LEFTFLANKPAIN

It is what it is, weather or not anyone can handle the truth, this is happening in my place. Looking for real, constructive input, I know there are other facilities that have big problems too.

Thank you.

How has Studer worked out for your facility? In principle, it's all very good. However in execution, our facility has seemed to lose touch with reality and moved out all of its proven high performers who have always behaved ethically, and moved in very green staff. The old staff who remain are considered high performers by our Administration, but in reality they are low performers. The green staff are so new that they go along with the old, unethical staff. For example, there are many extramarital affairs, drug use, people coming to work admitting they're very hungover by our new high performers. There's a heavy-drinking and partying staff clique with which many managers and supervisors belong. Many staff in this clique at work seem unfocused, are loud and always screaming and shouting about partying and getting drunk. At work, many disappear for hours and it's rumoured there are affairs occurring within the facility during work hours. Because those doing this are considered high performing by Managers, complaints about disappearing, appearing impaired, affairs fall onto deaf ears. Those of us who work hard and work ethically seem to be the targets of managers because the managers favor the unethical, disappearing staff. Administration's radar for who are high and low performers is so off, that there are days they will walk in and simply fire someone who works hard and ethically, calling them a low performer, while the true low performers are absolutely off of Management's radar. The Studer Mentor did a site visit and immediately took to one of the drug users, recommending she work for Studer! All of this has caused a massive decline in quality of patient care in our facility, people getting away with messing around on the job and the hard workers being overloaded with all the work. I also can't help but doubt the credibility of the Studer staff when a supposed proven mentor takes to a person who has been instrumental in the playing around on the job. I realize Studer's intentions were good, but in our place, in execution, it's made things far worse.

Thank you. These are scary times in some ERs around the country. I may try to lobby for a safe harbor type of program in my state. Thank you for that information.

I love the ED so I would still go there. It's our facility that has lost complete sight of the patient, relying upon extreme short staffing to maximize profits. It has become extremely dangerous to work there.

Might be time for me to do that.

Our facility chronically leaves our ED shorthanded by 25% to 75% in Nursing staff. This leaves extremely unsafe staffing ratios, I'm talking up to 11, 12 patients to 1 RN; also our RNs often must do our own housekeeping, be security for violent events in the department, hold ICU inpatients in the department etc because the hospital does not want to pay for ancillary staff; all of this is in addition to our 4-12 patient load for each RN. Then when a patient complains that their wait was too long or if a bad event occurs, the hospital blames the nurses. I would write an occurrence report, but that goes to our Risk Manager who is also a blamer. Everyone else is afraid to address the unsafe nurse to patient ratios due to our Administration will simply terminate anyone who questions them. What is everyone else doing to stay safe in this kind of facility?

Someone who does not get the Flu vax, does not get the Flu so does not pass it to patients is more dangerous than this? Deaths by medical mistakes hit records | Healthcare IT News

Again...we will see. Strong legal arguments abound. Strong ethical issues abound.

Have you even read the posts in this forum?

For those who may have been under a rock, this has been the recent buzz about Peer Reviewed studies and Scientific Integrity (aka *gasp* some scientists have been hasty, inaccurate or unethical): How science goes wrong | The Economist Hank Campbell: The Corruption of Peer Review Is Harming Scientific Credibility - WSJ

We will see how it goes when the lawyers come out. The Flu vaccination mandate brings up all kinds of Civil Rights and Medical Ethics issues. Sorry this isn't 1975 USSR, this is the USA.

As of late 2014, medical errors are the #3 cause of death in the U.S. This is one reason why I don't sit on my high horse as a Bachelor's Degree educated RN. Also have several other college degrees, decades of experience, but still do not condone the practice of sitting on a high horse. Have seen too much bad medicine to not want to make a concerted effort to stay humble and never feel like I "know it all". Cannot say that about some people, especially those with 2 year RN degrees who cite peer reviewed studies as their know it all go to.

It's called Coersion and it's Unethical. At the point where the RN is asked to take a medication into his or her body, that staffmember becomes a Patient. To coerce a Patient into taking a medication he or she does not want to take is considered assault in some states, to coerce a Patient into doing something is unethical and in many facilities a violation of the Code of Conduct. In my facility, coercing any patient like that would be a violation of the Code of Conduct and grounds for immediate termination, we signed a contract to this effect.

