Monday, November 21, 2011

Connecticut Nurses on: The Nurse Friendly

Connecticut Nurses on: The Nurse Friendly

New!

Sharon Gauthier RN/MSN-iRNPA, Patient Advocate for You, LLC:"Our services coordinate care, educate patients and families, collaborate with your healthcare team and support your needs with a personal seasoned RN patient advocate. We do not provide hands on care and don't replace home care agencies. We are adjunct to your support system while expanding your resources to stay well. Relieving your stress is our expertise. We are your voice helping you navigate through the system. We tell your story and make sure someone listens. We are a well respected addition to your present healthcare team by your side throughout the system you are in, evaluating, collaborating, educating and supporting you and your family."
Sharon Gauthier RN/MSN-iRNPA
[c] Patient Advocate for You, LLC (PAFY,LLC)
100 Pearl Street Hartford, CT 06103
ph: 860-249-7271 | fax: 866-281-5768
Facebook: http://www.facebook.com/pages/Patient-Advocate-for-You-LLC/128616980502014
LinkedIn: http://www.linkedin.com/in/sharonadvocate
Twitter: http://twitter.com/#!/ptadvocate4u
http://www.ptadvocate4u.com/

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Kristy Kamen, RN, BSN, LNC, Connecticut Nurses, Cardiac, Surgical, Operating Room Nursing
http://www.nursefriendly.com/kamen/

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Krin, Patricia, RN BSN C.S.N

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Alicia Sable Hunt, Founder & President of Sable's Foods, @SablesFoods Connecticut:""As a Registered Nurse, it is my role to collaborate with the healthcare team to educate the patient and provide them with the skills they need to travel the cancer journey. After years of working with cancer patients, I decided to develop a handcrafted bar focusing on their nutritional, taste and texture needs. I am proud to offer my bars to the cancer population as part of a nutritionally balanced diet." – Sable, RN and Founder"
"Nutritious Foods Created For The Cancer Community. Founded, owned & run by an Oncology Nurse."
Sable-Hunt, LLC dba Sable's Foods
111 Saugatuck Avenue
Westport, CT 06880
877.21SABLE (877.217.2253)
info@sablesfoods.com
Blog: http://www.sablesfoods.com/sables-food-blog
LinkedIn: http://www.linkedin.com/in/alicasablehunt
Twitter: https://twitter.com/#!/SablesFoods
http://www.sablesfoods.com

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Williams, Karen, RN BSN

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Department/Specialties Represented: In-patient rehabilitation physical medicine & School Nursing

See also:

Connecticut Nurses Association:
http://www.ctnurses.org/

Connecticut.com: Connecticut Tourist Information
http://www.connecticut.com/

Schools:

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Bridgeport Hospital / School of Nursing:"Bridgeport Hospital School of Nursing offers a two-year hospital-based nursing program. The curriculum, based on the School's philosophy, objectives and organizing framework is comprised of forty credits in nursing and thirty credits in biological, behavioral and social sciences. Sequential introduction of core knowledge courses supports the core constructs and core behaviors of the nursing program."
Bridgeport Hospital School of Nursing
200 Mill Hill Avenue
Bridgeport, CT 06610
Phone: (203) 384-3205
Fax: (203) 384-3046
E-mail: nytorr@bpthosp.org
http://www.bhson.com/


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Capital Community College / Department of Nursing:"Our Associate Degree Nursing Program is of prime importance at Capital. It is the largest nursing program in the state of Connecticut. It is a rigorous and challenging program that graduates Associate Degree Nurses who are in great demand. Virtually all of our graduates are now practicing nurses and the demand for them shows no signs of diminishing. We stand proud of their many contributions to patients and families in all practice settings. Feedback to us from their employers testifies to their satisfaction with the performance of Capital's nursing graduates. Our Associate Degree Nursing Program is fully accredited by the National League for Nursing Accrediting Commission (NLNAC) http://www.nlnac.org and the Connecticut State Board of Nursing."
Capital Community College
950 Main Street
Hartford, Connecticut 06103-1207
(860) 906-5000 or (800) 894-6126
E-mail: cadams@ccc.commnet.edu
http://webster.commnet.edu/dpNursing.htm

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Central Connecticut State University / Nursing Dept:"The nursing program was established in 1981 and accredited by the National League for Nursing (NLN) in 1986 and 1994. The program was accredited by the Commission on Collegiate Nursing Education (CCNE) in 2001, which is a branch of the American Association of Colleges of Nursing (AACN)."
Central Connecticut State University
1615 Stanley Street
New Britain, Connecticut 06050
Department of Nursing
Barnard Hall, Room 312
Phone: 860.832.0032
Fax: 860.832.2188
E-mail: williamsca@ccsu.edu
http://www.ccsu.edu/nursing/

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Fairfield University / School of Nursing:"The Fairfield University School of Nursing curriculum prepares future nurses at the baccalaureate and master's level in an exciting environment that not only includes classroom and clinical laboratory learning experiences on campus, but also opportunities to care for patients at numerous clinical sites. These sites are located in hospitals, nursing homes, clinics, and community agencies. Additionally, students are prepared for leadership roles in all health care settings."
Fairfield University
1073 North Benson Road
Fairfield CT 06824
(203) 254-4000
E-mail: admis@mail.fairfield.edu
http://www.fairfield.edu/x838.xml

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Hospital of St. Raphael / School of Nurse Anesthesia:"The philosophy of the Hospital of Saint Raphael School of Nurse Anesthesia is to provide society with highly competent nurse anesthesia practitioners. In order to fulfill this responsibility, the Hospital of Saint Raphael School of Nurse Anesthesia provides its students with a broad clinical and didactic experience, which is in keeping with the current standards and guidelines set by the Council on Accreditation of Educational Programs of Nurse Anesthesia."
Hospital of Saint Raphael
1423 Chapel Street
New Haven, CT 06511-4458
Telephone:(203) 789-3351 or Fax (203) 789-3352
E-mail: info@hsrsna.com
http://www.hsrsna.com/

