Chaya 8,413 Views
Joined Mar 5, '03 - from 'Bosstown metro area'.
He has '15' year(s) of experience and specializes in 'Rehab, Med Surg, Home Care'.
Posts: 1,132 (19% Liked)
It's "wildly inappropriate" to ask a coworker how many patients they have? That's news to me!
Thanks for a very sobering post. The fallout from being reported to the BON and/or terminated has huge repercussions. For me, as it seems for you, the emotional toll it takes on a practitioner is unbelievable. Providers who make mistakes are often the second victim. And for those of you who still sit on your high horse (as I once did), it CAN HAPPEN TO YOU! No one is bulletproof.
I've been sued and a claim was paid out on my behalf because of an error I made.
I wish the students and new APNs could understand that though we are paid well, have great benefits and respect, that when push comes to shove, you WILL stand alone.
I'm with you ... hate buzz words and scripted phrases. Just talk to me like a normal person.
You knew I was late at bringing you the ice water you had asked for. I know you knew this because the nurse who relieved me that day told me about how you complained for quite some time about it. How you couldn’t believe I couldn’t keep up with the two patients I had in the CDU. You knew you didn't want to be in the hospital on Christmas Eve. You knew you had more important things to be doing. You knew you had family waiting for you to get home. But here are a few things you didn't know.
You didn't know that my other patient, just across the hall from you, a 23 year old daughter of a loving family, mother of a 3 year old boy, had just gone from bad to very much worse. You didn't know how I kept my voice calm in the room as I told my aide to call for the doctor even though my internal voice was screeching. You didn’t know how many times I kept telling myself this wasn’t happening. I had taken a job away from my usual ICU so this wouldn’t happen. You didn't know, as I did, that her heart was going to fail her three seconds before she did. You didn't know the fear in her mother's eyes as I caught her gaze as I was compressing her daughter's chest. You didn't know about the controlled chaos that the code team always brings with it, the intubation, the bagging, the endless rounds of code drugs. You didn't know the word I uttered when the doctor finally gave up, nor the hatred with which it was uttered.
You didn’t know how I begged him for one more minute even though I knew it would make no difference. You didn't know I was left alone in the room to clean up the aftermath, to make a very unnatural scene look somewhat natural for the family when they came back in. You didn't know that while I was getting that ice water that you received late I was thinking about what I could have possibly missed that would have made a difference. You didn't know that by the time I gave you that ice water I was blaming myself. You didn't know that after the family left I sat by her and told her how sorry I was that I failed. You didn’t know how incredibly heavy her body was as I assisted the funeral home worker transfer it from my bed to his stretcher.
You didn't know that on that Christmas morning I wouldn't be thinking of my son and his third Christmas, but of another 3 year old boy instead, a boy who would forever remember Christmas not as a time of joy, but instead as the day he lost his mother. You didn't know that a part of me will always remember it that way as well.
You didn't know any of these things because I didn't let you see them as I gave you that ice water, late as it was. I simply apologized and asked if there was anything else I could do for you. The fact that you didn't know any of those things is a source of pride to me. It proves that I can go about my duties with a calm demeanor, regardless of what calamity may have happened. That fact says something about me, but as I get older I'm not sure it says anything positive. In fact, it seems to point to something very tiring indeed.
I have been following this and am so glad for the update, what a terrible ordeal. Hoping the writer continues to get better, and knows a good attorney because if that was me I'd sue the socks off them-and I am not the kind to say that normally.
Some people give shots like they have to push the needle in to the point it shows through the other side of the arm. I worked as a flu shot nurse and have given thousands of flu shots over the years. In one day I gave over 300 shots and never game close to hitting the bone on any patients because it is all about technique. Feel where you are going to stick first and make sure it is the proper place etc. You can't give the shot in the same exact place as you did one person. Everyone's bone and muscle is placed slightly different (some muscle is atrophied). You also have to pay attention to the size of the person (thin vs a heavier person). It is thanks to the flu-shot job that I developed an ability to give pain free shots as a whole. Many patients would say thanks for me not hurting them because it usually hurts. I do think of the patient and also try to be careful knowing that there is a chance harm can be had my the patient if I am not careful (plus I can get sued).
I think I might have said something like, "We're doing an awful lot of tests on her to find out what's going on, shouldn't we maybe give her some pain meds just in case there really is something? She seems like she's in a lot of distress." There are ways to get what you want without being overly confrontational. Of course sometimes it depends on the doctor!
You are right; nurses need to advocate for their patients with doctors and clarify/challenge orders that are/appear to be wrong or not in the patient's best interests. As nurses we are the last defense before an order reaches the patient. I think your topic is a very important one and I thought your examples were decent, except for the first one, and that is the one I am going to comment on:
This was a fictitious illustration but you told the doctor that his patient (who I assumed was also your patient) is asking for pain medicine; he said there's nothing wrong with her etc., and you retorted that if there's nothing wrong with her why are we doing $8000 worth of tests and maybe we should give her some pain medicine just in case. To me that seems unnecessarily confrontational; especially as you didn't state that you told the doctor what your assessment of the patient's pain was. It sounds as though you either hadn't assessed the patient when they asked for pain medication or you had done this but hadn't communicated this to the doctor, and that both you and the doctor needed to determine/discuss the patient's current pain assessment to understand why the patient wants pain medication.
