Latest Comments by Been there,done that

Latest Comments by Been there,done that

Been there,done that 30,053 Views

Joined Aug 4, '09. Posts: 4,719 (72% Liked) Likes: 17,277

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  • 1
    YP CVSICUnurse likes this.

    First and foremost, you did a great job. A first day post-op with TWO interventions and difficulty with weaning SHOULD have been a 1:1. Doubt that could have changed the outcome, though. I am not a cardiovascular surgeon ( I was a cardiovascular nurse for 3 years) but I am thinking one or both of his grafts blew. Nothing YOU could do would prevent his death.

    Not all surgical patients survive. For ME , researching the mortality rates on various procedures would reassure ME that I did all that I could.

    Let the emotions fade until reason can take over. Then, I am confident.. you will get back on the horse.

  • 1
    Erythropoiesis likes this.

    Quote from NuGuyNurse2b
    I've seen it happen too, with the opposite result. The poor lady ended up resigning. There are various degrees of herd mentality, and in OP's case, it appears there is a deep rooted culture there that allows that type of behavior. For you to stand up for yourself in an environment that allows it, or even encourages it, is a completely different system than one where the staff know one another, will cover for one another, and you're the odd man out if you tip the apple cart.

    That's the problem with this site...everyone thinks it's the same scenario everywhere. It's not. some places are indeed like the mafia. Why do you think OP is so reluctant to do any disciplinary actions against someone who is technically his subordinate and is seeking advice? Is it his personality or is there something in that setting that is making him question his intended action? From what I'm reading, it's the latter.
    I do not think the scenario is the same everywhere and I am aware of deep rooted culture and herd mentality. In the scenario I described, I was the minority and an agency nurse.
    I'm not going to try to interpret OP's reasoning.
    He still needs to grow a pair, and deal with it. Better to go down fighting... than turn tail and run.

  • 0

    Quote from Anna Flaxis
    I&D is a clean procedure. C&S is unnecessary for simple abscesses, as most abscesses heal without antibiotics.
    Per NIH "no compelling evidence for routine cultures or empiric treatment with antibiotics. Further research is required." This is my kid we are talking about. Use sterile procedure, culture that green and yellow stuff, determine if and what antibiotics are necessary. I would expect the same for my patients.

  • 6

    Quote from Reign21
    It has to do with an RN co-worker who is harrassing me about a personal issue at work. I am not sure what folder to put that in.
    Using work email to threaten you will be her downfall. Work email is to be used only for professional communication. Report this to management and security. Wish I was a fly on the wall, when those emails are evaluated.
    As far as outside of work, I,PERSONALLY, would get a lawyer.

  • 6

    Quote from LotusPetals82
    In Florida, it's not in our scope of practice.
    What kinda scope is that? You are not even touching the patient.

  • 1
    IowaKaren likes this.

    Quote from Anonymous865
    He may not be wrong.

    Mt. Sinai School of Medicine says "Abscess I&D is not a sterile procedure but field is customarily sterilized."

    Emergency Medicine News says

    "Prep using sterile gloves to keep it a clean procedure, though it is not meant to be a sterile one."


    From the book "Wound Management in Urgent Care" says "abscess drainage is not a sterile procedure so you can don exam gloves as personal protective equipment."

    Wound Management in Urgent Care - Brittany Busse - Google Books

    I have found P&P from facilities that say it is a sterile procedure and other facilities say it is clean procedure.

    With a quick search I haven't found any research to support one or the other. I'll try to dig some for it.

    EBP does show that culture and sensitivity are not necessary. Patients given no antibiotic and patients given an inappropriate antibiotic do as well as those given an antibiotic that the organism is sensitive to.
    EPB is ongoing and continually changing. In this case... what could be WRONG with using sterile gloves?
    My son had an I &D performed in an urgent care setting. I assured it was performed under sterile technique. I also demanded cultures and sensitivities to be ran. My kid had green and yellow pus coming from the wound. A simple C/S assured ME that the correct antibiotic was prescribed.
    In this case, to Hades with EBP. All patients deserve the same evaluation.

  • 2
    BSNbeDONE and BSN16 like this.

    Finding the time is entirely up to you. Taking PTO to pursue another position is not allowed per your employment agreement.
    Any PRN job will not make " special exceptions ." You are seeking a PRN position.. YOU work around THEM. Be advised, you will get anywhere from a 4 hour orientation to a 2 day orientation.. then you will be expected to hit the floor running.

