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bgxyrnf

bgxyrnf

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Content by bgxyrnf

  1. bgxyrnf

    Help getting kicked out have a 4.0

    Oh, that sucks. It's quite unfortunate that you didn't ensure that you met the requirements. I'd be quite shocked if they weren't well-documented in your program's documentation.
  2. bgxyrnf

    Do employers look at new grad grades?

    Some of us view grades as a significant piece of information to help form a complete picture of a candidate; others do not. Some people, in fact, express a bias AGAINST people with excellent grades, the common refrain being that excellent grades somehow indicate that the person lacks "common sense" (whatever that means) or practical skills. As with most such questions, the answer is quite simply that it depends upon the person/people doing the screening, interviewing, and hiring decisions. Personally, grades are very significant to me and a good indicator of one's mastery of a subject, their intelligence, and their work habits.
  3. bgxyrnf

    Do employers look at new grad grades?

    Some of us view grades as a significant piece of information to help form a complete picture of a candidate; others do not. Some people, in fact, express a bias AGAINST people with excellent grades, the common refrain being that excellent grades somehow indicate that the person lacks "common sense" (whatever that means) or practical skills. As with most such questions, the answer is quite simply that it depends upon the person/people doing the screening, interviewing, and hiring decisions. Personally, grades are very significant to me and a good indicator of one's mastery of a subject, their intelligence, and their work habits.
  4. bgxyrnf

    How do I become stronger clinically?

    Use the resources that the physicians used when they were learning... Harrison's is a great place to start.
  5. bgxyrnf

    Mandatory Vaccination

    None of the anecdotal comments regarding one's experience with vaccines and illness are worth the pixels in their display. Science, and the meaningful statistics that it produces, are all that counts... Vaccines prevent disease... and do not cause autism or RA or influenza or... It remains, however, the choice of the individual as to whether they will be vaccinated... just as it remains the choice of the employer whether said refusal constitutes grounds for mandatory masks, unpaid suspensions, or terminations.
  6. bgxyrnf

    Mandatory Vaccination

    Stigmatized? I think not. Plenty of people at both of my workplaces decline to be vaccinated and hence wear masks. These are fine nurses and nobody gives a rip whether or not they are wearing a mask. I often wear a mask DESPITE being vaccinated (twice) because there's plenty of crap that I don't in my lungs besides the few strains of influenza contained in the vaccine. Nobody cares. It most certainly is NOT force by any definition of the word.
  7. bgxyrnf

    Mandatory Vaccination

    It is not a punishment, it's an infection control measure. The definition of "fair" is having the rules equally applied to all; it would be unfair to exempt certain people from the requirement.
  8. bgxyrnf

    Troponin not flagged as critical?

    My experience, as well.
  9. bgxyrnf

    Holding voluntary patients - illegally?

    If I were your patient and you refused to unlock that door, I'd certainly come after you in addition to your employers because you would be the one who had denied me my civil liberties.
  10. bgxyrnf

    Holding voluntary patients - illegally?

    You made no assertion at all... you simply asked an honest question, and not a silly one at all. My 'patient not prisoner' remark is a deliberately blunt attempt to emphasize their autonomy and complete right to self-determination. My apologies if it seemed that I was wrongly assigning a belief to you... or if the comment came off as snarky.
  11. bgxyrnf

    Holding voluntary patients - illegally?

    I can imagine it quite easily. By refusing to unlock the door, you are imprisoning this person against their will. Unless you can justify it based on the patient's evident lack of capacity, it's easy to envision a jury entering a judgment against you. Were I empaneled, I'd be 1/12 of the vote.
  12. bgxyrnf

    Holding voluntary patients - illegally?

    Absolutely. Unless the patient lacks capacity, autonomy and self-determination rule supreme. They're patients, not prisoners...
  13. bgxyrnf

    Holding voluntary patients - illegally?

    Encourage them, yes. Make them, not a chance. Stable or not, unless they have been deemed to lack capacity or you can clearly articulate why you believe they do, it is both unethical and illegal to prevent them from leaving. If the patient is willing to hang out for a few minutes and the doc is sufficiently concerned, said doc can get out of bed and drag him/herself in to deal with the situation him/herself. Otherwise... off they go.
  14. bgxyrnf

    Holding voluntary patients - illegally?

    Patient: "Am I on an involuntary hold?" Nurse: "No, you are here voluntarily." Patient: "Um, I've changed my mind about being here and I choose to leave. I understand that I am doing so against medical advice and that doing so places me at risk for relapse as well as acute conditions possibly leading to permanent injury, disability, or even death. I acknowledge those risks and voluntarily accept them. Despite your urging me to stay, I choose to leave." Nurse: "OK, I need to talk to the physician and to case management first." Patient: "Am I being held here involuntarily?" Nurse: "No, you are not on an involuntary hold." Patient: "Then I choose to leave... right now." At this point in the conversation, any attempt to prevent the patient from leaving (that is, physically or chemically restraining them in any way - and yes, locked doors count) would likely constitute false imprisonment as well as assault and battery. If you have reason to question their capacity to make the decision for themselves, you'd better be able to clearly articulate it. Personally, I'd step out of their way and notify the charge nurse and physician... but I would not touch them nor in any way try to prevent them from leaving. If the person controlling the locks wants to take on the false imprisonment issue, so be it. If I were the one controlling the locks, I'd unlock them and encourage them to return at any time without prejudice.
  15. bgxyrnf

    Scared.....No Nursing?

