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tokmom, BSN, RN 44,613 Views

Joined Aug 20, '09. tokmom is a CMSRN. She has '30' year(s) of experience and specializes in 'Certified Med/Surg tele, and other stuff'. Posts: 4,681 (61% Liked) Likes: 8,654

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  • Sep 3 '17

    That is exactly what I'm doing! I count down 3 twelves at a time. I tell myself if I can make it through the week only x amount of weeks left.

    I know the experience will only make me better. I just hate the overwhelming sense of dread I feel the day before I start my shifts for the week.

  • Sep 3 '17

    What city is this giving you 7 patients in Med Surg. I started as a new grad with 7 patients fresh off orientation which wasn't safe at all. I thought that's how Texas rolls with no union. I was naive and new to the profession and didn't know how much power RNs actually have in the healthcare system. RNs have the MOST POWER in the hospital I learned even without a union and I will explain.

    We talked to other new grads that got hired at other branch hospitals in the city and their max was 6 patients on Med Surg. We were shocked and upset cause we had 7 patients everyday and never got a proper 30 min lunch because you can't with 7 patients. We found out we were the only hospital going up to 7. So we kept telling management 7 was too much at every meeting but they kept saying it's not in the budget to hire more RNs. Our hospital was owned by a billion dollar corporation but they can't allocate funds to hire more nurses? Oh really? We'll see how that goes with the employees that are over worked and risking their license.

    So a year went by with tense relations with staff and management cause they never listened to us because "it wasn't in the budget." So one day the tipping point came when they gave a day shift nurse 8 patients and the nurse filed for safe harbor to the Texas Board of Nursing. When word got out they gave that nurse 8 patients, we had 8 nurses quit in the same month. Our manager and director had to come in and work the floor for a month cuz they couldn't find enough scab travel nurses or agency nurses to fill the empty needs. After a month of our director working the floor the CEO of the hospital had a meeting with all the RNs on our floor and asked us what we wanted to keep us working there. We all had our arms crossed and told him we can't go up to 7 patients anymore. The limit has to be 6. The CEO promised us we will never go up to 7 patients again and our nurses never take more than 6 ever since.

    You see it's the RNs that keep the lights on in the hospital and keep the shareholders fat. 1 night inpatient stay in a hospital on a general floor is at least $4k a night. If just 2 nurses don't show up to work that's tens of thousands even hundreds of thousands of dollars in lost revenue in empty beds especially if there was a scheduled surgery. Everytime a RN calls in sick and they can't find a replacement that is tens of thousands of dollars in lost revenue for the hospital. That is why agency nurses get paid well. You fill in and save the hospital tens of thousands of dollars in lost revenue.

    So whenever your work conditions are not safe and management is not listening to staff remember as RNs you hold all the cards in the hospital. Even without a union if you all talk and band together if management still refuses to listen and meet your demands have enough of you threaten to quit in 2 weeks and management or administration will negotiate with you. RNs keep the lights on in the hospital not doctors remember that!

  • Sep 3 '17

    If counting down to the 6 month mark seems too overwhelming, count down to the next pay check, and then the next. Or count down the months. If you can make it to the 6 month mark, great. A year is even better.

    I didn't appreciate my med-surg experience until I was the only nurse in the building with any acute care experience. You will need this experience in psych. It's worth it to stick it out, if you can.

  • Sep 3 '17

    Quote from NWeems

    I am a recent May graduate and started on a busy Med/Surg floor in June...

    And I hate it.

    I don't know if it is because I'm so overwhelmed because it is a new environment or if I just am not clicking with my preceptor. There are some nights I cry all the way home from work and some days I can't even eat because I feel a sense of dread about going to work.

    Our nurse patient ratio has increased since I was hired from 6 to 7. And I just recently started taking 6 patients. It's SO overwhelming. I feel like my patient care is just a checklist. I feel like a robot nurse.. I don't have time to slow down care for and know my patients.

    We have had 3 nurses quit since I've been there and I feel like it's just going to get worse with winter coming.

    I started in Med/Surg because of the urge from nurses to "do my time". But my passion is psych. I really regret not starting there first.

    Is there any advice y'all have to make this more bearable?

    I feel like it will look HORRIBLE if just jump ship during orientation at my first nursing job, so I'm trying to tell myself to at least stick it out 6 month to a year.
    I'll bet there are at least two things going on- one is a normal (but very unpleasant) response most new grads experience during the first year.