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Naugatuck Valley Community College / Division of Allied Health:"Nursing is an essential health service and is dependent on the understanding of concepts which have physical, social, and biological sciences as their foundation. The NVCC Nursing Program includes courses in science, liberal arts, and nursing. Learning takes place in the classroom, the college laboratories, and a variety of health care settings including hospitals, nursing homes, and community agencies. The graduate of this program is awarded an Associate in Science degree in Nursing and is eligible to take the NCLEX-RN (registered nurse licensure examination)."
Naugatuck Valley Community College
Division of Allied Health
E600 Ekstrom Hall
750 Chase Parkway
Waterbury, CT 06708
(203) 596-8746
E-mail: jottman@nvcc.commnet.edu
http://www.nvcc.commnet.edu/allied_health/nursing.shtml

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New Britain School of Nurse Anesthesia:"The NBSNA in conjunction with Central Connecticut State University awards a Master of Science Degree in Biological Sciences: Anesthesia. Graduates are entitled to take the national certification exam for Certified Registered Nurse Anesthetists (CRNA) and are eligible for full, active membership in the American Association of Nurse Anesthetists (AANA)."
New Britain School of Nurse Anesthesia
100 Grand Street
New Britain, CT 06050
E-mail: jhdobbin@nbgh.org
http://www.nbsna.org/

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New England Technical Institute:"Your goal is to become a Licensed Practical Nurse. You extend comfort and care in sickness and in health. The money is good. The jobs are plentiful. You see, there's a dramatic shortage of nurses so you're in charge. New England Tech's team of nursing instructors leads you through a comprehensive curriculum including extended care, maternity and child development, geriatrics, and gerontology."
New England Technical Institute
200 John Downey Drive
New Britain, CT 06051
Tel: (860) 225-8641 or Fax: (860) 224-2983
http://www.lincolnedu.com/campus/hamden-ct

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Norwalk Community College / Division of Nursing & Allied Health:"The nursing program is a two year/five semester program. Upon completion graduates receive an associate of science degree. Graduates of the NCC Nursing Program are eligible to take the National Council of State Boards of Nursing's National Examination for Registered Nurse Licensure (NCLEX-RN)."
Norwalk Community College
188 Richards Avenue
Norwalk, CT 06854-1655
(203) 857-7122
http://www.ncc.commnet.edu/dept/alliedHealth/nursingProgram.asp

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Quinnipiac University / Nursing Program:"Our nursing students are prepared to enter professional nursing practice as skilled providers of holistic care for families and individuals of all ages and diverse cultural backgrounds, in a variety of settings. Accredited by the National League for Nursing Accrediting Commission,* Quinnipiac's bachelor's degree program in nursing offers theoretical and clinical education as well as preparation for the National Council Licensure Examination for Registered Nurses (NCLEX-RN)."
Quinnipiac University
275 Mount Carmel Ave.
Hamden, CT 06518
(203) 582-8200
E-mail: nursing@quinnipiac.edu
http://www.quinnipiac.edu/x740.xml

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Emergency Department (ER, Casualty, Trauma) Nurses on: The Nurse Friendly

Emergency Department (ER, Casualty, Trauma) Nurses on: The Nurse Friendly

Please choose from the following:

New!

Sharon Gauthier RN/MSN-iRNPA, Patient Advocate for You, LLC:"Our services coordinate care, educate patients and families, collaborate with your healthcare team and support your needs with a personal seasoned RN patient advocate. We do not provide hands on care and don't replace home care agencies. We are adjunct to your support system while expanding your resources to stay well. Relieving your stress is our expertise. We are your voice helping you navigate through the system. We tell your story and make sure someone listens. We are a well respected addition to your present healthcare team by your side throughout the system you are in, evaluating, collaborating, educating and supporting you and your family."
Sharon Gauthier RN/MSN-iRNPA
[c] Patient Advocate for You, LLC (PAFY,LLC)
100 Pearl Street Hartford, CT 06103
ph: 860-249-7271 | fax: 866-281-5768
Facebook: http://www.facebook.com/pages/Patient-Advocate-for-You-LLC/128616980502014
LinkedIn: http://www.linkedin.com/in/sharonadvocate
Twitter: http://twitter.com/#!/ptadvocate4u
http://www.ptadvocate4u.com/

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Judi S. Brantley, RN BSN MEd. Certified Legal Nurse Consultant, Charleston Medical Legal Consultants, South Carolina Legal Nurse Consultants, Nursing Entrepreneurs, Nurse-Owned Businesses:Charleston Medical Legal Consultants, LLC provides Case Analysis for Medical Malpractice cases. This includes, but not limited to:

  1. Inventory for necessary medical records
  2. Screening for merit
  3. Identify adherences to/deviations from Standards of Care
  4. Medical story
  5. Chronologies with Lexis Nexis CaseMap/TimeMap
  6. Rendering list of potential defendants
  7. Educate in medical questions
  8. Medical Research
  9. Assist in locating expert witnesses
  10. Charleston Medical Legal Consultants, LLC
    3575 Maybank Hwy., Suite D192
    Johns Island, South Carolina 29455
    Email Address: judibrantley@gmail.com
    http://www.legalnursingconsultant.com/charleston/

