Demonsthenes

I suggest that you obtain your Advanced Cardiovascular Life Support certification upon graduation. This should compliment the vast array of theoretical and practical knowledge that you already have as an LVN. The most important knowledge, skills, assesment, and intervention skills that you can have as a nurse are related to the cardiovascular, respiratory, and neurological systems. These systems are requisite for the support of life while the other systems are generally secondarily requisite for the same. The training that you receive through ACLS will prepare you to deal with emergencies and non-emergencies with regard to these most important bodily systems. Further training will only build upon this basic knowedge. You can more effectively build your knowledge and skills, after obtaining your ACLS, through nursing, in my opinion. I obtained my ACLS last week.

It is clear that one of the reasons why there is so much nursing burn out and so many medical errors and medication errors is the 12 hour shift. Also, the fact is that hospital nurses have significantly shorter life times than women in other professions. It is clear that one of the reasons for this is the emotional and physical stress caused by the 12 hour shift. End the 12 hour shift.

In phase I trials, the concern is to establish the safety of the medication and the appropriate safe dose. As this is the case, you need to report your concerns to the specific external committee responsible for insuring patient safety. To find out the name of the committe, ask the sponsor about the same. Or call the Federal Food and Drug Administration and ask them who to contact.If you do not do this, both the results of the study will be seriously compromised and the patient safety will be compromised. The guidelines for reporting to these committees require that no retaliation be taken against those who report the same anomalies. In fact, you will be assisting the company who is making these trials obtain the verifiable results that they want rather than sabotaging them. Those who are really hurting the drug company are those who insist that you follow the unsafe procedures now in place. I will soon, probably, have both my Clinical Research Associate certification and my ACLS.

Critical thinking is imperative for nursing. Therefore, a good knowledge of the basic principles of deductive logic is important as the same is the basis for critical thinking. There are two basic types of deductive logic. The first is the categorical syllogism and the second is the conditional syllogism as an subset of the hypothetical syllogism. The categorical syllogism state: All humans communicate through language, Jane is a human, therefore Jane is a human. This sort of categorical syllogism analyzed through: A. The definition of terms B. The Quality of terms and C. The quantitiy of terms. The type of reasoning generally used in every day life and in the clinical arena is the conditional syllogism as a subset of the categorical syllogism The conditional syllogism states: If a is b, a is c. A is b therefore a is c. The conditonal syllogism's rules are basically. If the antecedant is true then the subsequent is true. If the subsequent is false then the antecedent is false. If the antecedent is false, the subsequent is not necessarily false. If the subsequent is true, then the antecedent is not necessarily true. If you understand these basic rules of deductive reasoning, then you will understand the "critical thinking" that is so very important in making those critical nursing decisions and nursing assessments.

You should have followed the Advanced Cardiovascular Life Support protocol for Acute Pulmonary Edema, Hypotension, and Shock Algorithm. First you should have identified the most likely problem: 1. Acute pulmonary edema;2. Volume problem;3. Pump problem; and/or Rate Problem. From that point on in ACLS the treatment protocol treatment varies accordingly. Remember the aforementioned when identifying possible causes: Hypovolemia,Hypoxia; Hypo/hyperkalemia; Hypoglycemia;Hypothermia Toxins; Tamponade,cardiac, Tension pneumothorax, Thrombosis (coronary or pulmonary and/or Trauma (hypovolemia, increased ICP). I hope that this helps a little.:nuke:

My suggestion is that you do research on the role that "critical decision making" makes in nursing and how nursing educators should incorporate the same into their lectures on appropriate subjects such as Medical-Surgical nursing. For example, you might delve into the Logic related to deductive reasoning and how it relates to the Categorical proposition and the Hypothetical proposition. You might show how the conditional proposition, a derivative of the hypothetical proposition, relates to the critical decision making related to nursing practice. I tutor RN students and emphasize critical decision making as it relates to nursing practice, especially with regard to how the same relates to the tenets of logic, deductive reason, and hypothetical and categorical propositions. I hope this helps a little.:rotfl:

I suggest that you become ACLS certified. ACLS stands for Advanced Cardiovascular Life Support. With regard to preparing for the ACLS class, a good book is the Handbook of Emergency Cardiovascular Care for Health Care providers. The book is sponsored by the American Heart Association. It should cost below $18.00. By becoming ACLS certified you not only acquire new valuable skills that will make you more marketable in the nursing employment market, you obtain CEU's that might fulfill your Board of Nursing continuing education requirements. This book would probably answer the particular question you are asking and related ones. Best of luck!:roll

What the original poster exemplified is called a "hostile working environment" legally speaking, a form of illegal gender discrimination. Isolating an individual from other males is evidence of the same. Such isolation techniques have been used by plaintiffs in law suits involving "hostile working environment" as evidence probative of the same. By isolating the male nurse from other male nurses, other discriminatory practices can be utelized against him surrepticiously. I suggest that you contact an attorney about this matter. I would not refer the issue to the E.E.O.C. as this same agency has been sued by the Center for Individual Rights (I believe that that is the correct name) asserting that this same agency promulgates massive reverse discrimination against caucasian males. I believe the law suit was entitled "Worth v. Jackson". This agency would, probably, only collude with the employer to cover up and promulgate further gender discrimination. However, again, I suggest that you contact an attorney with regard to this matter. I am not an attorney. I am a Certified Legal Assistant and an R.N..:)

