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Content That Pistachio Likes

Pistachio 2,320 Views

Joined Nov 2, '07. Posts: 41 (61% Liked) Likes: 49

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  • Jan 2 '13

    Well, thanks to everyone who understood where I'm coming from. I appreciate it. Everyone who doesn't, well, Im sorry if you were offended by my candor.

    I want to say, that's it's not as bad where I work as it perhaps sounded. The fact is the vast majority of my residents either can't or won't tell if they need to go. Most simply go in their briefs and are changed during rounds. There's
    only a few residents who can tell when they need to go but are time consuming to get up. Usually we get them up in time. We know what we're doing (mostly). The aides have a toileting schedule for these residents. But sometimes no one is available and the resident has to be told "your aide is busy, but I'll let her know. If you don't make it, we will clean you up ASAP." that has to be said sometimes in LTC. Not all the time, but sometimes. Usually things go more smoothly.


    As for people who think I should stop my med pass and hunt down staff to help with a lift.... well, no, I don't let myself be interrupted unless it's emergent. It's not about the inconvenience (my entire job is inconvenient) it's about safety. If a nurse stops the med pass between every resident errors happen. I don't care how organized you are, with a med pass that size, constant interruptions WILL lead to errors. And I have a "no interruptions" policy that is stricter than most. A CNA reports a change in condition? A call with lab or x Ray results? Yes
    I'll stop and address it. But most everything else will wait. I've been at loggerheads with management because I refuse to talk to Resident's family when they call
    during my med pass. You need to know how Mom is doing or have a question about her care? Ok, take a message and I'll call back later. It can and will wait. Oh, unit coordinator, you have some new
    policy I need to read and sign or some pharmacy audit or something? Ok, but I'm not gonna even look at it till med pass is done. I do NOT stop med pass for anything non emergent and I don't apologize for that. Too many potential errors.

  • Jan 2 '13

    I dunno...I feel like a lot of people are piling it on BrandonLPN when he is just being upfront and brave enough to tell it like it is. My only experience in LTC was way back in clinicals, but I remember seeing that staffing there did not allow for residents to get an ideal level of attention/care. I work in an ICU, and even with a low patient load and tons of staff, it is still sometimes a struggle to gather the help necessary to move a patient. So I really sympathize with BrandonLPN's situation.

    To the posters saying that non-emergency meds can wait and patient cares should come first, I think that is just unrealistic. OP has 49 patients. If he interrupted his med pass every time a resident had a request, he would never, ever complete his med pass.

    Staffing ratios in many LTC facilities just don't allow for staff to drop everything to fulfill Pt requests. It's not that the staff is unfeeling, they just don't have the resources.

  • Jan 2 '13

    Lastly, on my fear of one day entering long term care: this is the exact reason I don't worry about my cholesterol or heart health, Lol. I would much rather go in the night warm in my bed, or "like Elvis." It seems science has extended life, while "quality of life" has lagged way behind.

    I'm pretty persevering, but I have a little "quit" left in me

  • Jan 2 '13

    The best antidote against that anxiety is to be honest. Chart what you see, don't make up anything that you did not see, and, if you have to answer for it under oath, hold your head up high and tell the truth. If your only plan is to tell the truth, you do not have to worry about developing strategies for handling any hypothetical future event. And yes, I have been deposed re: my notes on a patient. All of my answers were as follows: "yes," "no," "I do not remember," or "I do not understand the question." I was not afraid because I was not planning to do anything but tell the truth; including "I don't know," when that was the truth.

  • Dec 6 '12

    Quote from hherrn
    I work in an ER with very few written protocols.
    There is nothing written anywhere that allows me to start o2, iv, labs, let alone meds I might give without an order, including glucose, ntg, or ativan.


    In a perfect world, there would be a set of protocols for most foreseeable situations. I don't work in that perfect world. In the event of an emergency, I would really like for the doc to be there. They know more than me, and have the education, knowledge and authority to make better decisions than me. But- sometimes all the docs are tied up. At night, the one doc could be in the middle of a lumbar puncture, or an intubation. Or taking a poop.