Pretty unethical those here who are mocking Patient Choice. Judge, judge, judge. Ethically, our jobs are not to push our personal beliefs upon patients, but to inform them of the choices, the risks and benefits associated with them, and it's the patient's FREE CHOICE how they decide to approach their disease process. This is called Informed Consent, it's the cornerstone of what we do. I hope nobody ridicules their cancer patients for seeking complimentary therapy. Difficult enough to be dying then some know it all with a 2 year degree comes along on a high horse ridiculing how the dying are trying to best cope with what they're going through. Sorry but if my patient is dying, they can do what they wish. I had a dying patient who instead of pain meds wanted a small square of chocolate every hour, which was ok with the doctor, and I complied. It made him extremely happy and that's how it should be for the dying. I did not spout off about how the patient was wrong because randomized peer reviewed studies brought me to the conclusion that Opiates would be better than chocolate. Chocolate was right for the patient. Chocolate it was!

Exactly right!

Hoorah! Yes!

Lo and behold the day after I posted on this thread I had a fully immunized pediatric patient who had had the mumps months ago. .

Always baffles me when those who are pro-influenza vaccination imply that because they vaccinate their children, they are more compassionate than the rest of the world. Then in the next sentence will have such a hostile and indifferent stance when they cite or refer to children who truly have suffered vaccine injuries...or if a parent says that their child suffered permanent vaccine related injury or death they make personal attacks upon the parent and the child. The insecurity is mind blowing.

I agree.

Not necessary for you to be inflammatory and make personal attacks. There can be a respect for many opinions here without resorting to childish polarizing tactics. I am actually quite well educated with degrees in not just Nursing, but in several other fields, which has given me the ability to respect and entertain thoughts, theories and ideas from all kinds of perspectives without feeling threatened by them. Hurling the same insults back your way would be easy, yet is a violation of terms and conditions of these forums and i wont stoop to that level. Your respect for the opinions of others that has been extended your way is greatly appreciated.

Article about the Bioethics of tricky Informed Consent. Medical Research Stakeholders Seek to Overturn Informed Consent Protection | AHRP In the article it states that lack of strong or clear informed consent for studies that carry risk to the subject is unethical. I strongly believe that facilities who mandate the flu vaccination under coercion of job loss are unethical, because the consent is being obtained under a form of duress, thereby making it a tricky/dishonest way to obtain said informed consent. The flu vaccination carries a measure of risk, as disclosed by the manufacturers; hence mandating something that carries risks to the subjects, especially under duress,is medically unethical. Clear informed consent not subject to duress nor deception is the only ethical way.

I took lots of science courses and was an avid reader of scientific studies. The most very basic principle of science is, "scrutinize everything". The pro-vax camp who are dead set against scrutinizing the vaccinations to the point of ignoring actual adverse reactions, a lack of efficacy, etc, to me are akin to those who used to smoke cigarettes in the day when smoking was considered healthy for your lungs, diseases emerged related to cigarette smoking, and people continued to smoke for DECADES, in total disbelief of the future consequences. Today we know better, but it was a long road for us to hardwire smoking as a cause of disease because of huge financing and fights from Big Tobacco. I've been around long enough to have administered medications to patients "for their health" only later to see that drug recalled because it was causing adverse effects (fatal arrhythmias,GI bleeding, etc). Hence, I refuse to close my eyes and simply accept information thats fed to me by sources that may have a financial or other conflict of interest in the subject. As healthcare providers, we have a fiduciary obligation to scrutinize our interventions and whatever we promote, so I always read information from both sides of any scientific claims, as well as scrutinize the sources of "peer reviewed" studies. Again I've been around long enough to have actually administered drugs and interventions that passed the scientific, peer reviewed sniff tests, only to see adverse reactions then see those things recalled. It is our fiduciary obligation to the world as healthcare providers that we continually scrutinize and stay aware of the effects of the medications, interventions and advice that we give. This is my good advice.

Caffeine. Be sure to have a steady source of caffeine that's easily accessible at all times.

That makes my heart happy.