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I work in the 3M laboratory and wanted to condense and post some resources for all of you. As someone who is pushing paper safe at home (working to get more PPE out the door among other things), I want to thank you and your families for all that you are doing! Respirator Demonstration and Training VideosMask vs. Respirator. what is the difference? https://www.3m.com/3M/en_US/worker-health-safety-us/covid19/ Donning and Doffing Healthcare PPE with 3M™ Filtering Facepiece Respirators https://multimedia.3m.com/mws/media/1814380O/donning-and-doffing-ppe-for-healthcare-environments-ffr-hd.mp4 Tips for using a 3M™ Flat-Fold Filtering Facepiece Respirator 9210+ https://multimedia.3m.com/mws/media/1793207O/tips-for-using-a-3m-flat-fold-filtering-facepiece-respirator-9210.mp4 Tips for using a 3M™ Flat-Fold Filtering Facepiece Respirator 9105 https://multimedia.3m.com/mws/media/1793206O/tips-for-using-a-3m-flat-fold-filtering-facepiece-respirator-9105.mp4 Tips for using a 3M™ Filtering Facepiece Respirator 8511 https://multimedia.3m.com/mws/media/1793205O/tips-for-using-a-3m-filtering-facepiece-respirator-8511.mp4 Tips for using a 3M™ Filtering Facepiece Respirator 8210 https://multimedia.3m.com/mws/media/1793204O/tips-for-using-a-3m-filtering-facepiece-respirator-8210.mp4 Tips for using a 3M™ Flat-Fold Filtering Facepiece Respirator 1870+ https://multimedia.3m.com/mws/media/1793201O/tips-for-using-a-3m-flat-fold-filtering-facepiece-respirator-1870.mp4 Tips for using a 3M™ Filtering Facepiece Respirator 1860 https://multimedia.3m.com/mws/media/1793197O/tips-for-using-a-3m-filtering-facepiece-respirator-1860.mp4 General Respiratory Protection InformationRespiratory Protection for Airborne Exposures to Biohazards https://multimedia.3m.com/mws/media/409903O/respiratory-protection-against-biohazards.pdf Comparison of FFP2, KN95, and N95 Filtering Facepiece Respiratory Classes https://multimedia.3m.com/mws/media/1791500O/comparison-ffp2-kn95-n95-filtering-facepiece-respirator-classes-tb.pdf Hospital Respiratory Protection Program Toolkit (OSHA, NIOSH, CDC) https://www.osha.gov/Publications/OSHA3767.pdf Respiratory Protection Frequently Asked QuestionsRespiratory Protection FAQ Healthcare https://multimedia.3m.com/mws/media/409903O/respiratory-protection-against-biohazards.pdf Respiratory Protection FAQ: Workplace https://multimedia.3m.com/mws/media/1792539O/respiratory-protection-faq-workplace.pdf Respiratory Protection FAQ: General Public https://multimedia.3m.com/mws/media/1791526O/respiratory-protection-faq-general-public-tb.pdf Respirator Selection and Use ConsiderationsRespirators and Surgical Masks: A Comparison https://multimedia.3m.com/mws/media/957730O/respirators-and-surgical-masks-contrast-technical-bulletin.pdf Surgical N95 vs. Standard N95 – Which to Consider? https://multimedia.3m.com/mws/media/1794572O/surgical-n95-vs-standard-n95-which-to-consider.pdf Filtering Facepiece Respirators - Tips for Use https://multimedia.3m.com/mws/media/1796527O/3m-filtering-facepiece-respirators-tips-for-use.pdf Possible Alternatives to Surgical Filtering Facepiece Respirators: Healthcare https://multimedia.3m.com/mws/media/1803705O/possible-alternatives-to-surgical-filtering-facepiece-respirators-healthcare.pdf Comparison of FFP2, KN95, and N95 Filtering Facepiece Respiratory Classes https://multimedia.3m.com/mws/media/1791500O/comparison-ffp2-kn95-n95-filtering-facepiece-respirator-classes-tb.pdf Respirators Beyond Their Shelf Life – Considerations https://multimedia.3m.com/mws/media/1807271O/respirators-beyond-their-shelf-life-considerations-technical-bulletin.pdf Respirator Shelf Life ConditionsCleaning and Disinfecting 3M Reusable Elastomeric Half and Full Facepiece Respirators following Potential Exposure to Coronaviruses https://multimedia.3m.com/mws/media/1793959O/cleaning-and-disinfecting-3m-reusable-respirators-following-potential-exposure-to-coronaviruses.pdf Cleaning and Disinfecting 3M Powered Air Purifying Respirators following Potential Exposure to Coronaviruses https://multimedia.3m.com/mws/media/1793956O/cleaning-and-disinfecting-3m-paprs-following-potential-exposure-to-coronaviruses.pdf 3M Tech Talk- Disinfectants and General Information https://multimedia.3m.com/mws/media/1806346O/novel-2019-coronavirus-csd-ted-talk.pdf Cleaning and Disinfecting 3M™ Scott™ Reusable Full Facepiece Respirators Following Potential Exposure to Coronaviruses https://multimedia.3m.com/mws/media/1820232O/cleaning-and-disinfecting-3m-scott-reusable-full-facepiece-respirators-coronaviruses-tb.pdf Decontamination Methods for 3M N95 Respirators https://multimedia.3m.com/mws/media/1824869O/decontamination-methods-for-3m-n95-respirators-technical-bulletin.pdf Cleaning and Disinfecting 3M™ Powered Air Purifying Respirators following Potential Exposure to Coronaviruses - 3M™ Jupiter, 3M™ Adflo™ and 3M™ Scott™ Duraflow, Proflow and Tornado PAPR Assemblies https://multimedia.3m.com/mws/media/1824567O/cleaning-and-disinfecting-3m-powered-air-purifying-respirators-technical-bulletin.pdf Reducing the Risk of Secondary ComplicationsECG Alarm Response https://www.3m.com/3M/en_US/medical-us/coronavirus/secondary-complications/#ecgalarm Catheter-Related Complications https://www.3m.com/3M/en_US/medical-us/coronavirus/secondary-complications/#catheter Pressure Injuries https://www.3m.com/3M/en_US/medical-us/coronavirus/secondary-complications/#pressureinjuries Infected Wounds https://www.3m.com/3M/en_US/medical-us/coronavirus/secondary-complications/#infectedwounds

