P_Instructor

The ICN Code According to the ICN, a nurse’s primary responsibility is to patients, and she should treat them with respect for their rights, values, customs and beliefs. Personal information she learns about them should remain confidential. In addition, she should continue her learning because she is personally responsible and accountable for good nursing practice and she should take care of her own health so it doesn’t interfere with her ability to care for others. She should co-operate with her co-workers but, if a patient’s health or safety is threatened by others, she must take action to protect them. The ANA Code Like the ICN, the American Nurses Association believes that a nurse’s first commitment is to her patient, and she should have compassion and respect for every individual no matter who they are, what kind of health problems they have, or what social and economic background they come from. A nurse also has a duty to establish, maintain, and improve health care environments and conditions of employment so that high quality health care can be provided. She should work to improve health care locally, nationally, and internationally, and she should also work through her professional associations to influence social policy concerning health care. Finally, she has a duty to maintain her own competence and to grow personally and professionally. Types of Ethical Issues Registered nurses responding to a 2006 survey reported 21 different ethical issues they faced while caring for their patients. These issues included the use of restraints, pain management, determining best interest of the patient, organ donation, life-sustaining treatment and end of life care, reporting errors, dealing with impaired nurses, conflicts of interest, justice for people with disabilities, the ethics of research and the use of information technology and confidentiality. Nurse Dissatisfaction In a study investigating the relationship between ethics and the intent of nurses and social workers to leave their profession, researcher Connie Ulrich, Ph.D., RN discovered that 25 percent of practicing nurses and social workers wanted to leave the field. More than 52 percent of those who responded said they were frustrated with the ethical issues they faced. Hospital workers reported more ethical stress than caregivers who worked in other settings. Nearly 40 percent of hospital workers reported they had no organizational resources to help them with their ethical concerns, while another 25 percent said they had never received any ethical training.

No morals, no ethics. Societal changes that is sending this country downhill. I would own that whole franchise of nursing homes if it was my family member. Triemal04......what do you mean 'POS dispatcher' should be fired? They were trying to do the best they could trying to get assistance to the patient. The only morons in this case were the facility employees that can't/won't do the right thing.

Tough situation....one that you hope is rarely seen. However, can be very taxing when confronted with this type of scenario. One cannot routinely be prepared for this type of call unless working in that area/environment all the time. I would think out of the box and use common sense. On scene, utlilize shifts on the extrication if possible. One idea would be to get the biggest, heftiest tarp available and cover the car/patient to keep the wind off. That would be the biggest problem ... the wind chill (patient and providers). What was the outcome?

UPDATE: EMT Dead Following I-79 Accident in Lewis County Posted: Jan 15, 2013 7:23 AM CST Updated: Jan 15, 2013 11:24 AM CST By Stacy Moniot, Anchor/Reporter - bio | email Courtesy: Jan-Care Ambulance Services Local News UPDATE: EMT Dead Following I-79 Accident in Lewis County Jan-Care Ambulance Services confirmed Tuesday morning that a Jan-Care EMT died following an accident on Interstate 79 in Lewis County. A Jan-Care ambulance was returning to the station from an EMS transport when it collided with a flat bed semi truck Tuesday morning, according to Paul Seamann, Director of Operations at Jan-Care Ambulance Services. Jan-Care EMT, Mark Kinder, 26, was injured in the accident and later died as a result of those injuries at Stonewall Jackson Hospital, Seamann said. Seamann said the paramedic on board was also injured in the accident but has since been treated and released from the hospital. No patient was on-board the ambulance at the time of the accident, according to Seamann. The Lewis County Sheriff's Department said the driver and passenger of the semi truck involved in the fatal crash were not injured. There is no word on the cause of the accident. The Lewis County Sheriff's Department and State Police are investigating the accident. -------------------------------------------------------------------------------- Original Story An ambulance and a flat bed semi truck collided on Interstate 79 south near Weston Tuesday morning and closed the highway for almost two hours. The collision happened south of the Weston exit at mile marker 97.5. Lewis County Sheriff's Department and the Weston Fire Department were called to the scene. An accident reconstructionist was also called in to investigate. Drivers on I-79 south of Weston were stuck for an hour and a half until crews opened the shoulder to allow them to pass through. Crews on the scene and the Lewis County 911 officials were not able to confirm any injuries from the scene. Check back for updates.