    That is just a new-nurse kind of thing. It didn't take me long to figure out that docs would always follow with a predictable set of questions when I'd notify them of abnormal findings... and generally focused on ABCD... which don't take but a couple of minutes to assess... honestly, it takes longer to chart the assessment than it does to do the assessment (once you've done it a number of times).
  16. bgxyrnf

    Scared.....No Nursing?

    May I suggest that you stop listening to 'them' and start listening to yourself? They cannot tell you what are your core strengths and weaknesses because those are only revealed through time and introspection. Sit down and start writing out a list of general strengths and weaknesses and then try to rate yourself 1 to 5 on each so that you can start to winnow these out for yourself. You say that you've been told that your assessment skills are poor. Presuming that's true, that's a pretty easy thing to rectify. Grab a used copy of Jarvis or some other assessment text and start reviewing it during your break on each shift. Pick a system and focus on that for a whole week. Review the whole ABCD and head-to-toe concepts multiple times each week. When you're home after a shift, review a patient who is stuck in your head. Essentially, continue on as you might have while you were a nursing student but serve as your own instructor. Assessments are pretty easy. Try to find a mentor who can help you think through what you're facing and help you identify your pertinent strengths and weaknesses (pertinent meaning those that are germane to your present position... no point worrying about OB stuff if you're working LTC, for example). And by all means, as Davey Do stated, look to blossom where you're planted. I promise you, nursing is not that hard so if you're struggling, it's just that you haven't yet put it all together.
  17. bgxyrnf

    Triage scenario, opinions needed.

    Even they can refuse care unless there's a court order mandating same. Pretty much the only people who can't refuse care are those who (a) lack capacity and (b) have in a condition for which lack of immediate care is reasonably expected to result in serious harm. Capacity is, of course, somewhat subjective, particularly in the case of obvious intoxication.
  18. bgxyrnf

    Triage scenario, opinions needed.

    One of my pet peeves... people brought to the ED under coercion by EMS or law enforcement.
  19. bgxyrnf

    Triage scenario, opinions needed.

    If the patient wants to be. And generally speaking, very few patients from an MVC have occult injuries... especially among the demographic herein described.
  20. bgxyrnf

    Forgot to restart my patients fluids

    Yes, it is a med error but... not all med errors are created equal and... depending on the patient and the indication for the fluids, this has a high likelihood of not being a big deal. That said, it is very important to get to the root cause of the error because it COULD have been a vital infusion that was left off which then could have led to a negative outcome. There is no reason that I can come up with that would require disconnecting a fluid line for an IVP. Even if the med wasn't compatible with LR (which list has to be pretty sparse), one would typically just pause the pump, flush w/ NS, push the med, and then flush again prior to resuming the infusion... the pump will happily and noisily remind you that you forgot to resume the infusion :-)
  21. bgxyrnf

    RN MGR Told me I'm too old.

    Of course they do. That's why I do not show dates/years on my resume. Of course, the problem is that many web sites REQUIRE the dates to be added to degrees and jobs. In all cases, personal connections at the employer are vital for getting hired. Ageism is rampant... and simply a reflection of our culture.
  22. bgxyrnf

    Opposite Sex Coworker Social Boundaries

    Is that next to Pork Chop Hill? Battle of Pork Chop Hill - Wikipedia Hamburger Hill...
  23. bgxyrnf

    RN MGR Told me I'm too old.

    The whole "I'm xxx old and I can't keep up on the floor anymore" is a complete fallacy. It would be more accurate to say, "I'm in poor physical condition and..." I'm 54 and I can hang with colleagues half my age in a busy ED or in the units. It's not about age, it's about energy and conditioning.
  24. bgxyrnf

    Missed a fracture

    Maybe... but not at all likely.
  25. bgxyrnf

    Opposite Sex Coworker Social Boundaries

    Personally, I'd call off the event... just not worth it to me. Sure, I consider your wife's response irrational - and I've faced a few of those myself - but... your ex-colleagues are not really your friends in that it's not likely that you'll be maintaining an ongoing relationship with them and I would personally choose to validate my spouse in a situation like this rather than hang out with some people who are on the periphery of my life. You've already poured gasoline on the fire... cut your losses and don't follow that up with some rocket fuel. Really, is this BBQ the hill you want to die on? All the comments about trust issues and marital counseling are right on. Good luck to you, friend.
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