11blade

"Listen to the White House press briefings and you will discover that those journalists apparently haven't realized that the level of disease spread is in control of all of that. It's no wonder then, that they are almost completely unable to convey that fundamental message to the public.."

If you enjoyed the critical care aspect of your ICU jobs you might look into CRNA school. Yes, it's more school (debt) but with the added benefit of more autonomy of practice, better pay, and less a-holes to put up with, depending on what surgeon you would work with. There is a more collegial atmosphere in the OR...most times. Like every thing, some places are outliers, but at least you decide on a treatment plan with your anes. doc, or on your own, depending on what state you practice in.

I don't think that is doable, politically or logistically. There is no political will to institute or enforce the measures that were used last year, even if they might help stem the spread. The politicians will be crowing about job-killing in the next election less than a year away. The business cycle decline is now cooked into the economy with the loss of 600,000 plus and counting consumers, including people that were spending money to keep the economy growing. Commercial investment (real estate) is in limbo, which has frozen all those assets in place until people start paying rent again, or, evictions begin. Covid with trade partners (Canada, China) has interrupted supply lines, also sucking money out of the system. Yesterday, China shutdown another major shipping port over workers with COVID coming in contact with sailors. I'm sitting in place, out of state, away from my home, unable to travel because Firestone stopped producing the air Spring that failed on my RV a month ago. I have lost a month's wages, waiting, not to mention the countless hours on the phone trying to source a part that they don't make anymore. I was able to get the engineer team at the company that made the suspension to look at other company's aftermarket products and FINALLY found one that passed their specs, AND, is in stock! I've learned in the past month, from talking to heavy truck parts suppliers from Alaska-Michigan-California-Canada that there are transport trucks sitting in lots for 6 months and counting, also waiting on parts. Worse than that, the mechanic shop that can do the scope of work (I've used them before) lost 50% of their workforce to COVID. One mechanic succumbed, another still sick and unable to work. The last operating room job I was at had 'backorders' on many commonly used surgical items. It SUCKS to tell a surgeon he just used the last staple load on a bowel and he'll have to use something else 'close' in size. People, this country's commerce is grinding to a halt! And, it has nothing to do with ordered shutdowns. The dysfunction is baked into the system at this point. Until everyone that can get vaccinated does, the rest of us who are aren't spending money unless we have to.

I personally didn't notice much of anything with the first Moderna shot in January. The second one was a different experience. I woke up the next day with some lymphadenopathy in the injected arm, as well as a red rash, in the same arm, not even near the injection site. Had a slight headache and stiff neck. I just rested for the next two days, drank lots of fluids and took Tylenol Arthritis strength. The symptoms went away. I don't know who's telling you that 'it will be worse for the second shot", but they don't have a crystal ball. If you have to have a second shot, make sure they administer it while you are at work, stay 30 minutes, and don't go back to work if you feel bad. NOTHING bad is going to happen! Some short term discomfort is well worth it to avoid being a patient at your own hospital. Also, remind the health nurse administering the shot to fill out a VAERS report on your symptoms. If you are being 'mandated' to be vaccinated, and, you have a bad outcome, the VAERS fund is set up to compensate for that. If you had to burn a couple of sick days related to post injection symptoms, talk with HR about who is paying for that-it should not be YOU! https://vaers.hhs.gov/

I'm a month ahead of you, gal. I was working with nurses, technicians and surgeons that felt they didn't have to mask up at work, including in a cysto case! Six months prior to my working with them, the military was in their hospital to help with the Covid surge. I approached management (all levels in the OR, up to Director) about the increase risk to patients and my own health working around people that weren't following the rules. I got lip service and no action. I finally walked out on a contract (with LOTS of notice), and I'm done working as an RN. I will be driving a truck for potato and beet harvest in Minnesota and North Dakota next month. Long term, I don't see my future being retired in this country. Talking with family (NEVER imagined I would do this!) about liquidating U.S. assets (property, vehicles) and moving back to Canada.

