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Unreasonable Risks are not part of the job

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Read, Reflect, Assess

https://www.nursingworld.org/~4ade15/globalassets/docs/ana/ascec_whitepaper031008final.pdf

Adapting Standards of Care Under Extreme Conditions

American Nursing Association, 2008

https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/risk-and-responsibility-in-providing-nursing-care/

Risk and Responsibility in Providing Nursing Care

American Nursing Association Position Statement, Revised June 2015

When a health system is not prepared and puts healthcare workers at risk due to poor preparation to have PPE equipment available, and a virus's potential for harm is unknown due to his newness...only time will tell after scientific studies have been done.

Is it a choice to provide nursing care in this setting when you feel unsafe? The second statement mentions nurses have a right to not provide care when faced with a moral dilemma and that is a moral option whether or not to provide care, vs. moral obligation. How do you feel about the current situation RNs are dealing with nationwide?

Thank you for your sharing your thoughts and reading if you have time. Sending prayers to those on the frontlines taking a risk for the welfare of others. I hope we don't lose too many healthcare workers in the US.

I'm not promoting fear - I'm promoting Self-Care and Choice for RN's. Smart nursing, , because we are professionals who agreed to work in safe, prepared settings.

This one is pretty easy - according to ANA, unless you’ve got at least a bachelor’s degree, you’re not a “professional” nurse anyway - so, presumably they should have no problems if the poorly-educated LPN’s and ADN’s retreat to their caves and let the doctor-nurses show us how it’s done.

LibraNurse27, BSN, RN

Specializes in Community Health, Med/Surg, ICU Stepdown. Has 8 years experience.

I would hate to refuse to treat a patient, but if it really came down to it I would not want to care for a patient with covid19 without any PPE. If I got infected I would most likely not get sick as I am young and healthy but I would be quarantined and unable to care for any patients, or die! And I might spread it to others. But I really don’t want to ever have to make that decision. We need PPE now!

OUxPhys, BSN, RN

Specializes in Cardiology. Has 4 years experience.

I dont think it is wrong or immoral to refuse care if the hospital is not going to provide the proper PPE. Being a RN does not mean your well being does not matter.

RN-to- BSN, ADN, RN

Specializes in SCRN. Has 7 years experience.

I think that once report is taken, the nurse has to care for the patient. Sadly, also true even if no appropriate PPE.

This is why if I am at home, I have no patients, and ignore staffing office when they text: "Help to take care your patients". I have no patients when I'm home.

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN

Has 10 years experience.

On 3/22/2020 at 10:23 PM, rzyzzy said:

This one is pretty easy - according to ANA, unless you’ve got at least a bachelor’s degree, you’re not a “professional” nurse anyway - so, presumably they should have no problems if the poorly-educated LPN’s and ADN’s retreat to their caves and let the doctor-nurses show us how it’s done.

Excuse me? LOL

No, the LPNS AND THE Cnas are gona be the ones taking actual care of the patients. In the room , assisting with bedside care, emptying bedpans and urinals.

22 minutes ago, LPN Retired said:

No, the LPNS AND THE Cnas are gona be the ones taking actual care of the patients. In the room , assisting with bedside care, emptying bedpans and urinals.

Rzyzzy was being facetious! You don’t really think the degreed “professionals” are going to be rendering actual patient care, even to be instructive to the lower castes do you?

🤣

waufah, BSN, RN

Specializes in ICU,Tele,Interventional Radiology,PACU,Research. Has 14 years experience.

It is sad that in a time of like this we are fighting about our qualifications. If you havent read my post about the Nightingale Pledge, please do.If you are okay going to work without PPE,or you don't feel safe,that is a personal choice not moral/ethical obligation. For others like me who have refused to work in such conditions, I am human being first,and my contract as a nurse is not eternally binding. Some my not agree, but I will wait for the check from Uncle Sam,use my savings,borrow and as last resort apply for unemployment or social welfare for the first time in my life until this passes. You have options,we all do!

