Salty1

This is an injury that arose out of and in the course of employment and as such falls under the jurisdiction of your State's Workers Compensation Law. File the report post-haste. Time limitations apply! Do not become time barred by reason of failure to notify. Usually notice must be given within 30 days of the accident. THE CLOCK IS TICKING! Good luck. Salty1

Why not send an e-mail to [email protected] as the site listed on his home page (V-TACHONLINE) is a blind alley and has nothing to do with ACLS. I previously downloaded the ACLS program but have since misplaced it. It was a great site.

If I was counsel for the Defendants I would have only one question: "How much can we settle this for?" This is not the type of case to try in front of a jury - sympathy factor alone might result in a very large verdict. Of course, one may argue that an excessive verdict could be appealed solely on the basis of the amount of money. Defendants insurance carrier might very well ask plaintiff's attorney how much of their policy will he let them save to avoid further legal costs, etc.

I would agree that it appears to be primarily a custody issue. The program, enacted as a Federal Law, provides funding for training and is administered by National Institute of Corrections. The law's function at present appears to be one of collecting data from prisoners and ex-prisoners to determine the incidence of rape within correctional facilities-presumably to aid in the establishment of practices and procedures to reduce or eliminate the problem. Some facilities segregate inmates on the basis of their sexual orientation and also place young and vulnerable inmates in a "safer" area of the detention facility. It all sounds good in theory but in practice may have a different result.

I might suggest that you inquire of the New York State Nurses Association which represents bargaining unit nurses at Nyack Hospital. I do recall that in the not too distant past Nurses at Nyack were out on strike for approximately four months because of working conditions, pay, etc. Nyack Hospital sent an ultimatum to the striking Nurses stating that they would be permanently replaced unless they returned to work by a specific date. The hospital employed strike-breaker nurses (scabs). My recollection of events was that it was a bitter struggle and that the hospital made no effort to resolve differences. Negotiations were ordered by NLRB or Federal Mediators. Nyack Hospital is part of the Columbia Presbyterian (New York) system and Nurses from Columbia-Presbyterian also demonstrated in picketing at Nyack along with Hospital Professional & Allied Employees of New Jersey (AFL/AFT) as a show of support for the striking nurses.

i sympathize with you. many years ago shortly after heptavax was first available (now no longer on the market) i had my first dose about 2 p.m. and by 10 p.m. while at work in icu became ill necessitating a visit to the er with s/s n&v, diarrhea, sweats, elevated temp, headache. i was finally able to drive home at about 4 a.m. where i remained all day. i was sufficiently recovered 24-36 hours later to return to work and reported the matter to employee health. about a week later i was contacted by the pharmaceutical company manufacturing heptavax whose representative wanted to assure me that they had not received any other reports of adverse events and that the etiology was no doubt from some "bug" i may have picked up in icu. yeah, sure! notwithstanding their assurances, i declined any further heptavax immunizations and filed an adverse event report. hope you feel better soon. salty

I would think it is not because the COs are soft-hearted. Rather, they are acting in a manner under the doctrine of CYA. The COs, quite properly, want to keep everything on their cell-block quiet and under control. If the inmate is "kvetching" about a minor medical problem and blowing it out of all proportion to reality the CO will simply shift the problem over to the medical department. Otherwise, the inmate may agitate his fellow prisoners, complain to the ombudsman about the COs refusal to provide medical attention, etc., etc. The inmates are expert at "working" the system. Salty

I would suggest that you go to the CDC web site for both Meningococcal as well as SARS information. Official site is: Centers for Disease Control and Prevention.

Your post is somewhat confusing to me. The question is : At the time of discharge, did the patient have an IV access or not? If not, did he have one previously and did you inspect the site? Not what may have been or may not have been entered in the computer documentation. That is a separate issue. As I understand it, the patient said he did not have an IV as he was going home and you asked if you could insert one. Why, if he was going home, i.e., being discharged, would you want to insert an IV? If you have Nurses Liability (malpractice) you might be well advised to notify your insurance carrier of the possibility of a claim. Salty

For some strange reason, the public always seems to think it is okay to strike up a conversation with anyone wearing scrubs but who otherwise would not address the same person if they were in street clothing. On one occasion after finishing a tour in the ER I stopped at a diner in my scrubs, sat down at the counter for eggs and coffee. A wise guy total stanger in a booth called out loudly "Hey Doc! How many people did you kill tonight?" I replied just as loudly "Don't you remember me from last week when I treated you in the VD Clinic?" The wise guy immediately got up, went to the register, paid his tab and hastily departed. The only other comment I received was from the waitress who said "Good for you!" On the topic of wearing scrubs to and from work, note that attending physicians wearing suits travel from their office to see their patients in the hospital without changing clothing. Some don a lab coat, some don't.