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    Carol J. Rhodes RN, LNC, Medical-Legal Remedies Inc (MLR):"Medical-Legal Remedies Inc (MLR) provides medical-legal Litigation Support Services for Legal Professionals that include Legal Nurse Consulting, Paralegal Litigation Support, a Medical Information Service called Virtual Legal Nurse and Medical Expert Referral Service for Attorneys, Insurance Companies, Hospital Risk Managers, Government, and Claims Management. MLR MLR's Paralegal Staff and Legal Nurse work together as a team to assist our legal clients with comprehensive medical-legal litigation issues and are committed to serve clients by offering our extensive experience and expertise to provide specialized high quality medical-legal litigation support services. By utilizing Medical-Legal Remedies Inc Paralegal/Legal Nurse Team allows the litigator to control costs and increase revenues while securing the competitive advantage with superior work products. So whether your firm or company needs a Paralegal, a Legal Nurse, or both - MLR will assist your firm or company with any medical-legal litigation case project."
    Carol J. Rhodes RN, LNC
    14286-19 Beach Blvd. #248
    Jacksonville, FL 32250
    (904) 223-3969
    Carol@JaxLegalNurse.com or Carol@VirtualLegalNurse.com
    LinkedIn: http://www.linkedin.com/pub/carol-j-rhodes/30/81b/685
    http://www.jaxparalegal.com/

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    Larry Snyder, BA, RN, DBA, RN.ORG, SA, Nursing Continuing Education Providers:"Larry Snyder, RN is the Founder and President of RN.ORG®, SA. As a licensed healthcare professional with over 15 years of experience in nursing as well as a computer authority with in-excess of 20 years of experience, he is knowledgeable with the integration of healthcare and computers and sees a strong need for licensed professionals to maintain their license in an easy, convenient, comfortable no stress environment. Larry has worked in various aspects of nursing in many states in both large and small hospitals and has the experience and background to make healthcare and nursing education friendly. Larry also functioned as a consulant at large corporations in various aspects of IT management including CBS Sports, Sportsline.com, Sports.com, Universal Studios, Nickelodeon, Viacom, Flexsys and Monsanto. Larry also has served as an expert witness on several high profile cases throughout the United States sharing his valuable input as an experienced Emergency Room nurse."
    Latin America Office (Corporate Offices)
    Larry Snyder - RN.ORG®, SA
    CR 15A # 10A-03
    El Poblado, Medellin, Colombia
    Hospital Sales (English) USA: 1-954-369-4556
    Hospital Sales (Español - E.E.U.U): 1-860-786-1866
    E-mail Address: info@rn.org
    Blogs, Social Media (Twitter, Linkedin, Facebook, etc): http://www.facebook.com/MedellinRN
    http://www.linkedin.com/pub/dir/Larry/Snyder
    http://www.twitter.com/wwwRNorg
    Phone number: 954-369-4556
    Website: http://www.rn.org
    http://www.nursingentrepreneurs.com/snyder/

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    Jennifer A. Grisso, RN BSN LNC, GrissoMedLegal:"Experienced RN with recent experience in most areas including: Telemetry, Cardiac, CCU, Stepdown, MedSurg, ER, ICU, Ambulatory, Telephonic Triage, Telephonic Disease Management. We bridge the legal and medical world. We are involved in any type of litigation that involves injury or illness, to save you time and money on the medical record, research, chronology. Also we help you prepare for depositions, mediation, or trial, all at a lower cost than other medical professionals."
    Jennifer A. Grisso, RN BSN LNC
    GrissoMedLegal
    8640 Springfield
    Skokie, IL, 60076
    Phone: 847-204-2084
    Email: Jennifer@grissoinc.com
    Linkedin: http://www.linkedin.com/in/jenniferagrisso
    Twitter: http://twitter.com/Grissomedlegal
    http://grissomedlegal.com/

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    About Emergency Department Nurses:

    Emergency Nurse, Nurses for a Healthier Tomorrow:"Emergency nurses specialize in rapid assessment and treatment when every second counts, particularly during the initial phase of acute illness and trauma. Emergency nurses must tackle diverse tasks with professionalism, efficiency, and above all—caring. Emergency nursing is a specialty area of the nursing profession like no other. To provide quality patient care for people of all ages, emergency nurses must possess both general and specific knowledge about health care to provide quality patient care for people of all ages. Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack. There are approximately 90,000 emergency nurses in the US."
    Nurses for a Healthier Tomorrow/STTI
    Honor Society of Nursing, Sigma Theta Tau International
    550 West North Street Indianapolis, IN 46202
    bennison@stti.iupui.edu
    http://www.nursesource.org/emergency.html


    Lucille "Lou" Addington, RN, CLNC, Florida:"We do medical-legal consulting for attorneys, insurance companies and HMO's, and private individuals. Presuit investigations and affidavits. Expert witness location. Special interest in vaccine damage cases and long term care/elder care issues. My associate and I bring a combined 42 years of professional nursing practice to our cases."
    http://www.nursingentrepreneurs.com/addington

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    Battistella Kasey BSN, Louisiana

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    Brady, Karen Bryant, RN, EMT/Paramedic Instructor, Kentucky
    http://www.nursefriendly.com/brady/

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    Bulfamante, Joyce, RN BSN, New York

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    Bykowski, David, Nurse Entrepreneur, Texas Nursing Entrepreneurs:"I have a great interest in holistic medicine I am questioned many times as to why I sell products My answer is simple to spread the holistic approach You may ask how selling products spreads the holistic approach Well I have found that I can preach holistic philosophy all day long and accomplish very little but if I can change a persons life via the use of a natural substance not only have I won them over but all the people they share their joy with. Thus I find selling products is more effective than merely preaching the benifits of holistic health."
    Specialty Areas: ER, ICU, Psych and Home Health
    http://www.nursefriendly.com/bykowski

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    Callueng, Ronel RN CCRN, Delaware, Nurse Entepreneur

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    Cari Caruso, RN SANE-A, Forensic Nurse Professionals, Inc., California Nurse Entrepreneurs:"Forensic Services: Forensic Sexual Assault, Evidentiary Exams for Victims and Suspects, Domestic/Interpersonal Violence evaluations and Photography, Consulting for Defense and Prosecuting Attorneys, Expert Testimony, Education."
    Specialty Areas:

Emergency Department (ER, Casualty, Trauma) Nurses on: The #NurseFriendly #emergency #nursing #trauma #nursingstudents #nurses #healthcare

Please choose from the following:

New!