Because of the complexity of the facts at issue concommitant with the myriad number of legal issues involved, I suggest that you do two things: 1. Purchase health care provider negligence insurance (for example from Nurses Service Organization) and 2. Talk to an attorney with regard to this matter. I believe that my advice to you will provide you the best possible outcome in your particular situation with the minimal amount of both emotional distress and financial cost. In general, in negligence actions you must prove, by the preponderance of the evidence all of the following: 1. Duty ( in the case of a nurse what a reasonable nurse would do using ordinairy prudence under the same or similar circumstances). 2 Breach of duty 3. Causation and proximate cause (that is any damages caused are reasonably foreseeable) 4. Damages. I hope this helps a little. I am not an attorney. I am a Registered Nurse and a Certified Legal Assistant.

As with all professional- client and professional- professional relationships, each party has a duty to co-operate and to demonstrate "good will" with regard to the same. If one party refuses to do the same, it is your prerogative to give reasonable notice that you are quiting the patient. Without giving a reasonable period for your notice of quiting the patient, you might be accused of patient abandonment. I would deal with these recalcitrant individuals through a third party, if possible, such that there can be no equivocation about the reasonableness of your difficulties and your possible and/or real intention to quit the patient. Best of luck!

When I went to Texas Womans University Nursing School in Dallas, two of my nursing instructors failed me stating that " I would make an excellent doctor but a poor nurse." I have a B.S. in Biochemistry and am a Certified Legal Assistant.Also,in a large class at Texas Womans University, in an auditorium full of at least 100 nursing students, an R.N. instructor at that same school stated: "Good nurses do not make good doctors and good doctors do not make good nurses." After she stated this all of the nursing students smiled and noded their heads in approval. I just sat their amazed at the blatant sexism openly voiced. Now, I have come to realized that my two instructors and the one in the large class room were not only openly voicing their sexist prejudices but, also, voicing their opinion with regard to the stereotyped socio-cultural class of nurses. That is, good nurses should be female and from working class back grounds (remember, at one time women from upper middle and upper class back grounds were not allowed in nursing. It was a profession considered beneath them). Good doctors should be male and from upper class or upper middle class back grounds. I am a male from an upper middle or upper class back ground. Therefore, my instructors thought it was inappropriate for me to be a nurse but that I would make a good doctor. In my career as an R.N., I have found this socio-cultural stereotyping as much as a cause of discrimination as my gender. I hope our legislators take some action to protect male nurses from discrimination, something which that have refused to do.

In ancient Rome, only those of the upper classes were allowed to wear an all white toga. Therefore, I would suggest that all nurses wear a white lab jacket over civilian clothes. I do not like wearing an all white uniform. However, a white lab jacket has, as per the above, positive implications as to the status of the wearer (nurse or doctor). While an all white uniform has a negative implication for the wearer implying a servile status (like a maid).

A "nursing diagnosis" generally consists of three parts (P.E.R.). The P stands for the patients response to the problem. The E stands for the etiology of the problem. The R stands for the signs and symptoms of the problem. Only those patient problems which can be addressed by the nurse can be subject to "nursing diagnosis". A problem that requires the collaboration of both a nurse and another health care professional (an M.D. for example) can,aslo, be subject to a nursing diagnosis. A problem, such as certain medical problems, which can not be addressed in any manner by a nurse can not be subject to a nursing diagnosis. Thus given the above the P might be: Anxiety ;E might be:r/t financial distress ;R might be: with insomnia and anorexia.

When I went to Texas Woman's University school of nursing in Dallas, two of my nursing instructors told me that I "would make a good doctor but not a good nurse." Also, an nursing instructor there at a large auditorium full of nurses stated: "Good doctors do not make good nurses and good nurses do not make good doctors." All of the nursing students shook there heads in approval at that statement. Yes, there is both gender and class based discrimination in nursing. In the past, nursing was limited to women from working class back grounds. Women from upper or upper middle class back grounds were not allowed in nursing. Of course, men were not allowed. I graduated from another nursing school other than Texas Woman's University. I hold a B.S. in Biochemistry. I come from an upper class or upper middle class back ground. My father was an attorney at law as was my grandfather. In any case, it is clear from the statements made by my instructors at TWU that there are covert and overt forms of discrimination in nursing both because of gender and social cultural back ground comprehending that nursing is reserved for women from working class back grounds. Any familiarity with nursing education and practice will confirm the same. I believe that this stereotyping of nurses by nurses has promulgated the stereotyping of nurses as mean, vulgar, and discriminatory and that the same has provided some with the justification for oppressing nurses in general as unworthy of just and equitable treatment.:uhoh21:

The sort of abuse by patients and their families that you noted is common in nursing. Also, it is common for nursing agencies to punish nurses for just doing their job, as you did, for the purpose of attracting patients and avoiding the threat of a law suit. The nurse, therefore, is abused unjustly by the patient, the patients family, and their own nursing agency. This is a reason why there is a developing nursing shortage. Please remember that bad things happen to good people like yourself. Best of luck!