Latest Comments by Jolie

Jolie 28,866 Views

Joined Oct 17, '01. Posts: 9,537 (48% Liked) Likes: 13,756

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  • 0

    In our community, there are a number of service organizations that do overseas medical mission trips. They accept Epi-pens that are less than 6 months expired.

    If you have any that are more than 6 months expired, I would recommend using them in staff training. Discharging an actual Epi-pen into a Tupperware container is a powerful demonstration.

  • 6
    Jethro6, BedsideNurse, canoehead, and 3 others like this.

    Quote from JKL33

    What would you have liked them to do? I note your bias for allowing written work and reading, so long as it isn't on a phone.

    Let's be specific here. In a dark room on the night shift, what is acceptable? So far I'm hearing that using a small light in order to read a book-not-on-phone is okay. Anything else?

    What did the staffing agency sitters do that you approved of?

    We're not talking about anyone lying down on a bench. We're talking about what a good employee should do in a dark, quiet room in the night, when s/he needs to stay awake/alert.
    In my opinion, work-related tasks are fine. Paperwork, reading, policy & procedure review, use of a laptop or tablet to do continuing education or on-line coursework, etc. Having a beverage and/or snack is fine too, if it is possible for the staff member to consume it without placing his/her own health at risk (a clean place to eat without threat of infection control issues.) I also believe it is imperative that the other staff members on the unit offer frequent breaks, or at least pop their heads in the room to check on the sitter. My sister and I were more than willing to cover for breaks, but hospital policy did not allow it, which I do understand. I guess my point is that the sitter is working and needs to conduct him/herself in a professional manner, despite being confined for long periods in a single room. Scrolling on one's phone is not considered professional in the patient-care setting, and I don't see this as an exception.

    We had some wonderful sitters and some lousy ones, which undoubtedly is typical. The first 48 hours or so were difficult for our loved one who was experiencing delirium and trying to climb out of bed, pull out lines, etc. We were genuinely concerned for safety, fearing a fall. I am not a physically large person, nor do I have experience working with confused adults. There were times when I had to raise my voice to get the sitter's attention as my loved one was climbing over the bedrails and I couldn't keep her in bed myself. Once the sitter appeared to be sleeping. Once she was so engrossed in her phone that she didn't notice what was going on right in front of her, or was simply trying to ignore the situation and leave me to handle it. Hours passed without seeing a nurse, I think in large part because they assumed the sitter had the situation handled. When I requested a visit with the nursing supervisor at 0230, I was met with attitude. You asked what the "good sitters" did. In a word, they did their jobs. They interacted with our loved one. Talked calmly to her. Tried to distract her. Were on their feet when she was trying to get out of bed or trying to pull on lines. Spoke to us and offered their suggestions of how we could be helpful. Communicated with the staff when warranted to ask for additional assistance, evaluation by the nurse, etc. The sitters who worked really hard on our loved one's behalf were almost all agency staff. The ones who presented themselves poorly and did little other than take up space were hospital employees. It left us with the impression that "sitter" was a code for "night off with pay."

    Perhaps this is a little too fresh in my mind for me to be objective. The care at this Big City Magnet Medical Center left much to be desired.

    But old-fashioned as I may be, it seems that during an 8 hour shift (sitters were limited to 8 hours at this facility), it is not too much to ask a direct caregiver to keep his/her phone away from a patient's bedside.

  • 7

    Having recently been at the bedside of a family member requiring 1:1 sitter care for safety, I agree with Beth's response above.

    The appearance of a staff member assigned to the bedside being on his/her phone leaves a poor impression on the family members and others involved in the patient's care. Despite knowing that I am a nurse and my sister is a physician, and that one or the other of us was present 100% of the time, we were informed that a staff member had to be there as well. I certainly understand the legalities of that, but to say that it's necessary and then allow that person to be distracted by a phone seemed contradictory and unprofessional. We also noted that some sitters laid down on a bench in the room, making no effort to even appear alert or awake.

    I understand how difficult and fatiguing it is to be in constant attendance at the bedside. Frequent breaks are needed for the sitter, and there should be allowances made for written work, reading, etc. While our loved one needed a darkened, restful environment, it was possible for us to use a small, focused light to read and work that didn't shine on our loved one's eyes. The same would have worked for the sitters. Ironically, in our experience, the sitters who were staff members were the "worst offenders." Those that came from an outside staffing agency conducted themselves in a professional manner.

  • 2
    JustMe54 and brownbook like this.

    While your presence on the BON website may never die, you can excuse yourself from the professional duties of an RN simply by not working in nursing.

    Many states' mandatory reporting laws apply to circumstances you encounter in the course of your professional duties, not your everyday life. While I would advise you to familiarize yourself with your state's requirements, there is a good chance that simply not working as an RN (regardless of whether your license is active or not) would eliminate your legal obligation to report suspected abuse/neglect. NOTE: I am not commenting on the ethical or moral aspect of this, only your legal obligation.

    Some states mandate all competent adult citizens to report suspicions of abuse/neglect. If you live in one of these states, your obligation exists whether you are a nurse or not, so giving up your livelihood would not remove this legal obligation.

    Some states require continuing education and/or current work hours for license renewal. If you choose not to comply, you would simply make your license inactive at the next renewal period.

    Other than having your name on the BON website and complying with mandatory reporting laws, I am not aware of any burdensome professional obligations that would justify surrendering a license in good standing. Can you share exactly what you mean?

  • 3

    Quote from Brady29
    That's what I don't understand. This facility disposes of meds that were not given.

    That's not right. As a previous poster mentioned, meds can be repackaged. To discard a perfectly usable dose of medication simply because it wasn't given in "order" is to show a total lack of regard for patients' financial rights.

