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dream'n, BSN, RN 11,505 Views

Joined Aug 28, '06. Posts: 965 (58% Liked) Likes: 2,763

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  • Nov 21

    Whoa, whoa, whoa.

    You are in for a rough ride in your career if you plan to heap loads of blame upon yourself in this manner every time anything unfortunate happens.

    Yes, there is much we can do toward the goal of preventing falls. And yes, we should take responsibility for our actions whenever it is reasonable to do so.

    Just the same, every bad thing that happens is not always because someone else did something wrong - regardless if others try to shift blame by acting as if every bad thing should have been able to be prevented by someone else (anyone but themselves, usually - and I'm talking about the employer, not the patient, just to be clear).

    Now let's be rational here. Let's say that you had not been going around doing these quick checks/introductions and instead you had been standing at the desk receiving a full-on lengthy report. The patient woudn't have fallen then?

    I would never work in a situation where I would be blamed as if I'd personally pushed the patient down to the floor myself just because someone fell down after being checked within the past 5 minutes. Actually, if I'd been raked over the coals about the BM documentation I would've already been looking for another job. I do my best and I aim to provide excellent care, but I'm looking for an employer that is interested in buiding up and supporting my effort, not constantly tearing down.

    I'm glad you have compassion and concern for what has happened; obviously a fall and hip fx are both very unfortunate things. Just the same, I think you need to compose yourself a bit before Monday rolls around.

  • Nov 19

    Anti-anxiety drugs are/can be life savers for nurses and so many others.

    My first anxiety attack happened on my first assignment as a new nurse. My prescription allowed me to function as I needed to. It didn't interfere with my personality; it just allowed me to be me, without the anxiety.

  • Nov 18

    Anyone that hasn't made a med error is lying or hasn't made one yet. Dont beat yourself up too bad over it, as long as you learn from it.

  • Nov 18

    It seems to be in our nature to feel guilty, but I don't think you missed anything. And while you might second-guess yourself in your private moments, do not let anyone else second-guess you. It's not unheard of for administrators and doctors to throw nurses under the bus. Especially doctors who don't respond to pages.

    Remember all the interventions you listed here, and be prepared to list them over and over as you are questioned. You did assess your patient, and you did respond appropriately to her change in condition. Period. If there is something to be learned from this, it is probably to be learned by all concerned. Maybe some policies or practices need to change. Most untoward events are really systems errors, not individual errors.

    Is there someone on your unit who can debrief this with you? I once got a call at home from the regular charge nurse after an unfortunate demise. I really appreciated her sympathy and support. I am sending you good thoughts. ((((())))))

  • Nov 14

    There's almost always administrative work (audits, policy review, filing, etc) that's been piling up because nobody wants to do it. This might be available for you while you're on light duty but I'm not sure your employer would be amenable to keeping you on light duty for months at a time.

    More importantly: you're 28, you have serious back issues, and you're working in a field that is notorious for being rough on the lower back. Start preparing to take your career in a different direction NOW! Your back will get worse if you continue to work on the floor--period. Look for something with zero physical labor like case manager or nurse educator and work towards landing your first job in that role.

    Good luck

  • Nov 6

    Wow, that sounds crazy. At the hospital where I work part-time, each patient had their own insulin pen that stays in their drawer and goes home with them when they're discharged. When it starts to get empty, you call the pharmacy for a refill. At the hospital where I work full-time, we keep vials in the Pyxis and you have to type in the number of units you are taking out for that particular patient, then the computer notifies pharmacy when it's getting low so they can replace the vial.

  • Nov 6

    Quote from KristinCarter
    we keep vials in the Pyxis and you have to type in the number of units you are taking out for that particular patient, then the computer notifies pharmacy when it's getting low so they can replace the vial.
    This is what we do, too. Works great.

  • Nov 2

    The sad thing is that despite all your facility's high-stepping, their bruise rate MAY NOT go down, but instead will remain unusually elevated.

    I had a really wise instructor in my BSN Nsg Issues class. She pointed out that some statistics may not be really be unusually high compared to others in the facility. It was that some units just practiced better REPORTING all their occurrences, whereas some other units were less stringent with reporting/documenting.

    At my very first job, every unit received statistical monthly/quarterly Falls/Safety reports. My unit ALWAYS ALWAYS had the highest falls rate. But I knew we reported EVERYTHING & ANYTHING resembling a fall. (When I floated, I learned some occurrences were just DEALT with - no Incident Reports.)

    Sadly, your facility's aggressive reporting may be biting them in the butt when the Sate looks at the rate.

  • Nov 2

    No, due to a fear (real or imagined) that it would harm my employment and/or reputation at work.

  • Oct 28

    From my state's hospital regulations. Hospitals have been cited for floating licensed nurses who were floated without having demonstrated competency and oriented to the unit.

    ... No hospital shall assign a licensed nurse to a nursing unit or clinical area unless that hospital determines that the licensed nurse has demonstrated current competence in providing care in that area, and has also received orientation to that hospital's clinical area sufficient to provide competent care to patients in that area.
    The policies and procedures of the hospital shall contain the hospital's criteria for making this determination...
    View Document - California Code of Regulations

  • Oct 25

    Quote from dream'n
    It wasn't at my hospital. I was an adult Oncology nurse sent to L&D and Telemetry.
    That doesn't mean that it wasn't a JC violation, just that your hospital did it anyway. But yes, it is a violation if there are special competencies required on a particular unit.

  • Oct 25

    Quote from Crush
    So I work float pool but an interesting topic came up yesterday while I was on a med- surg floor. Thought it might be a good topic to discuss.

    So a nurse from a psych unit was also floated but he had not done med-surg in more than 15 yrs. No orientation to the unit or equipment.

    Anyhow, that sparked a discussion at work and obviously there were 2 sides.
    1) If you have RN/LPN then you are fair game and expected to float regardless.
    2) They should give an orientation at least before expected to float to other units. Not a full orientation but some kind of training/re-training. Especially if float nurse has no experience with that floor or has not worked that area in several years.
    1) is ridiculous. Anyone floating to an area with no experience or orientation should only be utilized in a supportive way ...help with vitals, answer call lights, etc.

  • Oct 25

    I wish the United States would treat education like a public health issue, as many European nations do. Democracies are strengthened by an educated populace. If we had the sense to fund public universities with tax dollars and make them essentially tuition-free, we'd eliminate the burden of student debt for the next generation. That and raising the minimum wage would go a long way toward a stronger economy and, frankly, a healthier, happier nation.

  • Oct 25

    Quote from TriathleteRN
    Mini2544 Sounds like you are just fine with the massive inequality and division that continues to grow. It's ok for the 1% to continue to get richer while the poorer get poorer and the middle class disappears? This is really working out right now.
    Usually the people throwing around terms like "socialism" and "communism" actually have very little knowledge about what either actually are. These are usually the same people who bleat about "welfare queens", "trickle down economics", "Obama phones" and "hand-outs", with nothing but the most superficial notion of the reality of economics, poverty, segregation, institutionalized and structural racism etc., which belies their claims to be interested in investing in schemes to "help people better themselves." Let's start by getting everyone on an equal playing field and ensuring a living wage. All the doomsday predications about cities which have already instituted the $15 min. wage have been proven false.

  • Oct 25

    Mini2544 Sounds like you are just fine with the massive inequality and division that continues to grow. It's ok for the 1% to continue to get richer while the poorer get poorer and the middle class disappears? This is really working out right now.


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