January, 2012 Archive

June 29, 2016, 5:42 pm

Adverse Side Effects Of Viagra

Adverse side effects of viagra Sorry, adverse side effects of viagra no.

Adverse side effects of viagra This is the problem.

Adverse side effects of viagra There is a huge injustice being perpetrated against a nurse right this moment.

Adverse side effects of viagra It’s getting worse.

Adverse side effects of viagra And the ones who got the party started aren’t happy that it isn’t quiet.

Adverse side effects of viagra That their moves, adverse side effects of viagra and their motives, adverse side effects of viagra are under public scrutiny.

Adverse side effects of viagra That nurses are talking.

Adverse side effects of viagra Because if you are quiet, adverse side effects of viagra it means they’ve got you frightened.

Adverse side effects of viagra If you are quiet, adverse side effects of viagra it’s harder for the next nurse to speak out.

Adverse side effects of viagra If you are quiet, adverse side effects of viagra it is easier to intimidate and retaliate against nurses with impunity.

*****

I received a call from the Arizona Board of Nursing this morning. Adverse side effects of viagra I am not able to obtain a copy of the Banner Del E. Adverse side effects of viagra Webb Medical Center complaint against Amanda Trujillo, adverse side effects of viagra RN, adverse side effects of viagra MSN.

They are able to tell me that a complaint was filed, adverse side effects of viagra and what date it was filed, adverse side effects of viagra but the actual content of the complaint is confidential. Adverse side effects of viagra A copy goes to the RN involved.

I appreciated the call, adverse side effects of viagra they could easily have sent an email.

That doesn’t mean I won’t see a copy of it, adverse side effects of viagra it just means I can’t get a copy from the AZBoN.

*****

Well, adverse side effects of viagra it gets worse.

Today, adverse side effects of viagra ten months after the original complaint was filed, adverse side effects of viagra Amanda was advised that the Arizona Board of Nursing had called her university and reported that she is under investigation. Adverse side effects of viagra Amanda is studying for her DNP.

Amanda got the email from her university, adverse side effects of viagra informing her of what they had been told.

WHAT???

Is it normal for boards of nursing to actively report registered nurses to their universities?

By phone?

While the investigation is still going on?

*****

I talked to a nurse investigator in Nevada, adverse side effects of viagra who said absolutely “NO”, adverse side effects of viagra they did not report nurses to universities., adverse side effects of viagra That until the case is decided, adverse side effects of viagra it’s confidential and there is no way of knowing that the nurse was in school or what school she attended.

There has been no disciplinary action against Amanda Trujillo by the Arizona Board of Nursing.

So why are they calling her university?

Why now?

*****

This has gone past a regular investigation of a complaint against the license of a registered nurse and has all the markings of a personal vendetta.

Adverse side effects of viagra I’m no Morley Safter or Mike Wallace.

Adverse side effects of viagra This blog isn’t 60 Minutes.

Adverse side effects of viagra I’m just a blogging staff nurse who is aghast at what she is seeing and I have questions.

Adverse side effects of viagra Who has ties to the Arizona Board of Nursing? What pull, adverse side effects of viagra if any, adverse side effects of viagra does Banner Health have with the AZBoN? What pull, adverse side effects of viagra if any does the doctor whose public display of rage set all this in motion, adverse side effects of viagra have with the Arizona Board of Nursing?

Adverse side effects of viagra What ties does the Arizona Board of Nursing have with Amanda’s university?

*****

And let’s keep in mind why all this is happening.

A patient received education concerning their condition and upcoming procedure, adverse side effects of viagra and a referral for a case management consult for hospice placed at the patient’s request.

No patient was harmed. Adverse side effects of viagra No patient was killed. Adverse side effects of viagra No medication given. Adverse side effects of viagra No procedure done.

A patient was given information.

Informed.

Empowered.

And god help the nurse who had the audacity to facilitate this autonomy, adverse side effects of viagra this right.

How can you not be outraged?

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June 29, 2016, 3:03 pm

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Thyroid health synthroid 200mcg pills (generic) $126.00 I’ve been blogging for 6 1/2 years.

Thyroid health synthroid 200mcg pills (generic) $126.00 I have a twitter account and although I went to Facebook kicking and screaming, thyroid health synthroid 200mcg pills (generic) $126.00 I’m firmly ensconced in the world of status updates, thyroid health synthroid 200mcg pills (generic) $126.00 messages, thyroid health synthroid 200mcg pills (generic) $126.00 and the occasional “poke.”

