Oh for crying out loud people

SeaCat

Hey, my Halo is smoking
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Sep 23, 2003
Posts
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Regulations in my hospital bar Aides/PCT's from doing things like I.V. Insertions and Catheterization regardless of training. (This is because of the laziness of some people as well as politics.) This can be a pain in the ass and sometimes it causes discomfort for the patients. Today was a case in point.

We had a male patient come in. His orders included him getting a Foley Catheter. Unfortunately for both him and the R.N. he had both an enlarged Prostate and Retraction. He also had shit for veins.

The R.N. attempted to get an I.V. started and couldn't. She then shifgted over to the catheter and couldn't get that in place either. Over the next hour every R.N. on the unit, including the Boss attempted to get the I.V. and the catheter going. None had any luck. Finally the patients M.D. was called in. I stood there watching as he tried it and shook my head as he had no luck as well. He noticed this as he washed his hands and pulled out the orders sheets to order a cut down and a surgical implantation of the catheter. He asked me why I was shaking my head and I told him that all of them had been going about things the wrong way. He asked what I meant and he didn't understand, instead he told me to show him and I told him I couldn't show him. It was against regulations. The boss was called in and informed of what I had said. She told me to either show the M.D. or appologize. I grinned and told her what I wanted/needed. A new Cath. Set as well as a New I.V. set. I also asked the M.D. to get the patient something for his pain.

When all was in readiness I again washed my hands and set things up. I worked on the patient for a couple of minutes, teasing his penis out of it's hiding place. (Something all of them had neglected to do. When I had it exposed I set up my sterile field, cleaned the paitent up and inserted the catheter. (I was using a much smaller diameter catheter than we normally use.) When it was in place I inflated the ballon and set the Cath. Secure in place. Total time needed? Five minutes. Done with this I again washed my hands and turned to the I.V.

I put the tourniqet in place and looked for a vein in the one place they hadn't bothered looking for one. On the outside of the arm. (There is a giant vein there but you have to find it. It is also rarely used by anyone other than Rescue.) I found it by feel, anchored it in case it was a roller then inserted the Sharps. Once more it had taken me all of a couple of minutes. Now the patient could begin their treatment.

The M.D. thanked me for my help and my boss stood there looking at me before telling me I had done a good job but not to expect anything to come from it. I just smiled at her while telling her I didn't expect anything. (I know where the majority of the politics comes from.)

Now the funny thing. Later in the day my boss asked me about putting in another Catheter. It seems we had another problem patient. I looked at her, smiled and told her it wasn't in my job description, I wasn't allowed to put in catheters. She wasn't happy with this answer but there is absolutely nothing she can do about it as she was the driving force behind the regulation barring Aides/P.C.T.'s from putting in catheters.

Cat
 
In reality, though, she is the one person who can best and easiest do something about it, because it's her will which put the rule in place. She's the only person who won't have to battle that will to change it. But Pride won't let it happen.
 
Bosses trap themselves sometimes. I think of it as the paperclip effect. Once a real supervisor lays down a special paperclip rule, suddenly all paperclips are hers. No one of lesser stature may address anything in the realm of paperclips.
 
Regulations in my hospital bar Aides/PCT's from doing things like I.V. Insertions and Catheterization regardless of training. (This is because of the laziness of some people as well as politics.) This can be a pain in the ass and sometimes it causes discomfort for the patients. Today was a case in point.

We had a male patient come in. His orders included him getting a Foley Catheter. Unfortunately for both him and the R.N. he had both an enlarged Prostate and Retraction. He also had shit for veins.

The R.N. attempted to get an I.V. started and couldn't. She then shifgted over to the catheter and couldn't get that in place either. Over the next hour every R.N. on the unit, including the Boss attempted to get the I.V. and the catheter going. None had any luck. Finally the patients M.D. was called in. I stood there watching as he tried it and shook my head as he had no luck as well. He noticed this as he washed his hands and pulled out the orders sheets to order a cut down and a surgical implantation of the catheter. He asked me why I was shaking my head and I told him that all of them had been going about things the wrong way. He asked what I meant and he didn't understand, instead he told me to show him and I told him I couldn't show him. It was against regulations. The boss was called in and informed of what I had said. She told me to either show the M.D. or appologize. I grinned and told her what I wanted/needed. A new Cath. Set as well as a New I.V. set. I also asked the M.D. to get the patient something for his pain.

