Pearlgirl 891 Views
Joined Nov 9, '03.
Posts: 22 (5% Liked)
I once said to a doc "oh, someone got out of the wrong side of the bed this morning!" when he came in early morning and proceeded to verbally assault me, a night nurse. It stopped him enuff to realize there were other people around the nurses' station and he became more subdued.
Not for my ego but just to diffuse his temper. As steph says, the pts. don't need the drama and neither do our co-workers. I didn't get an apology but this doc is civil nowadays...
yep! I recently ran into the family of a case I used to work through Maxim, and they had been without a nurse for over a month! Unable to staff a case for that long?! Maxim digs their own grave!! And this was a high tech case that got the highest reimbursement rates.
Kyasi, you sound great! I hope your nurses appreciate you. If you treat the nurses (and HHA's) like professionals and show appreciation for good work, you are more likely to get and keep reliable, competent, and loyal employees.
Maxim clearly does not get that. Their whole business structure is wrong.
Maxim gave me the biggest bunch of bull. Not only blamed medicaid reimbursement rates, but mentioned all the other "expenses" they have to pay for employees...ya know social security, office overhead, etc. I was about to start sobbing for how little Maxim makes. (yeah, right!) The male director of this location lives in a posh, luxury home. How do i know? He lives in the same neighborhood as a case I worked. He earns enough to live in luxury, but won't give a nurse a 50 cent an hour raise.
Feel like I'm going crazy!!!
I was diagnosed ADHD in my early 20's, although i had the classic symptoms as a child (I was so impulsive that in 2nd grade I went to the bathroom and my teacher came looking for me after awhile to find me climbing over the tops of the stalls because I wanted to see how tall they were!)
Anyhow, I didn't start meds til I was in my early 30's when I had no choice but to stay focused to perform a high stress job to supporty myself & my 8 year old son (who was also diagnosed). I got remarried, quit my job & went full-time to nursing school. I struggled even with my meds. I was smart enough to test out of 6 of my pre-requisistes thank God because I might not have passed if I had to sit through boring lecture after lecture and take notes on and read about things I wasn't interested in. During one of those tests, the professor put me in a classroom full of students during a lecture!!!!! I was taking a test so important that it would allow me to test out of a class and he actually thought I could focus (could ANYONE focus) in a classroom full of students during a lecture???
Anyway, despite the ridiculous "accommodations" made by my college, I graduated with a 3.0 GPA despite the hell I went through to graduate.
I started nursing in ICU on nightshift. Lots of good reasons for an ADHD'er to work nightshift, especially as a new nurse - so much less distraction than days, no families around to constantly interrupt you, no tests that you personally have to take your patient off the floor for (unless there's an emergent MRI or something) - and I worked with nurses who knew way more than any of the docs, so I learned so much from them! I was ALWAYS busy on night shift, and sometimes overwhelmed because I was a new RN, but I never left late past my shift because I had to catch up on documentatiuon.
My problem with Nights was that it REALLY screwed up my sleep-wake cycle. If I worked 3-12 hour shifts in a row, I would literally sleep for 3 straight days, I'd eat cereal and go back to bed. I felt like I was drugged. this wasn't making my new hubby or my teenage son very happy.
It took me a year to finally get to transition over to dayshift. However, the only opening on days was a Per Diem slot and I had to float between ICU and telemetry. My biggest problem was the fact that I was STILL exhausted all the time; my circadian rythm was totally out of whack! After almost a year as per diem, a permanent PT slot opened up in ICU., I felt like I was home again.
Except that the exhaustion didint get better. I was also recently placed on antideprssants that I later found out can prevent REM sleep. I was still sleeping for days at a time, but never felt rested. My stimulants would get me started in the morning, but by 5pm I was a zombie. So unfocused, in such a fog! Came close to making some serious med errors, caught myself before they were administered, but came toooo darn close!. My Vyvanse dose was maxed out at 100mg (as per the doc).
I just kept getting more and more unfocused at work and felt like I was always running in circles not knowing what to do next (no way for an ICU nurse to perform).
Finally, after mutiptle MD recomendations, I had a sleep study. I took an Ambien CR beforehand (or else I would not have been able to sleep). The results showed no Sleep Apnea, thank god, but did show that I get No REM sleep and that I have PLMD (periodic limb movement disorder) where my legs jerked 684 times!!
