Pet Peeves

[manderlyh]

That sucks. It really, really sucks.

I'm glad that Delta took care of her though. I'm sure she's happy that it worked out okay.

My sister was flying to Colorado from Boise in December, about three days after Christmas, and they canceled her flight from Salt lake to Colorado Springs. They were in the process of figuring out what Plan B was when they also canceled their flight from Boise to Salt Lake, so she didn't end up leaving that day.

I wonder what would have happened if their flight had been canceled from SLC to Colorado Springs. She was traveling with my then-little over 2 month old niece. They had to wait in the Boise airport for over 4 hours on two different days to get to Colorado Springs. I'm sure my sister never wants to fly with a baby again, even if she just slept the entire time, LOL.

[Gegenschein]

First time in this thread.

The reason? Barely surviving a workday.

The state of Arizona, where anything goes. California has safety staffing laws, the patient-to-nurse ratio which cannot be exceeded. Arizona has no laws.

Imagine you work in a restaurant, three waitresses called in sick, you show up to work and get punished for showing up by being slammed by just unbelievable workload. Every table occupied, people waiting in the lobby and outside, you're torn in five different directions and every customer is mad because they've been waiting.

Except you're not serving the food - you're serving chemotherapy. You cannot tell your customers to go elsewhere because they have to stay on the schedule of the chemo regimen. And God forbid in all this rush you make a mistake and dish out the wrong stuff or the wrong amount.

You have to weigh them and quickly figure out if the dose is still appropriate - if they lost too much weight you have to recalculate the doses - don't even think of asking the doctor to do that, they'd laugh at you - just bring your calculations and they'll sign off on it. You have less than 5 min to do that. Then quickly draw their blood while at the same time do their health assessment - if you think you have separate time for assessment you must be smoking crack, because in those 7 minutes you spent with this patient 8 other have arrived and they glare at you. In the meantime your patient's port-a-cath is refusing to give blood, and he has a 6-hour treatment to start pending lab results, it's already noon and you're nowhere near the start. You have less than 5 seconds to decide if you want to "declog" the port because his doctor is walking through the infusion room and will be soon leaving for the hospital. In the meantime 5 more patients arrive. You turn around and notice that your 4 other patients you started treating earlier all need something - usually their IV bags are empty, so you really should be in several places at once. You're paid to work 10 hours doing the work of one person, yet you work more than 12 hours juggling the workload of about 3 people, terrified that if you mess up something because you hurry it can be really, really bad - remember, you're giving cytotoxic stuff intravenously, there's no defense against it, you literally have people's lives in your hands and you hardly have any time to breathe. You forgot what "lunch" was supposed to mean. You're lucky if you get to use a restroom (2 minutes, hurry!) and at the end of the shift don't remember your name... yet you remember you still need to order 5 oxygen tanks - just couldn't get to it today. Work feels like abuse. You get home and just collapse. Next day you come back to work... WHY?!!!

[eternal light]

First time in this thread.

The reason? Barely surviving a workday.

The state of Arizona, where anything goes. California has safety staffing laws, the patient-to-nurse ratio which cannot be exceeded. Arizona has no laws.

Imagine you work in a restaurant, three waitresses called in sick, you show up to work and get punished for showing up by being slammed by just unbelievable workload. Every table occupied, people waiting in the lobby and outside, you're torn in five different directions and every customer is mad because they've been waiting.

Except you're not serving the food - you're serving chemotherapy. You cannot tell your customers to go elsewhere because they have to stay on the schedule of the chemo regimen. And God forbid in all this rush you make a mistake and dish out the wrong stuff or the wrong amount.

You have to weigh them and quickly figure out if the dose is still appropriate - if they lost too much weight you have to recalculate the doses - don't even think of asking the doctor to do that, they'd laugh at you - just bring your calculations and they'll sign off on it. You have less than 5 min to do that. Then quickly draw their blood while at the same time do their health assessment - if you think you have separate time for assessment you must be smoking crack, because in those 7 minutes you spent with this patient 8 other have arrived and they glare at you. In the meantime your patient's port-a-cath is refusing to give blood, and he has a 6-hour treatment to start pending lab results, it's already noon and you're nowhere near the start. You have less than 5 seconds to decide if you want to "declog" the port because his doctor is walking through the infusion room and will be soon leaving for the hospital. In the meantime 5 more patients arrive. You turn around and notice that your 4 other patients you started treating earlier all need something - usually their IV bags are empty, so you really should be in several places at once. You're paid to work 10 hours doing the work of one person, yet you work more than 12 hours juggling the workload of about 3 people, terrified that if you mess up something because you hurry it can be really, really bad - remember, you're giving cytotoxic stuff intravenously, there's no defense against it, you literally have people's lives in your hands and you hardly have any time to breathe. You forgot what "lunch" was supposed to mean. You're lucky if you get to use a restroom (2 minutes, hurry!) and at the end of the shift don't remember your name... yet you remember you still need to order 5 oxygen tanks - just couldn't get to it today. Work feels like abuse. You get home and just collapse. Next day you come back to work... WHY?!!!

