wernicke

My good friend is in the process of leaving an abusive relationship. She called the police after an incident because she was in fear for her safety. Unfortunately, the police got it wrong and arrested her, a shockingly common occurrence in abuse cases by all accounts. I'm afraid I'm not able to go into detail but it's a pretty outrageous situation. We are hoping for a dismissal or a not guilty verdict. However, God forbid, if a miscarriage of justice occurs, how can we best protect her license? I am willing and able to be a character witness for her-we've been friends for years and currently work together. I don't think this is a likely outcome (dismissal seems to be the most likely), but I like to prep for the worst case scenario. Sad to say that our society has a bit of a track record for punishing/shaming victims of DV. As an aside she is getting help and is currently safe.

Adderall doesn’t have those effects at therapeutic levels. The person saying that is a brand new account and that’s the only post, which makes me suspicious that they’re a troll who posted that to try and get a rise out of us.

It’s not clear to me either what the mechanism was but he did confess on the phone with his ex wife. He apparently didn’t realize it was being recorded and was admissible. https://www.ketk.com/news/crime-public-safety/william-Davis-murder-trial/convicted-christus-nurse-searched-a-list-of-serial-killers-by-number-of-victims-weeks-before-his-arrest/

Nah, it's only human. Had a lady, of sound mind, literally beg us for bed rails. State still gives us a really hard time in those cases, because the bed rails violate her "right to fall". The very concept of the "right to fall" is beyond absurd to me, and it seems to be a "right" that the state holds so sacrosanct that HCPs and even patients/residents of sound mind rarely succeed in overriding it. Anyway, I kinda hope whichever state official says that ends up in the exact same situation one day. Begging for bed rails or a seatbelt, of fully sound mind, but being denied it because it "violates the right to fall". Now that one's dark of me. And I do not want for them to actually fall-just to experience a sliver of the fear and dismay our patients/residents go through when they learn their "right" to have a painful, embarrassing, and too often disabling or even fatal accident is held in such esteem by the state that it triumphs over their other basic, intuitive rights.

Happy update-she stopped this behavior! Turns out she had a traumatic experience with incontinence in a healthcare setting. She was able to work through it, and the traumatic situation was very preventable so we were able to assure her that it would never happen here (not going to go into specifics for privacy but let's just say some people were possibly burnt out and definitely shockingly unkind at the other facility). She's a lady who likes to have her makeup just so, and everything in its place, etc. So the combo of a bad experience plus her personality led to this behavior. We very rarely use a bed pan-only for people who cannot be ambulated and for whom a Hoyer is painful. It's a way to preserve dignity as cognitively intact people are often very upset at the idea of having to "wet themselves in a diaper", as one once put it. She is now ambulatory with help.

The patient is in her late 90s and is here for rehab following an accident. She has absolutely zero cognitive deficits-sharp as a tack. She also has no diagnosed psychiatric history. Her medical history is surprisingly minimal, and her prognosis is great once she completes rehab. I'm willing to bet she will make it to 100 at least. However, she is at high risk for a pressure ulcer because of a behavior. She is absolutely insistent on sitting on the bed pan for as long as physically possible, even when she does not have to go. She is mildly incontinent of urine but only ever wore menstrual pads for this at home. It is worse due to her current situation. She has briefs, and our call bell response time is usually about 1-3 minutes (not bad given our ratios; everyone's a team player, even the director of the facility will answer call lights when making the rounds). She denies urinary urgency. She states that sitting on the bed pan makes her feel prepared. She has no fear of involving staff in her care, as she makes very frequent use of her call bell. I think she is struggling emotionally with needing what she considers to be a diaper. She has, however, refused all psychiatric consults including psychotherapy. Attempts to bring up the subject gently or casually have failed as well. She has been educated ad nauseam and in many different ways that she is placing herself at very high risk for a pressure ulcer, and what the consequences of an ulcer would be. She has also refused any and every intervention, even those strongly focused on her dignity. We have thought about taking the bed pan away as an option but the ethics of that are quite thorny. After all, since she is a totally competent adult, that would be paternalism. I am documenting, documenting, documenting so legally I think we are in the clear. It's just the ethics/morals of the whole thing. I hate seeing someone set themselves up for so much pain and a worsened prognosis.

I'd be stunned if this wasn't the case.

Sadly this was correct. The same patient has a wound vac. I did a dressing change for her today, found that she was soiled so cleaned her up. When she was on her side, and I was wiping her, she yelled out "no! no! no!" then whimpered "why John why" [name has been changed] before repeating the exact same phrase of " "I'm a good girl! Why? What's going to happen to me now?" Other staff say she's said this name before during peri care. It is not the name of anyone in her family that we know of. One staff person said that she was once sitting and rocking, saying "it's my fault I sinned I was alone with a boy". The idea that she is reliving her sexual assault every time we clean her or care for her makes me sick to my stomach. Given her age, and the age she seems to revert back to during these episodes, it seems she's been living with this for over sixty years, probably closer to seventy. She had a successful life beyond this, and seemed happy. But the whole time this trauma was there. Utterly heartbreaking.

Thank you all! And this thankfully happened. After three days off, I came back to her back to her baseline. She is a lot more "there" than given credit for-she has dementia that's quite advanced and cannot really communicate (lots of word salads) but she understands things. At one point today during wound care, she grabbed and held my hand which felt great honestly. It still haunts me honestly because she definitely experienced the insertion as a sexual assault I think. Other staff suspect she has an undisclosed sexual assault history. Really, really sad stuff. Oh wow...that brought tears to my eyes. That poor, poor lady.

