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BeenThere2012

BeenThere2012

Registered Nurse
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Content by BeenThere2012

  1. BeenThere2012

    Are Patients Cared for Equally? Challenges of the VIP Patient

    First of all...I admire your ability to overcome your background circumstances and take care of yourself the way you have. I came from a troubled family/childhood and can relate. Also, your points on this topic are well-stated and I am in agreement. In particular, the issue of assigning a less experienced nurse should be avoided for the reason you stated, and in general, a less experienced nurse could aggravate that "special" VIP and cause more problems than there would already be potential for. (Forgive the grammar) I haven't read every comment yet, so forgive me if this was already mentioned... There are VIP people in the world who are kind, respectful people. So aside from the ones who are "entitled" jerks, I think many from privileged backgrounds simply do not have the knowledge/perspective to behave appropriately at times. Their unreasonable expectations are born from ignorance.
  2. BeenThere2012

    Are Patients Cared for Equally? Challenges of the VIP Patient

    Got to admit...I feel the same. But as the patient...I don't want to tell my nurses that I am a nurse because I don't want them to feel nervous around me. Eventually they would find out, and I would tell them...Please do not worry about me being a nurse. Just know that I understand what you are up against and will not judge you.
  3. BeenThere2012

    Are Patients Cared for Equally? Challenges of the VIP Patient

    The list you gave regarding the Principles of Caring for VIPs....You state it was geared to physicians but have take aways for nurses....TO ME...It's clear principles that apply to anyone caring for a VIP. I don't see the distinction between physicians and nurses in any of the listed statements. My intended approach in caring for VIP patients is that I will care for them as I do any other patient. However....There were always the more nervous feelings that would pop up from time to time as I had felt as though I would be under closer scrutiny, or more worried than usual about displeasing them somehow or making an error. I never did anything out of the ordinary or gave them "special" treatment (consciously), going out of my way, so to speak to do anything "extra" for them. I'm not a Pollyanna, but my values and principles go against that, and rub me the wrong way.
  4. BeenThere2012

    Seasoned Nurses - This one is for you

    Yes! I was going to say wound vacs and all the various dressing supplies and wound care knowledge. O2 sat monitors Glucometers IV dressing thingy's Flush syringes G-tube/Mic-key buttons To name a few... Also,all the different types of IV pumps. There were none of them on regular med-surg floors when I started, and calculating drips rates based on tubing lumen size etc was a pain in the butt and obviously not accurate. I like the EMR's in principle, but hate the lack of accurate choices given at times and the way many nurses just repeat what was charted by the nurse ahead of them or pick something that is not entirely accurate. IMO, charting is often much less individualized to the patient. I understand the need for some standardization and more succinct wording. I like charting by exception and then having the opportunity to make comments to individualize and describe, but with the drop down menus provided in some systems, there often seems to be something lacking.
  5. BeenThere2012

    Holiday Bonus

    We get a bonus at the end of the year instead of a raise. Full time gets one amount and part time gets another. It's the same amounts for each depending on full time or part time, and has nothing to do with performance. Not individualized. At other places I've worked, we got some sort of "token" such as a 4 piece See's candy box or a cheap, plastic drink cup with the hospital logo....and, if you weren't around on the shift they were passing them out on, you didn't get anything at all.
  6. BeenThere2012

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I was thinking the same here. Talking doesn't help claustrophobia....but is a bit beside the point. Whatever the med prescribed and for whatever reason, the errors here were profound. This whole story obviously brings up so many issues. Nurse practice acts, punitive culture, contributing factors, accountability, responsibility, basic nursing knowledge, etc....And I can hardly wrap my head around how someone in this "Resource" roll did not know that she was administering a paralytic????? NONE OF THIS MAKES SENSE. I've made my share of mistakes after 30 something years in practice and have learned from each and every one of them. I've done work arounds and now NO LONGER DO. I've pulled and given wrong meds in haste doing overrides and NO LONGER DO. I've seen others' mistakes and changed my own habits as a result. As I have sympathy for this nurse and am to the point of anger towards the pressures we face by administrators who care only for their bottom lines....I still can't get my mind around how a Reaource nurse in an ICU setting could have made THIS mistake????? SHE IS ACCOUNTABLE to be sure. However, I still believe this hospital WRONGLY had her in this role. Vanderbilt has BIG accountability in this one point alone. She obviously did not have the knowledge, training, and/or skills to be in this role, let alone the appropriate integrity, and personal accountability, in that she agreed to work in this role in the first place. (I stumbled on wording, but I think my points are clear)
  7. BeenThere2012

