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rabbitgirrl 5,084 Views

Joined: Jun 6, '07; Posts: 141 (68% Liked) ; Likes: 289

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  • Mar 5 '10

    Quote from madwife2002
    I am sorry to read about the stress you are under. May I respectfully suggest that you may need to look at your day and plan it out ie organise your time management. It will help you be more organised and in control because lack of control will be worrying you now and it is a vicious circle which will cause you to be panicing and worrying over night. Ask a more senior member of staff who you trust to help you organise your day and once you are in a strict routine it will make your day easier. I know we cannot predict the day emergencies happen, but if you have a very strict routine are organised it becomes easier.
    While I agree that good organization skills are a must, as I am terrible with organization but have gotten better through trial by fire, I must say that this nurse's anxiety and mental stress is more likely due to the higher acuity and shorter staffing we are all experiencing. However, I was quite jealous when she said they do team nursing with only 6 patients. At my hospital, we do team nursing with 12 patients, all with high acuity. Rarely do we get walkie-talkies, they are usually all major surgeries, cardiacs, demented or total care turners. All this with totally unsupportive management who tends to blame the nurse and never listens to both sides of the story. I believe in the 1 year and 8 months that I've been a nurse, that I've become a really good nurse, and my coworkers and patients feel the same. However, there are many days that I feel the same as her because there is just so much to deal with.

    Sure wish I'd had an idea of what it's really like before I got out of school.

    Best of luck to all the newbies, and to all the seasoned nurses who I hope will show compassion to someone who is struggling.

    'May I never judge my neighbor before I walk a mile in his shoes."

  • Jun 17 '09

    Not sure what religon if any but some religons shun rewards and/or all pridfull events.

    An LDS friend of mine makes hugh donations to charities with no name attached. I mean thousands.

    He also has never attended any graduation event and he has a PHD. He is not shy, he just says it is his contribution to his personal humility.

    I am not this way but I do respect his right to choose !

  • Jun 3 '09

    I had a patient multiple times, frequent flyer, COPD/CHF. He was active in his church (Methodist? Presby? don't remember now), and he would often really fight to get dc'd so he could be in Sunday School. He would always tell us that he prayed for all of us every morning when he woke up. Even though I'm catholic, and he was protestant, he'd often ask me to join him in the Lord's Prayer first thing in the morning. If I could, I did. So, keep in mind, he initiated the religious aspects of the nursing care.

    One night, I got a call from a friend of mine in ICU. Mr. X was there, and he had taken a sudden turn for the worse and was dying. The family was 2 hrs away, and there was no way they could make it in time, flash edema was just coming out of the guy's mouth like a river. I got there, and he looked at me with this desperate expression in his eyes. I took his hand, placed a hand on his forehead, and told him, "Mr. X, I'm here. Do you want me to pray for you?" He blinked his eyes, and I said the Lord's Prayer. When I said "amen" he never took another breath, and flat lined...he had been waiting for someone to pray over him before he'd let go.

    Sometimes, prayer is the last nursing intervention we can provide.

  • Jun 3 '09

    just my ignorant student nurse opinion, if the police wanted him they should have stayed at the hospital. i don't mean to be overly naive, but would calling the police at discharge violate the hippa?

  • Jun 3 '09

    In my neck of the woods, for a while, the police would say that they had been "temporarily" signed out of jail so that the county would not have to incur the cost of medical treatment. They would also try to get us to notify them upon release. Like prior posters, not my job to hunt down people to come take these folks! After a few "slipped through the cracks" that stopped! Our hospital requires that anyone arrested, regardless of status, has a guard in the room with them at all times for patient and employee safety. No if, ands, or buts!

  • Jun 3 '09

    I would think that he left AMA since he was "last seen wearing a hospital gown". Unless he was arrested naked. LOL
    In my part of the country, if someone is arrested, they have a guard on them from the police department at all times until they are discharged. Even if they said to contact them and left a good number when the pt is discharged, who is to say the patient won't leave AMA and just walk out before the police have time to get there? That is just ridiculous. It is NOT the hospital's responsibility. The police department dropped the ball!

  • Jun 3 '09

    The police.

    It is their job to escort suspects who need medical care to ensure they 1) don't escape and 2) don't hurt anyone. The ER staff can't be expected to know the status of patients with regard to law enforcement, nor do they have any authority to hold a patient against his will.

  • Jun 3 '09

    I say the law enforcement dropped the ball...
    Check this line from the story:

    While Harris had been arrested, he wasn't arraigned yet so there were no officers there to guard him.
    I would insist that if you're under arrest that an officer should be there regardless...?

