Getting a bad reputation at work - page 2
Within the past month, one person has been fired, and another given a leave of absence because of documentation that I provided to two different nurse managers. In the first incident, I was pulled... Read More
Jun 21, '02I agree Russell, if management would start doing their jobs and start keeping track of those who are abusive and lazy, it would make all of our lives easier. Our managers don't do this where I work. The administrative philosophy is pit nurse against nurse. The KCL incidnet is a no brainer. That could have resulted in the patient's death. The abusive nurse-you really need witnesses to back you up so it doesn't become you against the other nurse. If mgmt had been doing their job a staff nurse wouldn't be being put in this position.
Hang in there RNinICU! You did the right thing. If others think less of you for it, shows you how much integrity THEY have!Last edit by fedupnurse on Jun 21, '02
Jun 21, '02Not intended as criticism and I hope it doesn't come off as one: I don't understand how you can give insulin when yu're not the one who checked the BG, Brownms. Wouldn't that be like taking a verbal order through a CNT? I would be afraid of exactly what actually happened to your patient.
I'm glad everything turned out okay.
Insulin and K+ are both things that scare me and I quadruple-Uber check and recheck.
There's no way you could let somebody giving K+ to someone to needed kayexelate go without reporting. No bleeding way. That's one of those things that is only NOT a sentinel event because of pure luck.
DennieLast edit by NurseDennie on Jun 21, '02
Jun 21, '02Originally posted by NurseDennie
Not intended as criticism and I hope it doesn't come off as one: I don't understand how you can give insulin when yu're not the one who checked the BG, Brownms. Wouldn't that be like taking a verbal order through a CNT? I would be afraid of exactly what actually happened to your patient.
Jun 22, '02Gotta agree, Dennie and Sleepyeyes...I have never been comfortable giving insulin by a CNA's fingerstick results either...prefer to do my own, too.
I am comfortable delegating physical care (baths, weights, ambulation, etc.) to CNA's but NOT vital signs (feel they're too important to my total head to toe asessment) or fingersticks...(too much room for error IMO )
Glad to know I'm not the only one who likes to do her own thing.........I've been accused of being a bit 'anal' about these things ...but I say, well, it IS my practice now isn't it??
Jun 23, '02I don't understand how you can give insulin when yu're not the one who checked the BG, Brownms.
Dennie, in Minnesota it is common practice to have the nursing assistants take the blood sugars and the nurses administer the insulin as ordered giving SS if the blood sugar dictates that it is needed. As long as the CNA is trained to do blood sugars they can do it and be held responsible for what they are doing and reporting and documenting the correct information. However in the hospital I work in the patients ID # has to be entered into the machine before a blood sugar can be taken and it has to be documented right away on the flowsheet, which decreases the likelihood of a mistake. Ultimately, we as RN are responsible and accountable for interventions we carry out.
Jun 23, '02I had a similar situation. I was working in a nursing home that was totally out of control and had a reputation for being this way. As a new nurse to the facility I was shocked at what was going on and how the nurses that had been there for a while had overlooked some very unsafe situations. One night I had a CNA come to work under the influence of ETOH. I reported this to the supervisor and her response was "what do you want me to do, she's a tough kid?" I was floored. Needless to say I sent her home and was threatened with bodily injury. I thought better me than one of the patients she was supposed to be caring for. SHe was fired. A new DON was hired and I reported a sexual relationship a 38 y.o. CNA was having with an 18 y.o. patient and she was fired. I also reported a nurse that was openly having an affair with a patient, she was fired. However when I reported that the CNAs were sleeping on the night shift and only doing rounds at 11p.m. and 5a.m. I was told that nobody wanted to work with me and that I was reporting "too much". I was told to overlook some things by this new DON. What I did was document what I had reported and when nothing was done I made a report to the administrator. All of the things I reported were serious patient safety concerns. Other nurses were complaining but didn't want to be the one who reported it. I took on the cause because I thouhgt the infractions were serious enough that I couldn't live with myself knowing that I had let these things go. We are patient advocates and have to look out for the well-being of the patients in our care. I finally left the nursing home after 3 years vowing never to return. I now work in the Trauma ICU and I have not experienced such problems and don't expect to. I think when there is a shortage of good staff facilities want any staff. Any staff doesn't necessarily mean good staff. They are bodies and that's what counts. I still think about the things that happened at this facility and have nightmares about working in another nursing home. RNinICU I have been in your shoes and know how it feels but if you are strong you will survive and if nothing else your co-workers have to respect your ethics.
Jun 23, '02Maula,
I would think that if the Administration in that NH didn't do anything about these serious infractions then I would have taken them to the Department of Health..The one's that Inspect the homes cause I'll bet that they'd be concerned!
I don't like writing people up either! I would rather talk to them personally or leave them a "love" note saying. Hey, MR Smith had the wrong IV hanging when I came on shift. It depends on what IV is ordered mind you but if D51/2 was hanging instead of D5NS then I'd change it, and leave a note for the nurse rather than fill out an incident report. If I was following a certain nurse and there were consitent mistakes being made and things hadn't gotten any better after leaving the notes for her then maybe I'd start writing things up. It just all depends on the errors being made and the nurse making the errors. If there is a consitent pattern of med errors then this nurse is obviously a danger to pt safety and needs to be dealt with.
I had an interview the other day for a job in a SICU/HU. The Clinical Nurse Specialist asked me how I deal with coworkers who leave rooms messy, etc and I've left notes for them and things don't improve. I said well if things didn't improve then I guess I'd pass it on to the nurse manager. She didn't like my answer and said to me are you sure you wouldn't talk to her again. I said well I guess it depends on the situation and the person I'm dealing with. Yeah, I probably would. Which leads me to believe that they don't like tattletales there. But in my opinion, this person had been given chances to "clean her act up" and hadn't so now it's time to go to the next step.