Sharon Gauthier RN/MSN-iRNPA, Patient Advocate for You, LLC:"Our services coordinate care, educate patients and families, collaborate with your healthcare team and support your needs with a personal seasoned RN patient advocate. We do not provide hands on care and don't replace home care agencies. We are adjunct to your support system while expanding your resources to stay well. Relieving your stress is our expertise. We are your voice helping you navigate through the system. We tell your story and make sure someone listens. We are a well respected addition to your present healthcare team by your side throughout the system you are in, evaluating, collaborating, educating and supporting you and your family."
Sharon Gauthier RN/MSN-iRNPA
[c] Patient Advocate for You, LLC (PAFY,LLC)
100 Pearl Street Hartford, CT 06103
ph: 860-249-7271 | fax: 866-281-5768
Facebook: http://www.facebook.com/pages/Patient-Advocate-for-You-LLC/128616980502014
LinkedIn: http://www.linkedin.com/in/sharonadvocate
Twitter: http://twitter.com/#!/ptadvocate4u
http://www.ptadvocate4u.com/

******************************************************

Judi S. Brantley, RN BSN MEd. Certified Legal Nurse Consultant, Charleston Medical Legal Consultants, South Carolina Legal Nurse Consultants, Nursing Entrepreneurs, Nurse-Owned Businesses:Charleston Medical Legal Consultants, LLC provides Case Analysis for Medical Malpractice cases. This includes, but not limited to:

  1. Inventory for necessary medical records
  2. Screening for merit
  3. Identify adherences to/deviations from Standards of Care
  4. Medical story
  5. Chronologies with Lexis Nexis CaseMap/TimeMap
  6. Rendering list of potential defendants
  7. Educate in medical questions
  8. Medical Research
  9. Assist in locating expert witnesses
  10. Charleston Medical Legal Consultants, LLC
    3575 Maybank Hwy., Suite D192
    Johns Island, South Carolina 29455
    Email Address: judibrantley@gmail.com
    http://www.legalnursingconsultant.com/charleston/

    ******************************************************

    Carol J. Rhodes RN, LNC, Medical-Legal Remedies Inc (MLR):"Medical-Legal Remedies Inc (MLR) provides medical-legal Litigation Support Services for Legal Professionals that include Legal Nurse Consulting, Paralegal Litigation Support, a Medical Information Service called Virtual Legal Nurse and Medical Expert Referral Service for Attorneys, Insurance Companies, Hospital Risk Managers, Government, and Claims Management. MLR MLR's Paralegal Staff and Legal Nurse work together as a team to assist our legal clients with comprehensive medical-legal litigation issues and are committed to serve clients by offering our extensive experience and expertise to provide specialized high quality medical-legal litigation support services. By utilizing Medical-Legal Remedies Inc Paralegal/Legal Nurse Team allows the litigator to control costs and increase revenues while securing the competitive advantage with superior work products. So whether your firm or company needs a Paralegal, a Legal Nurse, or both - MLR will assist your firm or company with any medical-legal litigation case project."
    Carol J. Rhodes RN, LNC
    14286-19 Beach Blvd. #248
    Jacksonville, FL 32250
    (904) 223-3969
    Carol@JaxLegalNurse.com or Carol@VirtualLegalNurse.com
    LinkedIn: http://www.linkedin.com/pub/carol-j-rhodes/30/81b/685
    http://www.jaxparalegal.com/

    ******************************************************

    Larry Snyder, BA, RN, DBA, RN.ORG, SA, Nursing Continuing Education Providers:"Larry Snyder, RN is the Founder and President of RN.ORG®, SA. As a licensed healthcare professional with over 15 years of experience in nursing as well as a computer authority with in-excess of 20 years of experience, he is knowledgeable with the integration of healthcare and computers and sees a strong need for licensed professionals to maintain their license in an easy, convenient, comfortable no stress environment. Larry has worked in various aspects of nursing in many states in both large and small hospitals and has the experience and background to make healthcare and nursing education friendly. Larry also functioned as a consulant at large corporations in various aspects of IT management including CBS Sports, Sportsline.com, Sports.com, Universal Studios, Nickelodeon, Viacom, Flexsys and Monsanto. Larry also has served as an expert witness on several high profile cases throughout the United States sharing his valuable input as an experienced Emergency Room nurse."
    Latin America Office (Corporate Offices)
    Larry Snyder - RN.ORG®, SA
    CR 15A # 10A-03
    El Poblado, Medellin, Colombia
    Hospital Sales (English) USA: 1-954-369-4556
    Hospital Sales (Español - E.E.U.U): 1-860-786-1866
    E-mail Address: info@rn.org
    Blogs, Social Media (Twitter, Linkedin, Facebook, etc): http://www.facebook.com/MedellinRN
    http://www.linkedin.com/pub/dir/Larry/Snyder
    http://www.twitter.com/wwwRNorg
    Phone number: 954-369-4556
    Website: http://www.rn.org
    http://www.nursingentrepreneurs.com/snyder/

    ******************************************************

    Jennifer A. Grisso, RN BSN LNC, GrissoMedLegal:"Experienced RN with recent experience in most areas including: Telemetry, Cardiac, CCU, Stepdown, MedSurg, ER, ICU, Ambulatory, Telephonic Triage, Telephonic Disease Management. We bridge the legal and medical world. We are involved in any type of litigation that involves injury or illness, to save you time and money on the medical record, research, chronology. Also we help you prepare for depositions, mediation, or trial, all at a lower cost than other medical professionals."
    Jennifer A. Grisso, RN BSN LNC
    GrissoMedLegal
    8640 Springfield
    Skokie, IL, 60076
    Phone: 847-204-2084
    Email: Jennifer@grissoinc.com
    Linkedin: http://www.linkedin.com/in/jenniferagrisso
    Twitter: http://twitter.com/Grissomedlegal
    http://grissomedlegal.com/