Some additional questions to consider: Were these CLABSI or CRBSI? Do you know if these were actually related to the catheter or was a central catheter just present?Were there any PIVs in place with these patients?Were they intraluminal or extraluminal infections?Was this a spike above baseline? Who does the dressing changes? When was the last time there was a training effort for dressing changes?Dr. Eggimann just published a MASSIVE 11 year catheter associated BSI reduction study in Intensive Care Med that is interesting. 18k patients, 155k catheter-days, 91k ICU days.

Not to be too off topic but although Jefferson was a slave owner, as were many wealthy individuals living in Virginia at the time, he actually attacked slavery and desired an end to the practice. Unfortunately, the southern colony economies required slavery at the time due to labor intensive agricultural practices, so abolishing slavery would have meant there would have been no union between north and south. The hope was that in a generation or two the union would figure out a way to abolish slavery. I guess P.C. was considered even back then.

Clinicians think of budgets as just money. It would be more appropriate to think in terms of resources, not money. You are a valuable resource and your time is a valuable resource. If you do not care about "money" do you care about how many CNAs there are or how many patients you are assigned? It is the same thing... The fact is that everything takes resources and resources are not unlimited. It is extremely harmful to the profession and to our patients if we are orientated if not well versed in resource management and allocation. We are all taught to critically think and triage our patients, you know even the whole ABC thing? Healthcare is best seen as a living and breathing organism and requires critical thinking and triage as well.

Kids have liked that kind of stuff since time immemorial. I have a personal belief that it has something to do with social boundary and personal hygiene development. Remember the Garbage Pail Kids, Ninja Turtles that live in the sewer, the Toxic Crusaders, etc?