We need to clarify and challenge orders when necessary, but we need to be aware of being unnecessarily confrontational, and we need to be able to provide sufficient assessment information to back up our requests of the doctor to act in regard to the patient (you were asking the doctor to act when you told him/her that his/her patient is asking for pain medication, weren't you?).
I've worked an 11a-11:30p ER shift, the heavy traffic hours, and alternated 4-shift and 3-shift weeks for nearly 24 years. We get one 30-minute lunch break in the middle. I workout at a gym for 30 minutes before going in on work days and do an hour of dance fitness on days off. A healthy lifestyle goes way beyond having our work hours bunched together. Some may prefer or need shorter shifts for family reasons. A choice would be good, but I like having whole days off. You are right that we need to advocate for ourselves, but I believe there are far greater challenges to our health and our profession than 12-hour shifts.
Recently, we had a new admit who ended up buying himself a ventilator really quickly because he was not breathing well at all. All during the intubation, and while the physician was dropping a central line, everyone was commenting on how huge and weirdly shaped the patient's nose was. After everyone else left the room, I decided to investigate further and squeezed it. What I found was never-ending whiteheads that smelled like rotting fecal matter, so I deduced pretty quickly that the size of the nose was probably due to a cyst or something right under the surface. No matter how much I squeezed, more pus-like material came out. By the end of the shift, I'd had at least five coworkers in the room squeezing on the patient's nose, because we are all freaks like that on my unit.
But boomers demand much more than that, and this is the problem. They want to live the way they were in their thirties - while applying as little efforts as physically possible
Ding Dong Ditch and Kindness
Ding dong ditch. For many those three words bring on a negative connotation, a feeling of frustration, and the thought of annoying children. Don’t be so quick to judge. Since I was a small child, random acts of kindness have always warmed my heart. I played ding dong ditch with friends, but there was never a negative intent involved. Rather we made bouquets of flowers and left them on the door step, delivered handmade treats, and even a few times left hard earned money for a person we knew was going through a hard time. The mysterious ditching neighborhood children even received thank you notes from some of the recipients.
National Random Acts of Kindness Day ~ February 17th
February 17th is National Random Acts of Kindness Day. According to the Merriam-Webster dictionary (2017) random means “without definite aim, direction, rule, or method” while kindness is defined as a “kind deed”. In essence, performing kind deeds with no strings attached and no expectation of anything in return. This is the time to act!
Favorite Random Winter Act
As I’ve gotten older, I’ve continued this giving tradition in two intentional ways throughout the year. For years, I stuffed my work locker in the emergency department with brand new winter jackets to give to homeless or less fortunate individuals in need. I never shared this with my co-workers, but rather had this little ritual that filled my heart when no one was looking.
Then one year I was asked to share a locker. Naturally it appeared I was completely hogging the locker space, so I shared with my locker mate, Jill, why the locker was so full. A week later I received an email from Jill telling me how during her rainy night shift, she had given the jacket away. She was hoping I wasn’t going to be mad. Jill giving the coat away was like a double gift, especially in reading her words and the joy she felt by participating in this act. We are no longer locker mates, but I hope Jill is continuing on with this tradition.
Favorite Random Spring Act
Every Spring I purchase volumes of daffodils and designate random days when I hand the flowers out. Anyone and everyone who looks like they need a pick me up gets a few flowers. Then I hand out extras to the fast food drive thru attendant, the grocery checker, post office clerk, garbage man, greeters in businesses…you name it! One of my favorites is randomly placing the flowers onto cars and secretly watching the person find them when they return. Something about giving warms my heart leaps and bounds. I can almost feel my heart dancing and smiling.
Ideas for Random Acts of Kindness Day…or Any Day!
Whatever random act speaks to your heart, go out and DO IT! This world needs a little more love and caring so here are 50 ideas to get you started.
1) Reach out to someone going through a difficult time and offer to listen.
2) Bring in a box of old clothes to a local emergency department, women escaping a violent environment, or to a foster parent in need (get permission first).
3) Thank a security guard or officer for being present.
4) Tell a teacher about the difference they have made in your life.
5) Smile at everyone you come in contact with.
6) Deliver a verbal compliment to strangers.
7) Donate blood.
8) Pay it forward. If someone pays your bill, grab the bill for the person behind you.
9) Encourage kids to call their grandparents.
10) Offer to brush snow of the neighbor’s car.
11) Pick up trash on the side of the road.
12) Sign up to volunteer at a local charity.
13) Encourage a child to be the best they can be.