Hospitals carry their own coverage and, in some (but not all) instances, may provide a defense for you. To help you in reaching a decision may I suggest that you check out the Nurses Service Organization web site including actual malpractice cases wherein judgments have been rendered not only against the hospital, but physicians and nurses as well. Personally, if I discovered that my Nurses Liability coverage had expired, I would not go to work until it was renewed. Some people may tell you that by purchasing liability coverage you will only invite a law suit - that plaintiff's attorneys will only sue the "deep pockets" and those who carry insurance. NONSENSE. How will the attorneys know if you have insurance coverage or not? Certainly the insurance carrier does not publish a list of its clients nor will they respond to such inquiries. By and large, plaintiff's attorneys will sue everyone in sight and let those who can, pick themselves out of the mess. Do yourself a favor and buy Nurse Liability coverage.

At $89 per year for $1,000,000 coverage including representation with any licensure problems with the BON why would you not obtain coverage. If you are ever sued for malpractice - even if you win - you lose. Without coverage who will pay for an attorney to represent you? Looks like a "no-brainer" to me.

ROTFLMAO! I thought everyone knew Bangladesh was on the northwest coast of South America between Upper Volta and Rwanda. Of course, Zenman will need to learn Spanish. In a more serious vein, as opposed to the basilic vein, I might suggest that anyone contemplating living in Bangladesh should check out the State Department and/or CIA websites for that particular country. Having lived overseas it is wise to investigate all aspects of living in a foreign country. Aside from Peace Corps folks (God Bless Them) it is sometimes quite expensive for Americans who try to continue their American lifestyle in a third world country. Good luck to Zenman if he and his wife decide to give up living in Hawaii for a country that has experienced one disaster after another.

As a matter of curiosity, noting that Imitrex did not work for your husband, was it p.o. or injected? For many years I had cluster headaches and after Imitrex became available injected same with complete relief of the acute episode. Oral form was without any benefit for me.

The best advice you have received thus far is to arrange for a nerurological consult. Many posters will tell you what works for them and will advance their own personal preferences in management of migraine. You will doubtless receive suggested remedies ranging from Acupuncture to Zen. SEE A NEUROLOGIST. Probably the foremost authority on headaches in the US is Seymour Diamond of the Diamond Headache Clinic in Chicago. Best wishes for resolution of your headaches.

I would agree with Z's Playa. Was the onset of pain sudden or gradual over a period of time? I note it is confined to the area of the left rib cage. I too, would suspect intercostal irritation. What is the level of pain (1-10), character of the pain? Is the pain intermittent or steady? If you are having difficulty sleeping it is often helpful to sleep with the torso elevated at about a 45 degree angle such as in a recliner chair. This position is often recommended to patient's post MVA with "cracked" ribs. Salty

Could you rephrase your question? Are you suggesting that an individual who is a registered sex offender is not afforded the same protection under HIPPA as other people? A conviction for a criminal offense becomes a matter of public record but this does not translate into public disclosure of the individual's medical information. Similarly, a person convicted of murder has the same protection under the law with respect to HIPPA. Having said that, I would add that if the criminal defendant's medical record has a bearing on the criminal charge, the court may subpoena the records. Salty

You are probably referring to a Saratoga Sump (Nasogastric Suction). A google as well as a dogpile search was not of much help in finding a definitive description. I believe that a similar named device (Saratoga Drain) may also be utilized as a cardio-thoracic device. Hopefully, some of the GI people on this board will respond with a more detailed answer. Is the tube extending from one of the nares and connected to a suction machine? If so, naso-gastric suction for stomach decompression/drainage. As an amusing aside, I recall many years ago telephoning Hospital Central Supply requesting a Salem sump as my patient's regular NG tube was functioning poorly - probably adhereing to the stomach mucosa - and the Salem sump would overcome the problem. The Supply Clerk was not familiar with a Salem sump and replied "The onliest thing we has is a Sataroga Sump." I inquired "What?" The clerk responded, "You know, Sataroga - like the State. My response was "No, Saratoga like the city in upstate New York." A personal trip to Central Supply resulted in finding a bin full of Salem sump tubes. Good luck with the search.