Just as you advocate for your patients, advocate for yourself. Now it is important to not focus on negative success but rather positive success. By that I mean, do not say you did something well because you caught the mistake of someone else, focus on that you have XYZ attribute that has allowed to catch ABC issue. Document your successes as well. If you can, email a supervisors for every success (try to play it off casually) just to discuss or email yourself simply for documentation. When you go in at the end of the year you can list your successes. Many nurses will look down upon self-advocating behavior but it is incredibly important for your career. Maybe that gold star won't be attached to a check but if you collect enough of them a really big check may come down the line or a new opportunity that you would have otherwise not been considered for.

What would you like to see administration do? What would be the punishment for the patient? Were you reprimanded by the administration or was the lack of patient punishment the concern?

Rotary, Lions, Freemasons all sponsor various medical missions. I personally have been involved in medical missions supported by Rotary. I would very, VERY, highly recommend that you volunteer with a larger organization. Rotary worked with not just the U.S. staff but also the Mexican officials and medical staff. It is much more complicated and dangerous (liability and limb) than what many would think. Most arrogantly go down to Mexico thinking that it is another 3rd world country but they have laws and standards just like the U.S. Sometimes they can be far more strict than U.S. laws and standards as well... When we would go down to Juarez the local Rotary would work with the local hospitals and the local formal and informal political powers to ensure that we were not harassed or targeted. And yes, we have had to call in support on multiple occasions to get some official, police officer, or some other individual to back off of one of our team members.

I know lots of nursing who left traditional bedside and went to work in various healthcare related careers in things like statistics, marketing, sales, product development/R&D, healthcare lobbying, etc.

No offense but have you actually read the Health Insurance Portability and Accountability Act of 1996 along with it's pertinent amendments? If not, I would highly recommend it. First thing you will note is that HIPAA is federal, not state. Generally speaking, covered entities who are on the health care team can access and review private patient information in the course of treatment. Reviewing charts in anticipation of receiving, but not actually having received yet, that patient for treatment is permissible. Otherwise you would never receive report from the ED, OR, or any other unit you receive patients from. Review 45 CFR 164.506 specifically. Fun fact, so as long as you are not accepting federal dollars nor crossing state lines to provide care you are exempt from HIPAA. Really only pertinent to private duty nursing or those nurses who work for or own independent practices.

I would bet good money it is a staged photo and there is no needle. Either that or I hope she is giving Fluzone or something.

This can be a confusing issue and a very grey issue. Unlike popular belief, coming in early to review charts is not a labor issue. What??? you are probably saying. The 2014 landmark Supreme Court ruling from the Integrity Staffing Solutions v. Busk case settled the questions around the 1947 Portal-to-Portal Act that did not require employers to pay for preliminary or postliminary activities to the primary productive activity that the employee was paid for. Technically, the hospital would be on very firm ground to not pay for chart reviews before shift nor charting after the shift once care for the patient was handed off to the next nurse. Of course many hospitals do pay to avoid the nightmare that would ensue from such an action but they try to limit it to reasonable exceptions. Many hospitals see staying after as avoidable but reasonable, coming in before is just unnecessary.

Overstep of who's power? An employer can mandate you wear clown shoes and butterfly wings, they are businesses. I know of hospitals that have a zero nicotine policy and actually test for it. Their company, their right, their prerogative. Same as you having the free will mandate certain behavior in your home. Now as far as I know there are no states that make it illegal to not vaccinate. Yes, there are some that will limit your participation in certain public events like school but that is different from making it illegal.

Great article. The best ideas are generally worthless unless you have the ability and desire to spread and advocate for those ideas. Assessment and advocating are just parts of the sales strategy that the suit wearing salesmen employ. When you look at Bell, Edison, Tesla, Einstein, Kroc, and even people like Jobs people will look down upon some of their various successes since they were not the originator of some idea or invention but what they all have in common was the ability and willingness to sell their idea...

Impairment is not defined by a certain threshold of chemical within your blood. In the case of alcohol states will set a maximum BAC level which will mean you are automatically charged with impairment should you meet or exceed that but most also have an "under the influence" statute as well. The "under the influence" statute is usually enforced by a series of standardized "field sobriety tests" as well. It will likely be a combination of factors to determine "impairment" with marijuana. No need to reinvent the wheel, states have been enforcing and incarcerating people for impairment for decades now related to various drugs.