14) Look someone directly in the eyes and tell them how much you appreciate them.
15) Babysit for someone who needs a night off…for free.
16) Bring magazines for the patients in hospital waiting rooms.
17) Bring in flowers and have the nurses deliver them to patients with no visitors.
18) Send an “I appreciate you” email to someone who never would expect it.
19) Bring to work a poster board with sticky notes and write compliments to co-workers for everyone to see. Hopefully other co-workers will add to the board.
20) Pay for the bridge toll of the person behind you.
21) Offer to grab something at the store for a neighbor or friend.
22) Deliver a meal to a pregnant mom, new mom, or a family in need.
23) Deliver treats to your local public service agencies.
24) Leave a good book on a bus stop or airport bench.
25) Put a note in your child’s or spouse’s lunch.
26) Leave a gift card in front of the corresponding store for a soon to be shopper to find.
27) Put quarters in a parking meter that is expired.
28) Buy the meal for public servants dining at a restaurant.
29) Deliver balloons to someone…anyone…just for the fun of it!
30) Write a note to someone you’ve never met and let them know they are important in this world.
31) Spend extra time loving an animal.
32) Sign up for Amazon Smile to donate to your favorite non-profit.
33) Buy a pizza for another healthcare unit.
34) Do nice things for others anonymously.
35) Bring in coffee and bagels for your co-workers.
36) Hand out crayons and coloring books to age appropriate children waiting in the hospital.
37) Bring in a bag of apples or tangerines for staff. Something healthy and sweet.
38) Deliver packs of “Lifesavers” to individuals who make a big difference in your life.
39) Ride the elevator and hand out flowers to everyone who gets in.
40) Sign up for a run for charity.
41) Leave a thank you note for your favorite barista at a local coffee or tea shop.
42) Thank the fire department or ambulance crew if they visited your house this year.
43) Leave a note or a treat for your mail person.
44) Spend time with an elderly person who could use some company.
45) Have your kids write cards to people who have made a difference in their lives.
46) Thank the military via a letter or donation.
47) Honor hospital ancillary staff via cards, food, or hugs.
48) Deliver individual cupcakes to school teachers and administration.
49) Make little bags filled with quarters and attach a note saying “Thanks for changing lives. Buy a treat on us”. Deliver anywhere!
50) Give a coat or clean socks to a homeless person.
Honor Each Other
Honoring everyone you come in contact with, whether you do so with a warm smile, sincere hug, flowers, a thank you, or treats. Taking time to do simple things that make others feel important and special is invaluable. Research has actually shown these acts to be good for your moods and overall health.
Together we can make the world a little brighter! What Random Acts of Kindness have you performed this year? Or what can you add to this list?
Merriam-Webster: Dictionary and Thesaurus (2017). Kindness. Retrieved February 13, 2017 from Dictionary and Thesaurus | Merriam-Webster
Merriam-Webster: Dictionary and Thesaurus (2017). Random. Retrieved February 13, 2017 from Dictionary and Thesaurus | Merriam-Webster
I always get the flu shot and so far have avoided ever getting the flu. As I age, the potential consequences of the disease become greater and greater and I have no desire to take that chance. I don't want to catch it from a coworker and I don't want to catch it from a patient. Nor do I want to be the vector for an outbreak.
I am very much aware of the flu pandemic of 1918 which killed between 20 and 40 million worldwide; more than the body count of WWI. Like the black plague, an experience better read about than undergone.
I have been immunized for many things in my life, going back to smallpox, polio, DPT, Hep B, and more recently shingles and pneumonia. If there's a way to avoid any of those diseases, I'll take it. I count my lucky stars that I have no drug allergies and have never reacted poorly to a vaccine. No doubt I'd feel very differently if I did.
All of that being said, we have a special responsibility to our patients to protect them to the best of our ability. I would ask my fellow nurses to let that be their guide as to whether to protect themselves and others, particularly if the real issue for them is that they don't like being told what to do. Hey, get over it. We get told what to do all day long. We ought to be used to it by now.
As a nurse, it is MY job to ensure my patient's safety to the best of my ability. That includes doing things like making sure I am completely vaccinated by getting the flu vaccine each year (even in years where it is a poor match). So I wholeheartedly stand behind the mandatory flu vax or mask if you are working in any setting where you can have patient contact. Hospitals, clinics, LTC, etc., but if you're working as a telephonic nurse and never visited patients then it's not as crucial (although if you've ever had the REAL flu you I can guess you would know enough to never want to get it again). If you're not willing to stay UTD on vaccines (those who don't believe vaccines work or are anti-vaxxers, not those with legit allergies) then maybe you should find another line of work, because medicine/nursing does not go hand in hand with pseudoscience.
I would love also to see further studies done to determine what best use of mask would be as discussed in the article.
Although masking does help protect me from the patients that received the vaccines and are now in the hospital with sepsis and other viruses they are floating around!
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