Thyroid health synthroid 200mcg pills (generic) $126.00 I never miss BlogWorld New Media Expo, thyroid health synthroid 200mcg pills (generic) $126.00 and if I can make it to BlogHer, thyroid health synthroid 200mcg pills (generic) $126.00 I will be at the party (can you say “swag”?)

Thyroid health synthroid 200mcg pills (generic) $126.00 You might say I’m into social media.

Thyroid health synthroid 200mcg pills (generic) $126.00 The best thing about social media? It enhances the ability of people to band together, thyroid health synthroid 200mcg pills (generic) $126.00 to support causes, thyroid health synthroid 200mcg pills (generic) $126.00 and each other.

Thyroid health synthroid 200mcg pills (generic) $126.00 This week, thyroid health synthroid 200mcg pills (generic) $126.00 we’ve seen nurses band together online to support one of our own, thyroid health synthroid 200mcg pills (generic) $126.00 fired and in danger of losing her license for acting as a patient advocate and providing patient education.

*****

Patients use social media to band together with others who share the same challenges, thyroid health synthroid 200mcg pills (generic) $126.00 to find support and encouragement.

They use the internet and social media to gather information; to be able to decide, thyroid health synthroid 200mcg pills (generic) $126.00 in discussions with their healthcare provider, thyroid health synthroid 200mcg pills (generic) $126.00 the best treatment to pursue.

The “patient” is you. Thyroid health synthroid 200mcg pills (generic) $126.00 And me. Thyroid health synthroid 200mcg pills (generic) $126.00 We are all patients.

Knowledge is power. Thyroid health synthroid 200mcg pills (generic) $126.00 Knowledge empowers a us to advocate for ourselves.

But what happens when you are sick, thyroid health synthroid 200mcg pills (generic) $126.00 lying in a hospital bed with new information flying fast and furious, thyroid health synthroid 200mcg pills (generic) $126.00 with no time (or access) to “look it up”. Thyroid health synthroid 200mcg pills (generic) $126.00 No time to find an “online support group”.

What if the quality of the rest of your life depends on the decision you make with the information you get, thyroid health synthroid 200mcg pills (generic) $126.00 now.

Who advocates for you/us then?

*****

The entire healthcare team advocates for you.

Nurses and physicians advocate for you.

They advocate for you by making sure you have all the information you need to make an informed decision on any plan of care.

They advocate for you by telling you all of the options open to you, thyroid health synthroid 200mcg pills (generic) $126.00 including no treatment.

They advocate for you by making sure you understand all of the information and education provided.

They advocate for you by respecting the fact that you are able to advocate for yourself and respecting the decisions you make.

Doing all these things is the right thing to do.

It’s also the law.

*****

When a nurse assesses that a patient does not have the information needed to make an informed decision about their care, thyroid health synthroid 200mcg pills (generic) $126.00 either because they have not been informed, thyroid health synthroid 200mcg pills (generic) $126.00 or because they did not understand the information provided, thyroid health synthroid 200mcg pills (generic) $126.00 the nurse has a duty to:

a. Thyroid health synthroid 200mcg pills (generic) $126.00 provide the missing information, thyroid health synthroid 200mcg pills (generic) $126.00 or the needed education and/or

b. Thyroid health synthroid 200mcg pills (generic) $126.00 refer the patient to the appropriate source of information

Thyroid health synthroid 200mcg pills (generic) $126.00 There is no choice.

Thyroid health synthroid 200mcg pills (generic) $126.00 It’s not a case of making a note and hoping the next shift deals with it.

Thyroid health synthroid 200mcg pills (generic) $126.00 It’s not a case of thinking, thyroid health synthroid 200mcg pills (generic) $126.00 “oh well, thyroid health synthroid 200mcg pills (generic) $126.00 they need this surgery/procedure anyway.”

Thyroid health synthroid 200mcg pills (generic) $126.00 The nurse is mandated by law, thyroid health synthroid 200mcg pills (generic) $126.00 and obligated ethically to act if they discover a patient does not have the information they need to make an informed decision about their care.