When all was in readiness I again washed my hands and set things up. I worked on the patient for a couple of minutes, teasing his penis out of it's hiding place. (Something all of them had neglected to do. When I had it exposed I set up my sterile field, cleaned the paitent up and inserted the catheter. (I was using a much smaller diameter catheter than we normally use.) When it was in place I inflated the ballon and set the Cath. Secure in place. Total time needed? Five minutes. Done with this I again washed my hands and turned to the I.V.

I put the tourniqet in place and looked for a vein in the one place they hadn't bothered looking for one. On the outside of the arm. (There is a giant vein there but you have to find it. It is also rarely used by anyone other than Rescue.) I found it by feel, anchored it in case it was a roller then inserted the Sharps. Once more it had taken me all of a couple of minutes. Now the patient could begin their treatment.

The M.D. thanked me for my help and my boss stood there looking at me before telling me I had done a good job but not to expect anything to come from it. I just smiled at her while telling her I didn't expect anything. (I know where the majority of the politics comes from.)

Now the funny thing. Later in the day my boss asked me about putting in another Catheter. It seems we had another problem patient. I looked at her, smiled and told her it wasn't in my job description, I wasn't allowed to put in catheters. She wasn't happy with this answer but there is absolutely nothing she can do about it as she was the driving force behind the regulation barring Aides/P.C.T.'s from putting in catheters.

Cat

I hear you on all of this! I am a certified Nurses Assistant(CNA) and Medical Assistant (CMA) and I cant do anything!!! While working at a Rehabilitation Center there was so many things I could not do while SOME of the nurses sat on their asses while the patients needed help! It is why I have gotten out of the medical field, despite how much I love it and want to be an RN! I switched to Paralegal work, cause at least I will get paid what I am worth! Where I live MA's get paid the same as CNA's despite the fact that we have more training then a CNA. As a paralegal I can START off making at least $36,000 a year! Way better then the $6.50 bull shit they offered me as a Medical Assistant!

Good luck to you on breaking the political BS for MA's and CNA's!

:D
 
Bosses trap themselves sometimes. I think of it as the paperclip effect. Once a real supervisor lays down a special paperclip rule, suddenly all paperclips are hers. No one of lesser stature may address anything in the realm of paperclips.
Also known as a "gatekeeper". I have a really tough time not being one.
 
Cat, I know this has been asked before, and I understand the practicalities, but why the hell aren't you in nursing school? Or medical school, for that matter?
 
Cat, I know this has been asked before, and I understand the practicalities, but why the hell aren't you in nursing school? Or medical school, for that matter?

The simple answer is politics. My wife and I both want to get our R.N.'s. Because of the politics involved we just can't afford the schooling right now. My wife qualifies for many grants and loans while I don't. My wife would be accepted to the Nursing Program without question while it would be problematic that I would be accepted. (Even though we both have Associates Degrees.)

Because of this we are saving our money so we can afford the schooling even as we take classes. By next spring we will have taken all of the pre-requisite classes for the Nursing Program and then some. (We're talking math up through Calculus. Organic and Inorganic Chemistry, Anatomy and Physiology, Biology, History, Microbiology and Psychology.) We shall see if both of us are accepted into the program.

Cat
 
CAT

What you report is common. This weekend I read a surgeon's memoir, and when he was hospitalized he got the full bullshit treatment everyone gets.

The author has 30 plus years experience as a surgeon, and trains surgeons at the local university medical school. And while he was admitting at the hospital, the ER resident refused to consider or even listen to what he said about his own injury.
 
The simple answer is politics. My wife and I both want to get our R.N.'s. Because of the politics involved we just can't afford the schooling right now. My wife qualifies for many grants and loans while I don't. My wife would be accepted to the Nursing Program without question while it would be problematic that I would be accepted. (Even though we both have Associates Degrees.)

Because of this we are saving our money so we can afford the schooling even as we take classes. By next spring we will have taken all of the pre-requisite classes for the Nursing Program and then some. (We're talking math up through Calculus. Organic and Inorganic Chemistry, Anatomy and Physiology, Biology, History, Microbiology and Psychology.) We shall see if both of us are accepted into the program.

Cat

Then I wish you and your wife the very best of luck. You'll absolutely rock as an RN... even more than you do now.
 
CAT

What you report is common. This weekend I read a surgeon's memoir, and when he was hospitalized he got the full bullshit treatment everyone gets.

The author has 30 plus years experience as a surgeon, and trains surgeons at the local university medical school. And while he was admitting at the hospital, the ER resident refused to consider or even listen to what he said about his own injury.

LOL

That is nothing new to me. I have seen it way too many times from both sides of the equation. I have seen both the good and the bad with this.

Cat
 
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