Uh, yes, I can speak definitively for ALL BON's on the issue on their purview and regulation of nurses, it's in every state statute published online for your review. "Nursing force"?! I wasn't aware I joined a 'force' when I got a license. Nursing may have been refined by the army, after Flo Nightengale, but if joined the reserves or the army I want their benefits, too-VA healthcare, GI bill, cemetary plot, etc.. "$10,000"....what is YOUR life worth? That amount is STILL not enough to make me go to a job where the people I work with won't even take the basic precautions to prevent transmission-handwashing, wearing a mask ALL the time, social distancing on/off work. I'm referring to NURSES I've seen at work, blowing their nose with gloves on, throwing the tissue in the trash, then grabbing a chart and going to take a patient to surgery! No glove change, no handwashing, no distancing in break room, and not wearing a mask when patients have left the department. "Email blast"?...going to the same SPAM folder as all other 'blasts'....

I disagree. Every one has to make the decision that is right for them. My choice to wait for the vaccine correlated with my actual ability to GET the vaccine. I was not going to be at the head of the line for this vaccine, but I was undecided on whether I would receive it or not. The facts that make this different from annual flu are the primary determining factors in my taking THIS vaccine and NOT annual flu(for over 20 years!). 1. The risk of NOT taking the vaccine outweighs the risks of taking it. Death doesn't scare me, living with residual COVID long-haul syndrome does. I have followed the data on outcomes from China since 1-2020, as well as Europe, Singapore, etc.. The science reporting validates the mainstream media reporting. This cannot be faked on that scale. 2. The infectivity rate of this virus vs annual flu is MUCH higher, and getting worse with every viral evolution coming from around the world. Pandemic, means that this virus isn't going anywhere for YEARS. The U.S. won't be finished vaccines for TWO YEARS, if ever. The rest of the world? Who knows? 3. The United States will be a reservoir of this virus for at least the next 10 years, allowing further mutations to circulate. This is primarily because of the inability of the public health system to coordinate efforts over a wide land mass, and, not having the infrastructure to do that for probably the next 5 years, if they ever get everyone rowing in the same direction.(political pressure) 4. The delusional faction of the public being exploited by political forces will persist in behaviors that will encourage spread...and, IMPORTANTLY, this includes some HEALTH CARE PROVIDERS (nurses, doctors, others). Increased communication and interconnectivity have elevated some of these people to prominence, further solidifying political aims of some bad actors. I have worked at TWO hospitals in the past year where I was at risk AT WORK from 20 somethings (partiers on the weekend? distancing? NO) that were dropping their mask at work, in closed spaces around me.

YES! Years ago, I was on bedside report with the team where the night nurse reported 'kussmaul' breathing with pauses...uh-huh. I lifted the patients chin to sniffing position, and golly-gee...air movement, regular, unlabored. This was before OSA was a thing...LOL

Your story PERFECTLY illustrates the tenet it is much better to know when NOT to attempt than to try and stir up the mud in clear waters (bleeding). Friable, post radiated airway tissue doesn't like being tickled with implements...you nailed that exactly!

The other posts about studying are on target. There are a lot more resources now (Youtube, online resources, this forum) to help you teach yourself. The big thing I would stress at this point is SELF CARE. You recognize that you've been out of school, and seem committed to putting in the work to get up to speed. There is a hack I used when I went to school that allowed me to recharge after a full day at class....naps. As soon as you get home from class, get 30-45 minutes in bed, sleeping or napping, NO MORE time than that. It resets your brain chemically and makes it MUCH easier for you to grasps new concepts and remember things. Then, be back in bed no later than MIDNITE...ALWAYS. The less you upset your 24 hour circadian rythm, the more effectively you will be able to study, write and work the next day. The first time you try to nap be sure to set an alarm AND go to bed, even if you don't sleep. If all you do is lie quietly for 30 minutes, that is a start. Once you find out how effective this technique is, you'll be eager to get to bed at 4pm, up at 445 pm then working like it's a new day, with energy until midnite. The nap makes it feel like you got an extra nites sleep, and the deadlines for your work aren't so scary, since you now have more energy than right after your last class.

