs a week. Amazingly it works around my full time job. It's a lot/busy...but I really want to make it work! Already I'm doing better...it's so hard, but having the support and structur is making it doable. As much as I'm scared and uncertain, I'm also relieved to now be on track to win the battle!

Firstly, thank you for the advice re: a written complaint. Makes sense. Second...weight alone can not make someone impaired in my opinion. This weight is only slightly lower than what I've weighed for years...I've never been more than 84% IBW. I'm not saying its healthy...but I'm no more at risk because of my weight than a 350lb nurse working. Yes...my behaviors do create risks which could interfere with my job. Currently they are not, though I know that's where I am heading if I don't turn things around. Start a partial program on Tuesday...scared but ready to fight!

Well, update: today the VP of the facility contacted me, and actually apologized for all this. She said he is new, blah blah blah...I certainly gave her my complaints about this guy! She assured me no reporting will be going on, especially as I am actively working on trying to get better. Technically I could go after him with a formal complaint...but a) I have enough going on for myself and just don't have it in me, and b) the VP assured me he'd be getting some words and further training.

Thanks for the replies. I really think he's trying to scare/threaten me into their particular program. My doctor told me that during their conversation he said he probably wasn't going to do it right now...but then when I talked to him he brought I up again (it his 'ethical' obligation). So the crappy thing is now I have another thing looming to make me anxious, wondering if or when I might hear from the BON. I feel like I should be reporting him for unethical behavior! He also called my mother...stated that this is an emergency! ReAlly?! Someone actively reaching out, plus cleared medically, is an emergency?! So mad. Well, trying not to give up...hoping to be more 'on track' in recovery by the time I might be contacted, making him look foolish.

So I'm fuming right now...and scared. The story in summary:I am a critical care RN with 4 years experience, working full time in a cardiac ICU. I have struggled with anorexia and bulimia since my teens, unfortunately never achieving full 'recovery' but a least periods of relative stability. I have taken time off work to receive intensive treatment, the last time being 1 1/2 years ago. Currently I've been struggling more again, and yesterday had an assessment for treatment...hoping to do a weekday partial 'day' program that would not interfere with work (I work weekends). Well, this place's policies related to weight criteria are strict, and they will only recommend their residential program for me due to my weight (75% IBW). So now I'm looking into other programs that, although less ideal due to distance, will work with me OP. I have also seen my medical doctor this week, had labs/ekg, and shee aggrees a day program is in fact appropriate for me right now. Anyway, the LSW who I talked to at the first place is now saying he he going to report me to the BON as an 'impaired professional', despite my medical doctor's clearance (she talked to him) and despite the fact that I am voluntarily/actively pursuing treatment. I've NEVER had any issues at work related to my health or the care I give. Can I actually lose my license over this?! To me, I would think if I'm cleared by my doc and obviously seeking help, it should remain a private medical matter. But I'm worried and upset. Thoughts?!

We 1:1 fresh hearts for 6hrs, then longer only if warranted (very unstable...). IABP in itself doesn't buy 1:1 for us...most often they're paired with another stable/"easy" pt; only 1:1 if extremely unstable (lots of pressor titration, CRRT, etc).

Often what we do is not noticed until we don't do it!