*****

Here’s the ethical principle in operation here, thyroid health synthroid 200mcg pills (generic) $126.00 as defined by the American Nurses Association, thyroid health synthroid 200mcg pills (generic) $126.00 who have a great website on nursing ethics:

Autonomy: agreement to respect another’s right to self-determine a course of action; support of independent decision making.

This is why the firing of Amanda Trujillo, thyroid health synthroid 200mcg pills (generic) $126.00 RN, thyroid health synthroid 200mcg pills (generic) $126.00 MSN, thyroid health synthroid 200mcg pills (generic) $126.00 an experienced transplant RN, thyroid health synthroid 200mcg pills (generic) $126.00 by Banner Del E. Thyroid health synthroid 200mcg pills (generic) $126.00 Webb Medical Center is so mind-boggling.

She was doing exactly what she was supposed to do as a registered nurse, thyroid health synthroid 200mcg pills (generic) $126.00 for a patient with a knowledge deficit regarding an upcoming transplant.

*****

For the record, thyroid health synthroid 200mcg pills (generic) $126.00 to those who have written to say I don’t have both sides, thyroid health synthroid 200mcg pills (generic) $126.00 Banner Health isn’t talking. Thyroid health synthroid 200mcg pills (generic) $126.00 They made a statement on their Facebook page to that effect.

I have written to the Arizona Board of Nursing for a copy of the original complaint, thyroid health synthroid 200mcg pills (generic) $126.00 which should be public record.

I’ll post any response I get from them.

In the meantime, thyroid health synthroid 200mcg pills (generic) $126.00 Amanda’s legal response to the original complaint, thyroid health synthroid 200mcg pills (generic) $126.00 which answers the complaint point-by-point, thyroid health synthroid 200mcg pills (generic) $126.00 can be found at vdutton’s posterous.

I encourage you to read the comments, thyroid health synthroid 200mcg pills (generic) $126.00 as there is some interesting dialog there, thyroid health synthroid 200mcg pills (generic) $126.00 as well

*****

I am not militant.

I rant now and again, thyroid health synthroid 200mcg pills (generic) $126.00 but I am very happy in my corner of the couch with my trusty old MacBookPro.

But I would take to the street for this.

I am that angry.

If I thought for one minute that there was more to this case, thyroid health synthroid 200mcg pills (generic) $126.00 I’d be watching from the sidelines, thyroid health synthroid 200mcg pills (generic) $126.00too.

My gut tells me, thyroid health synthroid 200mcg pills (generic) $126.00 there is not.

My nursing instinct tells me there is not.

My nursing instinct tells me that a hospital corporation got upset because a “rainmaker” (in the legal world, thyroid health synthroid 200mcg pills (generic) $126.00 that means “moneymaker”) got angry at an RN, thyroid health synthroid 200mcg pills (generic) $126.00 ergo, thyroid health synthroid 200mcg pills (generic) $126.00 she must be punished.

Most hospitals just fire people, thyroid health synthroid 200mcg pills (generic) $126.00 Banner Health reports them to the Arizona Board of Nurses.

God help the nurses at Banner Health, thyroid health synthroid 200mcg pills (generic) $126.00 because I’d be watching my derriere 24/7 if I worked there.

Corporate healthcare at it’s finest.

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June 29, 2016, 12:03 pm

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Blood pressure avapro 300mg pills (generic) $126.00 (ADDENDUM, blood pressure avapro 300mg pills (generic) $126.00 ADDED FEBRUARY 14, blood pressure avapro 300mg pills (generic) $126.00 2012 – When this post was written, blood pressure avapro 300mg pills (generic) $126.00 I mistakenly thought the patient in question had a transplant operation pending. Blood pressure avapro 300mg pills (generic) $126.00 The patient was actually scheduled to be transferred the next day to begin pre-transplant testing. Blood pressure avapro 300mg pills (generic) $126.00 Surgery would have come at a later date.

Blood pressure avapro 300mg pills (generic) $126.00 I now understand that Amanda assessed that the patient had a deficit of transplant knowledge in general, blood pressure avapro 300mg pills (generic) $126.00 and provided general transplant teaching concerning the evaluation process, blood pressure avapro 300mg pills (generic) $126.00 the waiting process, blood pressure avapro 300mg pills (generic) $126.00 and the care regimen. Blood pressure avapro 300mg pills (generic) $126.00 The patient changed their mind about undergoing the testing, blood pressure avapro 300mg pills (generic) $126.00 and requested a hospice consult.

