Kooky Korky 13,221 Views
Joined Feb 12, '10.
Posts: 2,445 (50% Liked)
This is touchy.
You are certainly able to function in the aide role. As others have pointed out, though, you will be held to the RN standards now that you are an RN.
As someone else said, though, you have not been trained and oriented as an RN by the employer. So...???
And if you ask if you could or should take some time off, you might point out inadvertently that your manager goofed up somehow.
No easy answers, sorry.
Congrats on passing and let us know what you decide to do.
Heck, I'm cheering for both of them!
When the supervisor called, Amber should have said that she needs help & ask that the supervisor come to help or things are not going to get done because there were 3 hot bodies working their fannies off with 14 patients and 1 admission coming through the doors that needed a chest tube. Amber should have refused the pleural effusion patient until the chest tube was inserted in the main ED---that is not a procedure to be done in a holding area. Moreover, a pleural effusion patient needs a more controlled environment, like a step-down or ICU. The supervisor should have been told, in no uncertain terms, that that a bad mistake was in the making due to insufficient staff and it was UNSAFE. I probably would have gone over the supervisor's head----to the chief of the ED or the supervisor's boss. And I also would have taken a couple of minutes to put it into writing and send it to the appropriate people so that if anything happened, the appropriate people had already been made aware of it.
One thing I have learned in my 25+ years of nursing is that you have to protect yourself. You want to provide the best care you can, but you can't provide good, safe care when you are overloaded with patients. And, hospital administration is the first to throw a nurse under the bus when something happens. Accepting an assignment that is not safe, accepting inappropriate patients being dumped on you from other units & TRYING to do it all is a recipe for disaster. Hospital administration will take advantage of the nurses all they can, until the nurses start standing firm & refusing to work under those conditions. Historically, nurses have taken the brunt of all problems in a hospital----the fact that the pharmacy failed to stock the Pyxis is somehow the nurses' fault. The unit secretary calling out sick is somehow the fault of the nurses. Then the nurses have to fend for themselves. The nurses are expected to do the work of the unit secretary----are unit secretaries expected to do the work of a nurse if a nurse calls out sick? Why should nurses be expected to do the work of another employee without being compensated for it? If there is supposed to be a whole other person working in the unit, with their own job for an entire shift, then the nurses that have to do the secretary's job should be paid the secretary's salary for the day. An administrator is not expected to do the work of another employee if that employee calls out sick, so why should a nurse be expected to do it?
I don't think this is really an unusual situation; as others have said, it just depends on how you word it. I think as a charge nurse I've probably said "Okay, give me a few minutes to figure this out and I'll call you back" multiple times. Not frequently, but occasionally. And knowing those five or ten minutes were possibly hellish for the people waiting; you don't want to overdo it.
As for the ED Main nurses gossiping about her--that's going to happen. The floor nurses give it right back to the ED. You have to let it go. We complain about "seriously, the ED nurses couldn't find two minutes to change the patient's bloodsoaked linen?" and that kind of thing. But when it comes to the patients and families complaining that (for instance, I heard this yesterday) no one in the ED cared about cleaning out the patient's abrasion, no one touched it the whole time they were there--we all stand up for the ED nurses, trying to explain (without alienating the patient/family) that the ED responds to the urgent problems knowing we'll have more time to take care of the rest of it on the floor.
It does sound like she was in a little over her head, which happens as a relatively new leader--and occasionally happens to everyone. Nothing to do but use it as a learning experience.
Thank you for the reassurance. I'm seeing on Facebook that at least one person has been fired over this and I feel terrible, but everyone here has really strengthened my conviction that I did the right thing.
Be patient. Do your best. That's about all you can ask of yourself because, as stated earlier, insurance and money rule the way we give health care today.
And people have to be ready for change. If they're not ready, just be patient. It might take 50 hospitalizations for someone to be ready.
Don't give up on people.
But if you are miserable, start looking elsewhere for work. Not that anywhere is so perfect, but you might find something you like better.
What are you interested in doing?
I was blindsided with an admission a couple yrs ago like that. Received a young woman to the floor on night shift, 5 days s/p c-section with preeclampsia. Mind you, this was the ortho floor. (Huh? You can have preeclampsia AFTER baby is delivered? And apparently, our OB dept won't take such a pt after delivery!)
Anyway, her parents & newborn were with her when she came up & as I did the admission. The grandfather mentioned that the baby needed diapers & I stated something to the effect that it was their responsibility as the baby was not a pt (although if it was gonna be a huge issue, I could have been able to get a couple from peds). Grandfather mentioned going to pick up some food & left the floor. Within the next hr or so, pt put on her call light & when I went in, I discovered that grandmother had decided also to leave but baby was still with pt who I had started on a mag drip & was on seizure precautions! Found out her parents were not coming back.