The evidenced-based regulation model required the committee as well as regulators to engage in continuously asking challenging questions about practices and asking why the agency is operating in the current manner.

Examples of questions asked were:

• Why are we conducting licensing and investigative programs this way?

• What complaints from the public need to be addressed?

• What regulatory barriers are perceived to not be in the public's best interest in the 2010?

• How should the regulatory agency align the limited resources with the regulatory activities to create the greatest impact?

• Are the identified problems under the Board's control?

We welcome your comments on the proposed changes and will keep you updated on progress on the Arizona State Board of Nursing website: www.azgn.gov

azbn.gov/.pdf

Directory of Issues/Problems and Who to Call

azleg.gov/ombudsman

Anyone can file a complaint with ADOSH regarding unsafe working conditions. A complainant may choose to remain anonymous, if so desired.

ica.state.az.us/faqs/osha

ica.state.az.us/complaint form

[Gegenschein]

Wrong. I dealt with AZBN for two years - they're really good at collecting fees. No help is coming from that direction. Arizona is a right to work state and will always be.

It all goes back to work ethics - or lack thereof. I'm so fed up with people who cannot handle the workload yet won't admit to it. Theoretically, we fully and safely staffed. In reality, I can count the "safely staffed" days on the fingers of one hand in the last year. I'm going to suggest to the manager to interview them on the busiest day, walk them through the infusion room and have them see what it's really like. If you cannot handle it, just be honest and say it. Don't drag it out, calling in sick every few days. Say it and get the fuck out. So we can hire a real person, not a placeholder. We cannot afford to have placeholders on staff. It's patients' safety at stake. I might be cutting too many corners, but I still don't compromise safety. I still infuse oxaliplatin over 2 hours - I don't want my patient to get lasting peripheral nerve damage because we're short-staffed. It's not patients' fault and it shouldn't be. But because 2-3 people cannot admit that this is too busy for them and won't just leave, they hold the positions giving the impression of having enough staff, and the rest of us work at such neck-breaking pace it's scary.

[eternal light]

Wrong. I dealt with AZBN for two years - they're really good at collecting fees. No help is coming from that direction. Arizona is a right to work state and will always be.

It all goes back to work ethics - or lack thereof. I'm so fed up with people who cannot handle the workload yet won't admit to it. Theoretically, we fully and safely staffed. In reality, I can count the "safely staffed" days on the fingers of one hand in the last year. I'm going to suggest to the manager to interview them on the busiest day, walk them through the infusion room and have them see what it's really like. If you cannot handle it, just be honest and say it. Don't drag it out, calling in sick every few days. Say it and get the fuck out. So we can hire a real person, not a placeholder. We cannot afford to have placeholders on staff. It's patients' safety at stake. I might be cutting too many corners, but I still don't compromise safety. I still infuse oxaliplatin over 2 hours - I don't want my patient to get lasting peripheral nerve damage because we're short-staffed. It's not patients' fault and it shouldn't be. But because 2-3 people cannot admit that this is too busy for them and won't just leave, they hold the positions giving the impression of having enough staff, and the rest of us work at such neck-breaking pace it's scary.

This would be a good time to find someone to whom you can effectively delegate the workload while still maintaining quality of services. Taking it on alone will eventually result in burnout as you have already noticed. You need to develop an effective support system. Otherwise you'll remind yourself of Linda Blair in the Exorcist when her head spun around 360 degrees.

Talk to an understanding, supportive person who listens at your workplace if possible or in your local area as a start. An ombuds person at your workplace would be ideal if one is available, if they can be a neutral party and supportive of you and your concerns and handle them confidentially if need be.

Nurses are in a unique position to get involved in public policy advocacy. Many infusion nurses advocate for a change in their organization's policies in order to improve patient outcomes. This act of speaking on behalf of your patients, yourself, and your colleagues translates well into the public policy arena because it involves the same process: becoming informed about an issue, understanding its effects, gathering support, and speaking out to change things.

INS feels that it is important to empower its members to take grassroots action, and to speak for themselves in the locations where they live and work. We hope the information provided on this Web site encourages you to stay abreast of infusion-related legislation at the federal and state levels and to contact your legislators on issues of importance to infusion nurses.

ins1.org

[Electrophile]

Delta Airlines.

