Ariesbsn 2,105 Views
Joined: Mar 5, '07;
Posts: 105 (15% Liked)
; Likes: 65
Years ago, yes. Per the lady at the employment agency that arranged the interview, the interviewer wanted people to show how much they wanted the job by contradicting his negative responses with positive information about themselves. He also wanted people who would be assertive. I threw a wrench in his interview when he pulled the "I don't think you will be a good fit" out of his bag of obnoxiousness, I said "You are absolutely correct. Thank you for your time," and walked out. His jaw dropped and he was speechless. In my humble opinion, life is complicated enough without the games.
Greetings! I was wondering if you all would be willing to share your institution's practice when it comes to supplies in an isolation room. I in an ICU that stores more than 24 hours worth of syringes, needles, gauze, tape, IV start materials, sat probes, kerlix, vacutainers, statlocks, yankauers, nasal cannulas, salem sumps, & more (all in their original wrappings) in the pt rooms. They don't dispose of what is in the pt rooms after an isolation pt is in the room. The rooms are all used for patients that need isolation as well as patients that don't. Nurses & techs have questioned this and are told it isn't cost effective to dispose of what is in the room & our infection control person says it isn't necessary. We are lucky if the isolation carts have gloves in them, much less supplies. This has bugged me since I started working there & I am about to tackle this issue in my unit. I would like to know what other facilities do. Thanks in advance.
Dude! That just plain sucks! No wonder you said in another post that you didn't want to bring your golf clubs to work. What if they took your wallet AND your clubs?
So, did you give the family the name and phone # of your manager? As in:
Pt: "I'm gonna complain!"
Tom:"Let me get a piece of paper. Here is the name of the person you need to call and their phone #. They are usually in the office by 0900."
I am really sorry that happened.
Sorry you had a stressful bunch of firsts all in a row.
The first thing you need to do is put yourself in your patients shoes. He is hungry. Hunger and pain will drive a person to do things that don't make sense to someone who has a full belly and doesn't hurt. Being frustrated and angry are natural, but also be sympathetic.
Just for kicks and giggles, on your off time put yourself NPO, get in bed, and do nothing but lie there and watch TV or read. See how long you can go before you have to eat. One of the things that may surprise you is that if you have nothing to do but watch lousy TV, you may find yourself unable to concentrate on anything but how hungry and thirsty you are.
OK, now on to the patient situation.
The first thing I would have done was to ask the patient to explain to me his understanding of why he wasn't suppose to eat and the consequences of that behavior. Then, if he knew why he wasn't suppose to eat and what could happen if he did, I would ask why he had someone sneak in food. Next, I would turn to the attorney and the medical doctor, look at them with the biggest, most innocent eyes, smile and say:
"I'm so glad to meet you both! So you are a medical doctor. How wonderful! Are you on staff here? Mr. X you do know that since Ms. T isn't 1. a staff doctor here and 2. not your doctor, I can't legally follow her orders, don't you? However, Ms. T, since you are a medical doctor, maybe you can do a better job of explaining to Mr. X how hunger never caused physical harm to a patient, but eating with symptoms such as his has. Oh, can you also explain to him how as a nurse, although I do sympathize with him being hungry, as long as one of our doctors writes orders that are safe, I am bound by law to carry out those orders. If he isn't totally bored with the conversation by this point, could both of you discuss the legal ramifications to the nurse and doctor of allowing a patient to do something harmful? While you all are having your discussion, I need to go report this to the charge nurse, the nursing supervisor, and the doctor."
Then I would talk it over with your charge nurse, I would also look up the results of his tests that morning, and then page the doc. What happens next kind of depends on your facility. In ours, I could tell the visitors to leave and that they weren't welcome back. I could also institute the rule that unless he is receiving care, his curtain is to remain open at all times. I would also fill out an incident report.
One of the things you will learn, in time, is to use that kind of b.s. of "my friend is a lawyer/doctor" to help you.
In the 42 years that my mother practiced as a nurse, she always talked about how busy she was and how physically demanding the work was, but not about being short staffed or worrying about safety issues and her license. It really is good advice.
Thank you all for the kind words and thoughts. My hope is that another nurse at some point in their career will think "If she did it, I can do it." It is rather neat to move from a position of feeling trapped and frustrated to feeling rather liberated. I can also say that I loved the expression on the charge nurse's face when I told her at 2100 that I noticed we only had 4 nurses on the schedule at 0300 and that I wanted to let her know in plenty of time that I would be happy to take an assignment that fell within the ENA recommended staffing ratios or clock out and go home; which ever she felt would be the most helpful thing for me to do was fine with me. I truly do believe in giving people as many choices as possible, ya know?