Unfortunately, YOU threw yourself under the bus. Even though you gave report to the receiving nurse, and, called again before you left your unit, dropping the patient off in the room, monitored or un monitored, and leaving is a BIG problem for YOU, not the receiving nurse. You have a duty to the patient to transfer their care to another equally licensed or higher level of care provider, not just leave them with an RT at bedside. I have transported patients from the OR to the floor, after phone report, and waited, used the call bell, and waited more time until the nurse arrives in the room BEFORE I leave the patient's bedside. Sometimes, I have my OR mgr. on my comm device squawking about WHY aren't you back in the OR yet? Legally, I cannot leave the patient until I've transferred care...period...no matter what state you are working as a traveler. Years ago, a hospital I worked per diem at decided that the nurses on the floor were delaying us too much, so the managers in the OR came up with the brilliant idea to 'fax written report' to the unit secretary, who would take the paper to the RN receiving, freeing us to drop and run...WAIT...WHAT?! When I confirmed their paper was 1. not part of the legal chart, just a worksheet to be thrown away, and, 2. the form had not been authorized by the hospital forms committe, I politely informed the manager I would NOT be doing that. Everything that comes out of a manager's mouth isn't kosher with the nurse practice act....

Not working, NOT feeling guilty. In fact, training to get my CDL (Commercial Driver's License) so I don't have to take another nursing job until it is 'safe' to do so. Feel sorry for all y'all that just got out of nursing school and feel obligated to work as a nurse to pay back loans. Nursing work AND saving shrewdly has afforded me this 'pause' to re-evaluate what makes me excited to get up in the morning. When hockey hurt more than it was fun, I put my skates and equipment away. I'm in the same space now, making a decision about working as a nurse. I worked at some of the largest HIV treatment centers in the U.S. (Houston), understanding my risk of HIV, Heb B, etc. was elevated from working in the OR, but I felt relatively safe in my practice. This was because I could control what I did, being careful handling blood & body fluids and appropriate PPE. This pandemic is entirely different. In the past year, working in two different states that had mask protocol orders in place, I found myself in communities in those states that were living in an alternate universe. The non medical town folk, AND, the should know better nurses I worked with wouldn't wear a mask?!? Other colleagues report working in doctor owned surgical facilities that 3 of 5 doctors are COVID positive, and, never quarantined, never missed a day...came to work POSITIVE and thought that was okay because they were wearing masks?! I have experienced the COVID break room risk, with no distancing, people with masks OFF much longer than it takes them to eat or drink, and, managers that can't or won't lead in these difficult times. There is a turning over of reptilian management in healthcare, to something that is even MORE malignant and focused on dollars not patients or the infrastructure to provide care to patients, nurses. It was always 'bad' but it is orders of magnitude worse now. They expect nurses to battle COVID defenseless, without adequate PPE. This baloney about mask reuse was malpractice a year ago, and, in the elapsed year, production has afforded more supply to the market. One place I went to did a fit test on a very good N95, then switched the brand when you got to the clinical area, to something that didn't fit....criminal behavior, if I cared to file a report with CMS....I don't. Don't believe the doe-eyed looks they give you about 'lack of PPE', they know EXACTLY what they are doing, because their budget metrics tell them what supply levels they SHOULD have based on pt DRG's. Their cost saving bonuses are coming at the expense of not just PATIENT lives, but NURSE lives...they KNOW that! Will I take another contract RN job? Maybe, more likely NOT.

So the virus is AIRBORNE, and, the original poster points out the RT spends 'all day' in one room where people are eating and drinking WITHOUT HER MASK ON. That is NOT paranoid, that is a break in technique that management needs to address. The RT has the HIGHEST risk of catching COVID from the activities she is involved with. Planting her in the break room (confined space with LESS AIR EXCHANGES than other spaces) is a recipe to take out the whole unit's staff.

There is no infrastructure to contact nurses by the boards because that is not what their function is. At best, they can sell the list of licensed nurses to a company that would contact you. Nursing boards function are to regulate the practice of nursing, not advocate for the nurse. They 'protect' the public from inadequate NURSES, not disease.