Blood pressure avapro 300mg pills (generic) $126.00 So, blood pressure avapro 300mg pills (generic) $126.00 although the patient did not fully understand, blood pressure avapro 300mg pills (generic) $126.00 and may not have been “informed” about what the entire transplant process required, blood pressure avapro 300mg pills (generic) $126.00 surgery was not imminent, blood pressure avapro 300mg pills (generic) $126.00 and “informed consent” for surgery was not the issue here. Blood pressure avapro 300mg pills (generic) $126.00

Blood pressure avapro 300mg pills (generic) $126.00 I have a firm belief in not altering a post once it has been posted, blood pressure avapro 300mg pills (generic) $126.00 and owning the mistakes/misunderstandings therein, blood pressure avapro 300mg pills (generic) $126.00 so I have added this addendum for clarification.

Blood pressure avapro 300mg pills (generic) $126.00 The issues remain the same – a patient was uninformed about what was happening to them and needed education on their illness, blood pressure avapro 300mg pills (generic) $126.00 a physician/hospital did not support/respect a patient’s decision/request for information, blood pressure avapro 300mg pills (generic) $126.00 and a physician behaved in a disruptive fashion.

Blood pressure avapro 300mg pills (generic) $126.00 I apologize for the misunderstanding.)

Blood pressure avapro 300mg pills (generic) $126.00 Sorry, blood pressure avapro 300mg pills (generic) $126.00 no.

Blood pressure avapro 300mg pills (generic) $126.00 Nurses and physicians share a collaborative relationship, blood pressure avapro 300mg pills (generic) $126.00 working with the patient in a team effort.

Blood pressure avapro 300mg pills (generic) $126.00 That is how it is supposed to work.

Blood pressure avapro 300mg pills (generic) $126.00 As a nurse, blood pressure avapro 300mg pills (generic) $126.00 my duty is solely to the patient.

Blood pressure avapro 300mg pills (generic) $126.00 If I am needed to be anyone’s “right hand”, blood pressure avapro 300mg pills (generic) $126.00 it will be my patient.

Blood pressure avapro 300mg pills (generic) $126.00 I’m very lucky. Blood pressure avapro 300mg pills (generic) $126.00 I work with great docs who get it. Blood pressure avapro 300mg pills (generic) $126.00 I’ll write a post about that.

Blood pressure avapro 300mg pills (generic) $126.00 I’ve seen my share of the temper-tantrum throwing screamers, blood pressure avapro 300mg pills (generic) $126.00 and I’ve been the recipient of their wrath three or four times in my career.

Blood pressure avapro 300mg pills (generic) $126.00 I should tell those stories; they happened long ago. Blood pressure avapro 300mg pills (generic) $126.00 I’ve kept them off the blog because of the emotions that come flooding back when I think about them.

*****

I’ve been blogging on the Amanda Trujillo situation for a few days now, blood pressure avapro 300mg pills (generic) $126.00 but lets move away from Amanda being fired by Banner Health and turned in to the Arizona Board of Nursing and look at this from a patient’s point of view.

As I see it, blood pressure avapro 300mg pills (generic) $126.00 based on information that has been made public or is in the public record, blood pressure avapro 300mg pills (generic) $126.00 three things occurred or nearly occurred (In hospital terminology, blood pressure avapro 300mg pills (generic) $126.00 we call those “near-misses.”)

This should make everyone of us queasy.

1. Blood pressure avapro 300mg pills (generic) $126.00 A PATIENT WOULD HAVE HAD SURGERY WITHOUT INFORMED CONSENT.

A patient scheduled for surgery, blood pressure avapro 300mg pills (generic) $126.00 in this case a major, blood pressure avapro 300mg pills (generic) $126.00 life-altering surgery, blood pressure avapro 300mg pills (generic) $126.00 did not know (a) the extent of the surgery, blood pressure avapro 300mg pills (generic) $126.00 (b) the ramifications of the surgery – this being complex lifetime care, blood pressure avapro 300mg pills (generic) $126.00 or (c) options other than surgery.

All of the above, blood pressure avapro 300mg pills (generic) $126.00 along with the risks and benefits of the surgery, blood pressure avapro 300mg pills (generic) $126.00 constitute “informed consent.” Before any surgery consent can be signed, blood pressure avapro 300mg pills (generic) $126.00 all of the above must be addressed.