    ******************************************************

    About Emergency Department Nurses:

    Emergency Nurse, Nurses for a Healthier Tomorrow:"Emergency nurses specialize in rapid assessment and treatment when every second counts, particularly during the initial phase of acute illness and trauma. Emergency nurses must tackle diverse tasks with professionalism, efficiency, and above all—caring. Emergency nursing is a specialty area of the nursing profession like no other. To provide quality patient care for people of all ages, emergency nurses must possess both general and specific knowledge about health care to provide quality patient care for people of all ages. Emergency nurses must be ready to treat a wide variety of illnesses or injury situations, ranging from a sore throat to a heart attack. There are approximately 90,000 emergency nurses in the US."
    Nurses for a Healthier Tomorrow/STTI
    Honor Society of Nursing, Sigma Theta Tau International
    550 West North Street Indianapolis, IN 46202
    bennison@stti.iupui.edu
    http://www.nursesource.org/emergency.html


    Lucille "Lou" Addington, RN, CLNC, Florida:"We do medical-legal consulting for attorneys, insurance companies and HMO's, and private individuals. Presuit investigations and affidavits. Expert witness location. Special interest in vaccine damage cases and long term care/elder care issues. My associate and I bring a combined 42 years of professional nursing practice to our cases."
    http://www.nursingentrepreneurs.com/addington

    ******************************************************

    Battistella Kasey BSN, Louisiana

    ******************************************************

    Brady, Karen Bryant, RN, EMT/Paramedic Instructor, Kentucky
    http://www.nursefriendly.com/brady/

    ******************************************************

    Bulfamante, Joyce, RN BSN, New York

    ******************************************************

    Bykowski, David, Nurse Entrepreneur, Texas Nursing Entrepreneurs:"I have a great interest in holistic medicine I am questioned many times as to why I sell products My answer is simple to spread the holistic approach You may ask how selling products spreads the holistic approach Well I have found that I can preach holistic philosophy all day long and accomplish very little but if I can change a persons life via the use of a natural substance not only have I won them over but all the people they share their joy with. Thus I find selling products is more effective than merely preaching the benifits of holistic health."
    Specialty Areas: ER, ICU, Psych and Home Health
    http://www.nursefriendly.com/bykowski

    ******************************************************

    Callueng, Ronel RN CCRN, Delaware, Nurse Entepreneur

    ******************************************************

    Cari Caruso, RN SANE-A, Forensic Nurse Professionals, Inc., California Nurse Entrepreneurs:"Forensic Services: Forensic Sexual Assault, Evidentiary Exams for Victims and Suspects, Domestic/Interpersonal Violence evaluations and Photography, Consulting for Defense and Prosecuting Attorneys, Expert Testimony, Education."
    Specialty Areas:

--

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

Visit our network of sites. Over 150,000 + Nurse Selected, Approved Nursing & Healthcare Resources:

For Health Information you can use, Follow, Connect, Like us on Facebook, Google +, LinkedIN, Twitter, StumbleUpon (Most Invites Accepted):
http://www.nursefriendly.com/social/

4nursing.com:"In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, CNAs, LPNs, RNs, Travel Nursing, Prescriptions Drugs, Medications, Nursing Associations and much more."
http://www.4nursing.com

InspirationalNursing.com:"InspirationalNursing.com. Touching Poems, and Inspiring stories that touch the heart and occasionally bring a tear to your eye. Affection, Ambition, Angels In Our Lives, Animals, Babies, Bereavement, Caring, Caring, Children, Christian Stories, Christmas, Computers & The Internet, Death, Dependability, Determination, Dying, Easter, Emergency Medical Services (EMS), End of Life, Etc., Friendship, God's Creatures, Grief, Holiday Thoughts, Honesty, Hospice Poems, etc."
http://www.inspirationalnursing.com

Jocularity.com (Former home to the Journal of Nursing Jocularity (JNJ)):"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
http://www.jocularity.com

Legalnursingconsultant.com:"This website is intended to be a resource for Legal Nurse Consultants, Attorneys looking to use their services, and nurses looking to enter the field of Legal Nurse Consulting. On our site you'll find a directory of LNCs by state and specialty."
http://www.legalnursingconsultant.com

Nursefriendly.com:"Nationwide Nursing Resources: In this Nursing Portal you'll find information on Nursing Jobs, Nursing Schools, Nurse Degrees, LPNs, RNs, APNs, Nursing Associations and much more."
http://www.nursefriendly.com

Nursinga2z.com:"It is our intent for this Alphabetical, A to Z index to be a comprehensive listing (In Progress) of Nursing-related resources on the Internet. It is indexed by Google and fully searchable."
http://www.nursinga2z.com

Nursingdiabetics.com:"Welcome to NursingDiabetics.com. Here you will find information on all aspects of Diabetes, a disease that afflicts millions of people world wide. I'll be adding pages as fast as I can research the information so remember to bookmark this page and return."
http://www.nursingdiabetics.com

Nursingdiscussions.com:"This website will be a portal to Nursing Discussion boards throughout the Web. If your site has a discussion board we don't have listed here, please contact us."
http://www.nursingdiscussions.com

Nursingentrepreneurs.com:"Nationwide Nursing resource to nurse entrepreneurs looking to nework and start home based businesses. On it you will find links to small and large business related resources."
http://www.nursingentrepreneurs.com

Nursinghumor.com:"Nursing & Medical Humor. Find hundreds of jokes and links to sites that will make you smile. Therapeutic Humor Associations, Battle of the Sexes, Bedside Nursing Humor, Brain Teasers, Clowning, Clowns, Therapeutic Humor & Comedy Links, Dental Humor, Emergency Department Humor, General Nursing Humor, Geriatrics, Senior Citizen, etc."
http://www.nursinghumor.com

Patient Left Unrestrained, #Patient Injured. #Nurses Judgement Call, #nursing #malpractice #nursefriendly #epatient #negligence

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Summary: The decision to use or not use restraints must be made with caution and good judgement. Their intended purpose must be to protect either the patient or others who may be injured by the patient including the staff caring for the client. The ultimate determination of necessity is left with the physician. Often, the moment to moment necessity is determined by the nurse. In this case a nurse did not feel restraining the patient was necessary. When an injury occurred, the patient sued.