It was near the later part of the shift by that point, 0500, so I notified RN supervisor who felt it would be fine to wait until a later time to call family (though I did explain to pt why it was not a good idea to keep her baby with her without another family member present). Luckily, it was a decent night with a good group of pts; the aide & I stayed near that room, watching like a hawk.
<sigh> ...an experience that makes me hyper-aware when kids are brought up with a parent who is admitted...
Where is OP?
It seems like some facts have been left out.
Many people say things like this. Is it smart to say? I guess not. How often do staff actually hit patients? To my knowledge, almost never. I do know of one person who did hit a pt back after he hit her. Staff was fired.
OP, get your story straight. What's with the 3 hours before you could say anything? What does that mean? What were you doing for 3 hours, did you tell your orientee her attitude was not acceptable? Who is the other busybody who ran to the boss?
You probably will get fired because you don't communicate clearly. Your orientee will try to lie, somehow it will be your fault that she verbalized her fear as a threat. If she's such good pals with the boss, how come the boss didn't tell her about this rule and does your boss/facility provide teaching about how to defend yourself from violent patients without it being considered improper?
IF you are smart, you will just take the correction and do not say anything else, like you didn't think she really meant it. You will just dig yourself in deeper. No defending yourself, just take the discipline or counseling and be done with it.
Wow. I had no idea the mother was a GYN nurse. That particular fact floors and disturbs me greatly (it goes without saying that the rest of the story is hideous). As an OB nurse, I have dealt with rape up close and personal, as have all of my colleagues, and to think that one of our "own" could be so insensitive is just unfathomable to me. The mother's refusal to support the victim and call rape rape isn't just willful ignorance at that point, and becomes something more insidious and malicious, IMO.
We are mandated to 16.5 hr shifts every pay period right now and our nursing aids can be mandated twice per pay period.
We get in trouble if we call in for the following shift even though it's only 7.5 hrs to get home, shower, eat, sleep, forget trying to spend time with your family.
I wish we could be relieved of that following g shift but we are too short staffed right now.
Too bad Psych nurses aren't protected by law from being assaulted and battered.
Yeah, no. It is actually lose-lose.
I didn't become a nurse - especially an ED nurse - for "job stability." In as much as I didn't become a nurse to treat "customers" instead of "patients."
This is exactly the kind of hokum peddled by un-supportive management to ensure a continuation of ED abuse and over-crowding. A few years ago at my old ED job, management tried to convince ED nursing staff that an establishment of an "Observation Unit" (monitoring admitted, stable Observation patients - usually for chest pain/ r/o ACS) was in our best interests. More "hours posted" for nurses/techs to pick up, hence bigger paycheck etc.
NONE of the nurses/techs 'assigned' the Obs Unit liked working it - for obvious reasons (not all that different from taking care of holds/boarders!)
And let me remind everyone - ED overcrowding is as serious as a heart attack, and can be just as deadly! How many of you would like to bring your Father or Grandmother to the ED with complaint of chest pain and be told to wait in the waiting room? Or let us assume the initial EKG shows an acute MI but the ED is so full (with emergent and 'non-emergent' complaints), the staff has to "create a bed" to accommodate an obvious emergency - would you like the nurse taking care of your Father or Grandmother, to also be responsible for 5 other patients? Or would you prefer that the nurse be able to hand off her patient load momentarily so that s/he can pay undivided attention to your loved one in their hour of crisis?
Or let us even assume that the initial EKG at triage was normal or borderline - how many of you would want the triage nurse to send you back to the waiting room instead of a monitored bed? Be truthful!
I had one a few months ago.
Very young, adult female. Came in by EMS. I triaged her out to the waiting room because I had no open beds. At 0830 in the am. She huffed and certainly appeared offended that she was going to the 'waiting room' even though "I came by ambulance."
As the EMTs were wiping down their stretcher and getting ready to head out, I noticed that their radios were going off constantly. The EMTs looked upset. I leaned over and asked "Y'all ok?"
"No. Not ok. That's the third call out requesting an ambulance to transport a critical patient but nobody in the township or county can respond because we're tied up with BS calls!"
The very young, adult female that came by EMS? Her chief complaint?
Nope, not kidding.
* Have you EVER had to take a "chronic headache patient" and smile about it, when it is the patient's 240th visit in the ED in 2016? For the same "chief complaint"?
The ones who are allergic to everything except Dilaudid and Benadryl/Phenergan? None of which are drugs recommended to treat chronic migraines or headaches?
* The ones who refuse Imitrex (for example) because "it doesn't work. That drug what starts with the D... Dilauntin.... usually helps."
* The ones who occupy a stretcher in the ED with their chronic, non-emergent complaint - while 80 year old gramma lies in withering pain in the waiting room!
Not burned out - but I am certainly very frustrated!
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