    Where I work, a nurse who followed the P&P would be considered useless. I have worked in severa ERs, and this is not all that unusual
    If nurses in your care environment are expected to initiate medical orders outside of physician contact, you should petition the docs and the department for standing orders so that your butt is covered.

  • Nov 8 '12

    This is the most ridiculous thing I've ever heard. The fact that you WON your first lawsuit on the basis of "discrimination" is a sad commentary on our judicial system. The entire world does not have to "accommodate" my or your religious practices. Being asked to work Saturdays is NOT "oppressive". When the Puritans fled "religious persecution" it was so they could practice their religion without being harassed. Asking you to fulfill the requirements of EMPLOYMENT that are expected of all other employees in that position is not persecution, oppression, or discrimination. If you are so set on observing the Sabbath, you need to be self-employed. Then you can do as you please. But as long as you are receiving pay for work, YOU are the one who needs to conform to the requirements of the position - the employer does NOT have to make exceptions for YOU. You seem to be an unreasonable, selfish, litigious person and that is not the type of person I want caring for my patients.

  • Nov 8 '12

    If religious people can be exempt from working certain days, does this mean people who aren't religious can be exempt too? What defines a religion anyway? Maybe it's my religion not to miss my children's school events. Since I don't ask to be off on Sundays, can I be off on a Tuesday or Wednesday if my kid is going to be in a play? I think religious exemptions border on ridiculousness personally.

    Unrelated, but this reminds me of when I worked with a lot of smokers, I used to tell my boss (when I was working in a restaurant) that I was going to go take an "I don't smoke break." I also thought it was funny when people who didn't believe in working on certain days would go out to eat. You don't believe in working on Sunday, but not enough that you'll stop supporting a business who requires employees to work?

    I never understood nurses who don't want to participate in blood transfusions either. Maybe instead of expecting everyone to accomodate your religious beliefs, you should tailor your job to your beliefs. If I didn't believe in abortions then I probably wouldn't apply to work in an abortion clinic. If I didn't believe in blood transfusions then I might not work at a hospital. Common sense trumps nothing, I guess.

  • Nov 8 '12

    OP, I'm sorry that you are going through this. Employers google candidates all the time and I would not hire you knowing that you could not meet weekend requirements and for fear of being sued. I'm Christian and I could not imagine telling my employer that Sunday is my day of worship and rest and expect them to be okay with it if the job had weekend requirements. I am surprised that you were able to prove discrimination and win a case. I believe that people are legitimately discriminated against all the time and I feel that they should sue but with the info you provided it doesn't seem that you were discriminated on. I currently work per diem and I love creating my own schedule. I don't work Sundays. Hopefully you can find a PRN or M-F position that works for you.

  • Nov 8 '12

    How did the second hospital discriminate you? I'd assume if they had heard of your prior case and worried you were a litigious nurse they just would not have hired you in the first place. If it was over working on the Sabbath seems like the issue would've come up before they had time to micromanage you and trump up reasons to fire you.

    edit: I see your issue goes something like this - you want to hang a discrimination charge on hospital #2 because you didn't inform them of your scheduling needs, and they are prohibited from asking about your religion during the hiring process.

    Then at some point your manager said "if I had known your religion I wouldn't have hired you" even though it's obvious that what she meant was "If I had known you couldn't work any Saturdays I wouldn't have hired you" - based on that you plan to sue them. I guess you could make a career out of doing that since it's based on blindsiding your employer. Not very ethical imo.

  • Nov 8 '12

    I was raised as a Seventh Day Adventist which is a Christian Sabbath observing religion. It is well understood in the SDA church that it is allowable to work on the Sabbath if you are in a "life saving" profession which includes law enforcement, fire department, and health care. Many people consider it another way of honoring God on the Sabbath.

    I would say if the OP is Jewish, that she should confer with her Rabbi about the matter. I was under the impression that Jewish Law had a similar exception as the SDA's do.