2 minutes ago, waufah said:

It is sad that in a time of like this we are fighting about our qualifications. If you havent read my post about the Nightingale Pledge, please do.If you are okay going to work without PPE,or you don't feel safe,that is a personal choice not moral/ethical obligation. For others like me who have refused to work in such conditions, I am human being first,and my contract as a nurse is not eternally binding. Some my not agree, but I will wait for the check from Uncle Sam,use my savings,borrow and as last resort apply for unemployment or social welfare for the first time in my life until this passes. You have options,we all do!

Nothing to fight about here, just pointing out that ANA doesn’t consider me to be a “professional” - they didn’t when I got my LPN certificate, and they still don’t with my ADN.

They are the ones who created the division, not me. Further, by actively denigrating the abilities of non-BSN nurses, they impaired our ability to find and maintain employment in times that didn’t involve a crisis.

They are the ones touting, quoting and re-quoting the one weakly-supported study saying that those without a bachelor’s degree are “less-safe”, because magic beans.

And now they’re largely the ones in nursing leadership roles, telling us that we don’t need N95’s - thus actively causing the spread of something that looks like it’s going to kill a lot of patients and more than a couple of us.

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN

Has 10 years experience.

4 hours ago, rzyzzy said:

Nothing to fight about here, just pointing out that ANA doesn’t consider me to be a “professional” - they didn’t when I got my LPN certificate, and they still don’t with my ADN.

They are the ones who created the division, not me. Further, by actively denigrating the abilities of non-BSN nurses, they impaired our ability to find and maintain employment in times that didn’t involve a crisis.

They are the ones touting, quoting and re-quoting the one weakly-supported study saying that those without a bachelor’s degree are “less-safe”, because magic beans.

And now they’re largely the ones in nursing leadership roles, telling us that we don’t need N95’s - thus actively causing the spread of something that looks like it’s going to kill a lot of patients and more than a couple of us.

I started off as a diploma RPN. Currently, I am a BScN-RN, but I still maintain and am very proud of my RPN license. This rank-ism is total ***; it's completely disgusting and unacceptable any any given time, and especially baseless during a bloody pandemic. I currently practise in Ontario, Canada. The professional body here for RPNs is called RNPAO, and they have been repeatedly sending out the call for RPN volunteers to help with COVID-19 efforts; all we're being told is that the RPNs will be deployed to bedside/frontline roles.

The professional body here for RNs is called RNAO; and they've been very clear to their RN constituents about how/where/in what capacity RNs will be used. Presently, RNs who have "answered the call" to volunteer are mostly being used for "virtual healthcare services". READ BETWEEN THOSE LINES🤦‍♀️🤬

Our regulatory college (College of Nurses of Ontario, aka CNO) is remaining silent on this matter. Surprise, surprise.🙄

Willcont2montr, LPN

Has 10 years experience.

I am an LPN who works from home and also does prn detox ( think homeless, hep c and hiv, not med compliant)

My mother is an NP getting her doctorate who teaches at a University.

I have three Master Level aunts 1 in ICU in GA

One Manages the nephrology department in another hospital

One last aunt who works outpatient ECT treatements in NC

I have 2 cousins in in Florida both ER nurses

COUNTLESS RN BSN friends in Boston Hospitals ( where I am ) working the front lines leaking me information not in the news.

We ALL agree that this not what ANYONE expected when they became a nurse.

MARTYRDOM was not on the admission requirements.

My mother and I are very fortunate BUT we hear first hand the conditions people are working in. My aunts in GA both say they are not telling the reality on the news.

Half our family shouldnt be wiped out because of a lack of ppe. I would gladly leave my house and go work where needed if guaranteed proper ppe. Like another person said, they are wear WHOLE HAZMAT SUITS SOME PLACES!

The fireman example has been used many many times. I agree. Those firemen also lifted one another up during 911 too something that I'm not sure nursing will be able to say after this.

Lastly,

This will probably be my one and only comment on here because it seems the toxic nursing culture thrives in this forum and its embarrassing.

I'm not sure if some nurses just dont have family, kids a spouse or just dont care about others but to tell nurses who are fighting the front lines to basically "quit whining" is exactly why we are in this situation.

You can say whatever you want. But my WHOLE family has agreed. If they are not peoperly protected they will have to walk away. That is a lot of knowledge leaving nursing but when you understand that they have people at home that love them theres just not choice.