OK, now the sleep doctor wants me to go off my antidepressants since most of them can suppress REM. They also want my psych doc to prescribe Nuvigil to me for excessive daytime sleepiness. Oh, and they want me to take Mirapex (which is an anti-parkinsons' med) for the PLMD.
Ok, so great. I wean off Lexapro & Concerta. I start Nuvigil 100mg in addition to my Adderall XR 100mg, and I now have the Mirapex 0.125mg to take at night with my Ambien CR. How's that worked for me, you say?
It's been around a month for all the meds to become aquainted. Some are gone, some are new. Now, do I feel 100% better??? NOOOOO I have always on my ADD brain had difficulty keeping up with the charting & might stay 45 minutes or so late to catch up.
Now, I'm focusing on the damn new online computer charting system that is totally redudent and fulll or errors. So much so that my patient's safety is being compromised!! I had a pt who came to ICU and within 30 mins his SBP was 62, at the same time I've got my manager yelling at me that I should NOT be far behind on my charting!!!! I thought I was going to lose it...Let's think here...what's the priority??? The patient of the PAPER!!!! My whole day and the day after were just a blur. Me trying to keep the patient alive & being pulled aside constantly by management so they could train me on this new documentation system! Oh, & just when it is getting really bad, someone from the bloodbank shows up with a unit of PRBC's for my patient and she tells me that she has to audit me during the whole process; this is while the man's 85 year old girlfriend is at the bedside asking me every 5 minutes "is he going to get better", "why is he in the ICU", "what are the doctor's plans", I'm hanging blood in one line and a pressor in the other!!!
Needless to say I cried all way home from work. I felt totally incompetent as a nurse. I got home @ 10pm that night & had to get up @5:30 to start it all over again. 2nd day was very similar to the 1st because of the patient's ever changing condition and all the new charting we had to do, along with taking care of my other very sick patient!
Went home defeated. Got into a fight with my hubby. He announces at dinner that he wants a divorce (with my son sitting right across the table)!
I make an appointment to see the psychiatrist whos been treating my depression / ADHD and now part of my sleep disorder. He's 15 minutes late getting me in to see him, I tell him the latest news with me, he tells me that he can't do anything more for my depression and I need to check myself into a psychiatric facility to get it resolved!!!! As he's saying this, I'm about to fall on the floor!!!! I told him perhaps the circumstances in my life at this moment might be worsening my depression (he took my antidepressants away almost 2 monts ago!) I said the my lack of sleep is only exacerbating my ADHD symptoms and I'm having too many near-misses at work. I said I'd like to get a medical leave from work until I can get my sleep problems under control. He asked me what more was being done about that and I told him I had an appointment with a neurologist the next day. He stood up and was basically shooing me out of his office as he handed me a refill for my Vyvanse!! Same dose as always, what's this going to do to help??? He asked me to bring up Klonopin with the neurologist to help me sleep and deal with depression.
Well, went to the neurologist who informs me that although my sleep study was done at the sleep center she works for that my dianosis given by another doctor there is totally wrong. She says I don't have Lack of REM, nor do I have PLMD. She explained them away and said it was probably because I was uncomfortable during the sleep study; I took an Ambien CR before the study and I never left the prone position, it wasn't like I was tossing & turning! She wants me to stop ALL meds and retrain my circadian rhythm.
Ok, I would love to retrain my circadian rhythm and I would LOVE to get off all the meds, but I DO honestly believe the sleep study report that shows I get no REM sleep & showed that my legs DID twitch 684 times!
In the meantime, I feel like I can no longer provide care to my patients in a timely & safe manner! I feel like I'm in a fog most days @ work and just can NOT concentrate or stay focused with ANYTHING. And having been reprimanded for the 1st time ever by my boss, in front of the entire unit, makes me think I need a breakl. Not to mention that EVERY time I drive home from work for the past couple of months, I honestly feel myself dozing off!
Effective today I requested FMLA for myself, on the basis of my sleep study results & the fact that it is still not resolved and when coupled with my ADHD, my ability to perform my nursing responsibilities in such a highly critical environment is impaired. There is no room for error in ICU nursing. I just need to get a doc to back me up!!!
I've got to find the right doc who knows what they're doing! Any ADHD sleep disorder docs out there??????