We provide this type of document, only if requested for a specific purpose. Usually for nursing students that need it (HCP only) before going out to do clinicals. They're the main culprits.....and the requesting agency or whomever must be notified and will authorize an acceptance of the form letter. We usually only provide a few of these. Less that 1% of the total thousands of people that go thru the HCP class.

Not the reason I retired from flying, but starting to think it was a good idea. Hits close to home as this program is a sister program to the one I flew for. Condolences for all the families of the crew, and also the co-workers. Sad, sad, sad......

Once, I repeat once, and never again.......Ipecac in the field. Can we say 'paint the walls with puke?"

Yeah, good ole times. Remember all the Verapamil that was given for SVT? Stuff actually worked good.

Glad your back!

The state of Iowa in it's infinite wisdom (ha) had all sorts of levels from FR (A)(D), etc., EMT A, B, Defib, etc, EMTI (85), EMTP (99I), Paramedic Specialist (PS), blah, blah, blah. They finally decided to get things changed to be more in line with the National Standards. Like other states whom are changing, the only levels will be EMR (all the old First Responder levels and endorsements), EMT (with all the other old endorsements), AEMT (new level above the old 85I and below the 99I), and Paramedic. Iowa's 99I level was considered as an Iowa Paramedic in this state only. The Paramedic Specialist was anyone that completed the Paramedic level, so they had to delineate the levels. If you are a current 85I, you will have to take further classes and con-ed, then take the NREMT AEMT test. If you opt not to go to this level, then you will drop to the EMT level. If you are a current 99I, you will have to take other classes and con-ed, then take the NREMT Paramedic test. If you opt not to go to this level, then you will drop to the AEMT level. In essence, Iowa is only cleaning up the mess of a numerous number of levels and endorsements to the now 4 levels of provider. Of course, this should have been done years ago, but now there is still a delay and some providers have a couple of years to decide or transition.

Just a question out there.....how many of you 'old' medics ever have Physostigmine and Nifedipine in your drug boxes. Then, did you ever have the chance in using one or both of them before. This is purely a question in 'wondering'. Oh yeah, I'm talking prehospital, not in house.

Dependant on the extent of impact as previously questioned (how deep of ravine, etc.) you have the initial cardiac symptoms to think about, the traumatic event and possible injuries sustained from this, and with the seat belt marks, this would indicate enough impact to cause any structural chest injury. Another concern would be cardiac contusion.

Now the real hard part starts.....con-ed, puke, blood, guts, gore; hair, eyeballs, and teeth. Good job and don't kill anyone

I am sorry and sympathetic towards my New York bretheren in EMS. I am not usually political, but your mayor is an idiot. They should have cancelled immediately and not have the publicity. If they run it, why don't they have the runners 'run' the provisions up the 20+ flight of steps to the elderly that can't get it for themselves......

With the chest pain and the adequate perfusion, anyone interested in trying Cardizem?

Thank you!!!

Respirations are useful for reporting your vital signs. However, the point that should be looked at is if the respirations are adequate for survival of the cells. This along with cardiac perfusion should be monitored much more than the number of breaths per minute. Waveform capnography is cool, but in the initial stages of patient assessment, are the respirations, whatever they may be, adequate enough? Otherwise, to answer your inquiry, all previous posters have garnered through experience how to count respirations by different techniques, All are good, so try them out and figure what best works for you.

Knee jerk reaction and thought.....any increased respiratory difficulty and or neck swelling due to sq air in tissues? (will go on from there)

Sorry for any 'intent' on my last post. Don't sue me . The post has generated ideas of how to handle a call like this. One must realize that legal matters can differentiate state to state, etc. The main purpose is do you really have that obligation to take the patient legally against their wishes, alibeit orders, ethics, morality, etc. To identify, try to adapt to, and also try to institute ways to transport, or get the patient to go can vary. What else can you think of?

OK Mike, grab him, strap him, sedate him, take him......get to the psych consult and find out the guy is sane. There goes your so-called pension.

Welcome to the world of emtcity.