Saturday, April 15, 2006

Code Blue??? or is it?--4/24

This is a long post, but important. Bear with it and realize this is a game stopper. This was another email that I bounced off a couple folks and then decided to publish in its entirety.

PRMC has to install new portable telemetry monitors. When the employees ask, no one seems to know what kind of heart monitors the hospital has bought, nor when they are going to be installed, or where they're going to install them. Rumors abound, of course, but no one seems to actually know. Of course, biomed and the former assistant CNO and director of goodness knows how many departments went somewhere to learn about the monitors, but, of course, one of those two people has now left PRMC.

The general plan seems to be to install these monitors that only one person in biomed knows how to work on (which is also something that currently happens, even with a system that's been installed for quite some time), remove the telemetry technician from ICU, and consolidate all telemetry monitoring in one place with two telemetry techs. Currently, ICU has a telemetry tech to watch only the ICU patients, and the other telemetry tech monitors all other telemetry monitors throughout the hospital (excluding the emergency room), as well as the cameras for the stepdown beds.

IF all of the portable monitors were all present, this would have the hospital telemetry technician watching approximately 55 heart rhythms, 13 cameras, and the 13 stepdown monitor's blood pressure and oxygen saturation readings. (But about 20 portable units have gone missing.) This is, of course, too much, so it would SEEM to make sense to combine the ICU telemetry and all other hospital telemetry and split the number of monitors between two technicians. The problems that this consolidation would create are actually numerous, and affect patient care.

At this point in time, the hospital has already acknowledge that there is a large communication problem that affects the efficacy of the hospital telemetry tech. The hospital telemetry tech sits in a small room (affectionately termed "the hole") and has the un-enviable task of sitting in a chair for 12 hours, begging the 3rd floor or ICU nurses for breaks, and having no way of effectively communicating with any other floor than 3A. Of course, currently, the only other floor that is allowed telemetry monitoring is 7A, as telemetry overflow. This is exists for a couple of reasons. 6th floor doesn't monitor telemetry because there's been something wrong with the telemetry system for that floor every since it was installed on the re-model. 4th floor doesn't monitor telemetry for a reason that the telemetry techs were never told of, but it may have something to do with a delayed Code Blue on a patient due to poor communication between telemetry and the other hospital floors.


The OTHER reason that telemetry monitoring has been reduced to only 3A and 7A is because there is a serious lack of nurses who actually know how to read a heart rhythm. Apparently, this is not a requirement of nurses who have to take telemetry patients. It is not an uncommon occurence for 7A to have no one who knows how to read telemetry, and only one or two nurses on 3A (the cardiac floor) who know how to read it. Add to all of this, the fact that the currently telemetry tech staff (both hospital and ICU) have very little training beyond the heart rhythms themselves. The telemetry techs are all perfectly capable of reading the heart rhythms, and identifying problems, but they have very little idea of what to tell a nurse is the biological reason behind a reported change.

So, the telemetry tech doesn't know, the nurse doesn't know, so somebody needs to pray that there's an experienced cardiac nurse to ask readily available. If the nurse doesn't understand that there is an importance behind the telemetry changes reported to them, then they are unlikely to follow an appropriate course of action. And, quite frankly, there are few of the staff nurses left who are going to take the time to search out someone who would know what to do.

Also, the proposed change would lead to problems for ICU and the patients there. The ICU telemetry tech would no longer be "on-site" with the patients. The ICU tech monitors rhythm, blood pressure, and oxygen saturation on all the ICU patients, but there are also other invasive lines/readings to monitor, such as arterial lines and Swan-Ganz readings. The hospital telemetry tech has never monitored these, except for a few arterial lines that are quickly discontinued on stepdown, and has no training on what they do and/or should read. Also, except for a few stable or non-titrated (which mean the medicine is not supposed to be increased or decreased), the hospital telemetry technician has very little experience with the common IV drips used in ICU. Dopamine affects blood pressure and heart rate, Cordarone affects rhythm, Cardizen affects rhythm, Natrecor is for CHF but can have a bad blood pressure side effect, and Nipride affects blood pressure. These are the most commond drips used, and if the person monitoring the patient doesn't know what they are, what to watch for, and what they do, the patient isn't being monitored properly.

If the ICU telemetry tech is removed from the ICU setting, then they will more than likely be unaware of what drips the patient is on, or how they are being titrated, so they will not know what to look for. The ICU nurses monitor their patients very closely, but they do have at least 2 patients usually. As happened when the telemetry was combined before, no one calls the techs to tell them about admits, drips, or patient changes. And how is the tech going to contact them in an emergency? Usually the nurses are on top of the situation, and gathered in the patient's room. So, that leaves the tech on the phone, no one answering it, and the tech having no clue if the nurses are in the room.

It's not a good move for the patients, it's been tried before, and failed before. If the problem is that the hospital telemetry technician is watching too many monitors, then, why not, when installing the new system, portion some into the ICU where they can be watched by that technician. Something like, ICU would watch ICU and 7th floor, and the hospital tech would watch 7A. Maybe not very cost effective, maybe not even feasable, but better for patient care than effectively ham-stringing the techs.

59 comments:

Anonymous said...

