[eddy]

Originally posted by mattsmom81
who would ever put a new grad into ICU as staff without requiring some clinical orientation/precepting? Quite dangerous.

Sadly, it was probably either that or you were going it alone. They probably figured 2 is better than 1. Unfortunately, this is not really the case.

On the flip side. I have had some pretty good experiences in the rural hospitals out my way (some bad too... but...). The ones here have nurses that more or less float to every unit. They seem to know their stuff, but there are just so few of them. I feel for these communities. I fear many of them will lose their local facilities in the near future as it is becoming near impossible to recruit young nurses out in BFE. Ultimately the health and safety of the communities they serve will suffer as a result. It's a shame.

[scherzo]

This post is over a year old...but I am a new member of this board...and upon reading the replies, I am not seeing the words "SAFE HARBOUR" anywhere.

I have been an RN in a rural hospital. Yes, they can put you in some really compromising positions. Safe Harbour is a regulation that says, "this situation is unsafe and I am making you aware of this." You are making them formally aware of the problem when you fill out the paperwork and submit it. If anything happens, it protects you from liability. The DON and the supervisor and everyone have formally stated that they know that it is unsafe but they have no other options. Most hospitals will do whatever it takes to avoid safe harbour because it increases their liability.

[mattsmom81]

Good point Scherzo...and I may have to resort to Safe Harbor in my current job...I have gone on staff at a relatively rural LTAC hospital with a small ICU and they are wanting us to take some fairly sick patients without appropriate resources. I have pulled Safe Harbor forms up from my BON and placed them in my locker.

[Spidey's mom]

Of course I'm gonna have to come to the defense of my little rural hospital. We have great and fairly young docs . . .29, 44, 46, 52, 54, 55 and 60. Have a well-trained 3 bed ER staff (EMT's, Paramedics, MICN's). Surgery crew that is awesome. Ortho and general surgeon. Labor and Delivery. 17 Acute beds. The nurses never have over 6 patients. We usually work with two RN's and two CNA's. Our DON is awesome and very supportive.

Of course we have no true ICU patients but we do have Heparin drips, Dopamine drips, Insulin drips, Cardiac patients on monitors, etc.

It can be boring at times . . .and then all heck can break loose.

steph

[4EverStudent]

I am sorry but I have to defend some rural hospitals as well. They are a valuable assest. I have worked in both and am now in a large hospital and still work prn at a small critical access hospital. The rural hospital usually has a better patient to nurse ratio and the nurses work together as a team. Thier staff is just as knowledgeable as the ones I work with in the larger hospital. In this state LVN's are allowed to push IV drugs so it surprised me when I heard that complaint. In the smaller hospital we do have surgery day; mostly outpatient minor stuff. We get alot of trauma in the ER in the rural hospital and we stabalize many before transferring them out. The patients and thier families love being able to stay close to home and are grateful for the good care they recieve. Especially the elderly spouses who can't drive to the nearest hospital. In the large hospital I work for new RN's are constantly requesting the ICU and ER and night positions usually so that they can just get thier masters requirement so that they can go on to become a NP. I have also worked as a traveling LVN and worked with RN's that didn't know that blood hemolyzed and need to be transfused within 4 hours or even how to check to see if the patient was having a blood transfusion reaction because they felt that it was ok to start the transfusion with a temp of over 103. When I the lowly LVN pointed out this I was told that just to stop the blood medicate and restart it later when thier temp went down. I also had to point out the irregularities in the patients heart rate. When I questioned the RN who was giving me report they didn't know what her rhythm was prior to the blood transfusion was the patient ended up transferred to ICU. When I asked for the forms for possible blood trasnsfusion reaction I was informed that "they" don't do that and the RN in charge just told me to throw the blood away. This was a smaller hospital but not what you are referring to. My point is I was offended by that you would have to work with LPN's and do thier work as well as yours when I have worked with and have had to clean up after many RN messes whether it be a rural hospital or a large one. I would rather work with the staff that works together for the patients well being no matter where that it.

