Kooky Korky 12,330 Views
Joined Feb 12, '10.
Posts: 2,321 (51% Liked)
Why didn't the darned doc reorder the pre-op BP Rx?
OK PEEPS LETS GET THIS STRAIGHT NOW!!! I am a cna who works as pct at two hospitals on the east coast. I DO NOT WORK AT A LTCF.I DO NOT WORK AS A HOME HEALTH AIDE. So my job description may not fit the same as the aides that you work with. In my job description at MY JOB I am able to start iv's-flush them to ensure the work correctly not start a bag of fluids or hang meds. I am able to draw blood do ekg's etc. PLease back to the pubs thanks u guys rock!!!!
I don't know where you guys work but if I called one of our doctors about a missing chair alarm I might be looking for a new job.
Several thoughts on this. . . .
*My employer made us take training on getting enough rest and how that was a safety issues. With no changes to the attendance policy.
*My coworkers do not pay attention to getting enough sleep for nights. They are not careless nurses. These are pretty much exclusively moms of kids who are not relieved of childcare responsibilities.
*My employer does not officially care why you are calling in to work, as long as you give sufficient notice (2hrs). You get 3 absences every 3 months before the disciplinary process starts. 6 or more and your manager has the option of terminating you. You don't get a free pass for days you didn't sleep well.
*On a related topic, quite a few years ago I was moving through the disciplinary process due to an exacerbation of my migraines. My immediate supervisor was really worried about me and didn't want to lose me so she directed me to intermittent FMLA leave. It's FMLA, but can be taken as needed for personal or family health needs. Usually with a limit of 12 weeks a year (depends). Those absences are federally protected leave. I am not subject to disciplinary process for absences when they are for migraines. Several of my coworkers have it and some are suspected of abusing it. Most of my coworkers don't even know I have it because I might only use it every few months. And I will call in as "sick" (not FMLA) when I'm not having a migraine.
*Would be interesting to know if a doctor would fill out FMLA paperwork for insomnia. I would qualify. I've been seeing a sleep specialist for about 3 years now though he's helped me enough that I almost always get 6-7 hours of sleep every day (or night).
Do a self-assessment. Ask yourself what the pros and cons are of trying to change yourself and keep your job. What are the pros and cons of this job?
Do you have any idea how to be more positive? Do you have some strength-giving sources? God? Other spirituality? Diversions? Recreation? (re-creating yourself) Relaxation? Breathing techniques? Positive affirmations? Exercise? Hobbies? Interests - gardening can be refreshing and gets you in touch with nature; Feed and watch the birds. Keep a journal, write a book, do not violate HIPAA or make your employer identifiable. Group therapy. 12 Step meetings, even if you aren't a drinker or drug user or overeater or relative or friend of any of these. (for whom the groups are formed)
If the job is just too stressful, look elsewhere.
If you were so negative that you drove off a new employee, think how that looks to your boss. How would you think of an employee of yours who did that?
Do you enjoy being around negative people?
I remember a particular coworker who was justifiably negative, but it got so old hearing her c/o all the time. ALL the time. Never anything + to say. And it's been 30 years since we worked together. And that's how I remember her. And I liked her and empathized with her, just was so dragged down by her incessant c/o about the job.
Count your blessings TID for 30 seconds. No fire, no flood, no famine, no war in our country, you have an income and benefits, you are physically able to work and there's 30 seconds right there and you are just getting started. You can see, hear, walk, use all of your organs and parts, you have someone who loves you and whom you love, you are in a line of work that offers numerous opportunites and lots of variety.
Become a nurse on a cruise ship and see the world. Join the military and earn great benefits and see the world. Become a CRNA - the military seems to produce a lot of them. Fabulous pay as a CRNA.
Be creative and don't beat yourself up - that does no good. But don't speak negativity. You can learn a new way of living.
You might try taking in some donuts or bagels or a veggie tray and announcing to your boss that you realize you really have been negative and that you are grateful for having this pointed out because you really do like your work and that, as of today, you are turning over a new leaf and this food is just a little something to mark the occasion. People are often very glad when someone who has been counseled comes around, sees the light, admits to realizing that he or she has been doing not so well, and wants to correct the situation. Tell her you are sorry for adding to HER stress and that you realize how hard SHE works - and she really does. Being a boss can be a highly stressful situation, even if you don't see her doing bedside care.
