Latest Comments by JBMmom - page 2

JBMmom, MSN, RN 7,914 Views

Joined Jun 24, '09 - from 'CT'. JBMmom is a Nurse. She has '4' year(s) of experience and specializes in 'Long term care; med-surg'. Posts: 436 (40% Liked) Likes: 680

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  • 0

    Quote from ally1991
    I probably didn't word it correctly, I don't have many patients who yell for trying to give meds or draw blood. There are currently 2 patients like that on the floor. They've been with us for a while now because they're homeless, and they've got nowhere to go, no shelter wants them. I get one of them almost every time I work, he requests me because I'm on time with pain meds (I don't want any trouble from that guy, so I work my day around and try my best to be on time with his Q3 pain med). Staff is happy to go with his request because no one wants to be his nurse. It doesn't stop him from saying all the terrible things to me. And it's okay if i got pts like that once in a while, that's fine, I can handle that. But every other time I work. On days that I don't have him, coworkers will ask me to help them out with him like "can you give med to this guy please?". And I go in, and I deal with him. The reason I don't ask for help is because my coworkers are busy, and won't go to the room right away, they'll go in 10-15mins whenever they're available. And who pt will be calling complaining and yelling that the nurse is late with his care(pain med primarily)? Me! So it's faster to do things by myself. So that's the story with that. I do get good amount of good patients as well, but this one just sucks all the positivity, self esteem and work enthusiasm out of me
    Ah, well a particularly demanding patient can definitely suck the joy out of any day. Try not to let it become the focus of all your experiences. Hopefully this patient will move on from your floor soon and will no longer monopolize your time. Until then you should feel free to set some boundaries. I've had patients to whom I have stated "I will be happy to provide your pain meds as soon as I am able, however, you have no right to speak to me in a disrespectful manner, and if that continues I will call security and they will have to come up here." Some don't care if security is called, some are still tough, but others settle when they realize I'm not going to put up with yelling and/or abuse. Sounds like you've already shown a pattern of conscientious behavior in responding quickly, now set the boundaries for what's expected of a patient. And someone must be working to get him out of there, case management? You can't keep someone forever without a medical need. Good luck, and don't let one bad patient get you down.

  • 0

    Maybe that school/program is doing something different. The students on my current floor are also assigned to patients and have a PCT/nurse role with the instructor. The do vitals, care, and meds with the instructor. Maybe you should talk with your management and have them clarify with the school the goals of their program to balance that the responsibilities of the floor nurses. Certainly we can all take some time to help students since we were once there are well, but if it's interfering with the care that you can provide then it's not in the best interest of the patient, or your hospital.

  • 5
    umad, snowflower2016, elkpark, and 2 others like this.

    Well, it certainly sounds like you've had a rough start. However, I think you may also be looking at your experience through crap colored glasses.I agree with part of your assessment of the med-surg environment that the job can be very task oriented and not allow for the quality of care that you would like to provide. Have you really not had a single positive experience with the patients you've cared for? Certainly someone must have expressed a small amount gratitude for quality care. But even if they didn't, did you get into nursing so people would express gratitude to you, or did you get into nursing to provide the best care you can for patients that need it? Your homeless patients that constantly want dilaudid- maybe they have chronic (and acute) pain from a hard life lived on the streets. If people are really yelling at you for every interaction, like checking blood sugars, is it possible that you have adopted an antagonistic attitude that's inviting conflict? And do you really have that many patients refusing blood draws? I can think of maybe two that I've had in recent months, maybe your lab people need to be more persistent? Maybe you're just miserable and only the bad experiences are standing out in your mind. In that case, maybe you should find something else to do. I've certainly had patients that were very frustrating, but the ratio of those to patients that I felt I really helped is pretty small. Not many have expressed gratitude, but that's not why I'm there. If I get to the end of my shift and I know for myself that my parents were cared for to the best of my ability I'm happy enough.

    There are going to be positive and negative aspects to every job in the world. If you can't find the positive in yours, that's probably a clue you want to move on. But if you can reframe your experience in a more positive way, you might find that you don't really hate it as much as you think you do. Only you can really make that call. Good luck.