Sorry to learn of your current situation. As you indicated, the discharge procedure (since changed) paved the way for this kind of occurence. If you have malpractice coverage I would strongly urge you to notify your insurance carrier at once - even though you may not have been served with a summons and complaint by the plaintiff's (patient) attorney. Any one can sue anyone at anytime for anything (subject to the statute of limitations) but whether or not they collect is another story. While dizziness is a known side effect of Tegretol, I would expect that " Bernie the Attorney" will make the allegation that his client was rendered sick, sore, lame and disabled, was unable to stoop, squat or bend, could not sit up nor take nourishment as well as a littany of all of the possible side effects that he can find in his office copy of the PDR. I would also expect that the plaintiff's attorney has a physician upon whom he can rely to further his claim. Plaintiff's attorneys often sue everyone in sight on the theory that "let those who can, pick themselves out of the mess" but will, of course, go for the deep pockets, i.e., the medical facility and its med-mal carrier. While most of the posters on this Board agree that the patient probably suffered little or no harm - particularly in view of the short period of time the patient was on Tegretol - none of us are prospective jurors in this case. Since this is a litigious society I would not tend to dismiss this as being a simple nuisance case worth only $100 - it warrants far more attention than that. Never underestimate your adversary! If you do not have malpractice coverage you should give consideration to discussing this with your own attorney. Best wishes and good luck to you. Salty

I would suspect that the wave of the future, if that is what it is, might very well swamp a great many ERs. Placement of hemodynamic monitoring such as Swan-Ganz catheters is probably better suited to ICU which has a more stable environment in terms of nurse patient ratios. Most ED's diagnose, treat and transfer as quickly as possible. Perhaps I am missing something but the question arises as to how long the patient will be in the ER? Will the ER Nurse be able to record PAWP, etc., etc. and still have time for setting up suture trays, fitting patients with crutches, applying dressings, putting kids in papooses for suturing, and so on, to say nothing of the Cardiac Arrests, OD's and the accompanying chaos.

You might try posting your inquiry under Nursing Topics by Location near the bottom of the Topics page and then United States Nursing Forum for each state in which you are interested. Salty

I am sorry that you misinterpreted my post. It was not intended to criticize your spelling. If you read the post again you will note that I asked if it was a regional usage as I note that other people responding to your original post also used the word stint. As a matter of fact, if you do a google search you will see several letters (primarily from lay people) utilizing the word stint in place of stent. It is simply that I have never heard the device called anything other than a stent. Upon further research, since I didn't receive any elaboration from anyone on this site, I found that Webster's Unabridged Dictionary indicates that stint is a variation of stent. I'm sorry that you took umbrage as it was not my intention, using your phraseology, "to down size someone". Salty

While this does not address the original poster's questions, I am curious as to the use of the word stint. Cordis and similar manufacturers refer to their products as stents - not stints. I have always referred to these devices as stents and had not previously seen the word stint as a substitute. Is this a regional utililzation? I have done brief stints (meaning short periods of time) in CCU where some of the patients had stents. During those stints I tried not to stint on the amount of time and care I gave to each of the stent patients. Any comments/explanations would be appreciated. Thanks. Salty

I would certainly agree with the above, Canoehead. It is interesting to note that they have extended your probation to a month. I cannot help but entertain the notion that they are hoping you will resign because of the down time and thereby administration may avoid any litigation you might institute - even though Oregon is an "at will" State in terms of employment. Still, you may very well have a cause of action. It seems that being correct in the treatment of a patient is not as important as being a team player - seniority substituting for sound judgment. After reading many of your posts on this site I must say that I respect your clinical judgment, knowledge and intellect. Good luck to you whatever course of action you decide to pursue. Salty

I think that to properly analyze the situation one must determine what percentage of the inmate population requires medical attention. Presumably, during the night shift the majority of inmates are asleep. The correctional population does not contain very many elderly geriatric types that in a normal civilian population would require somewhat more medical attention. Accordingly, I would think that 14-15 nurses for an inmate population of 1500,on the surface, sounds like a piece of cake. I realize that you may have early morning med pass and glucometer checks but, with 14-15 nurses, it seems like great staffing. Let us assume, for the sake of argument, that a small rural community has a population of 1500 people including infants and children who receive medical care from a local urgent care center. How many nurses do you think would be required during nights? Salty