So my sister's flight from Valdosta to Atlanta yesterday was delayed. Delayed by so much, she'd have 5 minutes between that flight and the one leaving to Greensboro. There's no way in hell she'd be able to get from B Concourse to D Concourse at Hartsfield in 5 minutes.

So she had to drive 5 hours from Valdosta to Atlanta. In a rental car. Thank God she had a GPS in the car.

Then the flight to Greensboro was delayed. She was supposed to be home by about 7pm last night. We didn't get home until damn near midnight.

She has made up her mind; she is never flying again or leaving the state.

[Mangani]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

[eternal light]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

But even St. Patrick wasn't Irish. He came from either England, Scotland or Wales depending on who is telling the story. He was kidnapped by raiders and taken to Ireland.

[jimmie ray]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

We only cook corned beef once a year, so it seems like today would be the appropriate day to do so. And Darby O'Gill and The Quiet Man are must see movies at this time. We do have some fraction of Irish in us, but don't go too nuts over it - German food and beer is much better, but maybe not the music. There's a movement to change Saint Patrick's Day to "Heritage Day" over here, which is upsetting a tradition very dear to many. We could just pick a day that has no current cultural designation for that, instead - but then the people who need to ruin everything wouldn't like it?

[spats]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

I agree completely. It's just an excuse for a lot of people to get drunk. And who wants to be seen out in public wearing green?? Even for one day. An awful color for clothes.

[Nathan]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

I'm a quarter Irish. Am I qualified to celebrate it?

[longdistancewinner]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

Yes!

I don't get it, either. You have all these idiots going out getting blotto just because it's St. Paddy's Day, and they're not even Irish. I wonder if they'd celebrate St. George's Day with just as much gusto? Probably not. Half of them don't know when that even is!

I don't celebrate it - but I am part-Irish. We may cook something typically 'Irish', but half the time it's what we'd eat on any other day, anyway.

[Electrophile]

I don't care if you're 100% Swedish and celebrating St. Patrick's Day. It's personal choice. I know people who aren't from the US, but they do fireworks and stuff for the 4th of July. A good friend of mine who lives in Vancouver, does a huge backyard barbecue and fireworks. She's not even American, but she has fun with it anyway. I don't personally celebrate Canada Day on July 1st, but if someone wanted to, to each their own.

And I always wear green on St. Patrick's Day. And my socks have shamrocks on them. I'm like 2% Irish, but so what? It's not affecting anything or anyone.

[ally]

I don't care if you're 100% Swedish and celebrating St. Patrick's Day. It's personal choice. I know people who aren't from the US, but they do fireworks and stuff for the 4th of July. A good friend of mine who lives in Vancouver, does a huge backyard barbecue and fireworks. She's not even American, but she has fun with it anyway. I don't personally celebrate Canada Day on July 1st, but if someone wanted to, to each their own.

And I always wear green on St. Patrick's Day. And my socks have shamrocks on them. I'm like 2% Irish, but so what? It's not affecting anything or anyone.

No harm at all celebrating it. If it falls on a day off for me then I usually hit the local for a couple. It's a good excuse for some fun. Mind you, I'm careful about how long I stay as usually there is some sort of donnybrook just waiting to happen . My son works at the Blarney Stone Pub in Gastown and he is just dreading going to work tonight.

[Black Dawg]

People who celebrate and wish 'everyone' a Happy St Patrick's Day.........and aren't even Irish.

Ridiculous.

The only people who should celebrate St Patrick's Day are the Irish.

The real Irish don't care if you celebrate it or not. We'll celebrate by ourselves if we have to.

My pet peeve:

Private Parties

[Virginia]

I'm roughly 1/2 Irish, 1/4 English and 1/4 Italian, give or take a great grandparent or two. Hubby is none of the above. The kids and I wear green on St. Patrick's Day but I don't drink; I never did get drunk on the day, even before kids; but my mom always made corned beef, cabbage and boiled potatoes.

[longdistancewinner]

I don't care if you're 100% Swedish and celebrating St. Patrick's Day. It's personal choice. I know people who aren't from the US, but they do fireworks and stuff for the 4th of July. A good friend of mine who lives in Vancouver, does a huge backyard barbecue and fireworks. She's not even American, but she has fun with it anyway. I don't personally celebrate Canada Day on July 1st, but if someone wanted to, to each their own.

And I always wear green on St. Patrick's Day. And my socks have shamrocks on them. I'm like 2% Irish, but so what? It's not affecting anything or anyone.

In England it's not so much that people celebrate St. Patrick's Day when they're not Irish, it's the fact that they don't celebrate their own patron saint. Not nearly as half as many would celebrate St. George's Day. Some people don't even know the date of it. Would the English celebrate St. Andrew's or St. David's? No, it's not nearly as cool to celebrate those.