  • 3
    Davey Do, Sour Lemon, and prnqday like this.

    You made a mistake, just the first little one, and edema will resolve itself without issue. Things like this will happen, just do your best to keep track of things and don't let it get to you too much.

  • 5
    Suzey, astormofswords, Ambersmom, and 2 others like this.

    As caliotter mentioned, this is not a phenomenon specific to nursing, I think in all areas, those with children are perceived to have a higher priority with regard to maintaining schedules, getting time off for sick kids, etc. I think you're well within your right to speak up if you see this treatment and remind a coworker or management that your time is no less important because you don't have children. When I was working in a different field, my husband was home with our kids so I wasn't impacted by sick kids, snow day at school, school vacation, etc. However, I had many coworkers that considered it a free day off if their child was home sick. Wouldn't use vacation time, sick time, etc. would just stay home. Clearly this was a different work environment, people could catch up on things on another day. But, some people definitely took advantage and it was frustrating to those of us that didn't use this "benefit", management can run things well, or poorly, best you can do is hope yours makes things equitable.

  • 2
    Tony1790 and Jules A like this.

    Quote from Jules A
    As more and more FNPs think they are able to "do psych" especially due to the higher pay rates I suspected this might happen. You are very insightful as there are actually no medications with FDA approval for agitation in dementia and yet that was likely most of the polypharmacy you saw. Geripsych is a specialty that in most cases, imvho, shouldn't be managed solely by a NP unless they have significant support and experience with this vulnerable population. Kudos for realizing it wasn't your cup of tea.
    You're so right. As a floor nurse in a long term care facility, I've always been depressed by the number of medications we're throwing at people. For example, almost everyone is on GERD medications. Since omeprazole can cause things like diarrhea, increased risk of bone fractures and low magnesium, then we put them on imodium and magnesium. Then they end up constipated and we add miralax, and the never ending trail goes on and on. The psych meds are rampant, and if they just had something to distract them, and look forward to, they probably wouldn't need half of them. I really like my job and my residents. Some do fine in that environment and some just don't- and throwing meds at them isn't the answer. OP, good luck finding something that meets your needs.

  • 0

    I don't work 12s, but I started night shift over the summer. After five plus years of working out six days a week, a stint of unemployment followed by the transition to night shift really torpedoed my workout routine. I'm finally getting back into it. I tend to not sleep well during the day anyway, so I go to a 9am class at my gym after work is over. I'm home by around 10:15, I can rest for 3-4 hours on days that I'm working again that night, or I just stay up after my last shift- I switch back to sleeping at night on my nights off. I don't eat anything at night, other than 2 saltines about 3am with one ginger ale. But I still managed to gain about 15 pounds with the transition. I think lack of sleep is the main cause. I've lost probably half of that by being super strict on what I eat again, and my workouts are improving. Good luck, you'll find a routine that works for you if it's a priority.

  • 1
    Crush likes this.

    It's reasonable to think that someone might not know the assignment was unsafe until report was received, then they're stuck. A tough situation, I'm sure. I would hope that coworkers would recognize a disproportionate workload and help their fellow nurse by trying to even out the assignment, or at least chipping in to help. I'm fortunate to work with some great nurses, we're always offering to help each other out during the shift and it helps everyone at different times. I agree that keeping track in writing could be important. It's ridiculous what meets the minimums on paper by comparison with what's reasonable as far as a workload. But, to keep a job, I think most people would have to stay.

  • 18
    Passion8RN, kathyrse, Jessy_RN, and 15 others like this.

    Good luck, you can move on from this and make it for the best. For what it's worth, I was let go after 15 shifts earlier this year from a hospital position. Was also told that my critical thinking didn't meet their standards, I just wasn't going to work out. It really made me question things at first. I got another job in a difference hospital and I've had nothing but positive feedback since starting. I've even been approached about being a potential fit for an upcoming ICU job opening. Sometimes crappy things turn out to be for the best, hope it's true for you as well.