    Best of luck, let us know how it's going.

  • 4
    joanna73, LadyFree28, cocoa_puff, and 1 other like this.

    Quote from Learningtobenurse101
    Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
    You would have "thrived" if you did not call out your preceptor that their actions were "Completely unacceptable."
    News flash... the five rights are not written on the Rosetta stone. Experienced nurses do what needs to be done.

    Best of luck in your next endeavor.

  • 5

    An I&D is a sterile procedure. The patient does not need another organism entered into their bloodstream during the procedure. The doc does not need pus all over their hands. The culture would also be contaminated and useless.

    You don't need a policy specific to your facility. This is evidenced based protocol. In the future , let this doctor ( ? )know that . Be firm that you expect them to don sterile gloves. Doctor also needs to wear full PPE to assure the PUS does not squirt into their eye or any other place.

    Now.. go do some serious teaching.

  • 11
    poppycat, TriciaJ, Irish_Mist, and 8 others like this.

    CNA has used "not in my scope of practice and I do not know how to do it".. many times to get out of her duties.
    Supervision agrees it IS in her scope, you should not do any further follow up. It is not your place to contact the BON.
    The next time CNA refuses your direction... write it up.

  • 5
    canigraduate, quazar, mimibrown, and 2 others like this.

    Quote from NuGuyNurse2b
    sounds like a toxic culture. ie, someone else kindly reminding you that G will lose his pension if he loses his job, as if that's your problem and it also hints of retaliation should that actually happen. Sounds like you'll be the scapegoat and most likely crucified while everyone else knowingly suffered in silence but will paint you as the bad guy even though you did everyone a huge favor. Which means you'll be the walking target for no good reason. Disciplinary actions such as the one you're contemplating should come from management - and if the history of his actions hasn't received that kind of change/action yet, it will never happen unless a change in management happens. Which tells me this type of behavior is condoned, and you're in no position to make any change without having your safety and reputation adversely affected.

    My advice: treat it like water down a duck's back, keep it professional, avoid direct conversations with him and certainly avoid providing further unsolicited advice to him, which started all this to begin with.
    I am agog at this suggestion. This is a hospital, not the mafia. OP is not suggesting any disciplinary actions.
    OP did not offer unsolicited advice. OP "told him he was speaking loud and that everyone could hear his conversation". That kind of conversation is NOT appropriate within earshot of patients, families, or co-workers. "G" is a loaded cannon ready to go off, and needs to be dealt with. OP should be able to report this without fear of retaliation.

    I have been there, done that. I wrote up 2 CNA's for having a VERY loud discussion at the desk bashing nurses. I told them that patients, families, and co-workers can hear this conversation. They got in my face, told me it was none of my business.. Well, yeah it was. I backed off for the time being.. I had patients to take care of.
    Then management got the write-up, then I was getting the dirty looks and suggestions that I better watch my back on the way to my car. I looked them straight in the eye... and kept on keeping on.

    There is no place for threats and intimidation in the workplace. I hope OP has the courage to follow through.

  • 15

    Yes, that is workplace violence , he threatened you. He was also interfering with the functioning of the unit. You need to report this to your manager stat.

    Do not make excuses for him. It is not your duty to get him "help". Let administration deal with this OUTRAGEOUS behavior.

  • 11
    TriciaJ, SororAKS, /username, and 8 others like this.

    Quote from menot
    Been there done that, you can go back and reread what I wrote. Also my sister isn't more important than any other nurse, you're right, cause she isn't a nurse, I said she was a department director and is a big deal, she has an office with her name on the door, so sorry you suck
    Oh no! I suck! Man that hurts.

  • 2
    cocoa_puff and BuckyBadgerRN like this.

    To the hospital, dietary aides, housekeepers and CNA's all perform the same function. A lower level position that requires little training. If CNA's are willing to work for the same salary as a dietary aid, that is what the hospital will pay.

    By the way, you DON'T have a license, you have a certification... learn the difference.

  • 11
    TriciaJ, SororAKS, /username, and 8 others like this.

    What does this have to do with nurses? Your issue was with security.
    YOU are the one profiling nurses. Without a clue of what we do.

    P.S. Your sister is NOT more important than any other nurse.