    If the OP and her Rabbi determine that she truly cannot work on the Sabbath, then she needs to try and find a job that is M-F days only - perhaps a surgery team, a doctor's office, school nursing, etc.

    I am still a nursing student, but I've worked in hospital administration before and I personally believe this should fall under the "reasonableness test" for religious accommodation. I don't think a hospital unit should have to work around someone who will never work a certain day.

  • Nov 8 '12

    Sabbath is all about taking a day of rest.
    A great book to read is Sabbath by Wayne Muller. Gives perspective about the act of Sabbath, not necessarily the date it occurs.
    God wants us to live at peace with others.
    I would spend time in prayer about your Sabbath. It's about glorifying God and finding rest. If you can do that on Monday instead of Friday, go for it. It's about the act, and where your heart is. Strongly consider spending time praying on observing Sabbath on your days off, rather than suing a company who won't hire you because you won't work a specific day of the week. Sabbath should be in your heart, not on the day of the week.

    I think your in a Catch 22 and I think your employment options are very limited. Try to work for some type of faith based clinic or something who can honor your request, as a hospital 24/7 operation will not work well for your schedule needs.
    I would spend time in prayer regarding your Sabbath, rather than suing each and every company that does not extend you the job offer. You have demands that aren't with the 'times', regardless if it's based on your religion or not. And if you won a lawsuit or not.

    Just because you CAN sue someone and win, does not mean that you SHOULD sue someone.
    What would GOD do? I think he would work work work work work work work, and take a day for rest. You can do that. Modern day work weeks are not those of biblical times. Please reconsider and do some inner searching and prayer. You can still honor God and work Weekends.

  • Nov 8 '12

    If all the Christians demanded "accommodation" to take off every Sunday (and holidays like Christmas, Easter, etc) it would be a scheduling nightmare! Everyone who goes into healthcare knows this isn't a 9-5 job and if you willfully decided to go into a 24-7 job knowing that you were going to make a fuss over working the hours that everyone knows you will need to work, then I'm sorry but I think that is your problem. The onus is on you to find a place where you do not need to be accommodated i.e. a doctor's office or something.

  • Oct 24 '12

    Just put a candy bowl full of drugs on the triage desk and the patients can pick what they want. As long as they fill out a survey first.

  • Oct 17 '12

    If you caused the accident?? You always stop if there's an accident you are involved it, otherwise it's called "hit and run" and you go to jail or whatever.

  • Oct 17 '12

    Quote from 8mpg
    You dont need a union..you need a staff with a backbone. Many hospitals have nurse practice councils, staffing effectiveness groups, etc that must be used for good purpose. Track the days and problems on paper. Have your evidence and paper trail. Complaining among your coworkers doesnt get anything fixed. I am like the poster above where we run bare minimum staff with total patient care (we draw our own labs, baths, etc) and we do just fine. If we have to triple once and a while we work together. There are much worse things out there at other hospitals where you start tripled. Check into your state employment laws. Im not sure about Ohio, but in TX its overtime after 40hrs. So we are scheduled 3 12's and will get 8 hours of overtime if we worked a 4th day. It usually is more due to the fact we never work 12 hours it ends up being 12.5-13 depending on how long report takes. Im not sure why you need a tech with 2 patients most of the time. You cannot compare any California pay to most places in the US as they pay insanely high due to extreme costs of living. Also, you dump your money into the union from every paycheck. Also in California you pay state tax, sales tax, federal income tax, social security, medicare, etc. Im sure the difference in pay is made up by not paying the California insane tax.Oh, and to give you a little context, midwest states and states like Oklahoma have RN's making $17-18/hr. These nurses will triple all day long in ICU, take 7-8 on medsurg, 4-5 REAL PCU with cardiac drips. So make sure you think about it when you say how horrible your job is.
    I feel like nursing is becoming a contest of who can tolerate the most deplorable conditions without accidently hurting a patient. Just because things are worse in another state doesn't make poor working conditions ok in the OP's state. I feel bad for both of you!


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