vamclouky3

In reply: With some persons you can fight a losing battle with a person that does not reform, so that puts you & the patient(s) in jeopardy by distractions that have nothing to do with A - B. Its the aptitiude that falls short of where the real problem began and how to fix it quickly. Find an avenue in private with a third person i.e. Nursing Supervisor or Nursing Chief and get it all out and decide who gets the boot or reassignment per person's choice. Death of a patient because of distractions costs a Nurse their entire career. Eating crow is not part of the deal with a bad co-worker. Handle it and be strong cause if its not YOU then who? Take care. ]

As a transporter:) , You come across all types but mostly the ones that are drunk, throwing up some or even cussing at the staff and here I come along to take this person to 2nd flr xray for a CT scan of his head. Full bolus on Vitamin pak, EKG done, VSSq30, U/A,C7 or spectrum, and whining cause they are hungy and knowing its an NPO order. And then it changes to a 1:1 by the afternoon he crashes and wants to kill everyone in the room -- i.e. security is nearby. Now the men who miss the urinal that is the funniest trying "REAL HARD" to assist standing up wobbling by the Stryker pee hitting the floor, patient curtin, shoes, pants, slurring loudly and flirting with me all at the same time while helping the ER staff make bio-collections. But I always recieve back the patients I cared for up on the units so I know them all by name now. I like helping down in ER because you learn alot more there than actually working on a Nursing unit. I seen ABGs being drawn, how to do H.L.'s, foleys by watching never really put one in a female/male patient though. :stone The one thing I want to do is go to Nursing School for LPN...yeah, yeah about the RN stuff its easier to move around than with an RN degree not as much school requirements but like the hands on with the patients. I care about my patients alot. T:rotfl:hanks

03/03/2005 In Nursing, there are "strong types" and "really tired of it". The strong types are the ones who make an effort to get along with the individual that is making the difficult task of taking care of the patient a problem, daily. And the other really tired of it meaning "had enough" got to take care of it now before I holla off and do something I might regret. Never, ever, ever use that supervisor as your crutch they like to get in messes like this its what admins do...Meddle. If it becomes an issue with the Nurse Manager and its affecting your work then by all means SAY SOMETHING NOW!!!! The patient don't want to hear anything about they worried about themselves and competent persons to take care of them as you dignify the situation. Stress is nothing to play with either...You did good by taking care of the situation and maybe they will now earnestly place you somewhere on another unit where you can still perform your nursing duties and they deal with the naughty unprofessional person through board policy. Don't quit the hospital unless you have alot riding there and family priorities that will have to endure a change in lifestyle. So, take the time to find yourself first and then go out again to that person and explain nothing but you did not want to stop acting like a two year old and not profession like your supposed to act -- I am not your momma and believe me you will someday see my point of view but for now my place is with my patients somewhere else but not here with you. Don't offer anything else to this person she wanted to act like a child be professional and let matters rest. Have a nice night. :rotfl: :uhoh21: :uhoh21:

this is er mica's: emergency room visits micas/profiles emergency room visits documentation the diagnosis categories used in this mica are based on the principal diagnosis which is submitted as the first of 23 possible diagnoses coded on the emergency room visit record. for purposes of the data provided in the community data profiles and missouri information for community assessment (micas), the term emergency room visits refers to episodes of care provided to missouri residents at hospitals that have emergency room facilities. the source of these data is the patient abstract system (pas) data file, which is compiled from hospital discharges, emergency room visits, and outpatient surgery records that are reported to the department of health and senior services by state law. the reporting requirements for the pas have been in place in missouri continuously since 1993. in some instances, certain data values in the patient record are missing or miscoded. visits with missing or miscoded data values are included in the statewide totals, but may not be included within the displayed categories of certain variables (e.g., race, county of residence). thus, a total of all categories of a variable may not equal the statewide total for that variable. patients with a missing state of residence were deleted from the analysis file. those visit records identified as missouri residents, but missing a county identifier, are included in the statewide totals only. emergency room visits definitions diagnoses and procedures associated with emergency room visits are classified in accordance with the ninth revision of the international classification of diseases (icd-9). this classification is the result of close collaboration among many nations and non- governmental organizations, under the auspices of the world health organization. its original use was to classify causes of mortality. later, it was extended to include diagnoses in morbidity. for example, the "clinical modification" of the icd is used in categorizing hospital diagnoses. in practice, the icd has become the international standard diagnostic classification for all general epidemiological, as well as health management, purposes. the ninth revision of the icd has been used to classify disease and procedures beginning january 1, 1979, to the present. clinical classification software the diagnostic groupings used in the emergency room visits profile and mica are based on the clinical classification software (ccs). ccs is a tool for clustering patient diagnoses and procedures into a manageable number of clinically meaningful categories. it was developed by the agency for healthcare research and quality (ahrq - formerly known as the agency for health care policy and research (ahcpr). the tool is updated periodically. it was originally named the clinical classifications for health policy research (cchpr). the ccs compresses the 12,000 diagnosis codes of the international classification of diseases, 9th revision, clinical modification (icd-9-cm) into 259 mutually exclusive categories. in its multi-level mode, the system further categorizes these 259 into some 26 broader groupings. the system can be used with any data that are coded using the icd-9-cm. it has been shown to be helpful in understanding and analyzing patient data by managed care plans, insurers and researchers. further information on the clinical classification, as well as the list of diagnoses and procedures utilized by ccs, can be found at http://www.ahcpr.gov/data/hcup/ccs.htm. if this is not what you was seeking then recheck the web that is where this came from. hope its helpful. :rotfl: :