THE IDEA THAT NURSES ARE SUPERHUMAN AND WEAR CAPES INSTEAD OF PPE NEEDS TO BE DESTROYED.

BULLYING NURSES TO DO DISREGARD THEIR OWN WELLBEING NEEDS TO BE DESTROYED.

Some of you "caring at all cost self sacrifing hero angel nurses" are exactly the reason people choose not to work the bedside.

Yes we are in a pandemic but cant you see people that tell you that you will be fine are never the ones standing next with no protection? They are writing you a letter from their home?

Its so funny how a career can boast care but treats its collegues with distain when they try to care for themselves. Calling nurses out of retirement is an example of that. Arent those the people we are protecting? These nurses better be doing telephone triage!

Again these forums have disgusted me with their attitudes but "I'm just an LPN" I'm sure youll say to LOL

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN

Has 10 years experience.

5 hours ago, Willcont2montr said:

I am an LPN who works from home and also does prn detox ( think homeless, hep c and hiv, not med compliant)

My mother is an NP getting her doctorate who teaches at a University.

I have three Master Level aunts 1 in ICU in GA

One Manages the nephrology department in another hospital

One last aunt who works outpatient ECT treatements in NC

I have 2 cousins in in Florida both ER nurses

COUNTLESS RN BSN friends in Boston Hospitals ( where I am ) working the front lines leaking me information not in the news.

We ALL agree that this not what ANYONE expected when they became a nurse.

MARTYRDOM was not on the admission requirements.

 My mother and I are very fortunate BUT we hear first hand the conditions people are working in. My aunts in GA both say they are not telling the reality on the news. 

Half our family shouldnt be wiped out because of a lack of ppe. I would gladly leave my house and go work where needed if guaranteed proper ppe. Like another person said, they are wear WHOLE HAZMAT SUITS SOME PLACES!

The fireman example has been used many many times. I agree. Those firemen also lifted one another up during 911 too something that I'm not sure nursing will be able to say after this.

Lastly,

This will probably be my one and only comment on here because it seems the toxic nursing culture thrives in this forum and its embarrassing.

I'm not sure if some nurses just dont have family, kids a spouse or just dont care about others but to tell nurses who are fighting the front lines to basically "quit whining" is exactly why we are in this situation.

You can say whatever you want. But my WHOLE family has agreed. If they are not peoperly protected they will have to walk away. That is a lot of knowledge leaving nursing but when you understand that they have people at home that love them theres just not choice.

THE IDEA THAT NURSES ARE SUPERHUMAN AND WEAR CAPES INSTEAD OF PPE NEEDS TO BE DESTROYED.

BULLYING NURSES TO DO DISREGARD THEIR OWN WELLBEING NEEDS TO BE DESTROYED.

Some of you "caring at all cost self sacrifing hero angel nurses" are exactly the reason people choose not to work the bedside.

Yes we are in a pandemic but cant you see people that tell you that you will be fine are never the ones standing next with no protection? They are writing you a letter from their home?

Its so funny how a career can boast care but treats its collegues with distain when they try to care for themselves. Calling nurses out of retirement is an example of that. Arent those the people we are protecting? These nurses better be doing telephone triage!

Again these forums have disgusted me with their attitudes but "I'm just an LPN" I'm sure youll say to LOL

Well said! From a fellow RPN (who is also a RN-BScN).

ajdizzle43, LPN

Has 13 years experience.

5 hours ago, Willcont2montr said:

I am an LPN who works from home and also does prn detox ( think homeless, hep c and hiv, not med compliant)

My mother is an NP getting her doctorate who teaches at a University.

I have three Master Level aunts 1 in ICU in GA

One Manages the nephrology department in another hospital

One last aunt who works outpatient ECT treatements in NC

I have 2 cousins in in Florida both ER nurses

COUNTLESS RN BSN friends in Boston Hospitals ( where I am ) working the front lines leaking me information not in the news.

We ALL agree that this not what ANYONE expected when they became a nurse.

MARTYRDOM was not on the admission requirements.