  • Jun 2 '09

    Quote from tnbutterfly
    just like with physical assessments, questioning the patient is a method of obtaining information regarding the patient's spiritual needs. and one of these questions might be...... "do you desire someone to pray with or for you?"
    i see a big difference in assessment and the wording you use above -- "do you desire someone to pray with you or for you" than "would you like me to pray for you?" the former is information gathering. to my mind the latter is both making assumptions and potentially putting someone who is vulnerable in an incredibly awkward and uncomfortable position. (although i have to confess, even the former question, without prior questions about their spirituality/religiosity has the potential for being an imposition).

    you talk about in your role as a parish nurse, well that is a very specific context. if you were working in a hospital, even one that had a religious affiliation, it would be making a heck of a lot of assumptions w/o the prior questions regarding their spirituality/religiosity -- someone does not have to belong to a religious group to wind up in a hospital w/religious affiliations.

    i am sure you do it in a very respectful manner, but i have seen enough of it done in a non-appropriate way that i think giving carte blanche w/o careful education regarding respect for people of other -- or no religious leaning has a certain risk.

    i agree that people in health care are often very uncomfortable addressing, or even recognizing spiritual needs, and that is an unfortunate lack, but i think that approaching this subject requires a high level of sensitivity and at least some training (role playing, case studies, etc) there's a reason that chaplains have to have special training, and the good ones are like gold. nurses are figures of authority, and i don't think that we are always aware of the amount of power we have in our interactions with our patients and families, particularly when they are vulnerable.

    i am a hospice nurse. i know the value, particularly at end of life, of meeting the needs of the whole person. but those needs must be defined by the patient. i personally am very uncomfortable when i see nurses wearing huge signs of their religious belief (i'm not talking about something small, but sometimes it seems like the only thing i can see is that person's apparent need to proclaim their religion.)

    you can disagree with me, but i am telling you what i feel, and how i would react, as a person with strong, but very personal spiritual beliefs if a nurse made overtures like that to me -- i would be uncomfortable, and i would not trust them to provide care that had my interests at heart.

    i don't know where dave the nurse was going w/his comments, as it seems he didn't finish his thought, but as soon as i see something like "christianity is the logical extension of judaism," i become extremely asked for people to share their thoughts and experiences. most of what i said echoes the comments of others, but mine are the only ones you are challenging. why is that?

  • Jun 2 '09

    I have not read this whole thread, so excuse me if I'm missing something.

    I would say that 85% of the time it is wrong to offer to pray for someone without their specifically requesting you to do so.

    The only time I would think it appropriate is if you knew the patient well enough to know their spiritual beliefs and what is comforting to them. Offering to pray for someone without that certainty or a request is, to my mind, invasive, immoral, unethical and out of your scope of practice. And it's proselytizing.

    As a Jew it is a really really uncomfortable experience to have others assume that they know what is the appropriate expression of spirituality and religiosity for me. People have been trying to convert us for 2,000 years, and it hasn't always been pretty. It feels like an assault. Doing it when I am a vulnerable patient would be terrifying.

    I think before one offers anything that is out of the normal realm of nursing, whether it is to share some personal information, or offer to provide a service that is not part of the nursing role, you have to ask yourself first -- "who am I doing this for?"

    If someone asks you to pray with them, or for them, that is one thing...and I also believe that it is OK to refuse such a request. Holding someone's hand in silence, or saying you will "keep them in your thoughts" if that is where your comfort zone is makes more sense to me.

    Yes, we care for the whole person, body, mind, and spirit, but we do it in a way that is helpful to them, not what we want or think is right.

  • May 13 '09

    But wait I thought there were 1 billion nursing jobs unfilled due to the nursing shortage

  • Apr 27 '09

    I hear you, and all the posters who said you have to set limits and demand the respect you deserve are exactly right.
    We had a lady on the vent for 60+ days with pulmonary fibrosis, and every day you could tell what her family had looked up on WebMD the night before. Asking detailed, questions about vent setting trivia, acting angry the split second it seemed like she wasn't the center of attention at all times. Her husband yelled at one of my co-workers one afternoon about how "no one has been taking care of her". I went in the room and told him to google pressure ulcer when he got home and then ask himself how she had been laid up here for 2 months without having one....then see if he still thinks no one's been taking care of her.
    He must have done it because the next day he apologized and that was the end of them acting like that. Miraculously, without us ever taking care of her, she managed to survive her admission and went back home.

  • Apr 27 '09

    ...what about setting limits? There are times when I have to tell a family member that I will get to a nonessential when I have the time. This is different from a needed PRN med or treatment.

    We do not need to fetch all night long. Set limits and then stick to them. I think we all have to have a night where we go thru it...trying to keep a family happy. But it isn't good nursing care, when the fam thinks they have to demand everything. I remind them that I have other patients and will be happy to come by after my assessments, etc are done, that I have the priorities for their mother's care on my schedule.

    ...having said that; we all have nights like that...and we want to be super nurse. But we can't. So we set limits...firmly but kindly. If necessary, write up an incident report and ask doc to remind families that their loved one is in hospital for care, rest, tx, meds, OT, PT, and it's not necessary to bully the nurses.

    AND if they want a private nurse, let them hire a private nurse from an agency, at no cost to the hospital.

  • Apr 27 '09

    The manager should really fix this problem because it can drive many nurses away from this facility.

  • Apr 27 '09

    I agree whole heartedly!!!! It's like this; NURSE= ONE WHO CAN BE VERBALLY ABUSED AT ANY TIME AND FOR ANY REASON. THERE WILL BE NO REPRECUSSIONS. (Did i spell that right?)

    Anyhow, I too wish there was a way to scream to the world about this very same thing. Just because we are nurses does not mean that we are not human beings. Alot of the time, people don't understand that we too have feelings. I do understand that there is a certain amount of customer service crap that we must put up with but I also believe there is a very fine line. I am lucky that in my job, we do have the support of our managers. I have decided after 18 years of doing this that I will NOT allow people to cross that line with me, patients, family members or otherwise. We DO have the right to be respected just like the next person. Demand it and you will get it.