Stray Kitty

When I was in nursing school, I heard the story of a woman who heard the nurses use the word "Meconium" when her daughter was born. You guessed it, that was what she named her!

It is great to finally see that I am not the only nurse in the world with mental illness. I have bipolar disorder. I was diagnosed in 1998. For years, I thought that the psychiatrists were quacks. I never recognized the mania/hypomania in myself until recently. I couldn't see past the major depressive episodes. It took a recent manic/hypomanic episode in which I started writing my memoirs to be able to see the whole picture. When you get depressed, you seem to loose the ability to recall ever being happy. You see only doom and gloom. I recommend keeping a mood diary and journal. They are both very helpful in keeping up with even subtle changes in mood and personality. http://www.psychiatry24x7.com/bgdisplay.jhtml?itemname=mooddiary I feel like I am now on the right track with my meds since my psychiatrist and I are on the same page. I wish everyone luck in your lifelong journey.

Thanks so much for all of the advice. I was informed just this morning that a meeting between us nurse supervisors and the new CEO is being scheduled. This will give us an opportunity as a group to voice some of our concerns. Our county is still somewhat involved in the management of our facility. Just this past weekend one of the county commissioners received a complaint about this Dr. (He also works as an ER doc some nights and weekends ) Maybe this will help get the ball rolling. I will try to keep you posted.

I am an RN with 13 years of med/surg and ER nursing experience. I don't claim to be an expert in cardiology, but I think that a cardiologist at my hospital may be misdiagnosing patients on purpose for financial gain. Here is the situation that keeps repeating itself. Our cardiologist is in the process of building a new home. He has asked his fellow Dr.s to refer more patients to him because he needs the extra income now. A patient comes into the ER c/o chest tightness and SOB. They have a long standing hx of COPD and/or CHF. EKG shows non-Q wave MI, age undetermined. Labs generally show essentially negative cardiac markers. Occasionally it may show mildly elevated troponin (well below AMI cutoff level), or mildly elevated CKMB with all other levels normal. The patient will automatically be refered to this Dr. for admission, and he will act as attending Dr. Even if CXR shows severe COPD, CHF or pneumonia, he doesn't treat them for this. His admitting dx is always the same- Acute non-Q wave MI. While he is concentrated on EKG's, serial cardiac markers, Heparin and Beta-blockers, the pt is in severe life-threatening resp distress. They are sometimes literally drowning. He usually refuses to order Lasix stating that they are dehydrated. In my opinion, they will sooner die from resp failure than from dehydration. He won't listen to us nurses when we request certain orders such as Lasix or Solu-Medrol. I have cared for 3 such patients who eventually had to be intubated when it could have been prevented if they had recieved the proper tx. All 3 did survive, but only because once intubated they were transferred to another hospital under a different Dr.'s care. In one case, when the pt's ABGs improved once on the vent, he said, "See, he didn't need to be intubated." Is he blind or just plain stupid and negligent. He has refused to let a pt's primary Dr. assume her care after she and her family requested it. I wasn't working that day, but 2 members of the Ethic's committee were involved in caring for this pt, and neither of them did anything about it. The problem we have had with incidences involving Dr.s in the past has been that administration has covered for them and threatened reprimands to anyone who speaks against these Dr.s. It is a very small rural hospital which has a hard time recruiting Dr.s, and they don't want to lose the few they have. I have to do something or else I won't be able to live with myself if someone dies because of him. Advice please.

Thank you for your response Granny. If I am seeing this, why doesn't someone else higher up see it. I wonder if I have read too many Robin Cook novels. I will do a search now for Professional review division.

I am an RN with 13 years of med/surg and ER nursing experience. I don't claim to be an expert in cardiology, but I think that a cardiologist at my hospital may be misdiagnosing patients on purpose for financial gain. Here is the situation that keeps repeating itself. Our cardiologist is in the process of building a new home. He has asked his fellow Dr.s to refer more patients to him because he needs the extra income now. A patient comes into the ER c/o chest tightness and SOB. They have a long standing hx of COPD and/or CHF. EKG shows non-Q wave MI, age undetermined. Labs generally show essentially negative cardiac markers. Occasionally it may show mildly elevated troponin (well below AMI cutoff level), or mildly elevated CKMB with all other levels normal. The patient will automatically be refered to this Dr. for admission, and he will act as attending Dr. Even if CXR shows severe COPD, CHF or pneumonia, he doesn't treat them for this. His admitting dx is always the same- Acute non-Q wave MI. While he is concentrated on EKG's, serial cardiac markers, Heparin and Beta-blockers, the pt is in severe life-threatening resp distress. They are sometimes literally drowning. He usually refuses to order Lasix stating that they are dehydrated. In my opinion, they will sooner die from resp failure than from dehydration. He won't listen to us nurses when we request certain orders such as Lasix or Solu-Medrol. I have cared for 3 such patients who eventually had to be intubated when it could have been prevented if they had recieved the proper tx. All 3 did survive, but only because once intubated they were transferred to another hospital under a different Dr.'s care. In one case, when the pt's ABGs improved once on the vent, he said, "See, he didn't need to be intubated." Is he blind or just plain stupid and negligent. He has refused to let a pt's primary Dr. assume her care after she and her family requested it. I wasn't working that day, but 2 members of the Ethic's committee were involved in caring for this pt, and neither of them did anything about it. The problem we have had with incidences involving Dr.s in the past has been that administration has covered for them and threatened reprimands to anyone who speaks against these Dr.s. It is a very small rural hospital which has a hard time recruiting Dr.s, and they don't want to lose the few they have. I have to do something or else I won't be able to live with myself if someone dies because of him. Advice please.