02/25/2005 In response to this thread: Many employees supervisors don't listen to their employees at all just want to save that little money in the budget, first!!! When (we) inform your supervisor that we need to see the company nurse its always ...well maybe or not at the moment too much paperwork...Its a jip!!! See, the employers find the weak ones then they find ways to get rid of them and the strong ones become their "pet/favorites" because they believe that they will become their friend -- favors and whatnots, kiss ***, suck ups, etc...Okay wrong way to go about this but it does happen. So the ones you treated down in ER didn't lose no time off from work did they? If not, then good. As far OT for you taking care of them you should have gotten your PAID time in logged. No excuses. Migraines and anyone's job goes hand in hand. You either let the crap go or make some restitution to fix the error with your employer. Nurses work long, shameful 12hr shifts (which is alright) but you end up making up time for Mandation the next day. MICU,CICU,SICU,NICU's,ER,L&D all have these tumultious hrs that unfortunately human beings are always getting sick or having babies or GSWs, ESRD,CHFs,Diabetics,Heart patients,hypo-/hypertensives all come back to the hospital in some sort of fashion. We all have our ways of dealing with stress and (we) nurses have to decide how much we really want to stay in school and miss our life in between cause in the end its you that has to be happy with what you can put up with. True? or not? WBS

02/20/2005 You know me not being an expert on nothing but you know there is only so much medicine can do for the body in order for it to "heal thy self nauturally". The body had developed a tolerance for the drugs taken and its not working anymore so you "need" something much stronger for the same effect i.e. smoking, caffiene, sex (just examples) but to read this exemplifies the need to self manage the symptoms. Imitrex has side effects noted and truth be known Steroidal aside your going to have to decide some natural ways to conquer the migraine headaches. Have that coke once in awhile and your basically telling me also your STRESSED out with your life!!!! With toddlers who has the time to make school when you have to pick them up before six p.m. everday. Your too young for this crap babygirl slow down before you end up in the mental unit and FMLA won't cover that. Sit down, regroup priorities again, find some suitable help with finances, toddlers, DOWN TIME, a study buddy for school if you don't drop out for being overtaxed; See your employer to redo your work days like everyother day SMWF schedule so you can manage your life better. I dream of returning to school for my RN even though I am N.A. one day but in reality -- work full-time, kids under 13 in school, parents who are running out of patients with me, finances,etc..life sucks but you keep plugging away but remember your "a" human being first and foremost! Make the re-adjustment before you collapse of strain the body knows when to stop doing nothing that is not working. Meditate, Aromatherapy,Homeopathic remedies w/Dr's assistance, look for a grant that helps single mothers out so your burden is lessened. Get Matthew Lesko's books on the web check through them and see what can be available for you in your state -- cannot hurt to look. Thanks. __________________________________________________ 12:44 pm

...Get your eyes checked out could be major sensitivity to any light source. In the middle of cooking dinner for my boys...later!!!

02/19/2005 Already knew that :Melody:

