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This is a discussion on Confused Company Nurse in General Nursing Discussion, part of General Nursing ... Hi guise! I'm a newly hired company nurse for 3 different branches of this company with plantilla...by meemaos Aug 15, '11Hi guise! I'm a newly hired company nurse for 3 different branches of this company with plantilla of no more than 150. This is my first job as a nurse and I had a previous jobs not related to nursing so I kinda suck at remembering some things that my employees are asking me. To add, I'm in a very independent role since I don't have a company doctor with me to supervise everyone. I'm worried that my immediate supervisor (she's a HR Supervisor) might kick me out whenever she felt I'm not suited for the job. For instances, I had a patient who came in to my clinic because of dizziness and numbness of his extremities. He has a known history of HPN and when I checked his VS it was only 140-130/90 which left me to not give him Catapres and guessed that his dizziness were not related to his HPN. I asked about his Potassium and he said that he had all work ups done and it was all negative. Also, he was diagnosed with Meniere's but he consulted an ENT doctor for second opinion and he was told everything was fine with his ears. Since he's still dizzy, I thought of giving him meclozine but he told me he took Serc 2 hours ago. I just felt down because I had to discharge him outta my clinic without even performing any nursing intervention or anything. I'm also pressured because I had the power to let my employees go undertime due to sickness. Mostly, they're asking if they could go home because of LBM and epigastric pain. And when I check their VS everything was in normal. BP of 110/70; Temp of 36.8; Pulse of 72. Sometimes I dunno if they're just acting ill or what. How would I know if it's true or not? PS every employee was required to put a lot of make up so I can't really tell if there's pallor. I felt like I had to do something for everyone and I feel wasted whenever I felt what I did is not enough even I had given everything I know that could help.
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- Aug 15, '11 by biker nurseOnly thing I can tell you is LBM and stomach pain , has been going around !. Sorry I couldn't be more of help
- Aug 15, '11 by tyvinCould you elaborate on the nurses required to wear heavy make-up ... I'm not understanding.
- Aug 15, '11 by 42pinesClearly you are holding a role that is for more than what is expected of an Occupational Nurse in America. Normally any intervention requiring attempts at blood pressure reduction is the realm of an MD, Nurse Practitioner (PA), or Physicians Assistant (PA). Catapres and Serc here are not over-the-counter drugs but are rather prescription drugs. In RP (Republic of Philippines) you have access to a greater array of meds that you can give as a nurse. Here, we would lose our license for distributing them without an order. Meclozine was only recently released here as an over-the-counter medication, and even there we need standing orders to dispense. It sounds like a rough job and all you can do is to do the best that you can.
You clearly fear your supervisor and probably for good reason. Considering this, I might wonder if the dizzy fellow with numbness in the extremities was experiencing a panic attack due to stress, and may have been hyperventilating. BikerNurse's comment runs true, though I'm not sure if she noticed that you were in RP. GI disturbances in New York do not necessarily translate to the Philippines. Still, perhaps you can ask around, or even call the local hospital to see if gastrointestinal disturbances have been on the rise.
Perhaps after keeping the #1 rule in mind: 'Do no harm,' you can 'fake it till you make it', and in time, you'll develop confidence and the stress level will hopefully drop. As far as employee's faking it, indeed some will and over time you'll get a feel of who's a faker and who isn't. RP's attitude towards work is likely to be much, much stricter there than here. Quantifiable symptoms are easy, subjective ones aren't, and also in America Supervisors are not privy to symptoms and to your results, here they are fit to work, and returned to work or not--nobody except my Clinical Doc can question my decisions or find out what symptoms the employee had, or what my findings were. But in RP I suspect that you do not have the privacy law that we do called HIPAA, and I suspect that you are expected to tell supervisors what you found. That is a tough place to be. Do your best, that is all you can. It sounds like you know your stuff. Carry on the good work.
- Aug 16, '11 by meemaosQuote from tyvinI'm sorry. My employees were the ones required to put on a lot of make up.Could you elaborate on the nurses required to wear heavy make-up ... I'm not understanding.
- Aug 16, '11 by meemaosThanks for replying everyone! Especially 42pines. I felt great after reading your reply.
- Aug 23, '11 by zerohour1320Hi, I'm a company nurse here in Bicol. I have read your post and I think I understand what you're going through.. Regarding your patient with the dizziness, I think it would have been appropriate to have advised him to come back after 30 minutes or an hour for reassessment.. But nevertheless, since the initial assessment was fine, I think there's nothing wrong with what you did. Also, keep in mind that since we have the power to send patients home, be careful of malingering patients. I think you are doing a great job there, so keep up the good work
uhm, would you mind telling me what company you're working for? thank you very much
- Aug 23, '11 by tyvinThis is all fine and good but I really am curious about "why" employees are "required" to wear heavy face make-up. Please elaborate.
- Aug 23, '11 by zerohour1320Maybe it's a mall or a department store? I don't know. I'm just presuming.
- Sep 9, '11 by meemaosThanks for the reply!
Sorry I cant disclose the name of my company.