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Tenebrae BSN, RN

Mental Health, Gerontology, Palliative
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Tenebrae has 7 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

Tenebrae's Latest Activity

  1. Tenebrae

    Ethical Question

    Unless there is a clear clinical reason for a photo document eg documenting the progress of a wound or something else, people shouldn't be taking photos in the work place. And if a person does take a photo, it should be with documented permission of the patient and only used by people who have involvement in the patients care People do some stuff without thinking. I'm all for giving people a second chance. Personally my first approach would be to remind your co worker about this and that they need to delete the photo. If they dont, or do it again, then thats when you should take it up with chain of command
  2. Tenebrae


    I get mine provided for me. In my previous job I also got a laundry allowance I get my yearly practicing certificate paid for And yes, I am union, part of a national mecca which accounts for many of the benefits
  3. Tenebrae

    Need Advice on Accused Medication Error

    And thats exactly what i would do. Any one who says you would be fired for not getting a pulse ox is fully of crap IMO I've found particularly in aged care, but other areas of nursing as well its helpful if you can always be thinking "what will I do with this information?" "will this information change the treatment for this patient" I had a scenario where the charge nurse obtained an order for QID BGL and act rapid administration. Sound reasonable right? In reality the patient was moving into end of life stage, and amoung other things not eating. The patient was NFR and comfort cares only so we would not have been starting IV dex or inserting an NG tube. In the end I refused to do the QID finger sticks and documented "BGLS not obtained, as patient appears to be in the end of life stage, oral intake minimal" and checked with the GP the next day who removed both orders
  4. Tenebrae


    Honestly i think what you American nurses have to put up with in terms of conditions is appalling I get: 10 days a year paid sick leave time and a 1/2 working weekends, double time plus a day in lieu working any of the 10ish public holidays Four weeks a year paid holidays, increases to five after a year 3 days bereavement leave Contributory superannuation and state pension when i get to 65 And most importantly none of this right to work, fire at the drop of a hat because you looked at someone the wrong way
  5. Tenebrae

    Unfounded abuse of a child

    Can I suggest you change your user name if that is your real name
  6. Tenebrae

    AMA Looks to Retrain Doctors on Taking Blood Pressures

    I struggle to remember last time I saw a nurse take a manual BP. Electric machines are fine, however I think they make it too easy to loose skills
  7. Tenebrae

    Depression + Anxiety as a Nurse

    I live with major depressive disorder and GAD. I take medications and have been a registered nurse for close to eight years now. No one will care if you have depression, they just want to know that you can manage your illness and it wont put patients at risk. I take regular meds and am of the belief that if most people had a physical illness such as diabetes, they wouldnt have an issue with taking meds and that a mental illness is no different than a physical illness.
  8. Tenebrae

    What does the floor really think of nursing students?

    I love teaching, I'm passionate about nursing and love sharing information education with others. I love enthusiastic students, students who are wanting to know more about what we do in my facility, who are willing to get involved with all aspects of a patient care. I'll go out of my way with those students to involve them in any patient or specialist care that I can I do not like students who expect to be drip fed. take the opportunity to find out stuff on your own, I dont mind asking specialist questions about my area, but seriously if you are asking me basic stuff you can find out on your own, dont be getting snippy when i point you at the text books. Does having a student add to my work load? Yes. However that can be both good and bad. It encourages me to think about what I am doing, clinical rationale etc however when they expect to be drip fed, its tiring and really painful
  9. What a load of bull If your nursing judgement is telling you the patient needs more help than you can provide, you are well within your parameters to tell anyone to call 111. Think about it, if a family member collapse in front of you and would you hesitate to tell someone to call 111 while you performed CPR. Who ever told you that sounds like a the clinical manager who told my CNAs they would only be allowed to use two pairs of gloves in one 8 hr shift
  10. OP you have been given some good advice. I had a situation in my final year. I wrote a public facebook post about living with clinical depression. Someone copied and posted it to my head of school and I got hauled in for a meeting. There was nothing about nursing in this post. The post basically talked about living with clinical depression and coping strategies to stop it impacting on my daily life. A wise nurse told me "if they need you to apologise, you apologise" what went unsaid is that while you may need to verbalise remorse, you dont have to mean it And that was what I did. I wrote a written reflection about the impact of social media and something along the lines of "I am sorry that my post caused such consternation and problems for the tutoring staff. After the meeting wrapped up, my head of year basically said "you should be careful about who you add as a friend on facebook"
  11. I got a tetanus booster yesterday. The idea of dying from lockjaw from a gardening injury really wasnt appealing. On the other postive side, it also had a booster for whooping cough.
  12. Not sure if its been mentioned yet, there is research coming out of the US that suggests measles wipes out a body's immune memory, basically the body has to relearn how to protect the body against certain diseases Harvard Study
  13. Not mandatory, however like all choices in life, there are consequences if a parent chooses not to vaccinate their child against easily preventable diseases, they should not be surprised when school authorities dont want to take the risk their precious little dear is exposed to god knows what
  14. Actually it is. Without vaccinations children and adults face very real possibility of disability or death from easily preventable diseases Where I live, we are having one of the worst outbreaks of measles we have ever seen and we are in serious danger of loosing herd immunity due to the declining rates of vaccinations, or delayed vaccinations. To give you an idea of why that is such a problem, take the example of "Rose" (not her real name). As a baby she had billary atresia and required a liver transplant. Rose is now a vibrant 12 year old who looking at her no one would ever guess she had been so sick as a baby. Due to her age, Rose is at very real risk of exposure to measles however because she is on immunosupressants for life, she cant be vaccinated. How do you work that out? We get our flu vaccination as work, doesnt cost us a thing. What argument could possibly counter the fact that polio is all but eradicated thanks to regular vaccinations against it? (I'm not being snarky I would seriously like to know)
  15. Its not about vengence. Its about nurses being responsible for their practice and dealing with the consequences of their actions if they get it wrong (sort of like being an adult I think)
  16. Tenebrae

    My facility is restraining a resident and I feel that I can't help.

    Working in long term care, we would routinely do a full set of obs TPR and BP on all patients once a month and more often if clinically indicated eg patient feeling unwell, neuro obs post fall. The last facility I worked in the doctor wanted a pulse pre admin of digoxin, I've worked in other facilities where the doctor didnt want a pulse pre admin of digoxin Particularly in long term care, stop for a moment and think about what you will do with the information and also look at the bigger situation. For example I experienced a situation where an patient was having hypo's. The charge nurse obtained an Drs order for AC BGL and administration of rapid acting insulin. Makes perfect clinical sense right? Unfortunately looking at the entire situation revealed that this patient was going into the end of life stage and hadnt eaten more than a mouthful of food for several days and often when the body begins to shut down it looses the ability to effectively regulate body processes. Understandably the patients BGL was low. Which raises the point, with a dying patient, do we continue to stick the patient three times a day and administer insulin to try and rectify what is in essence the patients body shutting down? Or do we go 'right, this patient is dying, lets focus on keeping them comfortable?" You mentioned your lady has severe dementia. I've noticed often patients with servere dementia can be very resistive to nursing care including things such as having their blood pressure taken and how would having a daily BP taken impact on that patient. More importantly would that information actually make a change in how the doctor chooses to treat their patient? Your nursing focus is usually very different in a community/long term setting as opposed to acute clinical care hope that makes sense