The patient was involved in a motor vehicle accident. A head injury was suffered leaving him in a state of confusion and prone to agitation.

"Each year, an estimated 2 million people sustain a head injury. About 500,000 to 750,000 head injuries each year are severe enough to require hospitalization. Head injury is most common among males between the ages of 15-24, but can strike, unexpectedly, at any age. Many head injuries are mild, and symptoms usually disappear over time with proper attention. Others are more severe and may result in permanent disability." 2

Following the head injury, the patient was visibly confused and frequently became agitated. During the course of his admission, an order for "soft" wrist restraints was obtained and implemented to protect the patient from injury related to mental status (personality) changes.

"Personality Changes-Apathy and decreased motivation. Emotional lability, irritability, depression. Disinhibition which may result in temper flare-ups, aggression, cursing, lowered frustration tolerance, and inappropriate sexual behavior."2

On the day of the incident, the nurse on duty had assessed the patient. In her professional opinion restraints were not needed.

"What Is Restraint?

"Restraint" is physical force, mechanical devices, chemicals, seclusion, or any other means which unreasonably limit freedom of movement. hospital staff may use four types of restraint to restrict patients who are acting, or threatening to act, in a violent way towards themselves or others.

Physical restraint--holding a patient for over five minutes in order to prevent freedom of movement.

Mechanical restraint--using a device, such as 4-point or full sheet restraint, to restrict a patient's movement (excludes devices prescribed for medical purposes).

Chemical restraint--medicating a patient against her will for the purpose of restraint rather than treatment.

Seclusion--placing a patient alone in a room so that she cannot see or speak with patients or staff and the patient cannot leave or believes she cannot leave."3

She based this decision on her observation of the patient's mental, physical state and level of consciousness. It is common procedure and protocol in facilities for patient's to be released from restraints when the danger of violence is felt to have passed.

"How Long May Restraint Continue?

When an emergency no longer exists, the patient should be released. Thus, staff should release a patient who, upon examination, appears calm. The total time which a patient may be restrained is limited:"3

Later in the shift, the same nurse was helping the patient get up. In the course of this maneuver, the patient fell and claimed that an injury was sustained.

A lawsuit would be filed against the facility alleging negligence on the part of the nurse. The patient contended that the removal of the restraints breached standards of care.

In the initial trial, the jury was instructed to view the nurse's role as an "error in judgement." Based on this and on testimony on the proper use of restraints, standards of care, the court found for the facility.

The patient appealed.

Questions to be answered:

1. Was the nurse in error to remove the restraints from a patient when she felt they were no longer needed.

2. Did the removal of the restraints directly contribute to the "injury" that the patient claimed to sustain?

3. Were the standards of care governing restraint use adequately maintained?

The plaintiff's arguments sought to convince the jury that poor judgement was exercised by the nurse. It was contended that removal of the restraints and ambulation of the patient put him in harm's way.

With the patient assessed to be calm, the purpose of the restraints, "to prevent the patient from harming himself or others," had been achieved.

The purpose of the restraints had not been to "keep the patient from falling out of bed." The removal of the restraints then, could not be deemed as negligent. There was no duty of care breached in allowing the calm patient to remain unrestrained.

The order was in place to ambulate the patient when stable. In the nurse's opinion, the patient was ready. Another nurse may not have agreed with her actions. The patient under a different nurse's care might have been kept in restraints. A nurse could have "held off" on the order to ambulate.

There was no causative relationship between removing the restraints and the patient's fall. In carrying out orders for ambulation, the nurse was providing proper nursing care.

It's not difficult to picture a lone nurse with an unsteady patient losing control and having the patient slip away. Would this be a breach of duty owed to the patient?

One could argue that the nurse had no business trying to move a patient by herself. One might also observe the staffing patterns at the time and realize the nurse was doing "the best she could."

The decision to remove the restraints was clearly a nursing decision. Often the decision to use them in the first place lies with the nurse too.

This illustrates the leeway and discretion given nurses when carrying out physician's orders. It also shows the typical catch 22 situation some nurses may find themselves in regarding restraint use.

"Historically, conventional wisdom supported using physical restraints, including bed side rails, to "protect and safeguard" residents. Ironically, little documented evidence exists that restraints prevent falls and risk of injury from falls. Clinical studies demonstrate that restraints, conversely, in some instances, precipitate or exacerbate fall risk."4

Both nurses in the above situation would be acting within their scope of practice. Each would be adhering to standards of care.

For the plaintiff to have a case, it would need to proven that either the removal of the restraints or the ambulation of the patient was premature.

This was clearly not the case. The actions of the nurse were in good faith and exercised reasonable concern for the well being of the patient. The fact that the patient suffered a fall is unfortunate, and reasonably unforseeable.

It can be compared to the actions of a physician when dealing with an acute patient. Depending on which course of treatment that physician chooses, the patient might or might not have a favorable outcome.

In either case, as long as the physician exercises reasonable judgement based on established principles of practice, a finding of negligence is unlikely.

It has been well established that Medicine is not an exact science. Outcomes are not guaranteed when prescribing courses of treatment.

They are the result of standard medical practices and individual patient responses. These responses are not always predictable. Basically, the caregiver can only hope for the best.

The same principle applies to Nursing care. Regardless of how accurate assessments are and how diligently orders are carried out, patients may or may not experience favorable outcomes.

When outcomes are unfavorable, it is the constitutional right of the patient or patient's estate to sue anyone felt to be involved.