My mother and I are very fortunate BUT we hear first hand the conditions people are working in. My aunts in GA both say they are not telling the reality on the news.

Half our family shouldnt be wiped out because of a lack of ppe. I would gladly leave my house and go work where needed if guaranteed proper ppe. Like another person said, they are wear WHOLE HAZMAT SUITS SOME PLACES!

The fireman example has been used many many times. I agree. Those firemen also lifted one another up during 911 too something that I'm not sure nursing will be able to say after this.

Lastly,

This will probably be my one and only comment on here because it seems the toxic nursing culture thrives in this forum and its embarrassing.

I'm not sure if some nurses just dont have family, kids a spouse or just dont care about others but to tell nurses who are fighting the front lines to basically "quit whining" is exactly why we are in this situation.

You can say whatever you want. But my WHOLE family has agreed. If they are not peoperly protected they will have to walk away. That is a lot of knowledge leaving nursing but when you understand that they have people at home that love them theres just not choice.

THE IDEA THAT NURSES ARE SUPERHUMAN AND WEAR CAPES INSTEAD OF PPE NEEDS TO BE DESTROYED.

BULLYING NURSES TO DO DISREGARD THEIR OWN WELLBEING NEEDS TO BE DESTROYED.

Some of you "caring at all cost self sacrifing hero angel nurses" are exactly the reason people choose not to work the bedside.

Yes we are in a pandemic but cant you see people that tell you that you will be fine are never the ones standing next with no protection? They are writing you a letter from their home?

Its so funny how a career can boast care but treats its collegues with distain when they try to care for themselves. Calling nurses out of retirement is an example of that. Arent those the people we are protecting? These nurses better be doing telephone triage!

Again these forums have disgusted me with their attitudes but "I'm just an LPN" I'm sure youll say to LOL

I reckon because many of times, we LPN's (and other support staff) feel the squeeze that many higher level folk just now are feeling...EVERY...SINGLE...SHIFT...and healthcare folks all around are acting brand new. Just like many "middle class" individuals who are looking for the same handouts that "poor welfare people use to milk the system"...

It is OK to talk down/demean/tell on/act superior than fellow healthcare staff that work for less than, sub subordinates and treated as such, but clamoring WHAT ABOUT HAZARD PAY!! (RN's only $100/hr)...but then agree to loosen NCLEX-RN requirements to allow GRN nurses to work for $40/hr....and pay LPN $20 an hour still...We look fractured, because we are as a community. It should now be this way...

We have to come together, especially now. We are all in this together...

We are conserving PPE at my hospital. One of my colleagues said, nope, she was going to use what was there to feel safe as long as it lasts, and then quit if she couldn't be protected. She said she's a person, too, and her life matters, and if she has to choose between her patient and herself, she's going to choose herself. We are aware that in some places, people are using home-made cloth face masks, because something is better than nothing, but my colleague said, "I'm not walking into that room with a sock on my face." I have to agree with everything she said. However, I don't know that I'll be okay saying no, if it comes to it. No, there hasn't been a pandemic like this in 100 years, so it was definitely not something we signed up to do. But I became a nurse because I truly want to help. People are going to need care, and someone is going to need to provide it, even with suboptimal PPE. If it's my turn to help, I don't think I could bring myself to walk away.

PoodleBreath

Specializes in Hospice, LPN. Has 15 years experience.

I feel like Rzyzzy was making a point about the way the industry disparages healthcare workers who don't have BSNs and who don't work in hospitals. I understand the bitterness and feel it as well. At the moment all the media talks about is hospital doctors and nurses on the front lines and it's frustrating to be left out of the conversation. Especially, in my case as someone who is out in the field going into health care facilities and patient homes with no protective gear, no hospital infrastructure or support system -- for whatever good that does -- and very limited ability to screen. EOL patients tend to present with fever and SOB. How do you make screening decisions about that? No hospital is going to admit a hospice patient with Covid, and they are still going to require medical care, so it will fall on field staff to go into these situations to manage care. You can't get more front line than that. And no one is running PPE drives for us - if you listen to the news we don't even exist. At this time it seems more important than ever to embrace and support each other, let's not forget the CNAs and lab techs, X-ray techs, social workers, chaplains and therapists of all kinds who are working in the community to keep people out of hospitals in the first place. Now is the time in our history to come together and to recognize each other as a tightly connected team, it's the only way we are going to be able to go forward.