Hello I am new to the forum, and as a 20 something who was diagnosed with ADD in college I have faced many of the same issues. In my early school days (elementary-high school) I always felt like something was wrong with me because I could never sit through class without becoming extremely agitated and annoyed. I felt that teachers always went too slow and I could never focus on/remember what was being said as my mind was constantly wandering and thinking about a million things at once. Teachers always got mad at me for being a "chatter box" or not paying attention, but I found it too difficult to sit quietly and listen. I always made good grades, but completing the simplest of tasks would take me forever because I would get side tracked and want to move on to something else. I had heard about ADD before, and although I thought I might have it I never wanted to admit that I had a "problem". My fear of seeking help was worsened when I brought the subject up to my parents. They told me that I was being ridiculous, accused me of wanting "legal speed" and that I was probably just bored because I was "too smart" to have to pay attention. Once I started college, things only got worse. My grades were still good, but I could not sit through a lecture and eventually found myself deciding not to go to class because it was just too painful to sit through. I eventually decided to seek help, especially since now I could do so without my parents approval. I was very nervous about discussing my issues, because it was not something I was ever very open about, but luckily the doctor was very understanding and told me I was not dumb or weird for feeling the way I did. He determined that I did in fact have ADD, and started me on adderall. I was a little apprehensive about taking the prescription because of the stigma of the diagnosis and being prescribed amphetamines, but he assured me that he had seen wonderful results with medication and if at any time I felt that it was not a good fit to let him know and we could try other things. Needless to say it worked miracles! I could sit in class, pay attention, and read for more than 20 minutes at a time. My grades remained the same, but achieving success was not the painstaking challenge that it had been in the past. I made the mistake of telling others about my diagnosis when I was completing my first degree (nursing is my second). This led to constant harassment from my friends and others to sell my prescription during finals and resulted in ridicule and hatred from those "friends" when I refused to do so. I also had to deal with my peers questioning my diagnosis because of my good grades, and jokes about being a "crack head" for being prescribed amphetamines. They also made me feel like I was somehow taking the easy way out because when they illegally used the drug it was like "studying on steroids". I tried to explain that when I take my prescription, I don't have super human study powers, but instead I can study normally and stay focused on the task at hand. Before, I always studied alone because when I would group study, I could tell I was annoying with my constant need to get up or talk and distract others. When I was accepted to nursing school, I decided to hide my diagnosis in order to prevent similar occurrences and have a fresh start, but it often has left me feeling lonely. So many people misunderstand ADD. They seem to think that you have to be stupid or make bad grades to really have ADD. This led me to question my diagnosis, and my doctor reassured me that many people who have ADD are very intelligent and are able to compensate for it during their early school years because they can get by without properly concentrating. Having ADD has not been easy, and it is something I feel like I have to hide from my friends, peers and family. Now that I am about to begin my career as a nurse, I wonder if it is something to discuss or hide from my future employers and coworkers. Also, I have been asked to take UDA and I am afraid of testing positive for amphetamines. I know that you can prove you are legally prescribed, but I have heard/read several horror stories about results being reported regardless of having a prescription and the consequences of such events. Anyone who has any advice to offer on the subject would be greatly appreciated!
Sorry to hear of your dilemma. I would make an appointment with her soon as you can, so that she can look for someone else.
The more positive way to go about this would be to examine your time commitments to your off-duty activities. Do you take a family member for appointments? Do you watch a neice or nephew or have your children do weekend activities on a certain schedule? As much as you do sound like a team player, begging off this rotation due to prior commitments will save your health. Healthy coworkers multiply productivity over the long haul. They also reduce turnover, because people want to work where others pull their share and work together.
Maybe in discussing your original rotation, you could offer to do something different, that would still help your Manager. Best wishes.
Just provide a pen and ask the patient to write their name, and DOB when he/she gives the sample. Get the sticker later, whether it's the actual order sticker, or a generic patient sticker from the chart. if the patient themselves at least writes their name in a grease pencil, problem solved.
We are making this task much harder than it needs to be.
sounds as if you are a contientious rn. you did right without even knowing the new law.
if this place makes a practice of you all being the last to find out about new legislation, and their effects on your practice, move on out.
go to a place where education and updated matierial is displayed prominently as to learn something new each time you come to work.
Take this experience in the boarding school and produce numbers according to your accomplishments. For example, are these young people considering medical careers? You must have the same shortages as we do in the states. Can you positively influence some of the students to investigate the personal recognition and pay they would receive by becoming a nurse?
During this time, keep your eye on exactly what you want and if possible, ask for a paid internship? Another Volunteer Position to network and get to know what things are like at your place of interest.