  • 5
    JustMe54, Heylove, cleback, and 2 others like this.

    I won't attempt to answer your question, because like the posters before me, I simply can't.

    Congratulations on your accomplishments, and my heartfelt best wishes that you and your boyfriend are able to work together to overcome the challenges in your relationship.

    Not to be negative, but to be realistic: This is only the beginning. When you graduate, there will be a new set of challenges: NCLEX, job search, adapting to the full-time workplace, changes in childcare needs, financial and housing decisions, etc. Please anticipate these, and work to find healthy ways to address them, possibly via counseling.

    My very best to you.

  • 0

    Have you considered continuing your current employment until your daughter finishes her treatment?

    My very best to you and your family.

  • 1
    Brady29 likes this.

    I can understand the wisdom of both options: dispensing in order, regardless of the date the medication is given, or dispensing according to the dates on the punch card. But I don't understand how the latter option is wasteful. Doses that are "skipped" remain sealed in the packaging. Why wouldn't they be used at the end of the month?

  • 1
    NutmeggeRN likes this.

    It sounds to me like the provider's office is being asked to confirm an illness/absence that they have no first-hand knowledge of, as you may already suspect.

    Families with good relationships with their primary care offices can occasionally call and receive a school note covering a mild illness that did not require medical attention, especially if they contacted the office during that time, for example: a phone call to the advice nurse, a medication refill, or made an appointment that was later cancelled because the child felt better.

    My guess is that your student's family had no contact with the provider during this child's "illness," yet later insisted on a note to excuse the child from school. Without any first-hand knowledge, they provided a note (to satisfy the parents) that is utterly meaningless in your investigation of the child's absence. I don't blame them. Writing the note probably saved them from enduring a temper tantrum from the parents, who are responsible for explaining their child's absence, without a BS note from the doctor.

  • 4

    Only your university can answer that question. Get a copy of the course description and syllabus of the class you intend to take and ask the nursing department at University of South Florida for a written opinion as to whether or not it will meet the program's requirement.

  • 1
    Meriwhen likes this.

    I don't understand how the OP is certain that consulting with an attorney will:

    a.) Result in being fired, and/or
    b.) Ensure that she maintains her license.

  • 17
    matcha-cat, MBARNBSN, llg, and 14 others like this.

    You have been "awarded" a $4K subsidized loan for the upcoming semester and need $7.5K more. That 's $11,500 in loans for one semester of school. At that rate, you may owe as much as $50,000 by the time you graduate. That's just not reasonable, based upon job prospects, earning potential, cost of living and desired lifestyle upon graduation. Ask your school for a 1-2 year deferral of enrollment and get busy paying your debt from your first degree and saving towards your next one.

    Otherwise, in 2-3 years, we can expect you to post about how you were forced to take a job you didn't want because you had massive student loan payments to make, and now are overwhelmed by a terrible work environment, living in a crummy apartment to save on rent, driving an unreliable, unsafe car because you can't afford a new one, and you would like to start a family, but don't know if this is a good time to do so.

    We read posts like this every day. Please don't be the next one.

  • 4
    Hopefulpsych, poppycat, GrumpyRN, and 1 other like this.

    Welcome to Allnurses! Since this looks like your first post, you are more likely to get responses if you explain why you're asking this question. If it's homework, please let us know what you have learned from your own research. If this is a real-life situation, a few details might help us respond with relevant information.

  • 4

    Quote from morte
    any nurse should know better and not need a friendly reminder
    You are absolutely right. Any nurse should know not to improperly discard papers containing PHI and not need a reminder.

    Any nurse should also know to arrive to work early, fully dressed in uniform, clock in on-time, never eat or drink on the unit, never take a personal phone call, never fail to introduce him/herself to each patient and family, never miss hourly rounding, never administer a medication or treatment late, never forget to document, never accidentally walk into the wrong room, never misplace a patient item, never forget to return a phone call, never inadvertently walk into or out of an isolation room improperly attired, etc., etc., etc. and not need a friendly reminder.

    But we all do.

  • 15
    purplegal, Nurse_Diane, Rexie, and 12 others like this.

    I'm going to offer a different perspective. I may be way off base, and if so, please feel free to let me know that, but I would like you to consider this:

    I think you are doing just fine, clinically speaking. You sound like a highly conscientious professional working in a reasonably supportive, albeit challenging environment. I believe you may have had unrealistic expectations about the ease of settling into a routine in your first nursing job. Very few basic nursing programs have access to sufficient clinical instructors and placements to allow students to fully experience the role of a staff nurse prior to graduation. Most new grads have never had to manage (independently or with minimal assistance) a full patient load providing direct care and coordinating with other disciplines, family, clergy, etc. Most have mastered care of 2-3 patients, at best, often without juggling the responsibilities other than direct care. While this is often the maximum that the academic setting can offer, it is not realistic preparation for the workplace.

    New grads have a lot to master in their first 2 years: Specific knowledge of the pathophysiology, pharmacology, etc. of their patient population, clinical skills specific to that population, organization and time management skills, politics and social environment of their unit and facility, networking with peers and other disciplines, etc. It takes time and patience with one's self to accomplish all of this. I believe your manager and co-worker understand this and are pleased with your progress. I believe you are suffering anxiety and stress largely because you don't grasp this and are measuring yourself against an in-attainable standard.

    Please consider this in deciding whether you would be better served by staying on your unit a while longer to continue to master these important skills, or whether you would prefer to seek out another area of care, where I believe you are likely to begin the process all over again.

    Also, my most important suggestion to you is to seek professional guidance from a counselor or therapist who can help you manage stress and anxiety, whichever career decision you make. It will serve you well in your personal and professional life. My very best to you. I would be pleased to be your employer.