One more problem fixed, by a clueless person who does not listen, and is just creating worse problems.

They don't learn by history--they let history repeat itself with detrimental effects.

It does sound good at the board meeting, at the round table discussion. The people that know the situation and oppose, because they have tried it before are the negative people. Essent hates the negative people.

Anonymous said...

Maybe, if they fire all the personel, they could save more money...

and the patients could take care of each other!

The end is near folks!

Anonymous said...

This comment may upset some but so be it. Once again, nursing education or the lack of it, rears its' ugly head. There is absolutely no reason for ANY RN working in this facility to not be able to interchange with any telemetry tech. There is no reason for any RN not to be able to place orders or cancel orders in medi-tech. Yet, there seems to be very few, if any, capable of either. WHY?! Poor nursing management and poorer nursing education...PERIOD! Proffesionalism, quality healthcare, caring staff seem to all be on the decline. Question: is it better to save a life or to save a buck?

Anonymous said...

Well obviously (current administration in mind)..........A BUCK!

Anonymous said...

As a former employee, with 19yrs. experience at this hospital, the telemetry situation has never been optimal. First of all, the telemetry techs have been people who were hired off the street, with no medical knowledge. Second, one person can not watch every monitor and camera in the 'hole' and be able to keep track of them. Third, ICU tele tech was also unit secretary. Who can watch the monitors and put stat orders in the computer, in an emergency?
I'm proud to say that the one's who were there when I was, were super.
When I went to work there in 1987, it was a rule that every nurse on 3rd floor or ICU was required to take & pass the telemetry course within 6 mos. of hire, and retest yearly.
In my opinion, every nurse who takes care of a pt. with tele, should at least know what dangerous rhythms are.
New monitors would be nice, but only if proper training goes along with the change. This was not always the case. When the monitors were installed into step-down we got a 5 min. demo & nothing more. I don't know about you, but I would be more comfortable with proper training instead of trial & error. That may be alright on the golf course, but not with my heart.
Since I an still on Cobra, I'm required to come there for treatment. I'm actually afraid that if I get sick, I may not have the care that everyone deserves.
What happened to the "Patient" comes first????? The mighty buck can not cure a community, only caring loving people who are happy in their jobs and not in fear every day that what they say make make them the next canidate for a pink slip. I loved my pts. and my job until E$$ent came. Someone please listen to the outcry.

Anonymous said...

One-deep maintenance is ludicrous for critical systems. Of course, that's what they have had in x-ray for years.

Anonymous said...

Well 642 you were right it did upset me but you must understand that lvns are taught only the basics of tele readings such as SR, asystole, a-fib, v-tach and v-fib. Then if you go on to RN school they do the best they can to teach about all the heart blocks, all the juctional rhythms, and about pvcs and pacs and why the pt is having them and what they mean and what is supposed to be done to fix them. And trust me every tele reading of a-fib is different and every SR doesnt always look text-book either, we do the best we can with the knowledge we are given but a lot of the knowledge you get is from working on the floor, so you cant say it is all poor nursing education.

Anonymous said...

I always thought it was the chinese heart surgeon who learned surgery in a high school biology lab and now your telling me it is the telemetry techs? Come on Andrew the bottom line is asystole.............

Anonymous said...

Here' a partial job listing for PRMC as of 4/16. Makes you wonder who's left to run the place?

Administration/Management: Director of Information Management Services (fired 3 wks ago)
Anesthesiology: CRNA x 2
Cath Lab: Registered Nurse Computer/Information Systems: Systems Specialist x 2
Laboratory: Medical Technologist
Nursing: Registered Nurse x21
Nursing: Certified Assistant x2
Nursing: LVN
Nursing: Nurses Aide x2
Nursing: Surgical Technologist
Nursing: Telemetry Tech
Nursing: Unit Secretary
Occ Therapy: Occupational Therapist
Pharmacy: Director of Pharmacy
Radiology: C T Tech x2
Radiology: Radiography Tech x3
Radiology: Support Associate Radiology: Ultra Sonographer
Respiratory: Resp. Therapist x2
Women's Imaging: Mammo Tech

Anonymous said...

1:32 post

You should not be upset. This is not something you learn in LVN school but---the hospital should provide a telemetry class if you are working a tele unit--and ACLS.

If your an RN you should be provided the same. If the doctors were concerned enough to put telemetry on the patient- there should be people who can do something about the problems that could arise.

Nursing education starts at school- but is continued your entire career, and good hospitals care about it- because it makes a big difference in the care the pt receives.

will-never-work-for-prmc_RN said...

Well 132 instead of getting upset at other posters for pointing out the FACT that all nurses should be able to do a tele tech's job maybe you should supplement your edjucation of EKG's and rhythms. Stop making excuses and fix the problem (your lack of knowledge). People like you with your weak and worthless excuses and your "it's not my fault attitude that I don't know" are a disgrace to nursing everywhere, and only shows your incompetence. So either learn what you need to know to properly care for your patients of find another career.

Anonymous said...

