Nerd eNurse
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I don't think unionized or not should be a primary reason to work there. The hospital is either a well run good place to work or a good place to stay away from. Unions are the same. Some are well organized and reasonable... others aren't worth the dues they get paid. I have worked in both environments and paid dues. I don't want to make a blanket statement but the unions that I have worked under tended to support candidates or movements instead of sticking to fighting for specific issues related to nurses. Two examples: 1. My dues went to supported Bernie Sanders for president instead of focusing on a specific cause like staffing ratios and targeting all Senators and Congressmen. They tend to spend their political capital on liberal candidates. 2. They supported anti pipeline protests. They can both be great causes but not to the level of spending precious dues money on. If I had to vote union or non-union I would have to vote TBA
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I appreciate that. With the number of union hospitals driving the wage scale in many areas it is hard to fathom that there is truly a wage disparity between the genders. If there is it seems that it should be able to be isolated to a specific area, system etc. Data is useless unless your going to do something about it other than complain. I hope this study can identify the sources of wage discrimination so they can be dealt with. The majority of CNO's are female so who is doing the discriminating? Identify the source to get to the root of the problem.I look forward to seeing the results.
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I am up front with addicts. Straight up tell them I am not there to judge them and I will give them what they are ordered when it is due unless they are snowed or vitals won't support giving it. I write down the times the different medications are due for my sift and follow through. In some cases I will tell them they can feel free to call the physician themselves. Many patient rooms have phones. If they can't talk the doctor into increasing their pain medications during rounds I am not going to get them to change them over the phone unless something changed. When nothing seems to be working I don't hesitate to advocate for IV Tylenol as a supplement. It seems to work in many abdominal surgery's and I have seen it work for other chronic pain patients post-op. Legalize marijuana especially for pill or liquid form. If they are using the call system excessively then I will place a mark on the communication board every time I go into the room to show the pt I am keeping track so that they can't say I have not tried to take good care of them. Most will agree 5 to 10 times an hour is excessive those that don't are one shift wonders. If there is a psych component you definitely need to factor it in... make sure Psych in on the case. They can help sift out if it is a pain issue or a psych issue. The may need ativan, haldol etc. as a bridge to get them back on track after surgery especially. We aren't going to cure addiction during hospitalizations so I advocate forgiving them what they are use to when they are at home. If they drink ask the doctor for some alcohol. All they can say is no and it is fun to see the shocked look for the doctors that say no. I had one very elderly lady that like her whiskey. Thank goodness that the doctor had the same philosophy. He ordered that she could bring her own in and ordered it PRN dosing. Worked like a charm. She was in her 80's and you can't argue with success. It kept her going for over 80 years! There was a time when I felt people should be responsible for their actions but I have learned people with pain or psych challenges usually have a valid reason for it and did not wake up one day saying I want pain or to have PTSD.
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Great article. My initial thought was that it is a good reminder for nurses like me not to be pressured or rushed when giving medications. My heart goes out to those you wrote about and I can say from experience that it is way better to take ownership of mistakes. It makes it easier to live with yourself afterwards. Fortunately for me no harm was done but I definitely don't have a problem having others verify dosing/rates even just for my peace of mind at times.
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The different pumps that I have used are per-programed by pharmacy. The problem is that some medications like Vanco seem to always have a substantial amount left in the bag after delivering what the pump is programed for. I don't know if the bags are over filled, the pumps aren't accurate or if the viscosity of the Vano mixture messes up the calibration on the pump drip volume. I never adjust above the set volume or the bag volume(+ additive if liquid like cardizem). I guess how much is left over and add it at the end. I hate getting air in the line.
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Thank you for the good information! The ruling does not limit highly complex testing to Istat machines. And with the lack of training of nurses on the basics of quality blood drawing(order of draw, invert don't agitate, maximum amount for blood culture bottles, best to draw without a tourniquet... etc.) I have a low confidence level that proper training is or will be done for nurses doing highly complex testing. Some train critical care nurses on how to use Istat machines but not the intricate details of the process. Many times the nurses will rarely do an Istat test and need a quick refresher from someone else that has done one recently. I don't like hoe broad the ruling is. There is too much room for interpretation.
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