Before the discussion with the nurse, blood pressure avapro 300mg pills (generic) $126.00 the patient did not know this information.

2. Blood pressure avapro 300mg pills (generic) $126.00 A PATIENT’S DECISION WAS NOT SUPPORTED BY THE MD, blood pressure avapro 300mg pills (generic) $126.00 OR THE HOSPITAL

Granted, blood pressure avapro 300mg pills (generic) $126.00 the surgery did not happen. Blood pressure avapro 300mg pills (generic) $126.00 But instead of supporting the patient’s decision as being the patient’s decision after the patient had been fully informed, blood pressure avapro 300mg pills (generic) $126.00 as was their right by law, blood pressure avapro 300mg pills (generic) $126.00 there was anger and recrimination from the physician and the facility.

Why?

Why did a patient’s decision to not have surgery cause this upheaval? Who lost out here?

I’m speculating, blood pressure avapro 300mg pills (generic) $126.00 but I wonder – how much of that anger did the patient hear, blood pressure avapro 300mg pills (generic) $126.00 or sense?

3. Blood pressure avapro 300mg pills (generic) $126.00 A PHYSICIAN DISPLAYED DISRUPTIVE BEHAVIOR AT THE NURSES STATION.

Well, blood pressure avapro 300mg pills (generic) $126.00 this has been going on from time immemorial, blood pressure avapro 300mg pills (generic) $126.00 but it is no longer tolerated.

Now, blood pressure avapro 300mg pills (generic) $126.00 concern over a patient is not disruptive behavior. Blood pressure avapro 300mg pills (generic) $126.00 Anger is not a disruptive behavior. Blood pressure avapro 300mg pills (generic) $126.00 (If it was, blood pressure avapro 300mg pills (generic) $126.00 I’d be in trouble.) Screaming and throwing a temper-tantrum at a nursing station is, blood pressure avapro 300mg pills (generic) $126.00 no matter what the reason.

How would you feel as a patient if you heard a screaming rant going on at the nurse’s station outside your door?

How would you feel about the doctors, blood pressure avapro 300mg pills (generic) $126.00 the facility? The nurses?

*****

Two of these, blood pressure avapro 300mg pills (generic) $126.00 the informed consent and the disruptive behavior are issues that are covered by licensing bodies. Blood pressure avapro 300mg pills (generic) $126.00 Joint Commission has looked at the impact of disruptive behavior by physicians and other members of the health care team. Blood pressure avapro 300mg pills (generic) $126.00 The Centers for Medicaid and Medicare Services are also concerned with the effect of this behavior of patient safety.

What happened at Banner Health Del E. Blood pressure avapro 300mg pills (generic) $126.00 Webb Medical Center was not innocuous.

If not for the actions of a registered nurse, blood pressure avapro 300mg pills (generic) $126.00 doing exactly what she was educated to do, blood pressure avapro 300mg pills (generic) $126.00 and bound by the Arizona Nurse Practice Act (and her ethical duty) to do, blood pressure avapro 300mg pills (generic) $126.00 a patient would have had a surgery they were not prepared for, blood pressure avapro 300mg pills (generic) $126.00 and would not have wanted had they known what was happening.

That should scare the hell out of every single one of us.

Blood pressure avapro 300mg pills (generic) $126.00 Because something like this has a chilling effect on all the other RNs in a facility – and I hope that the other registered nurses at Banner Health have the guts to keep educating their patients without the fear of losing their jobs and their licenses for doing their ethical duty.

Blood pressure avapro 300mg pills (generic) $126.00 As a nurse, blood pressure avapro 300mg pills (generic) $126.00 and as a patient, blood pressure avapro 300mg pills (generic) $126.00 I am appalled.

Blood pressure avapro 300mg pills (generic) $126.00 Now I want to see exactly what Banner Health, blood pressure avapro 300mg pills (generic) $126.00 and the Arizona Board of Nurses, blood pressure avapro 300mg pills (generic) $126.00 are going to do to rectify this situation.

Blood pressure avapro 300mg pills (generic) $126.00 This has huge implications for nurses, blood pressure avapro 300mg pills (generic) $126.00 and patients.

Blood pressure avapro 300mg pills (generic) $126.00 All of us.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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