To put it bluntly...she was out of line professionally. Hello everyone I carry two titles, (1) Transporter by day or (2) Nurse Assistant...Now which one of the two I am is the funny part that changes daily where I work. You have to learn to adapt quickly with the changes. The RN in question had a problem with not getting what she wanted and that is a support person like an LPN who can do most of everything but this nurse did not lift a finger to help you. She always set you up so that "some sort of violation would be addressed." Now, I came in with no experience as a Nurse Assistant. Training was offered as part of the job condition and be flexible with hours. As over time I got accustomed to some aspects of Nursing as a whole but fascinated with what all goes into being a "nurse". Anywho, my friend, who trained me as a transporter got promoted to another higher paying position. She had been in govt for 26 yrs it was time. So, the other one who was over me well was out on sick leave changed jobs temp then I was lead person. To make a long story short...I trained lots of people under me and all have graduated to better jobs. I, on the other hand have to bid out this year for more pay & experience. This RN was nasty to my crew telling them that "she wanted a RN not a support person" and my new trainee under me was just finishing up her 6 week orientation that day. Me, trying to figure out what she had to get but only a signature from the Preceptor. My trainee had to be pulled to the floor for support work for awhile but she came back and told me what she said to her face...which was inappropriate very unprofessional. I made it known that I did not approve of this type of behavior and the Preceptor heard her say it to her face. Immediately contacted my supervisor and sent down my trainee to her office. The same day it was brought to my attention that an inquiry was being made into this allegation and my trainee was worried for getting a bad rep 6 weeks into the job. The next week a hearing was being set up to discuss it with the Nursing Manager, RN (Beotch), and my trainee. After it was said and done the RN has had several complaints against her anyway about her non-professional overeagerness to please but herself. Rude to the Unit Secretary constantly....Case in point she left me with her patient who had a bowel movement for 10 minutes then acted like I left the room telling me..."OOOh, I didn't know you was in here??" Yeah, who ya trying to play me now...told my supervisor about that too then she cancelled my support duty for the day and returned back to transporting. The RN was let go for disciplinary reasons as well so after that the floor she worked actually (tension wise) got better. The other people on the floor kind of looked at me as hmmm maybe we should have done something about this first ourselves.:chuckle All it takes BUT One TO get on your last nerve!@!!! I know everyone in the hospital on a first name basis now. I could say that congeniality is the key but patience is the other. When I first started in orientation class in groups we had a question to answer>"What is your job?: and I replied that :I am just a transporter: and too my suprise the following year with the same question winning an award for best new employee the same question, different answer..."I was wrong...my job is to help my patients recieve good care no matter what and to thank my colleagues for molding me into a much better person for being here".... I got applauses from everyone and I told them I love them all!!! :-) Anyone else had to deal with an obnoxious p.i.t.a. co-worker well x-co-worker???? WBS:coollook: :balloons: --------------------------------------------------------------------------

02/18/2005 Sounds like work related stress to me and lay OFF the caffiene at lunch or during the day. Inform your Nurse Mgr that you need to see the Employee Health Nurse to help you out and take care of it. Either switch to a unit with less patients or cut back your hours on the job to third shift, less work. I was having migraines and actually within a two week period missed 5 days total but my boss was not understanding the reason for missing work. So, I basically told her I cannot do all the work (transporter/N.A.) without any help and when you have the entire hospital to do -- admissions, emergencies, or just plain support person your gonna get spent...emotionally. With shoulders hurting, back, sciatica down one leg (me) its a battle and also a torn Rt tibia that WILL require surgery to correct it. Be down 8 weeks if I actually get it done. Tiby is work-related injury....Ouch!!!! WBS :Melody: :balloons: -----------------------------------------

02/18/2005 In firm reply: You are required to notify your nurse manager of what your unit needs and anything else goes back to your floor supplier, ours do. If your out of Iso gowns, masks, gloves, needle boxes (housekeeping duties), etc all goes back to your Nursing Manager. That is what they are paid to do -- staff the floor and keep the patients safe. And the bloody scrubs deal get a "red disposable bag" and have a change of clothes with you @EOS and get some surgical socks (slip ons are available ask your linen service to bring up some for your unit.) Its your fault for not making sure your patients are taken care of if you cannot protect yourself first. Yeah, the body fluids are a pain to deal with Urine, blood, feces (messy, stinky, pungent...), snott, sputum, oozing places on the skin where breakdown is occurring - lots of Camoseptine ordered for most of our Ttl Cares now. That is all for now.... :balloons:

In reply to this: Most or all of the doctors that I work with usually wear ties in or dress semi-casual. As far contamination they as well as you are working around patients with all kinds of diseases like MRSA/VRE/Staph/HIV/HepA-C, etc so if your not wearing your protective (yellow iso gowns) then you know better. Its required. Read all signs to visitors that don't know anything about why their loved one is in a private room or (pos pressure/neg pressure) room. I make sure that all visitors know why it must be worn, hospital policy, how to wear the N95s (banana face), to wash up using the macrobial soap up to their wrists, and wash clothing in a bit of non-chlorine bleach when get home, spray shoes with disinfectant, keep young children out and why, do your job when required to work in pairs is always best one will remember to do it if your called away to take care of something important. Keep up with lab order requests, bed transfers or admissions, chart everything unless using CPRS for all functions, watching 1:1s or just sit with them if FP, accucheck verify info on new admissions, diet order changes. Best of all be good to your patients spend time with them because when its time to chart your brain will kick in and you can get it done faster. Always write down the Oxygen orders if per NC,NRB,BIPAP,RA c Ox supplement, Sterile water inhalation, breathing treatments NOW orders, general info on upcoming tests make sure the NPO patients are not sneaking food if they are then take it away from them and explain why they must not eat....ALRIGHT!!! :balloons: