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RNed

RNed

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  1. Yes, it does good for society. However, there needs to be an ethical, moral and healthcare discussion on how much money and services should go to support those that, by study, we know will have poor or bad outcomes. Too much money is spent on the last days of life because our society fails to accept death. Healthcare has continued a mission statement to postponed death at all costs and has spoonfeed this as "good" to society without open and honest dialog. It attacts anyone who would limit funding as immoral, unethical and without compassion. In other words you are a bad person if you do not continue to fund the medical machine. This is an unfair statement and used to keep the funds flowing. Medicine is a double edged sword. It has its good and its bad. However, because we can, does not mean we should. Society is served with good medicine, but like anything else to much can be a bad thing.
  2. RNed

    Do I report this?a long post!

    You did the right thing by informing the nurse of your findings, actions and concern. The O2 was started and his sats went up to 96%. The question of suctioning is subjective. Should he have been suctioned or not who knows? I somewhat agree with canoehead, here. Report ? What are you going to report except your findings and actions? You did that to the nurse. If you are drawing a conclusion that this patient would not have gone into V-tack if the patient had been suctioned - that is an assumption. The patient could have gone into V-tack at the time of suctioning, before suctioning or after suctioning. If asked as to what actions you preformed related to this event then answer truthfully and fully, but don't assume there is a fault because the other nurses did not act in the matter you felt they should have. You may find out later after your reporting - the patient had a potassium of 2.2 or 6.8 or some other abnormal lab finding which could have attributed to his V-tack. Hypoxia is only one of many reasons a patient may go into V-tack. It would be appropriate to inform the charge nurse that during this time a family member was present and needed help. Do we have a policy that identifies a spokes person for this family need during a code event? If not should we develop one? Would Social services be an appropriate referrel? I hope you get the idea here, there are many factors why patients do what they do. Sometimes even with the best nursing and medical care the outcomes are not good. I am not saying that you do not report things, you do. However, you report the facts and leave the conclusions, assumptions and analysis up to those skilled in that side of nursing. Strong clinical, experienced, long time staff can get "away" with making some conclusions and guide the investigations of quality care provided by other staff and this is done usually around the corner and quietly with the charge or management staff. Seldom do students and the inexperience get "away" with this. If there is a need for more information, they will come to you and ask.
  3. RNed

    What's WRONG with nursing management?

    I agree with most of what is said about management and the inability to accept the reality and importance of nurse retention. However, Corporate is the mountain we need to move. As long as we (the community and politicians) allow and encourage with tax incentives, subsidies, etc. for building additions and the newest state of art equipment, there will be minimal gains in staffing. Corporate continues to operate with the rule that "if we build it - they will come, patients and staff. " they have sold this policy and idea to the community and to the politicians with the belief - it alone improves community health care. WE need to terminate local, county, state and federal tax incentives to non-profits that build additions without demonstrating the ability to recruit, maintain and retain current staff for present buildings and existing services. They exist as non-profits soley on the idea, they re-invest in the community. That re-investment continues to be in buildings over staff because buildings continue to appreciate and add value to the power base, we call the hospital system. Our current tax laws are out dated. WE need to change non-profit tax laws to those that would encourage the development of staff first and buildings last. Has your union talked with the local mayor or state representative about supporting such tax law changes? Good idea or a piece of pooh ? Just thinking out loud !
  4. I'm not sure we are the best ones to make or pass judgement on our co-workers and co-workers on other shifts. Yes, we should file and report errors and potential errors, concerns regarding safe practice and nurses, docs and other heatlhcare workers. However, unless we are the ones with the authority, responsibility, skill and training to investigate, evaluate and analysis nursing care, we should probably stick to reporting our concerns and leave the investigations to those responsible for that aspect of nursing. To often, I hear nurses make derogatory remarks of care that was provided by so and so. It is suprising how frequently these nurses can instantly assess the appropriateness of care 5 minutes after they arrive to start their shift. These truely are the "SPECIAL" nurses because to listen to them they know absolutely everything that went on that night and yet they did not work that shift. Therefore, they must be "special". We need to provide the best possible care to our patient during our shift and we need to report our concerns. It is not our job and we do a disservice to our co-workers when we say so and so is a bad nurse. Report your findings, not your assumptions, that is part of the job. Now - if you are the boss, that is different, you are special !!
  5. Is your manager also a good leader ? I have a good manager, however I do not believe she is a good leader. I distinguish management and leadership with different characteristics. Today, I believe it to be difficult to be both in our current health management style. What would be the characteristics and behaviors of a good leader is supressed by the style of management demanded by the higher ups. Money as the major decision maker is the message sent to middle management and this stymies leadership behaviors. I identify more leadership people in private business than corporate or organized business. I believe this is a result of corporate buisness saying, " we want you to manage our people, it is we who will lead." I say I have a good manager. I do not fault her for not being a great leader. She must abide by the messages giving to her and that is, " do not lead, manage."
  6. RNed

    Universal Health Coverage?

    Once again, insurance is not healthcare. We continue to use these words as interchangeable. They are not !! Having insurance does not mean having healthcare. And the cost of insurance is NOT the cost of healthcare. Until we can adequately define the difference there is not going to be a solution. We can not pay for all the healthcare needed in this society. Some may say or believe we can. However their answer to this equation is to take money from others for their cause. I doubt this will be given freely. Healthcare is not a "right" and insurance cost is not the cost of healthcare.
  7. RNed

    Nursing and Euthanasia?

    I am not sure we need a policy regarding euthanasia. This question poses the idea that we can assist someone who determines their quality of life is not ideal or tolerable and after this evaluation take acts that terminate life. I question whether we need to have a euthanasia debate. I believe the problem lies much earilier in the equation. People seem to die fine without our help and despite our help ! The real question is, " should we intervine with massive support to postpone a death event.' The fact that we can - does not mean, we should. I may be out-of-line here, but I don't necessarily believe withdrawing ventilator support is euthanasia. The cause of death is underlying lung disease. This person was not born with a ventilator and the fact that a ventilator is not available or choses not to be available is not the cause of death. Many people have died because service was not available or the technology had not been developed. Never-thel-less their cause of death was not do to lack of intervention, but do to underlying disease. In summary, do we need euthanasia or do we need stronger laws regarding patient rights and choices in how much medical care is utilized? Absolutely, we need to continue education of society in the application of medical interventions. Society needs to have a full understanding of what we can do and can not do. The questions regarding euthanasia becomes mute, if we do not apply the full weight of medical intervention. In short, euthanasia is closing the barn door after the horses are gone. We need to ask these types of questions long before we call for the ventilators, tube feedings and pacemakers. Its not magic or mystical to keep someone alive, but to have them think, interact, respond and smile that is magic !!!
  8. RNed

    Divorce And Affairs????

    Nursing and marriage is like mixing apples and oranges. Being a nurse places no more hardship on a marriage then other professions. I have heard it said, "that you get married when you don't know each other and get divorced when you do!" Some spend to little time in understanding who they are marrying. To often I hear nurses referring to work as a cause of divorce in the false belief that being a nurse was the problem. Marriages do not work when the two in the marriage can't, don't or won't continue the hard work it takes to make it work. Being a nurse does not bestow additional burdens over and above anyone else. It takes two to get married and two to get divorced. My long hours and I'm always tired caused my divorce. He or she didn't understand what it is like to be a nurse. You and your spouse bare the responsibility of divorce and it didn't have a darn thing to do with being a nurse. Nursing and divorce do not belong in the same conversation. One has no relationship to the other except when one tries to justify the act and project the cause.
  9. RNed

    Obesity Costlier Than Smoking

    I have somewhat always thought obesity was more or equally as costly on society as smoking. This study brings this cost more to light. Again, we are faced with the question of behaviors. Although smoking does bring about a different death than obesity the results and effect is the same on society as it relates to money and healthcare expenses. I suspect the biggest and most identifiable difference is the second hand smoke issue associated with smoking and no identifiable issue with second hand obesity. So as some of us have to put down our cigarettes and cigars, others will have to put down our snickers and ding dongs !! Will we have a law suit against "junk food" distributors like we did cigarette distributors? Will we see a band on "junk food" TV commercials? Is sugar as addictive as tobacco? Will our lawyers rush to all the diet centers to start that class action lawsuit? :chuckle
  10. RNed

    Difference in dregrees and licensures

    Nursing is fractured into many pieces. We have "nurse" in labels from Nurse Practioner to Certified Nurses Aide. It is little wonder that nursing can not speak with one unified voice. Just a few: Nurse Practioner, Registered Nurse, Licensed Vocational Nurse, Licensed Pratical Nurse, Nursing Assistant and Certified Nurses Aide. This is not to mention all the lay people working within a Doctor's Office, who do not clarify to the patient, they hold no license and only assist the Doctor under his directions and allow patients to incorrectly identify them as nurse. When society thinks of nurse, they think of all those who have "nurse" in the title. Society is confused because we are confused. Why should they, we have failed to educate society and continue to bicker among ourselves about the ADN vs. BSN. We go so far as to continue fracturing the Registered Nurse into Certifications such as CCRN, IV Certified, etc, etc. The list will be endless. I am not agaisnt these certification, I use the example just to demonstrate we continue to divide ourselves and then ask the question, " Why do we seem unable to unite".
  11. RNed

    Dedicated too a Nurse of 94 years...