I saw PRMC from the inside while I was in LVN school and then again through RN school. Needless to say from this experience I made the decision to never work for this hospital as long as E$$ent is in control. What I cannot figure out is why the employees don't do anything to change things. I know most of you are "job scared" and afraid you will be fired if you do anything. But read the posts from PRMC employees; you sound like a bunch of "whipped little puppies." Think about it. What if you do get fired? There are major shortages of health care workers both locally and nationally. I know alot of you guys. You are as good as the staff anywhere. Take control of your lives and do something to help your community and yourselves at the same time. Organize with a union. Not one of you can do anything with E$$ent by yourself but THERE IS POWER WITH NUMBERS. Like it or not E$$ENT is not in financial trouble and E$$ENT is not going away. Think about it they are making everyone do the job of one to two people. It's simple less staff + same number of patients = more money for the big wigs. E$$ENT is laughing all the way to the bank. They overwork you, don't give you what you need to do your jobs, patient care and the community suffers, and if you say or do anthing E$$ENT doesn't like they fire you. Do yourselves a favor and check out this link, http://www.seiu.org/faqs/faq_howcanaunionhelp.cfm

Anonymous said...

You wonder how many of the temps that are used on 6th floor are actually ortho nurses? The other aspect is how many of the monitored floors have ortho nurses? Guess they feel anyone can do turns....

Anonymous said...

How many millions of dollars did they spend on the 6th floor and they can't get telemetry signals? Maybe their coming out party should have had less shrimp and more substance.

Of course, they might have considered raises but, no, that would be inappropriate. And, why that extra nickle will add up. Pretty soon you'll be able to buy a coke--just not with the extra you got for today's work, it takes two days....

Anonymous said...

$1.6 MILLION...that's what 6th floor cost. For rooms that are too small to swing a cat in, much less assist a pt to a BSC. For the beds that are "so special" that they won't let one leave the floor, even when there is a critical ortho pt in ICU, especially if there happens to be an ortho pt on another floor....

And there is a 6week telemetry class offered. All 3rd floor/tele staff is suppose to take the course within 6 months of hire...AND all 3rd floor/tele nurses are SUPPOSED to be ACLS.

Heck...even I can recognize what's bad on a tele strip and know to call a doc, or get them to step down or the unit ASAP, or if they just need closer monitoring by myself. I'm nothing but a plain old brand new med-surg nurse.. I can't tell you off the bat the difference between a type one Mobitz or a type two...but I do know v-tach, v-fib, afib, pvc, pac and what to do with each... But then again, my floor no longer takes tele pts. so this info is just in case I get floated I suppose..

Anonymous said...

Ok, 1219 have you worked at PRMC. I have, the only thing I was trying to say was they can’t teach us what every tele pt is going to do in school, b/c they will all be different. When I was a CNA at the hospital I used to go sit w/a friend in the "hole" and she would teach me about some of the rhythms. I’m not making excuses for anyone they should know the basics is they are unsure they should take initiative and ask, but I’m not going to sit here and say I know everything I graduated LVN in may '05 and will graduate RN may '06, and seeing the things that have happened at PRMC scared me. I left there in tears not even sure if I still wanted to be a nurse, I voiced my concerns to the CNO Connie, I voiced them to my clinical supervisor Anissa, and one Sat. night I told them I couldn’t work due to some conditions of Fri. night and what did I get a call from the new director Cecilia Kane screaming in my ear telling me to get to work! After working for a year and a half every Friday and Saturday night while in school and volunteering to work extra during the summer and Christmas breaks this is what I got. Back to the point I have to agree w/ 412's post they should have been offering me classes to help w/ my education, not putting me down and make me feel like I wasn’t good enough for them. Essent I have news you weren't good enough for me.
No need to sign my name, everyone who works at PRMC knows who I am. I’ve really wanted to say this for along time and you gave me the push to say it. Thanks.

Anonymous said...

Essent does not offer the education or reimbursement for education that they say they will. I know- 1st hand

Anonymous said...

Let's just hope some of "the powers that be" are reading this whole blog section. If they are laughing at us, then we know they came for the purpose of putting any hospital in this area out of business. What a shame, it used to be the place for all to come and get quality health care. The only way this can be helped is if the whole community and surrounding areas get involved to make a change. What do you do with trash? THROW IT OUT. I want to see the hospitals back the way they were before E$$ent came here to destroy them. Why spend money on tele monitors when pts. are afraid to come in for heart problems?

will-never-work-for-prmc_RN said...

you're welcome erin

will-never-work-for-prmc_RN said...

No 1138 I have not worked for PRMC I did clinicals there in nursing school for 2 years and unlike you I was smart enough to find employment at a real hospital. And yes everyone does know who you are........ even me.

will-never-work-for-prmc_RN said...

Well Well Well 1138
There you go again. You worked on tele floor and you say

"I’m not making excuses for anyone they should know the basics is they are unsure they should take initiative and ask"

and then you say

"they should have been offering me classes to help w/ my education, not putting me down and make me feel like I wasn’t good enough for them.

God what a crybaby, quit feeling sorry for yourself. You are still making EXCUSES for lack of skills YOUR lack of skills. So they didn't offer you classes? One of your current PJC classmates completed the EKG class a couple of months ago. Hmmmmm I guess they offered it to her and not to you huh. Bottom line, it is YOUR RESPONSIBILITY to learn the skills YOU need to properly care for YOUR patients. I understand that you work at the sorriest excuse for a hospital that has ever existed, but dont use that as an excuse for YOU not to get the training that YOU need to properly care for YOUR patients. YOUR patients should come first not your weak excuses and obvious laziness. Seems to me that the health care community as a whole would be better off without you and your excuses. Luckly you stated in your posting at 1138 that,
"I left there in tears not even sure if I still wanted to be a nurse."

Lets hope for your patients that you decide not to be. Obviously you dont care enough to get the edjucation you need to properly care for them.

Anonymous said...

Actually, I sort of agree--they should offer the training, if they are going to utilize you in a position that calls for it...which they apparently do.

There are other avenues available for tuition assistance, heck if I were smart about it, I'd probably offer tuition assistance to someone from the hospital that I wanted working in my office in the future.

Lock them in with a contract for payback, and then I don't have to deal with the restrictions on the shifts they can work for me, until they're done. Since LVN/RN classes are during the days, they can still work pt/ft on the off shifts.

Payback can be money, or employment, in either case it's a win-win. If I don't have a position when they finish, a no-interest payback would be done, if I do have one and they elect not to take it, payback with interest. Everyone wins...if they graduate.

Anonymous said...

It is the hospital's responsibility. It needs to be mandatory.

This name calling needs to stop. We need to encourage each other instead of tearing others down. How are we ever going to have a united front to get anything done?

Anonymous said...

You'll never have a united front because you're all a bunch of cry babies. It's all about what can hospital do for me. It needs to be about what you can do for hospital to make it the best it can be. Stop making excuses and do something about it.

Anonymous said...

Amen to 9:56pm. Other hospitals provide and PAY for the courses that YOU need to care for YOUR pt's. Why should Essent slide by? And the nurse that ran out crying had way to many straws breaking the back, not just one.

Workin4Change said...

Actually, I agree with the 11:38pm and the latest posting at 9:56pm, it is the hospital's responsibility to offer continuing education of this basic type...though if they don't, do it yourself, for yourself and your patients.

By the way "will-never-work-for-prmc_RN", I am so glad you won't because you reek of the back stabbing types that PRMC is loaded with at this time! Glad to know you won't be on my team!

Anonymous said...

Well if you know me so well, who the hell are you. And what hospital do you work at, I dont care what u say to me I am a good nurse and when I worked at prmc none of my pts had any complaints about me. I do care about my pts or I wouldnt be in this field. And again if u know me so well and you have never worked at prmc then how would you know what kind of nurse I am. So speak up tell me who you are if you dont want to say email me @ sugar75473@aol.com or any one else that would like to comment on my statements.
erin

Anonymous said...

6:36 post

The hospital should take care of you, and you should take care of your patients. It should be a synergistic relationship.

One has a direct link to the other. You can call me a crybaby all you want---this crybaby has been a nurse for a long time, member of 5 nursing organizations, certified in 3 areas, work a full time job and a part time job.

I am smart enough to know if we do not pull together, we will never accomplish anything. Nursing will amount to what hospitals dump on us, and we will never have a voice.

Our profession will not grow, because conditions are too bad. We are almost there now.

If you can't treat other employees with respect--I don't want you taking care of me or mine, I can tell you that.

Anonymous said...

Ok 1100 your turn
here is it stated that it is the hospitals responsibility to offer CE? Nowhere, and unfortunately your hospital is run by a bunch of A**holes who don’t care if you have the classes you need to properly carry out your duties to your patients.

I am very happy to see that you understand that if the facility doesn't do it for you, you should do it for your patients. That shows a lot of concern for your patients and it is commendable. Seems that a lot of people just don’t get that it is all about what you can do for patient care.

As for the second part of your comment you are right I won’t be on your team. You work at PRMC, there aren’t any teams. Maybe one day you can come to Dallas and be on mine and you wouldn't be Workin4Change, but I doubt it.

Furthermore, if posting on makes me a backstabber looks like we are in the same boat. Actually I guess since you post here too, that would make you a backstabber and a hypocrite, now wouldn't it?

And 451
I agree as stated above that the hospital should offer the training needed to its staff members. However, as I also stated if the facility doesn’t then it falls to the nurse to ensure that she is trained to at least the minimum level that she needs to provide competent care.

As far as your ramblings about nursing organizations I have a question: Where are they now and how are they helping you or your communities situation?????

Addressing the crybaby thing: Anyone that wants to cry that the hospital is the reason they don't have the education to do their job IS a crybaby, and one that is too irresponsible or unwilling to do whatever it takes to ensure competent patient care is the end result.

Finally, you don't want me taking care of you or yours. Hell that's fine with me. Take them to PRMC and you won't have to worry about it. I don't work there, I work at a real hospital!

Anonymous said...

ok im tired of lowering myself to your standard, my pts are taken care of and thats my only concern b/c as I said before if I didnt care about my pts I wouldnt be in this field. So I guess if pt advocacy is a crime now then I should be arrested. But this is the last time im going to say anything else about taking good care of my pt b/c my pts know what kind of nurse I am.
Erin

Anonymous said...

11:13 The nursing organizations will help---but there has to be more than one person willing to work with them.

There has to be more than one person, working as a team to make the change.

Don't talk to me about footing the bill for the education I need to take care of my patients either. I've spent thousands, and continue to do so.

I left PRMC a while ago. My goal here has nothing to do with my personal gain. I want to be able to go to this hospital again for medical puposes, and not be afraid for my family--even if its just to stabilize and transport.

My concern is that the hospital is not taking care seriously. Some nurses are taking care of their family on a limited budget--single parents etc... and can't afford to spend money on classes. I've been there before, but fortunatly the hospitals that I have worked for, have provided what classes I've needed, and I had wonderful educators that I worked with, that were encouraging and helpful, to help me to understand what I did not. Doctors- nurses, and lab techs as well.

I do not think it makes me a backstabber to post on this site. I spoke out when I worked at PRMC, and I continue to do so. I think its important to work together for improvement.

If you see a nurse that needs help, encouragement or understanding, and you belittle them instead of helping them-- I think you must be an administrator or a want-to-be.

Anonymous said...

The nursing organizations will help. Yeah look how much they have done for us so far. Wait let me guess. Its not their fault; its our fault right. What have they EVER done here?????????????

Anonymous said...

Are you a member of the Texas Nurses Association? Are you a member of the American Nurses Association?

Probably not, or you would know what they are doing. They lobby on the state level for nursing and pt. care. If you need for them to come in and do collective bargaining at your hospital, they will. The thing is, if one person is griping about what is going on----then nobody is going to take it seriously.

If they have several TNA members at one facility with complaints that effect patient care and nursing, they will come in and collective bargain to get the hospital back on track.

One problem is, there aren't many members of the Texas Nurses Association at PRMC. Another problem is, many don't want to be involved in a team effort to get things back on track.

Another problem is there are many different nursing organizations, and they don't necissarily help each other or pull for the same things.

One the other hand, the hospital administration organization, all work for the same goals. The AMA works for the same goals, therefore their voices are louder and carry more weight, even though we out number them tremedously, we can't get together enough to get needs accomplished.

In other words---they are smarter than we are, because they work together better. They work more effectivly with less people.

Anonymous said...

WELL MRS. WILL-NEVER-WORK-FOR-PRMC, YOU OBVIOUSLY HAVE EVERYTHING COMPLETELY WRONG. WORKING AT PRMC AND HAVING CLINICALS THERE ARE TWO VERY DIFFERENT THINGS. I WORKED AT THE HOSPITAL FOR FOUR YEARS, ALWAYS TRYING TO GET THINGS TO CHANGE, BUT THERE WAS NO HOPE. YOU CAN CALL US CRYBABIES ALL YOU WANT, BUT THE THINGS I "CRIED" ABOUT WERE THINGS THAT AFFECTED MY PATIENTS. I THINK THAT'S CALLED PATIENT ADVOCACY, OR DID YOU OVERLOOK THAT IN YOUR EDUCATION. GEE... ISN'T THAT SOMETHING YOU "need to know to properly care for your patients"? IF YOU NEVER WORKED FOR THE HOSPITAL, HOW CAN YOU POSSIBLY KNOW ANYTHING THAT GOES ON THERE EXCEPT WHAT'S ON THE SURFACE? YOU CAN'T. BUT, IT SEEMS TO ME THAT YOU WOULD FIT RIGHT IN WITH PRMC ADMINISTRATION. ARE YOU SURE YOUR NOT? THERE'S A REASON IT'S CALLED "CONTINUING EDUCATION". NURSING SCHOOL CAN'T POSSIBLY TEACH YOU EVERYTHING. I TOOK THE TELE CLASS EVEN THOUGH I WASN'T ON THE TELE FLOOR. I LEARNED A LOT, BUT PRMC DOESN'T EXACTLY OFFER CLASSES AT CONVENIENT TIMES FOR PEOPLE IN SCHOOL WHO ACTUALLY HAVE TO WORK FOR A LIVING. AND BY THE WAY, AS A PERSONAL FRIEND OF ERIN, SHE IS A VERY GOOD NURSE WHO CONSTANTLY FIGHTS FOR HER PATIENT'S RIGHT TO ADEQUATE CARE, THAT'S WHY SHE DIDN'T LAST THERE, NOT HER "IMCOMPETENCE"

Anonymous said...

In ANY professional organization, union, etc., the assistance you get from them is directly porportional to your level of ACTIVE involvement in them. If you joined an organization expecting them to show up at your work, stand over you, and protect you like a guardian angel, you joined for the wrong reason.

Your dues help make your profession better by helping those in your profession on a overall scale.

There is personal responsibility that goes along with anything. If your employer is not breaking any labor laws as they pertain to your job, 'though they may be making your job miserable, there is little any organization can do to change your working conditions.

Organizational or union assistance is based on laws. If labor laws are being complied with, then you have to look at your membership in your organization as helping yourself by helping the profession as a whole.

Anonymous said...

Must be cat fight season!

RARRRRRRRRRRRRRRR!

Anonymous said...

Let's talk about the lab for a while.... What about all the short staffed techs? Why do some tech's only have to work in one department? Would they be lost in another department? They should have learned to work in all departments in school. And the phlebotomist having to take on the entire hospital by themselves? What do you do when you have several STAT'S on the floors, ER calling for help, and then you have a code in all that mess, and you are by yourself? Does anyone have any answers to these Questions? But it goes to show you the lab is understaffed too. So what is the answer to these problems?

will-never-work-for-prmc_RN said...

ok 4:44 I'll just start at the top and work my way down. Here we go.
For the nursing organization part I'll just agree with the post at 6:51 I think she pretty well summed that up. next

You say "There has to be more than one person, working as a team to make the change." I agree next

About edjucation and funding. Let me try to make this clear. Nurses must be have the proper knowledge to carry out proper patient care. We all know that the employer, in this case e$$ent, should pay these fees so that the highest level of care can be provided in their facility. Well e$$ent isnt going to do that, because they are greedy pieces of crap. When the employer wont pay it falls to the nurse to take care of her edjucation so that she can provide the care that patients deserve. When you make excuses such as some people take care of their family on a limited budget and some are single parents,(I am in both categories by the way), you are doing just that MAKING EXCUSES. Who suffers when nurses do this???? The hospital....no
The nurse....doubtful wait I know who suffers THE PATIENT. You can make all of the excuses you want, and you can point all the fingers you want it doesnt change that next

The backstabber thing wasnt aimed at you that was meant to point out the hipocracy of another poster. next

I have no problem helping, encouraging, or understanding a nurse that needs help, encouragement, or understanding.
However, I do have a problem with laziness and/or excuse making in nusing that is or, may be, detrimental to patient care. If you don't then I guess that's your patients problem huh. Finally, no I am not an administrator or a want-to-be... I am a nurse.

Anonymous said...

You know it's funny you should mention that. I am a member of a nursing organization, that has a list serv--it's not unlike the blog spot, where we communicate.

It is an international nursing organization, and we help each other daily. We support each other, network with each other, teach each other, and work out problems---we actually solve problems internationally.

These nurses come from such diversity of education, culture, budgets etc.... It's amazing that everybody has something to offer--from novice to expert, and so many ideas for improvement blossom.

I find it a shame, that we here in one town, from the same background, same educational opportunities etc... can't even stick together enough to get anything accomplished.

I guess many people here don't understand the rewards of communicating, collaborating, brainstorming and coming up with solutions.

I guess some here have gotten rewarded by making someone look stupid to make themselves look smarter to get ahead. You just have to go with whatever works for you.

Anonymous said...

1025
It is managements responsibility to make sure the nurse's and tech's are liscensed, registered and competent to do the jobs they were hired to do. We have all seen first hand management has failed in this field, the blinders they wear and excusses made are reprehensible. They have x-ray tech's with no registry which is MANDITORY with E$$ENT. Nurses floated to areas they are uneasy about. This is not the employees fault, Fault starts at the top. Look who hired these people for these positions, look who has keep these people in those positions without giving training or offering training, or mandating registeration (apparently this means it is OK with mgmt), that they have incompetent people in critical positions, maybe they think the strong will carry the weak, well the strong have left.
I know , look at the money they are saving.
As stated before, management wont loose your liscence, you will lose it on your own. management will be behind you, only with a knife.

Anonymous said...

9:49

You are right. It is their job to make sure everyone is competent--from the top to the bottom.

When the law suits start rolling in---Essent administration will be named first. I hope everyone has their own personal malpractice insurance, or they will be at the mercy of Essent for defence of their license, and their role in the claim.

You can bet whoever doesn't have their own malpractice insurance, will be the fall guy.

Anonymous said...

Laziness comes in many forms and fashions as well. I've busted my a$$ for many years and never considered myself lazy at all, but....if you don't take the time (or have the time) to mentor, and teach someone who needs it.... then your lazy, and stupid.

I have for many years been guilty of this. Busting my butt, doing for others...but if I had just taken a little time with someone, and taught them how, it would have been more rewarding for them and me, and much less stress on my back and my mind. Not to mention a good difference in pt. care.

Yes --you can say they are lazy themselves for not taking the time to learn it---when you did it, or you can try to help them out and ease the fears that they may have about it.

None of us can know it all. Some people in the cath lab, may think someone in the ER is stupid because, they don't know how to do a cath. Someone from ortho floor may think someone from the cath lab is stupid because they don't know how to set up traction.

But the truth of it is we all have something to offer, something to teach, someway to help. We all have areas that we feel comfortable with, and some that we just don't.

It is hard to be patient with someone who doesn't know what you know. It is hard to take the time to teach and mentor, when you don't even have time to pee.

I just think it is very unfair to judge your peers, based on your ideas of lazy and excuse making. What's your excuse for not mentoring and teaching them----no time right?

Anonymous said...

Will-never-work-for-prmc....

Its education not edjucation

Anonymous said...

I think many people around here are very closed minded to using their proffesional organizations and what they can do for you, and your patients.

I think many underestimate, the power, and worth of networking and the information that these organizations provide--not to mention the opportunities that come with membership.

I don't think the importance of these organizations are stressed enough in school. The Emergency Nurses Association, provides so much useful infomation online daily, and classes available that many people don't know exist with reduced prices, in many areas.

Look into these organizations. They do so much to promote nursing, and patient care. Your membership to these proffesional organizations are tax deductible. They lobby for you and pt care. There are many benefits to membership.

Why not look into it---or stay closed minded with no idea. You can have a voice--voice your concerns to someone who can do something about it. Or you can do nothing, and allow what is happening at PRMC to happen everywhere. It's happening more and more everyday in many places.

Even in Dallas.

Workin4Change said...

To Ms.will-never-work-for-PRMC...

What has made you seem like a backstabber is your own comments that have gotten PERSONAL with "Erin"...and your "real" hospital in Dallas ,or wherever...comments that accomplish what???

This blog is not about whining or crying, but FOR and about people who are desperately seeking a solution to the serious situation at PRMC.

When I started at PRMC...then St.Jo's...it was an awesome place to work and you could be sure that your most precious loved ones would be well taken care of...that is what we are trying to recover here.

I believe it's time for people to organize, by whatever is the best way, pull in organizations, have meetings...let's quit yakking and get something REAL going on!

Anonymous said...

IS THERE A WAY WE COULD ALL GET TOGETHER FOR A NURSES MEETING HERE IN PARIS? WE GET A PLACE AND A TIME SET UP AND WE CAN ALL SIT AROUND AND DISCUSS OUR CONCERNS FOR OUR HOSPITAL. I AGREE 1048 LETS GET A PLAN GET ORGANIZED AND GET MOVING!!!!!
ERIN

fac_p said...

The Love Civic Center rents meeting rooms fairly reasonably. You just need someone that will be responsible the funds--and take up a collection.

Anonymous said...

If you plan to organize, take some advice from an outsider who has been through that.

Get a small group, a handful that can be trusted without question. Organization usually fails because of moles. A lead person from that group needs to contact the union, association, etc. Get all the info you can. Ask all the questions you can think of. Ask for ways to spread the word without management finding out and firing all involved. If anything is clear about E$$ent, it is that they are not adverse to removing those they perceive to be trouble-makers. Above all, make sure the union, association can do for you what you want it to do.

Once you have gotten all the info you think you need, share it with your group. The tricky part is getting the word out beyond that group. If you tell just one person who runs and tells management, all hell could break loose.

If you manage to get the word out to enough people, have reps from the union, association come and speak to your group. Be prepared to organize that night. It is very important that you not make a big deal about it at work. Remember, one person...

Once you've organized, membership won't be a problem. People will be coming to you in droves.

It is very important, especially for local officers, that you learn as much about the laws that govern your profession as possible, including labor laws. It is also important that you listen to and give sound advice and be prepared for some backlash from management once the word gets out, and it will get out. Make sure your local officers are up to the task at hand. Being a local officer is sometimes no fun. You must be willing to endure to the end.

Be advised, any corporation worth its salt will be well versed on union busting. This is just something that union leaders have to be prepared for. Your parent association, union will advise you on how to combat union busting.

Good luck. Change is never easy.

Anonymous said...

There is a small problem with all of us getting together, and that is the people that still work for the hospital--- and someone from there figuring out that they were meeting based on the blog.

The ones that are still there- are there because they have been smart enough not to make any waves, and watch their backs.

If a meeting were arranged, it would have to be off the blog, and its hard to know who to trust in nursing anymore. Some of those, who aren't as strong clinically may be wanting to climb the corperate ladder, and would turn their backs on us in a min. to get the chance to buddy up with administration.

However, if we could meet in a proffessional organization meeting---say the ANA with maybe CEU's involved, I don't see how that could hurt anything. We could just slip a union rep in there for after the CEU's for persons interested.

So if we could get the free CEU thing arranged, posted in the paper, and done that way--it could work, but it might take some time.

What do you think about that?

Anonymous said...

Count me in, I also think it would be wise to include health care professionals who do not work @ PRMC, but care because they live in Paris or have family members that may have to use the hosp. They may be more help 'cause they can't be fired.

Workin4Change said...

So now it's being suggested that because some are still working for PRMC they are going to be excluded from participation in meetings, etc??

I'm really shocked and trying very hard not to be totally angry that this is being said!

In another area, Monster Mash, this was posted regarding a proposed scholarship...

"Another stipulation should be that the scholarship recepient should not work at PRMC and poison the good education that the scholarship is paying for....."

Perhaps "loyal" bloggers should get a secret tattoo...or a special ring...to be able to tell them apart from the evil spies that will infiltrate the resistance?

Everyone that I know that still works for PRMC is DISGUSTED by what E$$ent has done to our hospitals.
Just because we are still trying to make changes from within, doesn't mean we support what E$$ent is doing.

Keep going in this vein, and maybe this blog too will deteriorate into a special little elitist group that can have it's own little galas and golf tournaments...just let me know now that I'm not important here too.

Anonymous said...

1123

I think you misunderstood what has been said. No one is trying to exclude anyone from the meeting that wants to be there and is for change.

The problem is, hospital employee saftey. If anyone from upper management suspects you are trying to get a union going, or are getting organized, they will fire you. Make no mistake about it.

There are also many little spies that come with organizing that sabotage the game plan.

If I were to say right now, that we are going to have a meeting to organize a union today at 3pm at the Paris Golf and Country Club, management or a mole from management would be there, they would take pics, and send it to the bosses, and there would be a mass firing in the morning.

People have actually been killed because they were trying to organize a union, families threatened etc...

So it has to be people that is trusted, and you have to come up with more than 51 percent of the staff that wants a union.

If you have one in there that sabotages efforts, they will kill the majority vote.

If people understood what it was like to have someone you could go to that would fight for you, intead of against you, they would love the idea. If people don't take it for granted, or try to bleed the system, it is a great thing.

If you have a grievance, you take it to the union, and they take care of it for you. It's as simple as that. The ever long chain of command=that never goes anywhere is eliminated.

As far as the scholarship comment goes, I don't know what that was about. All I know is that the poison that PRMC has spread is killing the community, and causing much distrust, and because they don't lead by example, they are causing anamosity.

Anonymous said...

1123

I don't think you understand how dangerous trying to organize a union can be. It's not that anyone is trying to get anyone out of the loop, they are trying to protect the workers that still work there.

You will be fired if anyone suspects that you are trying to organize, and that is the very least of it.

Administrators, and higher ups, know that if a union comes in, their pie in the sky is gone. No more getting away with what ever they want to. Someone is watching over them now too.

If you mess with someones livelyhood, they will fight back. That is what we are trying to do, because they are messing with our livelyhood.

But they will fight back if we try to organize. Because they will get back, what they are shoveling if it succeeds. And they don't want what they are shoveling.

Anonymous said...

For a long time I've said the evaluation criteria for here or Dallas was if it was arterial or could I last the trip.

I want to have a facility here that can take care of me and mine in an emergency.

This place doesn't cut it. And it's really a shame, because it had the potential for everyone to make out. The major problem is E$$ent. They need to go, because the well is poisoned, now. But, I think that they will stay far beyond what is even economic for them, just because they can't afford to lose.

Anonymous said...

11:23 post

I know everyone is discusted with what is going on. But think about it this way, who would sway because they have to.

If administration came up to you and said--tell me the names of the others that are trying to organize a union or you are fired, could that person afford to be fired?

If administration came up to you and said if you'll tell me the names of the people involved in organizing the union, you will get a raise, move up to whatever position etc.... could this person avoid the temptation?

This is what I mean by trust. There are some people out there, that abosolutly can't afford to be fired, and when push comes to shove will cave.

If you think Essent is sneaky and cruel now, you ain't seen nothing yet.

Anonymous said...

8:38 post:

You are absolutely right. Rest assured, E$$ent is not sitting around wondering that they are going to do to keep a union from organizing. They know what to do. And don't be surprised if you start seeing this plan go into action soon.

The threats and bribes are a large part of stopping organization. That's why it is so important to talk to the union BEFORE you do anything else. They will be able to give you some guidance in terms of how to get started.

There was a comment about if you have a grievance, take it to the union and they take care of it for you. Yes and no. Members will have to make sure they follow all hospital rules. If you violate a work rule, there may not be a lot your union can do for you. Remember, union representation is based on work rules and labor laws. A violation of a work rule may render your union powerless in a given case.

Don't get ahead of yourself. Call the union. Let them walk you through this.

Good luck.

Workin4Change said...

My bad for over-reacting and I apologize...just really am going to be a part of this, whether I lose this job or not!

Attention E$$ent...if you figure me out or any of the others still employed there that I know, we've agreed you can kiss our lil' butts goodbye!

Anonymous said...

2:41

I think on the grievance thing, everybody just wants fairness, and to do what they say they are going to do.

If the rules say they must park wherever--administration must follow their own rules---If they say they pay for education----ante up-- if someone blows the whistle--as long as they follow the rules, they should be protected. If OSHA says we are supposed to have lifting equiptment--we should have it.

These are some basic rules and rights that we have that aren't being protected under PRMC. There is no body speaking out for fear they will get fired, and that is not even talking about the pt. care issues and staffing. And their are rules and regs not being addressed.

The ligitamate grievances are on a list longer than Santa Claus' on Christmas Eve.

I honestly don't think their would be many grievances that would not fall under the rules and regs set before us.

But thanks for pointing that out. There are always a few that will take advantage of protection.

8:40
No need to apologize--its kind of hard not to take offence sometimes. I think there are so many with frustration here, occasionally misguided, and occasionally spiteful, (and who knows who may be posting to create more poison--(administration).

Anonymous said...

"I worked 3rd floor tele yesterday...and was told by a contract nurse that JACHO had been on the floor previously that week. And that they were writing feverishly in their little books of inadequacies.

And on a positive note....this particular nurse advocated for us...the workers...and started pointing out other inadequacies to the JACHO people. I for one like the contract nurses, and AMEN that one of them took the initiative that the PRMC employees should have done, but then again, if she gets "let go" she just moves on. Thank you contract nurse!"


I brought this forward from the "Sinking Ship" post. Looks like they got someone's attention! Way to go!!!!

This will hit E$$ent in their pocket book... $$$$$$$$$$$$.

Of course there are other agencies such as the Texas Department of Health.....

Andrew, how's your resume looking these days?

Good catch, I should have done the same! Guess Bud is sweating blood... fac_p