I am an RN with 13 years of med/surg and ER nursing experience. I don't claim to be an expert in cardiology, but I think that a cardiologist at my hospital may be misdiagnosing patients on purpose for financial gain. Here is the situation that keeps repeating itself. Our cardiologist is in the process of building a new home. He has asked his fellow Dr.s to refer more patients to him because he needs the extra income now. A patient comes into the ER c/o chest tightness and SOB. They have a long standing hx of COPD and/or CHF. EKG shows non-Q wave MI, age undetermined. Labs generally show essentially negative cardiac markers. Occasionally it may show mildly elevated troponin (well below AMI cutoff level), or mildly elevated CKMB with all other levels normal. The patient will automatically be refered to this Dr. for admission, and he will act as attending Dr. Even if CXR shows severe COPD, CHF or pneumonia, he doesn't treat them for this. His admitting dx is always the same- Acute non-Q wave MI. While he is concentrated on EKG's, serial cardiac markers, Heparin and Beta-blockers, the pt is in severe life-threatening resp distress. They are sometimes literally drowning. He usually refuses to order Lasix stating that they are dehydrated. In my opinion, they will sooner die from resp failure than from dehydration. He won't listen to us nurses when we request certain orders such as Lasix or Solu-Medrol. I have cared for 3 such patients who eventually had to be intubated when it could have been prevented if they had recieved the proper tx. All 3 did survive, but only because once intubated they were transferred to another hospital under a different Dr.'s care. In one case, when the pt's ABGs improved once on the vent, he said, "See, he didn't need to be intubated." Is he blind or just plain stupid and negligent. He has refused to let a pt's primary Dr. assume her care after she and her family requested it. I wasn't working that day, but 2 members of the Ethic's committee were involved in caring for this pt, and neither of them did anything about it. The problem we have had with incidences involving Dr.s in the past has been that administration has covered for them and threatened reprimands to anyone who speaks against these Dr.s. It is a very small rural hospital which has a hard time recruiting Dr.s, and they don't want to lose the few they have. I have to do something or else I won't be able to live with myself if someone dies because of him. Advice please.

Note to Administration: I will be expecting a substantial pay increase for doing my part to raise hospital revenue. Since your recent budget cuts do not allow for PRN staff and the hiring freeze that is in effect, I have been forced to work while deathly ill. I have managed to infect every staff member and visitor I have come into contact with. The current patients were excluded from said bioterrorism attack, so don't be concerned about losing money from increased length of stay. Hospital admissions have sky-rocketed, thanks to me. I hope that the cost of using agency nurses to care for all of us hospitalized staff members along with the rest of the patients doesn't eat up too much of your precious profits. Please hand deliver my check to me in room 1313 by noon today because I have to make a 25% down payment on the lung transplant that I must have due to the severity of my untreated lung infection. Our crappy, so-called "insurance" has an exclusion for this particular treatment. Thank you P.S. This is not actually a Post-it note as they are not allowed for in the budget. This is just a plain piece of scrap paper stuck to your desk with my infectious green snot.

My Life As a Nurse by Imussta B. Krayze

How to Prepare for Your Rectal Exam by Ben Dover, M.D.

OK Strange, are you my long lost twin? You sound exactly like me except for #5. Hmm. I'm suddenly feeling an almost uncontrollable urge to go out and buy a hand-held Yatzhee game, but I got off work at 7am and haven't been to bed yet. Don't fret. I'm off tonight. Although according to my fellow co-workers I'm off EVERY night! I have an 'official' medical diagnosis of being weird confirmed with a second Dr's opinion. I don't believe it though. My keyring says, "I'm not weird. I'm gifted."--and I will always take a keyring's opinion over some dumb doc's. It's much cheaper too.

Parent brings their kid into the ER and says the kid has a high fever. You ask how high it is and they say, "I don't know. I didn't check it, but she feels hot." Then you look at the kid and they have on 4 layers of clothes, a snow suit, and are wrapped in 3 blankets--and the outside temp is 68 degrees! Get that crap off of them! Parents who don't give the kid any Tylenol before rushing them to the ER with temp of 100 degrees. Some people should be required to get a license to have a kid. You have to have a license to catch a fish, and taking care of a child is much more of a responsibility than that. Oh, I also just love the nurse who writes her notes out loud. I have actually found myself writing down what she is saying! And the veteran nurse of 30+ years, who used to be charge nurse at her former job of many years, who pulls me away from my work because she wants my opinion about whether her patient's IV has infiltrated. The hand is 3x it's normal size and weeping fluid! YES!! IT IS INFILTRATED!!! :angryfire But my biggest pet peeve is the nurse who is always saying, "Where I came from...". Well, if it was so great there, why the heck are you here?

I work in a very small rural hospital on 12 hour night shifts. I am the charge nurse/house supervisor. I have worked both shifts and I can definately say that days and nights are different, but I can't say that one is busier than the other. We do encounter problems on our shift that day shift doesn't have to worry about. Days always has a unit sec. We never do. Shouldn't really be a problem, except that the doc who always has the most patients doesn't make rounds until our shift comes on. So, sometimes the unit sec sits around all day and does NOTHING, and I end up taking off orders on 10 charts. Another prob that we have is that after 11pm, there are only 5 nurses, 1 NA, 1 doc, and a lab tech in the WHOLE hospital. Until very recently they only had 1 nurse in ER after 11pm. Then if our census is down, they either cut the NA or a nurse. Makes life really interesting when there is a code or a multiple trauma situation. Day shift has a resp therapist, nurses in outpatient dept, paramedics who work in ER, and even "clipboard nurses" available to them in case of a crisis during their shift. We have just us. I am very thankful that those of us on nights work so well together as a team.

My biggest weakness is my sense of smell. I mean, I have a nose like a Bloodhound. I even once paid an NA $5.00 to empty a BSC for me. The patient was passing old blood