laurinemory

I do not trust the CDC because I can see with my own eyes what nurses in other countries, namely China and Italy, are wearing--N95s, most importantly. And what we call a "bunny suit". Head to toe coverage and a face shield/eye protection.

If you have the choice to not work, I would hold off on it for awhile, or at least let the city you live in get past the worst of this. If you are determined to start work right now, a few words of advice. -Do not come out of orientation until you feel ready. Do not sign any competencies unless you feel truly competent. Do not be afraid to ask for an extended orientation if you feel you need it. -Make sure you have a good preceptor that not only teaches you relevant skills but will also support you through the added stress of being a new nurse in a pandemic. Do not be afraid to ask your supervisor for a different preceptor, if necessary. There is a way to do so professionally without throwing your first preceptor under the bus. -Have clear goals with your preceptor and be honest about what you feel comfortable/uncomfortable doing and have a plan for each week. Don't be afraid to ask questions and admit weakness. We are all constantly learning. I am way more worried about the new nurse that acts too confident. -Do not let the hospital intimidate you into doing anything unsafe. Read up on your state's Nurse Practice Act and familiarize yourself with your rights as a nurse and protecting your license and your patients. -If possible, join a hospital that has a union. Pay union dues. -Ask about nurse turnover rates, employee satisfaction survey results in your interview. They need you just as much as you need them. The last thing you want to do is join a toxic work culture in the middle of a crisis. -Consider joining a hospital that has a nurse residency program. Personally, my first nursing job had a residency program that was a joke and didn't really help me. However, I think when residency programs are executed appropriately, they can be great resources for you to discuss challenges and grow as a nurse. I hope this helps.

We wear N95 or PAPR for all suspected and confirmed COVID patients, regardless of the type of nursing care that is being done. Since mouthcare almost always involves some suctioning, I would use that to argue in favor of a N95 (or whatever your equivalent airborne isolation mask is). In the beginning of this crisis, my hospital tried to tell us that we only needed N95 for aerosol-generating procedures, but we fought like hell to get N95/PAPR for all COVID patients.

I only see my family/friends from (well over) 6 feet distance, and I only go out for necessities like groceries, while wearing a mask and, obviously, practicing social distancing and hand hygiene. I will not feel comfortable until I have either had COVID and recovered or there's a vaccine. I would be heartbroken if I got one of my family members or friends sick. It is a hard pill to swallow, but the virus is highly contagious and the mortality rate is 3-4% so far. The choice is clear for me.

I would be very concerned if a hospital is aggressively recruiting you in this way. There is usually a reason hospitals are offering sign-on bonuses. They are desperate because they have had a massive turnover of nurses, likely due to a toxic work environment. Feel free to message me if you have any Memphis-related questions.

UTGE1-LR, In response to Mhunt17: You brought up a really important point when you said that patients often have comorbid conditions that require more than one physician. It is really important for there to be standards to facilitate effective communication for among healthcare providers for patients who have multiple diseases and are prescribed many medications. I was thinking about all of the renal patients we have cared for on our floor at Methodist; most of them have comorbid diseases: diabetes, CHF, and so on. Not only do we have to consider each of their medical diagnoses and numerous medications, we also have to take into account their level of kidney function. It is easy to imagine a situation in which their safety could be compromised if the EMR is not regulated by a set of communication standards.

UTGE1-LR, In response to cwoodru5: I agree with you, that "standards keep interoperability on track". Often times, especially with patients who have an extensive medical history, the EMR is our best resource for keeping everything straight. Patients may be seeing multiple doctors who are prescribing multiple medications, so creating standards for the EMR across multiple healthcare settings is extremely important not only in terms of patient safety but also in terms of quality of care. Geriatric patients especially come to mind as I am writing this.

UTGE1-LR According to Sewell and Thede, “interoperability is not possible without standards” (p. 266). First, “interoperability” is defined as “the ability of one or more systems to pass information and to use the exchanged information” (Sewell and Thede, 2013, p. 266). Furthermore, a “standard” is “an agreement to use a given protocol, term, or other criterion that has been formally approved by a nationally or internationally recognized professional trade association or governmental body,” (Sewell & Thede, 2013, p. 266). Establishing set standards is germane to creating a system that is interoperable. For example, a set medical terminology and medical acronyms are used in the electronic healthcare records to facilitate understanding of a patient's health across multiple systems and healthcare settings. Without consistency in those acronyms and terms, medical records would be cumbersome to understand, and patient care would suffer. According to HIMSS (Healthcare and Information Management Systems Society), if we consider the numerous healthcare professionals that are involved in a single patient's care--physicians, nurses, pharmacists, medical assistants, physical therapists, and so on--the need for standardization is clear (Why do we need interoperability standards?). It is difficult to imagine a time when diseases were not even classified in a standardized way, but it was 1900 before there was any agreement in medicine on standardizing the causes of death. Currently, the ICD (International Statistical Classification of Diseases and Related Health Problems) maintains a list of known diseases and injuries that is “described, classified, and assigned a unique code” (Sewell & Thede, 2013, p. 270). In the United States, the use of these codes is required by the Health Insurance Portability and Accountability Act (Sewell & Thede, 2013, p. 270). As globalization continues, standardization of medical language and protocol will become increasingly important. As Sewell and Thede point out, quick access to health data concerning disease outbreaks has become increasingly important as individuals are traveling between states and nations more than ever before . Healthcare and Information Management Systems Society. 2014. What is interoperability? Retrieved April 18, 2014 from https://www.himss.org/library/interoperability-standards/what-is Sewell, J., & Thede, L.Q. (2013) Informatics and nursing: Opportunities and challenges.(4th ed.). Philadelphia: Lippincott.