You did the right thing. It is so much easier to vent about the idiots than to pray that the person who had a reaction doesn't sue you because you didn't follow policy and gave the shot without the epi pen.
Thanks to the wise advice of the people at allnurses.com, I took a stand at work and started refusing to take assignments that were more than double the ENA recommendations for staffing because it wasn't safe for my patients for me to have 5 shock room patients or 9 exam patients.
I have been very vocal at work about how unsafe it is to have all 28 beds full with only 5 nurses in the department. I have also been quoting the quarterly publication that the board puts out regarding how a nurse should handle an unsafe assignment. The icing on the cake was having to put a trans-venous pacer in a woman with a heart rate of 20 and not enough nurses to cover the little things such as recording (we paper chart) and someone to be the "go-fer" for the sterile nurse setting up for the pacer.
Yes, I was smart enough to start looking for another job BEFORE I did this and have accepted a position in a different hospital. It is a good thing too because this went over like a lead balloon. I was told last week by the assistant manager that I was not allowed to say at work that I was going to call the board and find out if the article from 2005 was still in effect, or if I needed to do something different to protect my license. I was also told that my negativity was undermining "all of the positive changes" that they had implemented.
Now, at the time of this conversation, the changes that had taken place were that all of the agency nurses (30-40% of our "staff") were cut from the schedule, additionally, the number of nurses allowed for every 4 hour time block was decreased by 1, in-house registry (IHR) staff were allowed to bump a regular staff off the schedule because IHR never gets put on call, the exam beds were going to be staffed at a 1 nurse to 7 room ratio, and there was the addition of 12+ tasks to the list of things that we already don't have enough time to do.
My immediate supervisor has been very supportive of me and my stand. She confirms that I haven't missed any positive changes. She also confirms that no, I am not negative, I am realistic and the reality is that it is dangerous here. She was told by the assistant manager to stop mentioning the ENA recommendations because we weren't going to staff by them and the assistant manager was tired of hearing about them.
There are 10 people that are trying to find a way out of this department. I am one of the lucky 2 that so far have. It is bad enough in our department that one of that people with 15-35 years of ED experience are saying it is unsafe an looking for jobs.
One day, after reading something here about staffing ratios what popped into my head was "Shame on them for putting me in a position where my patients and my license aren't safe, but shame on me for allowing them to do it day in, and day out."
So, thank you to everyone who has ever contributed to threads about staffing ratios since I found allnurses.com in March. If it hadn't been for this site, I would have never gotten up the courage to take a stand. I would have bought into the philosophy that 1) Staffing was like this all over so I just needed to suck it up. 2) If I didn't take the extra rooms, I would be making more work for everyone else. 3) A good nurse would be able to handle this and not even complain.
Even though it seems like your heart is breaking, think of the gift you give each family by taking care of their loved one and helping them have the best death possible given the circumstances. They are so fortunate to have you there to explain things to them and to support them with whatever decision they make. I would be honored to have a nurse who cared enough to cry take care of my family any day.
Big hugs to you, and I hope you find peace.
We have the walkies with the ear piece in the ED that I work at. I HATE IT!!!! They have 2 volumes regardless of where you have the volume dial set; loud and inaudible. The other problem is that sometimes they transmit, sometimes they don't. So, I frequently have to track someone down the old fashioned way.
Wow! We had a half day lecture about it, but were never tested on the material.
Say, can you use "energy field disturbance" as a diagnosis for a person who repeatedly causes light bulbs to not only become unusable, but also issue a loud pop, and, many times shatter, when they flip the switch? I am not talking about every so often they flip a light switch and the light bulb doesn't work. I am talking about phases that last for days.
This is one of those things where I feel if you are interested in the idea, have $400.00 left over after you meet all of your financial obligations and have nothing else that you need or want to do with the time the class takes, why not? You may learn something.
I also feel that you shouldn't use this on your patients. Since it wasn't part of Kaplan's NCLEX preparation class, I would wager that energy manipulation is out of our scope of practice.
Hmmmm, my 2 cents worth
Staffing: both nurse retention and staffing with fewer nurses than are needed for the acuity and # of pts
The sound of retching gets to me too. I am fine if the person vomits silently, and I don't wig out if I wear someone else's vomit. However, the loudly yakking person 7 rooms away gets to me.
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