    The other is unrealistic work expectations.

    Only you know your breaking point- but if at all possible, try to stick it out for one year. If that seems too long, think 6 months and then reevaluate.

  • Sep 3 '17

    I find the whole story disturbing.

    Most people, even nurses, are unaware of the responsibilities of nurses in critical care areas and the ER. Especially the ER...nurses have a responsibility to know about medical legal issues, collecting evidence, chain of evidence whether a rape kit of a legal BAL/tox screen. What alarms me is the fact that these officers seemed to be in the dark about proper procedure, the legalities of obtaining the proper permission, and the routine of the hospitals. Even the "Duty Sarg" supervisor seem to be utterly clueless.

    Several things they said on these released tapes id deeply disturbing. One of which the Duty Supervisor was "not aware of how they [the hospital] did things" and that he was unaware that there was blood drawn in the ED and that ETOH/tox screen is a normal part of a trauma panel. In many cases these bloods are enough and admissible in evidence. Sometimes the investigation warrants a "Legal" BAL which is drawn in a certain manner with approved cleansing substance. Now you get into chain of evidence and the patients/perp "permission"....which entails a warrant. Without such warrant it is a violation of the Fourth Amendment....illegal search and seizure. The supreme last year voted and supported obtaining a warrant when the patient cannot or will not give permission.

    Now this patient....

    1.) IS No longer in the ER
    2.) Is not under arrest
    3.) Is not the perp
    4.) Cannot give consent

    Now in any ER I have worked there is a protocol/policy that is approved by the local PD AND the hospitals Lawyers.

    The usual and customary policy is... The patient needs to be under arrest and consent to the lab draw. Now if the patient cannot consent or refuses a warrant must be obtained. Like anything else this the "USUALLY" the standard.

    My question...Why is it so important to get a tox specimen from the victim who also happens to be a reserve police officer? What are they looking for.....any tox screen is a moot point with the narcs on board. People have the right to not be subject to illegal search and seizure. They were talking about his ambulance job and taking on the indigent to the facility giving them the problem and the paying to the other facility. That too is a cannot cherry pick where you send patients.

    I think this was going to be swept under the rug and someone released the body cam they really have a problem.

  • Sep 3 '17

    An occasional bad apple is one thing, it happens, what's more concerning in this case is that the response to the situation was clearly systemic rather than isolated.

    The incident was apparently initiated as much by the officer on the scene as by the watch commander, who then later showed up to berate the nurse about there being a frequent problem with the nursing staff getting in their way (which is not apparently true), he complained that the hospital's policy conflicts with the law even though the policy is actually just a restating of the law, a law which absolutely should be part of his basic knowledge base.

    The Chief of Police put out a statement that he was aware of all the circumstances of the incident within 12 hours of it occurring, yet both of these officers were continuing to work without restrictions except for officer Payne who was no longer doing blood draws (but otherwise still working). It was only when the incident came under the scrutiny of the public a month later that these officers were removed from active police duties. In other words, this wasn't just a bad apple, there's rotting from the leaves to the roots.

  • Sep 3 '17

    This is the way the police operate. You are either going to do what I say, or I'm going to make you do what I say. That's the mentality of law enforcement and it stems from their ****** training.

  • Sep 3 '17

    Quote from RunnerNurse09
    Resisting arrest is not lawful. Yes , the cop was wrong and she was wrongfully arrested. But think for a minute what it would be like if everyone who was ever placed under arrest was allowed to resist because they thought they shouldnt be arrested. Do you think drug dealers and murderers think they should go to jail? Its not that easy. I think they said she was released 20 minutes later. So resisting does nothing except escalate the situation.
    With all due respect your analogy is not appropriate. Drug dealers and murders and even those who break petty-but-well-known laws know damn full well they have done something wrong. This gal was completely blindsided and thus confused about what was happening because she was being ASSAULTED and had done nothing wrong. In this country the police are not allowed to attack such individuals. She looks terrified. The officer's very first step he took after he decided "WE'RE DONE" was not to begin an appropriate arrest procedure but to lunge at her, try to knock that phone out of her hand and grab her while she stood there in a civilized manner with multiple witnesses in a very controlled situation. He is the ONLY person out of control.

