Friday, October 24, 2014

I'm tired

Done this month:

1) 8 hour de-escalation/how to deal with violent patients class.



4) Ebola baloney

5) Brand new drug dispensing system starting.

6) My regular hours

How was your month?

After you have done acls, pals, tncc, bls 20,000 times shouldn't you be able to be grandfathered in for cripes sake?

Thursday, October 23, 2014

doctor has ebola

So here comes news that a doctor in NYC has ebola.  He treated patients with doctors without borders in Africa.. Doctors Without Borders is at the forefront of ebola treatment.  In other words they know what they are doing when it comes to isolation procedures and equipment.  This proves, that despite all of that, you can get ebola. Yet they keep telling healthcare workers the chances are so, so low... As of about september 1st, 240 healthcare workers in Africa developed ebola, 120 died.

Today I asked someone from infection control if, after we cared for a patient with ebola, we would keep working and taking care of other patients.  Answer: yes.

BTW,  if you would like to donate to Doctors Without Borders, a truly awesome organization, go here.    

I have become a part time psych nurse

I wonder why nobody seems to care about mentally ill patients? It is evident in the fact that patients are being housed in emergency rooms because there are no beds available. That's happening in our ER.  It has now become routine to house people for hours, sometimes more than a day.

Funding has decreased for mental health, so patients don't have access to services on an outpatient basis. Just like physical illness, if your condition isn't managed it gets worse and becomes a crisis and sends you to the emergency room.

There are less psychiatrists.  Apparently they aren't paid as well as they used to be, especially in hospitals.  The profession is less attractive because most psychiatrists have essentially become medication managers rather than the therapists they used to be.

Reimbursement for psychiatric patients is less than those who are physically ill making hospital reluctant to increase bed space.

I don't see any of the above changing anytime soon. So the situation will get worse.  We will be part time psych nurses trying to manage patients for hours on end, sometimes overnight and beyond. Patients will lay there with nothing to do, getting more agitated because of it.  They will get bad care because we don't have time to care for them. Our wait time in the ER will increase because there are times when 30% of our beds are occupied by psych patients.  It is more dangerous for the staff because after sitting for hours, sometimes these patients get agitated and start acting out and become violent.

So ERs have become part time psych wards and I have become a part time psych nurse.

Tuesday, October 21, 2014

nurses have perverse sense of responsibility and loyalty

The administrators at Dallas Presbyterian where the ebola patients have been treated are scrambling. From what I have read only 30% of the hospital is full.  It seems nobody wants to come to a hospital which fumbled so badly.  Can't say I blame them.

Well, everybody knows that a hospital can't survive at 30% so its panic time. It is time to trot out the nurses who are willing to be on TV and say what a wonderful place our hospital is, led of course by the head honcho nurse at the hospital.  They held a press conference praising the hospital essentially saying that those damn radical nurses who said we weren't prepared are wrong, wrong, wrong.  We are a great hospital, so there. This is essentially like saying to someone who is going to intentionally harm you: Its OK, I love you anyway.

Unfortunately, this kind of behavior is typical for a lot of nurses. Oh, the poor hospital, they tried their best, they didn't do it on purpose. Instead of standing up for ourselves and demanding that we be protected, we say to ourselves they are doing the best they can.  Then we go forward and put ourselves in harms way because we are so wacked we are willing to sacrifice ourselves out of some perverse sense of responsibility and loyalty.

Will this hospital recover? They are apologizing profusely left and right. They are shitting their pants about law suits, because they know they will be filed.  They are already mounting their defense. I saw on the internet that the CDC said they were following their protocol, now the CDC realizes that it was inadequate. Our bad, not the fault of the hospital.

Dallas Presbyterian is finished. This will bankrupt them. The public won't forget this for some time.  When they do, it will be too late, the hospital will be closed.