Update for everyone: It all worked out! I had a new job within two weeks, and word of the situation had actually gotten around in some circles. I also had a ton of people volunteer to be my reference, including people who could vouch for the situation. I also made the right choice. Everything hit the fan a few weeks later. That former colleague who was going after me didn't just sit down and do nothing once I was gone. Unsurprisingly, someone like her always has to have a target so she began going after others. I cannot go into a ton of details on a public forum but I would have lasted about 3 more weeks from when this was first posted had I stayed. She is somehow even more devious than I realized, and she is quite devious! My new job is wonderful, and in the specialty I wanted to transition to (geriatric rehab). For any other nurse seeing this: If your license is at risk, quit. Get out. It is helpful to have references. Quitting without notice isn't unprofessional if it's self-defense, for lack of a better term. As for worries about "only place you can go is SNF", worry not! I got two hospital offers that I turned down, three hospital interviews that I declined as I'd already accepted my current job, and offers from several SNFs. This one is top ranked, has sane ratios, and a great working environment with management that has our backs. Thank you so much to everyone! I just wanted to post this as closure as I know I surf old threads here all the time.

I had an elderly female patient with advanced dementia who required a Foley Cath. Her family very much wanted it done, and before her disease progressed, she herself wanted everything done for her as well. Her survival was at risk without the catheter. Myself, another nurse, and an aide all helped as she is not mobile, has a rigid muscle tone, and is heavyset. She became terribly upset. At first she began yelling "no! no! no!" then began crying, saying "Why? Why? Why?", "I'm a good girl! Why? What's going to happen to me now?", "I'm ruined", etc. By her words and demeanor, I think she was perceiving this event as a sexual assault. I tried explaining what was happening as we were working but with her stage of dementia I do not think she was able to understand. I did explain in simple terms on a loop as she got upset (p sure my colleague thought I was nuts but I always do that just in case they somehow understand. It does work sometimes). Ever since, she has been a bit more withdrawn. I do not think she remembers the event but I do think it impacted her a bit mentally. Is this inevitable? I have had stuff like this happen before but it was never as visceral or as bad as this. There is no known sexual assault history but given her generation and devout Catholicism (I grew up Catholic myself) alongside tendencies of survivors to feel unjustly ashamed, I do not know if she would have told anyone if she had been.

I was worried it would come off as unprofessional or as bashing my last workplace.

It's a very long story, but I currently work at a pediatric facility plagued with many problems. I have spent the last 18 months trying to sort them out, and I had a wonderful manager. Was making progress-our last audit was our best ever. I have a colleague who is ultra competitive and has been out to get me-others back me on this. It started because when I was new, I outperformed her on something. I didn't even realize it at the time, and did not understand why she was targeting me. She once filed a false report on me to the state, which was promptly dismissed. She has a long history of doing this, and I do not think they take her too seriously anymore thank God! She has done dozens of other things, all unethical and some borderline illegal. Not just to me, but to many others too. I cannot be more specific on a public forum, and even if I could, it'd be hard to believe. My manager just left. She is in line to be my new manager. Between that and the intrinsic problems of the facility, I have to get out of here. My license is at risk and that is not hypothetical. I am devastated as I really love my patients. I also have to quit without notice as this place has a very long history of retaliating against people during their 2 week period. Right now I have a very good reputation and I want to keep it that way. I have never before quit a job without a new one lined up. I have multiple people willing to be references, some of whom offered outright. I am contemplating a lateral move as well as elder care, as I used to volunteer at an SNF from age 13-18, and I actually miss it. I want to keep my foot in the door in other specialties too though, so actually considering doing two part time gigs-one in peds and one in SNF. All that aside, in interview, obviously less is more. I am not going to say all of the above. But, what do I say? The honest truth is that I quit without having another job lined up because my license is at risk intrinsically due to issues with the facility, and this is amplified by an incredibly vindictive individual.

As of right now there's only been one ticket. In my state, I will not be towed or booted as long as I pay. Parking tickets do not go against me, they go against the vehicle, since the state officially has no way to know who was driving the car at the time. But there will be no lien or repo as long as I pay the tickets. Only way I could get into real trouble would be if I left it parked in the same illegal place for three days, as the car would legally be considered abandoned at that point and the city would take possession of it. If it becomes a chronic problem we will readdress it. For now, it's a one-off as most of the time I sorta get away with it I suppose.

I'm still a ways away from doing it but I like to plan ahead. I'll be applying to jobs in about six months all being well. Im a new grad in home health; virtually all my patients are ventilator dependent. There's also central lines, TPN, trach/peg, etc that I think help to provide useful skills I had planned to be a family provider but now I'd like to be a transplant coordinator. It's a really long story but I had the opportunity to get someone on the transplant list after being denied (this was in Europe), find relevant research to make it possible for them, and they indeed got on the list and received a transplant. I also worked with the team to implement new research that reduces the odds of rejection. It's by far the most exciting, fulfilling thing I've ever had happen in my life! I realized after that experience, plus 3 years of working with this population while in school, that this is where my heart is. I know it's not always glamorous and that my experience was very unusual, but in looking into that option, I just see it as a strong fit. To do that I must get a few years of ICU experience. Has anyone made this transition? Or, alternatively, does anyone make hiring decisions for an ICU, and would you consider a home health nurse? What do you recommend I do in the next six months to make myself the most marketable candidate I can be? I plan on applying to community hospitals as large urban hospitals tend to want ICU experience. I won't run in a year or two either; I know any hospital that takes me is making an investment. I plan on getting telemetry certified, what other certifications can/should I do? How can I beat "sell" my skills? How do I make sure my resume gets by recruitment software so it can be read by a live person? Thanks!