My practice area is operating room, so I've assisted on thousands of intubations. The fudge factor for IO insertion is much less than that for sucessful intubation. It depends on why you need to intubate the patient. If you can maintain an airway and Sat with ambu, nasal or oral airway, keep doing that. The problem with pushing an RT or RN up to the head to intubate when you CAN'T maintain the airway is that the patient would present a higher degree of difficulty to an experienced provider, nevermind someone who is playing off the bench. Having seen the BEST of the best providers sweating on difficult airways, I would hesitate to rush to intubate as an RN, having seen what I've seen. Like starting an IV, sometimes it's better to look at a situation and realize there are better people for the job than you. And, having said that, situational exceptions may occur. IF I was in the middle of no where, AND, there was no upper level provider, AND I had adequate materials to do an intubation (crash cart, Glide scope, Eschmann, Rhino kit, etc.) would I attempt intubation IF THERE WAS NO OTHER capable provider? Maybe, maybe not. I've seen intubation shitshows where the parade of residents 'attempts' swelled the airway so bad, the staff anes. doc had nothing to work with....do I wanna be THAT provider? If the airway can be maintained without invasive monkey shines, stay in your lane.

Absolutely get the money together to buy one of those masks. I bought one last Summer, after seeing them in use by surgical assistants in the OR. In the OR we still have to put another mask OVER them because the vent flap allows our exhaled air to blow out, unfiltered. The MAIN thing I like about the mask is that they are so comfortable. The fitting around the face is similar to an ambu bag mask, form fits to all kinds of face shapes. The form fitting + soft silicone material provides a MUCH better seal than any other N 95 mask I've worn. The next BEST thing about the mask is the frame that holds the filter material away from your face. Your face feels DRY all day, because the exhaled moist air isn't precipitating the moisture on the barrier type masks that are in constant contact with your face. The only thing I don't like about them is their weird straps with ear pieces. The ear pieces are too uncomfortable to wear longer than an hour or two. I just tied them together, because I haven't decided if I want to just cut them off entirely. Pro tip: Take time to get the mask comfortable on face, fitting the straps, etc. at the beginning of your shift and you will have longer filter use. The more fiddling with it, adjusting on your face, taking it on & off, the more wear and tear on the filter in the filter holder. Once the filter won't seat properly in the frame, it's time to throw it out and get a new filter. The mask comes with 5 filters and a container to store the mask. Buy an extra 25 filters when you buy the mask to save on shipping.

This is ABSOLUTELY done in California, where rent is so high. I worked with a surgical scrub tech (both of us are travelers) that told me about heading back to a 2nd assignment at a California hospital (large city) where she would spend the entire 13 weeks living out of her van in the parking garage ROFL! She was very low key about her footprint in the parking garage. The van windows are blacked out with insulation (reflectix) and curtains so that no one can see inside. She is very careful about who is around when she enters/exits the van. Showers are done in the OR locker room showers. She leaves the parking garage on the weekends so she can cook, since food odors coming from the van would be a giveaway. She works all the OT they throw at her and they are overjoyed they have someone who will work all the hours. A year is a bit of a stretch, but if you are careful it might be done.

"Extreme circumstances" don't appear on a schedule....I'm scheduled to get robbed today, so I think I'll carry my gun today. Likewise, carrying a gun is not an innoculation against criminal behaviour. Accuracy and judgement aren't conferred by osmosis just by picking up a gun. Consistently practicing with a weapon, including getting it out of a concealed posture, are mandatory. The gun is not the weapon, YOU are the weapon. If you don't go the next step and get the proper training it's like turning a16 year old loose with the family car and NO driving lessons. If you are not willing to make the commitment to training to safely operate a weapon of mass destruction (car, gun, chainsaw, etc.) you are right to decline to do those things.