[Hellllllo Nurse]

Originally Posted by mattsmom81

This new grad was all puffed up they were letting her in the ICU...I gave her the CYA talk with plenty of warnings...reminded her she would likely be alone at night in this ICU very soon...her eyes got real big and hope she's thinking about what I told her.

Sounds like this new grad does not have the sense to know better. Hospitals love these types!

When I was a new grad, a hospital tried to put me in ICU, with no orientation or training whatsoever. I refused. They replied "We think you are selling yourself short. You can do it!"
Big sales pitch, haha. "'Won't you come into my parlor', said the spider to the fly...."

I said "No thanks. I know better."

I agree with another poster- You're wise to stear clear of that place!

[mattsmom81]

Originally Posted by Hellllllo Nurse

Big sales pitch, haha. "'Won't you come into my parlor', said the spider to the fly...."

I said "No thanks. I know better."

Yup. LOTS of hospitals operate this way don't they? Give a young nurse a title and a little praise and they can swindle...er,talk...her into anything...

Actually I was talked into my first charge position in this same way

But things were better way back then too...not like now.

[mattsmom81]

[quote=4EverStudent]. My point is I was offended by that you would have to work with LPN's and do thier work as well as yours when I have worked with and have had to clean up after many RN messes whether it be a rural hospital or a large one. /QUOTE]



Hmmm.I don't see anywhere in this thread where anyone mentioned not liking to work with LPN's...and I sure didn't say that (I used to be one myself)

[mattsmom81]

I did not mean to insult those of you who enjoy your small rural hospitals...and I've certainly been dumped on at inner city mega hospitals too. Just not in the same way...


As a nurse returning to agency work. I need to remind myself the important questions to ask before I take an assignment at a rural facility, so I am not caught off guard as the only RN in the building, etc. This can happen especially at night (which is my shift of choice). I am kicking myself for not asking the right questions, then being overwhelmed by the responsibility I carried..

I've had some wonderful shifts at smaller rural hospitals...the people there are generally very nice and friendly, the environment more relaxed than the metroplex hospitals.

[AmethystVeralyn]

A very long gripe held back for several years.

Could someone please give me some advice.
I worked in a place for five and a half years where a certain hand full of staff members were always playing head games.

They would insult me by demanding that I work alone
while the rest of them all worked together and would refuse to
offer me any help with transfers and would also go out on breaks
together without stopping to ask if I needed help.

I always made it a point not to do this to anyone and always offered to help the others before I left the floor.

For a few months when I worked on the day shift
they stuck me on what everyone knew
was the hardest patient goup in the building, eg. "We have to do something about
group six...maybe we'll put K. on it." I jokingly answered
"What did she ever do?" The next thing I knew
it was not her but me that was on
group six with no explanation and they refused to offer
their assistance, and then acted like I was being unfair to them
because I couldn't finish my assignment in the required amount
of time. They were insinuating to me that I was refusing
to help them put away clean laundry
because I wanted to take advantage of them
when they really knew I couldn't
finish my assignment early enough to help them.
They also probably knew that I was
working with no breaks and about five minutes for lunch.

Sometimes they would REFUSE to help me with transfers
on patients who were officially two person transfers and demand
that I transfer them alone

and then would get enraged
when I would refuse to threaten the patients safety this way.

Then someone had the nerve and audacity to write
that I was, "very bossy to fellow staff members..."
when it's the other way around and I was
very blocked when I needed to stand up to them.

Sometimes I would try to reason with them and
they would go deaf and report me to the supervisors.
During these episodes no one took time to hear
the actual facts when they insisted on putting words
in my mouth and making me out to be taking advantage of them.

There was one episode where a girl REFUSED to help me transfer HER patient after I answered her signal light.
She said, "I'm taking care of Mary," when it appeared
that she was really just standing there and did not
have Mary in process.
At this time I was already busy
with my own patient group which was still the
hardest one in the building
and I had to get a visitor to help me (the patients
daughter in law) However, this girl, instead of saying
she was sorry she reported me to two supervisors for
telling the daughter in law that she,
"disappeared" (a nice way of saying she was rude)
One of these supervisors immediately scapegoated
me, "Why didn't you finish care on Bessie?"