    Grandmothers are special people. Mine said the first time she crossed the Red River she was in a covered wagon and the last time she crossed it, she was in a jet airplane. I said, "wow, things have really changed." She said, " I don't think so, I was scared to death both times !!" Apparently somethings don't change. They are all special ladies.
  12. RNed

    Unions/Attitudes

    The employer and employee relationship has deteriorated and I suspect both are lying to each other. Typically, I fault the employer for allowing the unions to get a foothold. If the adminstration wanted to keep the union activity out of their facility they should not have pushed the nurses to the point of seeking union representation. When adminstration pushes the staff to the point that union activities occur, the risk is that union activities occur !! The fault truly lies with adminstration, it is their failure. Unfortunately, it demostrates adminstration does not "know the staff and the needs of the staff". If they missed this and they did, they most likely are not intuitive enough to make corrections and resolve this issue. I'm sorry, if you are in management, I suspect you are in for a few bad months. Good Luck.
  13. RNed

    opinion on legalization of marijuana in Canada

    Sucevid, Is marijuana a nurisng issue and should nurses take at stand? Unfotunately, we have perconceived ideas of pot based in history and experince. When, I look at the issue of pot as a medical tool and a medical tool only. I believe there is room to have additonal studies regarding the medical use of marijauna. All chemicals currently used have benefits and pitfalls. Each use is defined and their abuses and dangers identified. Opiates in society are abused, yet, we use this chemical daily in healthcare. The fact that marijuana is considered a recreational drug and therefore is not worthy of additonal studies for possible medical benefits is wrong and in my humble opinion is worthy of nursing support for the continue research of possible benefit. Yes, nursing can and should support the medical use of marijuana as an adjucnt to medically treatable disease or at least support the research. Leeches at one time were used and then discarded as nonsense. Never-the-less we have again see leeches with a medically defined benefit. I see no reason to rule something out, which might add to our medical tool chest, just because some of society abuses the chemical. As to it being available over the counter, so to speak. We see many drugs which by concentration only is made available over the counter. Can and should marijuana be made this way? Maybe, have there been any studies related to the concentration, effects. abuses, long term use and benefits of marijuana use. Low dose situational anti-depression therapy, anti-emetic therapy, adjucnt chemotherapy medication are all within the realm of possiblitlities. I suspect if a pharm company was to get on the bandwagon and throw there support behind this issue, a medical grade marijuana would capture support and eventually make its way to market.
  14. RNed

    So FRUSTRATED!!!!!!!!!

    I tend to agree with RyanRN, as long as the hospital gets away with this activity, they will continue. Don't answer the phone and don't do the extra shifts. The hospital does not exist to solve your problems. And as long as you make it your problem it will remain unresolved. However, the hospital is designed to manage its problems. When the hospital identifies this as their problem more likely defined as, when they can't get a nurse to come in extra, they will fix it. Until then, I suspect it will remain your problem.
  15. RNed

    Oregon: Extra strike pay to nurses illegal

    I agree replacement nurses cause some disruption during negotiations, however, most I have met care about nursing as a profession. Their act of crossing a picket line is about money. It is not a statement about nursing or patients. Let's face it - this is not an issue about patient care as the line implys, nor is it an issue between staff nurses and replacement nurses. It is between the adminstration (facility), who wish to compensation nurses with the lease amount possible and the staff who wish to be paid what they are worth. Let's not fight with those who cross the picket line, they are few in numbers, have no authority, are not the decision makers or winners and they do not determine the final outcome. In fact they charge excessive fees to keep the doors of the hospital open. The hospital continues to pay liability insurance, electricity, water, supplies, retirements, doctors and payroll and all during a time of low patient loads and therefore reduced income. They are also exposed to greater risk of errors using an unfamilar staff . If the hospital actually closed, transferred all the patients and turned out the lights, they would save millions of dollars and be less likely to sit at the table to negotiate. We may believe those who cross the picket line do us a dis-service, then again, that might not be true. Having been on both sides of this table, I feel assured they are just as concerned about what it is costing to keep the doors open currently as they are about what it might cost them to settle. The fight is not with those that cross the picket line - the fight is with those that caused the picket line. Nurses must support each other to protect nurses, not patients'.
  16. RNed

    Oregon: Extra strike pay to nurses illegal

    I don't know about the law. However, the nurses did not do an illegal act in receiving compensation for services rendered. However, the hospital did an illegal act in offering this compensation. It is the hospital that is illegal and not the nurses. The money received by the nurses was not obtained illegally and in my humble opinion should not be paid back. The hospital paid those nurses over and above the offer to pay regular staff - that is illegal under the currrent fair labor laws. Therefore, the nurses should get to keep their money. The hospital was illegal and should pay a penalty for that activity. To bad for the hospital.