I guess you haven't experienced 'extreme circumstances' yet. I have-burglar at top of stairs in townhouse, me waking up to go into work on Sat. for on-call ortho case...me: no gun, burglar: armed? Unknown, couldn't see his hands. Thank goodness I convinced him I was armed (total BLUFF) and he ran down the stairs and out the window he removed to get in. Or, my neighbor, cycling with her two small children on the local bike path 1 mile from my home in a 'nice' area, robbed of her wedding rings by man with knife last week. If you have some magic wand, other than a gun, that immunizes YOU from being a victim of criminal behaviour, please share where I can get one, too. Until then, I carry, legally and lawfully. This means CC in places that do not discriminate against legal & lawful gun owners. Do I go to a movie theater? Not if they demand I be unarmed. I will stream what I want to see if theaters want me to leave the gun in the car. Do I carry in a hospital, govt building? Hell NO! As I mentioned, LEGAL & LAWFUL are keys to being a concealed carry license holder.

The level of transport is not the issue. The receiving nurse did not get report prior to the patient being dumped on the floor. What if all nurses are responding to an emergency on the floor at the time the patient is put in a room? What if the covering nurse has an emergency with her own patients, or is otherwise tied up and cannot get report or see the patient? If you, the transferring nurse, cannot document that you transferred care to an equally competent level of care (another RN), you risk charges of abandonment. A fax report to a fax machine does not meet that nursing standard in any state. Here's an example: Nurse A in ER faxes report to floor at 1145hrs. Nurse B (receiving nurse) is off floor on lunch break. Nurse C (covering nurse) doesn't get fax paper as she and every other able body on floor is passing out trays or helping feed patients. Transporter drops patient off in room unseen by floor staff (busy in patient rooms). Patient suffers some bad outcome after arrival on floor and there was a delay in nurse admitting pt to floor. Who's license is on the line? The transporting nurse. The receiving nurse could 'lose' the fax paper and claim there was no notice of transfer and no report given on patient.

I can't give you an exact quote on commercial liability insurance, I would have to get that from an agent. I have discussed this with my personal insurance agent who doesn't write commercial. Civil vs criminal attorney? Depends on what you do with the gun when you whip it out. Reason out what you are implying about pulling out a gun on premises of any employer (paint store, donut shop, hospital) that has a written no-gun policy. I've attached a reference for your edification..... https://www.associatedbrc.com/Resources/Resource-Library/Resource-Library-Article/ArtMID/666/ArticleID/610/Conceal-carry-As-an-employer-what%E2%80%99s-your-liability

I hope you have consulted your own personal attorney to make that statement. In the event of a worst case scenario, you shooting someone at your job site, are you SURE they will back you up? Does your employer have a gun carry policy? Does is specifically authorize you to carry a weapon on premises 'if requested' or is it the usual blanket 'no guns by anyone' policy. Your employers liability insurance policy costs a LOT more to have you on premises toting a gun around. These questions are better answered BEFORE there is an incident, not after when your doc and employer are standing in front of the TV camera denying they said that to you..just saying.

I agree with others-apply for unemployment benefits NOW in the state you are working in. You may not even be able to get through right now, but keep trying. Some states have a waiting period for benefits, so you want to do this soon. It may take some time to get paid. I was lucky this past week. I spent all day on the phone Monday, got a live person. I had applied on line, but the online website directed me to call. I was unable to get through until just this week. I got submitted Monday by the live person, then the computer had to update overnight..a few overnights. I requested payment on Wednesday and actually got a payment (6 weeks) on Friday. Don't wait, you've earned that money!

I hope you realize that this is textbook definition of abandonment. If the transfering nurse allowed this to happen, and, some harm came to the patient on the floor, the nurse would have to answer Board of Nursing charges, NOT administration. They tried a variation of this in a place I worked years ago. Manager said in am report that they were going to do a 'new' thing in transferring patients out of PACU to the floors. I, the PACU RN (also the pt's OR RN, too) would just write up a report sheet, fax it to the floor, and send the patient up with a transporter (non medical assistive person). I looked at the form, which didn't have a form number assigned by the institution and asked when it passed the forms committee. Mgr looked like a deer in headlights...'committee'. Any form or change to policy and procedure has to be passed by the hospital committe prior to being instituted. It gets reviewed, especially by risk mgmt (legal team), with yay or nay. She said it hadn't gone thru committee, so I told her I wouldn't be doing that until it did...end of that crap!