Then she claimed that the girl who
refused to help me in the first place, "would reciprocate,"
when this hadn't been the case with some of my co workers
for an extended period of time.

As if this wasn't enough they lied to the
supervisors and the DoN on a number of occasions, always
claiming that I wasn't working as, "part of a team." The reality
was that they would sit in the nurses station
and watch me
answer their lights and do things for their patients
and would refuse
to admit that I ever did anything for them or they
would, "go out for a smoke."
I am always forgiving on people
who forget to say thankyou but when they lie
and make it appear that I'm
taking advantage of them it always
sets me into a rage.

So I had to sit in the DoNs office after they turned me in for allegedly not participating in teamwork and I had to listen to her put words in my mouth and
assign attitudes and opinions to me that were not my opinions.
She then refused to listen to my side of it.

Also around this time period, when I was done
with my work on my wing I would go help the
others on the other wing (the harder wing)
until one charge nurse insisted that, "you don't have to help them."
I realize now I was wrong to go along with her
on this. I should have gone to help them anyway and
explained my reasoning.

But nowhere did I ever hear anyone say,
"You were good about helping on the other wing why don't you do it now??"
Instead they went blind and acted like I never helped them.

No matter where you work the game of, "You're
not gonna help me," and the game of, "She can't do it by herself,"
are not part of being a team!!
In these cases they are bullying
people who are more than glad to help them and making up
their minds for them.

One night I was doing hs care on an abusive patient who belonged to another girl because she was nervous about
taking care of her.
I had done this for
a number of weeks because of my concern for this patient and
because I wanted to help the girl assigned to her. While I was taking care of her one of the girls I was
working with reported me to the charge nurse (the same one who
scapegoated me when I couldn't get help with the transfer)
and she came in the room and started screaming
at the top of her lungs
that "We are a team!! ...You're the only one
not working as part of a team!!"
Then they were smug
because she was screaming at me like I was some sort of
an idiot.
As it turned out
there was a new rule that on my assignment
that I was supposed to
put gowns on all the patients
but they didn't bother to tell me
this until it was too late to follow through
so they had it looking like I, "wouldn't gown the residents," just to be a jerk.

I think on some level they knew
if I had known this
I would have made sure I did what they asked.

Later on one of the charge nurses friends who worked
on the other wing told her, " I heard you over their screaming
at her....." and I had commented to her that, "I couldn't read
their minds!!!"

I also was sometimes confronted with things I
actually did, at which time I appreciated the feedback
of various people which included visitors.

During these times some other people would
complain about the way the were treated by other
staff members.
Some of them were excellent nurses
and they quit.

I discussed these problems at great length
with the assistant DoN and again with the DoN
and with one floor supervisor
and was shocked to find that none of these discussions ever
made it into my file including one where every single thing I
said was written down word for word.
Instead there is a written comment that I am
"not a team player," that stares me in the face when
I open my file. There was no mention of the fact that they deliberately set me up.

They constantly demanded that I do, "the onsies," while they refused to help me and refused to communicate and
then went out for a smoke while I worked without breaks.
They tried to make certain patients into, "onsies," that really were not one person assists and then they would
bully people into moving
them alone just because some other people could move them.
I always made sure
I never forced anyone to transfer a patient alone when
they asked me for help but no one would ever acknowledge this.

Over the years my evals hardly ever reflected the problems
I was having on the floor and instead told me I was an
excellent worker. This made it confusing when I thought
about quitting.
My husband suggested, "they're trying to make it so miserable
for you that you have to quit."
I finally did quit when I realized that their game of lying and going deaf had no solutions.
What should you do when people in your work place
are in a habit of twisting the truth and are accusing you
of things you're not doing and you can't afford to quit?