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Former PICU nurse here. Agree with your points. However, where I have worked in the past, we always took an emergency med kit with us when we transported a patient to a different department for procedures. I get that with Pyxis systems, you can't just pull out meds and leave them in a kit. But kits can be made and stocked in the Pyxis. This is safer, requiring a second nurse witness, and more convenient for other situations when these meds are needed for a rapid intubation etc... Maybe I haven't thought through all the consequences of having kits, but it seems like a safer practice all around. As far as this situation in general, most of what I believe has already been said. Rushing and being pressured can cause even a knowledgeable nurse to make errors. I cannot stress enough how horrible it is that for a role as important as ours (Nurses...especially critical care), should ever be rushed and pressured with all we juggle. Nurses cut corners all the time in order to get things done expediently. This is WRONG WRONG WRONG, but I've done it myself at times and understand the urgency one feels when in this position which is more the norm now than the exception. Our knowledge base, capabilities, and responsibility has grown tremendously over the years. Yet, we staff as we did 20 plus years ago when there was less to know and do. Less procedures, less medications to know, less treatments and equipment for just about anything I can think of. There most certainly were errors in this tragic situation at just about every turn, but as far as errors in general, there would be less, no doubt, if we took out rushing and pressure from the equation. When a Resource Nurse is rushing around from task to task, you know the ones with assignments are doing the same. There is just too much to do all around.
  8. BeenThere2012

    Nurse Staffing Ratios Up for Public Decision? Ballot 1 in MA

    I need to ask...what type of patients were the 16 you had? Psych or med-surg? We're they counting on you to provide care or just shadow?
  9. BeenThere2012

    Thankfulness - What's Yours?

    Thank you for a beautiful gratefulness post! Meaningful to me. Got a tear.
  10. BeenThere2012

    Nurses Can Be at Risk for PTSD

    I'm wondering why more are not responding to this post? Do nurses not believe they are at risk for this? Denial? I'm not saying ALL nurses get PTSD....don't get me wrong. I believe many are probably experiencing some degree of unhealthy stress, burnout, etc and don't realize how close they may be to experiencing it.
  11. BeenThere2012

    Nurses Can Be at Risk for PTSD

    I've experienced this. I wrote an article posted on this site about what I went through. I now know the PTSD I experienced wasn't entirely caused by the incident at work that triggered my reaction at that time, but contributed to it and/or was the Straw That Broke this Nurse's Back.
  12. BeenThere2012

    Holding Hands with AI (Artificial Intelligence)

    Excellent article! Scary, for sure, regarding all the mistakes that can happen using computer systems. The examples you gave explain it well and I've actually experienced a few of them. One issue in particular effected me quite adversely. It can be confusing to explain, so bear with me... I was assisting another nurse in an emergency situation and pulled a Morphine dose from Pyxis. Gave it to her and she administered it. Some weeks later, I was called into the managers office to explain how I pulled a morphine dose, but didn't show documentation of giving it, 5 mins after it was documented as given by a different nurse. Turns out, the flipping clocks on the Pyxis and the bedside charting computers were not in sync. The problem was that I couldn't explain it at that point and dumb-founded. I looked suspicious. It wasn't until a later time when I was telling a colleague about this and she had a similar experience in another facility. So she checked the clocks on said Pyxis and bedside computers and found they were approx 5 mins apart. Not a life threatening situation, but potentially may have ruined my reputation. I no longer worked at that facility when this was figured out and it went unexplained. It was a travel contract and I was "let go" at the time. WRONLY, but none the less, it still bothers me whenever I think about it.
  13. BeenThere2012

    "You made a mistake."

    I've had that dream! oh my God! And I can't find my way back to the unit...SAME damned dream!
  14. BeenThere2012

    Family Practice - overworked

    I think stick it out. 6 mos goes by quickly and if that ensures a better employee record for you, then I would try to stay until then. I don't know the specialty you are in and also, easier said then done, but.... Unless someone is critical or tilting on the edge of critical, just try to slow down as far as feeling pressure and do your best. Just try to work your priorities and flow with your work. If everything is not done, then so be it. The fact that we nurses run like crazy and manage somehow to get the work done, allows the managers to get away with short-staffing. Just some thoughts without knowing the details of your work...Good luck!
  15. BeenThere2012

    Is this legal?