The court reviewed the facts of the case and a nursing expert's testimony on restraint use. The appeals court agreed that standards of care had been maintained.

There exists today intense pressure from family members, governmental agencies and regulatory agencies to limit restraint use to "only when absolutely necessary." As soon as they are put in use, the plan of care must include provisions for their removal.

Link Sections:

Head Injuries:
http://www.nursefriendly.com/nursing/directpatientcare/head.injuries.htm

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Mechanical & Physical Restraints:
http://www.nursefriendly.com/nursing/directpatientcare/mechanical.physical.re...

Medical Legal Consulting Nurse Entrepreneurs
http://www.nursefriendly.com/nursing/ymedlegal.htm

Sources:

1. RRNL 2 (July 1997)

2. Family Caregivers Alliance Clearinghouse. Revised November 1996. Fact Sheet: Head Injury. Retrieved May 30, 1999 from the World Wide Web: http://www.caregiver.org/factsheets/head_injury.html

3. Mental Health Legal Advisors Committee. No date given. Your Rights in Hospitals Regarding Restraining and Seclusion. Retrieved May 30, 1999 from the World Wide Web: http://www.psychiatry.com/mhlac/basicrights/restraintandseclusion.html

4. Braun, Julie A. & Quish, Clare J. 11/10/98. Illinois Institute for Continuing Legal Education. Physical Restraints And Fall-Related Injuries. Retrieved May 30, 1999 from the World Wide Web: http://www.iicle.com/articles/braun11_10_98b.html

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Friday, November 18, 2011

Extravasation Follows Chemotherapy Administration, Potential Complication or Nursing Negligence

Extravasation Follows Chemotherapy Administration, Potential Complication or Nursing Negligence

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Extravasation Follows Chemotherapy Administration. Potential Complication or Nursing Negligence
Iacano v. St. Peter’s Medical Center, 334 N. j. Super. 547 – NJ (2000)

Summary: Intravenous therapy has inherent risks and potential complications. When you introduce chemotherapeutic drugs and known vesicants, those risks increase dramatically. In this case, a known risk, extravasation, occurred following administration. The question arises, could the nurses have acted sooner to prevent the extravasation and resulting tissue damage.

The patient was an Oncology patient being treated as an outpatient for non-Hodgkin’s lymphoma, a cancer of the lymphatic system. On a regular basis (every third Friday), she would come in for her treatments. Her Chemotherapeutic regimen consisted of four different drugs, three of them given intravenously. The IV drugs were Cytotoxan, Oncovin, and Adriamycin.

Oncovin and Adriamycin are known vesicants (chemicals which can cause tissue damage and destruction if they leak into surrounding tissues) and typically administered via “IV Push” meaning they are injected directly into the bloodstream through an IV access device. It is critical that the patient be monitored for signs/symptoms of adverse reactions or complications during and after this type of administration.

“Extravasation of chemotherapeutic vesicant agents can result in significant tissue damage, alteration in limb function, and pain. Quality of life for long-term survivors can be severely impacted by negative sequelae from vesicant extravasation. Currently, there is no known preventive therapy. Early detection and intervention are paramount to halt tissue damage and reduce the chance of permanent disability or disfigurement.”2

On this day, the patient was accompanied by a friend who witnessed her treatment. She would attest to the patient’s account of administration of the medications and complaints of discomfort soon afterwards. She would state that the nurses on duty had been informed of this discomfort not once but twice but did nothing. Reports of a red, swollen and puffy hand appearance were allegedly made to the nurse with no action taken.

The patient was initially given Cytotoxan (not a vesicant) through a peripheral IV line in her right hand. Shortly after the infusion began, the patient would begin her complaints of discomfort in that hand.

The patient would state that even after describing her hand discomfort, the nurse injected the vesicant medications into the right hand IV site.

The nurse would later state that she got “good blood return” from the site and did not recall any complaints of pain by the patient. No nurse’s notes were available to collaborate her testimony.

Soon after administration of the vesicants, there were further complaints of pain, and new complaints of “burning.” An extravasation was then reported to the physician. Orders were obtained to discontinue the IV in that hand and treat the extravasation with cold compresses. Apparently, it was not until the patient reported a “burning” sensation that the nurse took notice and took action on the patient’s concerns.

“What is Extravasation? The leakage of intravenous drugs from the vein into the surrounding tissue.(1) Extravasation injury usually refers to the damage caused by leakage of solutions from the vein to the surrounding tissue spaces during intravenous administration. Once an extravasation has occurred, damage can continue for months and involve nerves, tendons and joints. If treatment is delayed, surgical debridement, skin grafting, and even amputation may be the unfortunate consequences.”3

(Please visit http://www.extravasation.org.uk/Definition.htm for a photo example of the type of injury involved in this case (center photo))

It is important to note that despite the patient’s complaints of pain, and witness reports, despite the documented report of an extravasation and resulting physician orders to deal with it, despite the restarting of the IV to continue therapy, no mention of these events was available in the nursing portion of the chart when it was reviewed after the fact.

The patient would need an Orthopedic consult to deal with the extensive damage caused by the extravasation. Debridement and tissue repair would leave permanent scarring and irreversible damage.

The patient sued the Nursing staff on duty that day for negligence. The courts returned an award of 1.5 Million dollars. This would later be ruled excessive and reduced to 0.5 Million dollars.

The defense appealed for a new trial based on the excessive award initially granted.

Questions to be answered.

1. Who was responsible for monitoring the patient for potential complications, and was this monitoring carried out within acceptable standards of care?

2. Special precautions/monitoring must be in place when administering vesicant medications. Were the nurses negligent in their duty to monitor for complications of chemotherapy?

3. Was the patient in fact having pain and discomfort well before the administration of the vesicants? If so, was the nurse in error, to administer the medication despite the patients concerns and complaints?