Edited by PoodleBreath

ajdizzle43, LPN

Has 13 years experience.

3 minutes ago, PoodleBreath said:

I feel like Caffeine was making a point about the way the industry disparages healthcare workers who don't have BSNs and who don't work in hospitals. I understand the bitterness and feel it as well. At the moment all the media talks about is hospital doctors and nurses on the front lines and it's frustrating to be left out of the conversation. Especially, in my case as someone who is out in the field going into health care facilities and patient homes with no protective gear, no hospital infrastructure or support system -- for whatever good that does -- and very limited ability to screen. EOL patients tend to present with fever and SOB. How do you make screening decisions about that? No hospital is going to admit a hospice patient with Covid, and they are still going to require medical care, so it will fall on field staff to go into these situations to manage care. You can't get more front line than that. And no one is running PPE drives for us - if you listen to the news we don't even exist. At this time it seems more important than ever to embrace and support each other, let's not forget the CNAs and lab techs, X-ray techs, social workers, chaplains and therapists of all kinds who are working in the community to keep people out of hospitals in the first place. Now is the time in our history to come together and to recognize each other as a tightly connected team, it's the only way we are going to be able to go forward.

Yell a bit louder for the folk in the back, we can not hear you through your bandana mask...=)

CaffeinePOQ4HPRN, BSN, MSN, LPN, RN

Has 10 years experience.

On 3/26/2020 at 11:40 AM, CaffeinePOQ4HPRN said:

I started off as a diploma RPN. Currently, I am a BScN-RN, but I still maintain and am very proud of my RPN license. This rank-ism is total ***; it's completely disgusting and unacceptable any any given time, and especially baseless during a bloody pandemic. I currently practise in Ontario, Canada. The professional body here for RPNs is called RNPAO, and they have been repeatedly sending out the call for RPN volunteers to help with COVID-19 efforts; all we're being told is that the RPNs will be deployed to bedside/frontline roles.

The professional body here for RNs is called RNAO; and they've been very clear to their RN constituents about how/where/in what capacity RNs will be used. Presently, RNs who have "answered the call" to volunteer are mostly being used for "virtual healthcare services". READ BETWEEN THOSE LINES🤦‍♀️🤬

Our regulatory college (College of Nurses of Ontario, aka CNO) is remaining silent on this matter. Surprise, surprise.🙄

Once again, I said this 👆. Our sad profession deteriorates every passing year, and the esteem it once held just isn't there anymore. We're all catalysts to this deterioration, and low morale. All nurses will continue to be disrespected because we can't seem to respect each other, nor give each other recognition where it's due. So, why should the public respect us when we're not united? A united front would be the only way to address, and one day ameliorate the issues our profession faces.

LPN/RPN, RN, NP... we're ALL qualified nurses!

The bullcrap rankism needs to stop. We're in the middle of a freaking PANDEMIC and people are squabbling about titles🤦‍♀️ and taking digs at diploma nurses?! This is NOT productive, it's pathetic.... it's also a common baseline for most horizontal violence and bullying. Is this what you want our profession to look like? Is this the toxic environment you'd like to work in?

I'm both a RPN and a RN-BScN. And I'd like to mention that more than 50% of my classmates in the Practical Nursing program had baccalaureate degrees in another discipline before becoming RPNs (myself included). So, all this crap about LPNs/RPNs bing less qualified because they don't have "university preparation" is, well....FALSE! After studying to become both and RPN and RN, I can assure you we study from exactly the same textbooks, we cover the same material, we learn the same "generalist" skills. The only difference is RPNs study for 2 years, RNs traditionally used to study for 4 years (unless they're in a compressed program) and cover more depth. Does this make them better for bedside? Not necessarily. The ability to digest /process information is only as good as a person's ability to apply it to real life scenarios.

Anyone trying to diminnish the value of LPN/RPNs can take their insecurity elsewhere.

Edited by CaffeinePOQ4HPRN