    Not sure if this is the correct forum...? We have a policy where I work, that marijuana is confiscated from patient belongings when they are admitted, unless they have a medical marijuana card. We are in California where it is legal for recreational use. Our administrators tell us that we must abide by the Federal laws regarding this and not the California law. Generally, I'm not against people using marijuana with certain exceptions like kids and mentally ill who can be adversely effected. It just seems to me we are "stealing" legal personal property. Its confusing to me from the legal aspect. Another example: Drug paraphernalia can be confiscated and yet it is legally sold in stores all over the place here. Can anyone shed shed some light on this?
  16. BeenThere2012

    Is this legal?

    We list Meds, bag and send to pharmacy. If there are any controlled substances, we count and co-sign with another RN. Anything else is bagged and sent to the supervisor. In CA we don't flush anything due to preventing ground water contamination. For illegal substances (including marijuana, even tho it's legal) and paraphernalia, the Supervisor then turns these things over to risk management who turns it over to the Police.
  17. BeenThere2012

    Is this legal?

    One more thing.... I am guessing this still needs clarification... I work in a psych hospital. The patients are brought in on a hold. Many are homeless and carry everything they own in this world with them. They don't have the choice to turn around and walk out, nor do they have a family member at their side who can take contraband home for them.
  18. BeenThere2012

    Is this legal?

    Thank you for your support. I plan to talk to risk management about this. I was hoping to get some information first if anyone had any legal precedents I could site. None of this makes any sense to me and I am hoping to get clarity beforehand. In any case, I truly appreciate all the input here and at least know I'm not the only one concerned about this. My co-workers don't comment when I bring this up other than to say..."This is the policy.You'll get in trouble if you don't follow it." (As if I wouldn't follow policy). Of course I have no choice at this point if I want to keep my job. Just feel compelled to advocate for the rights of my patients where I see potential injustice.
  19. BeenThere2012

    Opposite Sex Coworker Social Boundaries

    To your last question...No! I think your wife is being inreasonable.
  20. BeenThere2012

    Is this legal?

    That's what I was also thinking??? I still think we are confiscating someone's legal property. If they have a card, we store it in the safe and return it. If they don't, it is confiscated and given to the risk manager. I don't "get it" and still questioning if this is legal to do, or even ethical?
  21. BeenThere2012

    Is this legal?

    To answer and clarify some questions.. We are in California where it is legal for recreational use. I work in an Acute Psychiatric Hospital, so all belongings, (except clothing without strings etc.) are placed in a locker for the patient. Anything valuable like purses, wallets, etc are placed in a tamper resistant bag and put into a safe. All items are inventoried in front of the patient, including purse and wallet contents. This is so the patient cannot claim we stole money or a phone etc from them after they were admitted. Their belongings are returned to them at discharge. Pot, pipes, or anything illegal/contraband is taken away, given to our risk manager who turns it over to police to be destroyed. No names are attached to the items as far as I know.
  22. BeenThere2012

    "My pain is about an eight and a half"

    oh my God! Have we all lost our minds? How far does this crap really have to go?
  23. BeenThere2012

    "My pain is about an eight and a half"

    OMG! That was hilarious. Thanks, I needed a laugh!
  24. BeenThere2012

    It's Time to Stop Nurse Bullying in Its Tracks

    HomeBound...Your post was spot on and I admire your ability to handle the bullies you referred to. Many of your points I fully agree with from experience. I am having more of a "rudeness" issue with some of my coworkers currently, and feel lost as to how to deal with it. I wouldn't call it "bullying" outright, but it is very aggravating and makes my work life more difficult than it already is. The behavior is subtle. There is a clique of nurses who reinforce each others' styles if you will and they gossip constantly. One is the leader and strives to be perfect and better than "everyone". Examples: She will agree to work ANY OT, extra shifts, double shifts etc when asked which sometimes adds up to ridiculous double doubles, 18 days in a row without a day off and so on. She is a "yes" person to anyone in authority. She jumps in the middle of care with my patients for example before I've had the chance to do what my plan was that she overheard me say. She will ask me a question. I give the answer, and then she will go to someone else to ask the same question...right in front of me. (She gets the same answer by the way). She interrupts me in report continuously, sometimes shifting her attention to something as I'm in mid-sentence. I can't tell if this is a power struggle or somehow I threaten her from being the only darling of the unit. It's these subtle behaviors that gnaw at me. I'm just trying to ignore her and do my thing at this point. The crap is not worth bothering management over, and frankly is not a threat to our patients in any way. It all just makes my work life so difficult. We have to work together every shift. Thanks for "listening". I could go on...
  25. BeenThere2012

    From Nurse to Nurse Influencer

    Thank you for giving us your story. It is inspiring and commendable.
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