4. Was there appropriate documentation to support either the nurses or the patient’s account of the situation.

5. Could the extravasation and resulting tissue damage have been prevented?

6. Did the jury in the initial trial award an excessive amount based on flawed information in the initial trial.

The two nurses on duty were clearly responsible for monitoring this patient (and all the other patients in the office as well). It is recognized that the greatest responsibility would fall on the nurse who was administering the vesicant-type medications. Before administering any medication into an IV site, it must be assessed for signs/symptoms of irritation, patency and proper placement.

It would seem incredible, that a patient’s complaints of first discomfort, pain, and then burning would not be investigated by the nurses on duty. These are obvious signs/symptoms of potential vesicant complications. Due to the lack of documentation, this is what we must assume happened.

Of the two nurses on duty, at least one of them would have been made aware and had the responsibility to notify both the other nurse and the physician when appropriate. In light of the fact that an extravasation did occur and resulted in tissue damage, a case for negligence in the monitoring of this patient is established.

It can be argued that the “prudent nurse” when made aware of a patient’s discomfort, would have either slowed or stopped the intravenous infusion and checked the site before proceeding. With the patient’s companion echoing complaints of both pain and a “puffy, red” appearance, that IV site should have been discontinued immediately.

It is unfortunate that no nurses notes were available to give the nurses’ side of the story. It can only be assumed that there was in fact a problem with the site (based on the later reported extravasation and tissue injury).

"Each state has enacted a nurse practice act that authorizes an individual to practice as a registered nurse if the applicant meets specific criteria. Laws or administrative rules in each state further outline documentation issues, such as handling of records, falsification of records and confidentiality.6 Regardless of your work setting or nursing specialty, you must document care based upon the requirements of your state’s nurse practice act. For information on your state’s nurse practice act, contact the National Council of State Boards of Nursing at www.ncsbn.org.”4

There is an inherent duty which a nurse (like a physician) owes to a patient which is to do no harm, and protect them from foreseeable complications. In this case, when the nurse injected the vesicants into an IV site that had already been reported as “causing discomfort,” that duty was clearly not adhered to. Her testimony later that she had “good blood return” from the site was clearly an inadequate assessment.

The presence or absent of “blood return” is not a reliable indicator of an intravenous line’s proper placement or appropriate location.

Again, it would seem incredible that a nurse would inject vesicants, chemicals known to damage tissue and cause significant complications, into an already problematic intravenous site. Due to the lack of documentation in the medical record, we must assume this is what took place based on the end results.

If in fact the patient was complaining of discomfort from the site, then the vesicants should never have been injected. It is dictated by standards of care that, the existing site be discontinued and treatment initiated if warranted by nursing judgment or physician’s orders, another intravenous site be initiated and the medications placed in an alternate location. If no other location was available, or accessible a call would need to be placed to the physician for further orders.

Summary: In the end, the appeals court would find that even though the initial award was excessive, it was not based on an error or misinterpretation of fact. The request for a new trial was denied and the $500,000 award for the negligence on the part of the nurses was upheld.

Related Link Sections:

Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation.nurses.notes.htm

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Cancer, Oncology, Malignancy, Tumors (over a thousand sites):
http://www.nursefriendly.com/cancer/

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Direct Patient Care Links :
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

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Extravasation, Vesicant Infiltrations, Complications of Intraveous (IV) Therapy:
http://www.nursefriendly.com/extravasation

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Informed Consent
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/informed.consent.medical.legal.htm

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Intravenous Therapy, Nursing IV Team
http://www.intravenousnursing.com

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Nurse Practice Acts, Legal and Medical Links
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/nurse.practice.acts.htm

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Nursing Professional Malpractice & Liability Insurance
http://www.nursefriendly.com/nursing/directory/business/insurance/nursing.professional.liability.insurance.htm

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Starting An IV Line, Intravenous Therapy, Infusion Resources:
http://www.nursefriendly.com/nursing/directpatientcare/intravenous.iv.therapy/starting.an.iv.line.htm

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Torts Law & Personal Injury, Legal Resources
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/law/torts.htm

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Related Nursing Malpractice Cases:

August 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or
Quality Of Care
.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

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August 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 –ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

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September 12, 1999: Sleep Apnea Monitor Turned off or Ignored By Nursing Staff, Patient's Coding Goes Unnoticed.
Monitors and Monitored patients present special challenges to practicing nurses. Like a call bell, when alarms on a monitor are activated, they can signal benign or life-threatening events. In this case, a patient's monitors did not alarm as expected. The patient was in distress and would be found without respirations and pulseless by the nurse on duty.
Odom v. State Dept. of Health and Hosp., 322 So. 2d 91 -LA (1999)
http://www.nursefriendly.com/nursing/clinical.cases/091299.htm

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October 3, 1999: Grand Mal Seizure Follows Cervical Myelogram, Anticipated Risk or Nursing Negligence?
Cascio v. St. Joseph Hosp., 734 So.2d 1099 - FL (1999)
Summary: With a proper Informed Consent obtained, it is accepted that a patient is aware of potential risks & complications prior to a procedure. In this case, following a cervical myelogram, a patient developed seizures and suffered an injury. The physician would blame the nursing staff for causing an "increased risk" by not following procedures.
http://www.nursefriendly.com/nursing/clinical.cases/100399.htm

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References:

1. 41 NLRR 6 (November 2000)

2. Kassney, Elizabeth. (6/1/2004). Evaluation and Treatment of Chemotherapy Extravasation Injuries. National Extravasation Information Service. http://www.extravasation.org.uk/Eval.htm (21 January, 2004)

3. Stanley, A. (6/1/2004). What is Extravasation. National Extravasation Information Service. http://www.extravasation.org.uk/Definition.htm (21 January, 2004)

4. Habel, Maureen. (1/13/03). Document It Right. Would your charting stand up to scrutiny? Nurseweek.com. http://www.nurseweek.com/ce/ce670a.asp (21 January 2004)

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