  • 7

    Quote from Purple_roses
    My management actually encourages night nurses to take a 15 minutes nap during the shift because studies have shown (according to them) that this improves outcomes. Now, not a single nurse in my short career thus far has taken a nap during shift because nobody has time for that lol.
    My hospital is pretty strict with making sure nurses get their 30 minute break. If you miss it more than twice it becomes a discipline issue, for the nurse and the charge nurse. Depending on how I'm feeling I sometimes take a lap around the building to get some fresh air, or I take a 27 minute nap. I feel great after either one. I'm fortunate that my facility sees the importance of getting nurses off the floor regularly, I wish every work environment was as committed to ensuring their nurses get proper breaks. It benefits my coworkers and our patients.

  • 24
    NICU&ERnurse, Soxchica, gpsrn, and 21 others like this.

    I'm surprised that such a demanding patient wasn't traded to different assignments for so long. If someone is known to be that draining, our charge nurses do their best to A)give the nurse the lightest possible assignment with the demanding patient and B) not assign the same nurse repeatedly- to avoid such a situation. As for their right, just no. I have told many patients things like- I am happy to provide the best care I can for you in the next eight hours, but I will not tolerate abusive language behavior towards myself or my staff. I will call security if it continues to be an issue. Most people calm down after that. Especially an alert and oriented person? Unacceptable. I also find it highly unusual that your patient can do out and smoke, I haven't seen that yet in my hospital. I would question why management did not get involved earlier with this patient's behavior. It was clearly disruptive to everyone and should have been addressed.

    Don't let this one experience drag you down too much. Focus on the positive experiences you've had, and will continue to have, after this miserable one. Good luck!

  • 9
    HazelLPN, PANYNP, Raicho, and 6 others like this.

    It certainly sounds like a difficult situation to be in. Have you worked with her in past when she didn't have any trouble? Maybe she's dealing with some issues that are making her more tired and that will obviously affect judgment. If you're very concerned about it, maybe initiate a conversation with your manager, it could easily be framed as concern for a coworker. Obviously falling asleep throughout the shift could be unsafe for everyone, especially when covering more patients. I wouldn't jump to questioning competence first, though, that will bring a whole different tone and make you look very accusatory. We all make mistakes, I would hope she can get back on track.

  • 0

    On nights we aren't supposed to call, we text the hospitalists. Name, DX. Complaint. That's all they want. Apparently they read on a small cell phone like screen, so more than three sentences and they get annoyed. They enter orders and we go on our way. Don't even think about trying to address anything that's not a one-time, all you'll get in response is "pass it to the day team". Sometimes it's frustrating, but it's what we've got.

  • 1
    Davey Do likes this.

    That sounds like a challenging goal, but you're definitely not alone in working full time while going to nursing school, and you can do it. You're going to need to bring scheduling, organization and efficiency to a whole new level. I can't address all your questions specifically because I did not have the same schedule, but I can share my experience. I had a job that was fortunately pretty flexible but I worked 40 hours a week throughout all of nursing school. My core hours were 7am-3pm, but I had class one day a week and I had evening clinicals twice a week. I usually ended up putting in four hours on one weekend day, and working 5a-5p on another weekday. My studying was basically 4-6am on Saturday mornings before my kids got up, and whenever else I could find some free time to go over notecards, do readings, etc. It did not consume my entire life, I still spent time with my family, still taught Sunday school and swim lessons, and I wasn't miserable the whole four semesters. Don't let the horror stories scare you, if you're committed to doing it, and you have a good support system, it can be done. That being said, if there's any possibility to reduce your hours, it would definitely help make things easier. Good luck!

  • 2
    42pines and nuangel1 like this.

    It's unfortunate that sometimes the day to day experiences of care givers in the acute care environment lead to a change in attitude that makes them more suspicious of patients. I am sure that you're not alone in this experience, similar to those that are admitted with pancreatitis and it's assumed that they're denying alcohol intoxication, but a CIWA protocol is added to their care plans. I think that people get tired of feeling like they're being played, and there are certainly scenarios where the ED is used by those seeking drugs and back pain is a common complaint for which narcotics are requested/prescribed. I'm sorry that you both had such negative experiences, it's unfortunate that, as usual, a few bad apples can really spoil things for everyone.


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