What is next in your upward route of the educational process? Are you looking at a Master's Degree, or to become a Nurse Practitioner? Your area study that you choose, would be a shot in the arm to co-study by working on that floor. I would say that would be a GREAT reason to hire someone like you to that specific discipline. Having a detailed, plan complete with goals, facts and figures of measured accomplishments will sell you. One such accomplishment could be writing a health and safety newsletter, which talks about young womens' new option of receiving an HPV vaccination. Another topic could cover young people's volunteering in a hospital. It would be prudent of them to understand the various types of contact isolation. Just being involved in MANY organizations while you are doing this job, will liven up the boredom, and who knows, it may lead you to the right person or place.
you write about backstabbing and not supporting each other ... as you condemn us all, stabbing us all in the heart with your gross generalizations. in your post, you yourself are guilty of not supporting your fellow nurses and weakening the profession through your harsh condemnation of your colleagues.
some of us have had good careers and are working hard (and successfully) to improve conditions where we work.
i'm sorry you have had a bad time and are unable to cope with your situation. but please don't try to take the rest of the profession down with you. your nursing colleagues deserve to be treated better. we don't need one of our own treating us as badly as you did in your post.
As I have worked both days and nights I can see your plight. Day nurses are (as you have stated) incredibly busy. YOu have family members, docs, procedures, labs...all of this to deal with. At night we get less...much less.
For her to treat you that way is
D. All of the above
The answer is obviously....D. There is really no excuse for that to happen. You have a few options -tell your manager, take her aside and explain to her that her type of attitude will not be tolerated or ...next time that happens...politely confront her in front of everyone and let her know that her attitude is unacceptable. You'd be amazed how many people just "take it"...and there's no need for it.
It's all about attitude, your attitude toward your coworkers, patients, families, et cetera. And she just needs a good swift kick in the ass.
Best of luck.
i would be less fussy if she were a overly eager student, or an emt, but if she is a seasoned na, she knows she is overstepping.
Break or no break it is just plain wrong to ignore students the way some OR nurses do. They belly-ache all the time, "we're over-worked, understaff" but will continue to ignore them in the name of patient care. Poppy-cock! There is always time to give to students who show the interest and try to explain what is going on. Just sitting there and reading a magazine, which is a no-no in the first place, is just plain rude and on the edge of being elitist. We are no better than anyone else and have to remember that if we impress just one student out of dozens, or 43, that rotate through our department we have done good. RNin2007 can come around anytime to me and will feel welcomed and not fill like a second class citizen. I guess my time management skills are pretty good since I can not only take care of my patient but also the needy surgeon and sometimes the clueless anesthesia. Come on people stop being so self-centered and help these students in their hour of need, all they want is a little help and we as oldies but goodies don't need to snack on the helpless.
I started this thread because I wanted to talk to nurses with ADD. Please save the "overabused" or "it doesn't exist" argument for another thread. I deal with these myths enough in everyday life.
Agree. Employees need to CORRECT the implication by stating EXACTLY what their role is, otherwise it is illegal to impersonate.
i strongly recommend that you do not take a position on this cardiology stepdown unit as an rn. these aides are grooming you to be their pawn. how absolutely bold of them to reveal all their little secrets to you. that should tell you something about the kind of power they think they have over the rest of the staff. i guarantee that you won't be treated any differently as an rn. the minute rn goes after your name, you will have crossed to the enemy's side and you will no longer be one of their group. they will be mericiless with you. they will be a supervision nightmare for you. unless you feel you are ready to take the bull by the horns and get tough with them and get them in line (which doesn't sound like anyone has done yet, so you would be all alone in your efforts), they will run you out of the place if you refuse to play along with their little games. at the first circumstance where you are faced with a dilemma that challenges your license you will pursue the right course of action, but it will tear you apart since these people have developed an emotional bond with you. either take an rn position on another unit or find work in another hospital as an rn. i'm not kidding. you, as a new grad, don't need the pressure of a bunch of aides with "attitude" giving you grief every day along with all the other new things you are going to have to learn as a new grad rn. if no one else is addressing the problem with them, you are not going to be the one who will come in to save the unit. you do not have enough experience or training to do it. another thing you should think about it this. if the management of this hospital is allowing this to happen among their cnas what other management faux pauxs are also going on. you want to work at a place where managers are making sure employees are working together and not squaring off against each other in little territorial wars. someone(s) is(are) not doing their management job correctly at this place. get out. there is probably also problems among the other staff as well.
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