That's what bothers me.

[Electrophile]

St. Patrick's Day is synonymous with boozing and being a general party animal. For strict Catholics, obviously it's a lot different. If St. George's Day or St. Andrew's Day or even St. David's Day had a general atmosphere like St. Patrick's Day does, then yeah I think there'd be more people celebrating them.

I don't who was responsible for turning a Catholic feast day into an excuse to be drunk from sunup to sundown, but they basically made it impossible for the true spirit of the day to be celebrated without well.....spirits.

[Gomper]

I don't wear green on St. Patrick's Day because I like to get pinched. It happened several times today.

Of course I only let the pretty ones near me.

[kirchzep27]

Oprah

90million dollar/yr oprah.

[longdistancewinner]

Oprah

90million dollar/yr oprah.

Try Sir Fred Goodwin.

Disgraced banker who lost £24 billion as the head of one of our major banks in Britain - and he's gotten a £1 million 'tax-break', along with his £16 million pension.

What kind of fuckery is that?

[BUCK'EYE' DOC]

Mine today is more of a gripe that a pet peeve:

When I arrived at the office today, one of my patients was waiting for me (without an appointment). He had his artificial eye in his hand. It had become dislodged and he couldn't get it back in. He is in his 70's and is mildly mentally challenged (retarded - not a good word but I don't know how else to describe him, sorry).

So I take him back to my exam room to re-insert it for him (I do this for him three or four times a year, he always just shows up in a panic, no appointment) and I notice that he has new glasses on that he did not get from me. I never charge him for my services, so the least he can do is buy his glasses from me.

Then he tells me that he has had shingles on his face for the last month or so. I examine his eye socket and discover that it is badly infected. That is why the arificial eye would not stay in place. So I gave him a drop of antibiotics, and he tells me that he has just seen an ophthalmologist last week! But he did not get treated for the infection. I am sure that the other doctor did not examine his eye socket because he wouldn't take the time to remove the artificial eye. So I call the other doctor up and make arrangements for the patient to go back over to him for treatment (I could have treated him but I figure that he had started with the other doctor so out of courtesy I sent the patient back to him).

After all this time, doing this for free for the guy, I was about 45 minutes behind schedule and never caught up all day. Thank goodness no one got mad about it. But that made my staff have to stay late tonight also.

The guy is in his 70's and lives alone and I feel sorry for him, but he only comes in when he needs his artificial eye cleaned and re-inserted. If I am his doctor, then he should come to my office for his glasses and for his eye infections as well. And he should make an appointment first or at least call, not just show up with his eye in his hand. (That freaked out my receptionist today. LOL)

[BUCK'EYE' DOC]

Wow Buckeye. I didnt know you were a Dr.

I am an Optometrist, an eye doctor.

That's why I am BUCK'EYE' DOC. LOL

[BUCK'EYE' DOC]

My wife was born with a bad eye. They wont let her have corrective lens surgury in the good eye for fear of something going wrong. now she is getting bifocals. She had the muscle surgery when she was young. I myself had three detached retinas and I dont even wear glasses. I have had cataracts in both eyes. When I lay on my back I see the tiny floater or gas bubble. I had the surgery in the early 2000's. I guess they put in something called a buckle. Is it normal to see it when lying on my back? Every once in a great while Ill see one small black floater. Left eye. I guess this is something that goes with the territory? Hope you dont mind me asking a question about your practice. If you dont want to answer, Ill understand.

Hi Yukon,

You are probably not seeing the gas bubble, as it resolves fairly quickly after the surgery for the detached retina. It is probably a vitreous floater, which is a piece of tissue or protein moving through the vitreous, which is the gel tissue inside the eye which thins as you get older, causing the tiny tissue bits to move more freely and be more noticible. You tend to have more floaters after a detached retina.

I bet that you have a genetic predisposition to having weekly attatched retinas and cataracts.

How is your vision after the detatchments and the cataracts?

Most people don't have the greatest vision after having detached retinas and surgery.

[BUCK'EYE' DOC]

I think very good. Good enough to not requre glasses and I can read the phone book without glasses. Thanks for the info. so you dont think I have anything to worry about in general? I know without seeing me its tough to access, but just wondering if I have to worry down the road?

Have you had the cataracts removed yet?

There is alot of tugging on the eye during cataract removal surgery, and sometimes the retina detatches again afterward.

If you have already had the cataracts removed and it has been some time, then there still is a possibility of having another detatchment down the road. But the longer you go without another detatchment, then the less likely it will happen again.

You definitely need to have your eyes examined regularly and get to your surgeon immediately if you notice any decrease in your vision, flashes of light, increase in floaters, loss of peripheral vision or curtain-like veiling of your vision.