  • Sep 3 '17

    It is a complete outrage. The offending police officer has been removed from the blood collection unit (according to the Washington Post article), but he is not FIRED or even on administrative leave.

    Watching this video, it is no wonder to me why the general public doesn't trust interactions with police officers. When they rough up and arrest a nurse who is simply doing her job under the LAW, why should anybody trust the cops?

    The WP article also said the nurse hasn't decided yet as to whether or not take legal action against the Salt Lake City PD. I hope she does. This individual police officer needs to learn a lesson and get a refresher course in his job duties.

  • Sep 3 '17

    I'm not particularly litigious but I would sooooo get an attorney!!!!

  • Sep 3 '17

    The brief story I read online implied that the hospital security people did nothing at the time to help her. I hate to say it ... but if I were her, I'd be talking to an attorney and preparing for a couple of lawsuits -- against the police AND against the hospital that didn't help her. (unless those people step up "big time" now)

  • Sep 3 '17

    I just read this story in the Washington Post and it horrified me. That nurse was doing exactly what we are all taught to do: protect the patient. She was exactly right and knew the law, unlike the police. I came to AN to express my support for her. I'd call her "my hero" (and she is), but I'll bet she would say she was just doing her job. Sister, we nurses have your back. This is an outrage!

  • Sep 3 '17

    A nurse says she was assaulted and illegally arrested by a Salt Lake City police detective for following a hospital policy that does not allow blood draws from unconscious patients.

    Video shows Utah nurse screaming, being dragged into police car after refusing to let officer take blood from unconscious victim - The Salt Lake Tribune

    What kind of world are we living in that we're at risk for being arrested for doing the right thing? I'm wondering why no management or supervisors stepped in for this situation. This is not my home state, but I'm pretty sure that the law is the same when it comes to consent. Anyone else able to shed some light on this situation? This is terrible that she was treated that way. I can't imagine.

  • Aug 29 '17

    Staff nurses will never fully understand the Manager Role unless they have been managers in the past. That's just a fact of life -- and is true of just about any position that is not the staff nurse role they know. Being happy in any role that is not the traditional staff nurse usually involves having to come to terms with the fact that many nurses will misunderstand your role and think you don't "really work for a living as a nurse like they do" because you are not doing the same job as they do. So, accept that and move on.

    However, you can do some things to foster their support of you even though they never fully understand your job.

    1. Let them see your work. Tell them what you are doing on a regular basis so that they can see you being their advocate. Instead of saying that you are doing paperwork, say that you are "preparing a report to try to get XYZ improved for them." Instead of saying you are doing the payroll, say that you are making sure their work hours are correct so that they can be correctly and on time this pay period. etc.

    2. Don't ever let them say something like, "Oh, I see you working today" when you help them on the unit clinically -- which implies that you are NOT working when you are doing office stuff. Respond with something like, "Oh I work every day -- I just don't do the same job tasks that you do." Of course, say things like that with a smile.

    3. Give them updates on your work and progress with projects that are meaningful to them. I have been in mostly educational positions -- but I have had some jobs that were a combination of education and management at the unit level. I found that posting a monthly report of my activities (written in politically wise ways, of course) was very helpful. When people knew what I was working on and how it could help them ... they were much more supportive.

    4. I am also a big fan of being as honest as possible. Sometimes, you have to say something like ...."Listen, I have my doubts about the value of this change, too. But we need to give it an honest try. We'll collect data and if it doesn't work, then we'll have the evidence we need to change it to something that will work better." Or ... "Listen, I know this isn't the most convenient thing for us to do ... but it will really help our colleagues in the XYZ department. Let's given it a try to help them and maybe we can figure out a way to make it work for us by adjusting it a bit. But we won't be in a position to help either XYZ or us until we start giving it a try."

    Those are just a few thoughts off the top of my head.

  • Aug 29 '17

    That sounds like a job with a lot of responsibility and no power ...the worst kind.
    I decided that staff meetings were a waste of my time before I even got off new grad orientation ...and I don't think I've been to one since then at ANY job. It's not that I don't have suggestions, it's that I know they will never be taken. It's a forum for managers to talk to US, not for us to talk to THEM.
    I could go on about some of the other issues, but I'm already bored. I've already heard myself say it all too many times before.
    I do wish you luck, but you may not find any.