I truly wish you well.
OP set in motion the chain of events that led to the fall, that is, she violated policy. IT is true that the receiving nurse accepted the pt, so that does mitigate things. Also, the fact that OP asked boss for help in obtaining the means to follow policy mitigates in OP's favor.
The only thing she should have done differently is to have notified MD that no alarms were available so, by policy, she could not get pt up to a chair because she would be breaking policy by doing so. MD could then have pursued the matter with the powers that be. I bet an alarm would have been found, even if someone had been sent out to Radio Shack or Best Buy to get one.
I understand all about the benefits of activity to the pt. However, the real issue is that the employer did not provide the equipment necessary for OP to follow policy, so OP violated policy. However, we are now back to oncoming nurse having accepted the assignment - without the alarm. Knowingly. The fall is definitely not all on OP.
I completely agree. After report you are no longer legally responsible for that patient. If the on coming nurse had any issues with the situation they should have been addressed in bedside report. That's the point of report. You don't let the other nurse leave until you are ok with everything. If report is accepted then so is all the responsibility.
You have gotten lots of good advice. I will just add something others have already stated - that you need to really think about what line of work you are entering. Choose another field if you don't have or can't arrange for lots of child care options. As someone said earlier, you need a regular resource and a couple of back-ups. There will be plenty of times you will need to be off for the kids' concerts, sports, lessons, etc. Is the child's father available?
I know it's tough. I never had this problem, as we lived with relatives and we all somehow managed to take care of the kids. But I knew plenty of nurses who had to be creative at times to get child care. One person used to sneak her very young baby in to work on the night shift! Kept him in a carrier under the desk! It was in a jail. But she had to stop that when, inevitably, she was found out.
You might find that Nights works best. Child in day care while you sleep, spend some of the evening hours together, go to work while child sleeps. You just need someone there at night. Tenant? Relative? Live with roommates and their kids? I know it's tough and I wish you all the best.
In some workplace cultures, relationships and politics, "who you know", etc. trumps everything else. I worked in a dysfunctional facility where management routinely hired their relatives and friends. It was a mental health facility, where many of the patients were vulnerable. Some of the technicians were absolutely horrible and had no business working in such a place. However, their aunt / cousin/ niece was a bigwig, and these employees made sure to let everyone know just whom they were connected to. New employees who came in and "made waves" by reporting verbal abuse or patient mistreatment were terminated while still on probation. One female tech was reported by several of her colleagues for patient abuse, but guess what? Her boyfriend, and later, her fiancée, was the facility investigator. No one saw anything wrong with their totally inappropriate relationship. I can understand the OP feeling ambivalent about reporting her preceptor if he is friends with people in high places.
I have a question maybe you can offer some input. Even if you can't I need to vent a little to people who may understand.
I'm a relatively new ICU nurse. I've been on the unit for about 2 month now, 5 weeks or so on my own. I have never had less than 2 patients. Several weeks ago I had a very confused patient fall while I was next door working on a spontaneous breathing trial for a vented patient. I was told it was my fault because I should have asked someone to watch the confused one any time I stepped away from his room. OK I accepted this and took responsibility.
Fast forward to yesterday. I have a patient who is alert and oriented x 3. Orders are to get her out of bed and to bedside chair, commode, etc. I get her out of bed to the chair (with multiple BMs in the commode along the way). I look for a chair alarm - there are none - and I request it from our charge nurse. None can be located. Throughout the day we find 2 single alarms but utilize them for the 2 most confused patients on the floor.
Come shift change - this is long I know please bare with me - I give report to the night nurse and let her know about the lack of chair alarm. I also explain to patient that myself and night nurse will pUT her back in bed shortly. 5 minutes later I'm documenting and night nurse calls me and says she was in the room, saw patient attempt to stand up, aND she lowered the patient to the ground. Charge nurses are made aware, director is made aware. No injury.
Today I get in and am told that I am being held accountable for the fall because the patient was out of bed without a chair alarm which never should have happened .
Finally the meat and potatoes - your opinions are requested. Was this my fault for allowing patient to remain in chair with no alarm? Does the fact that we didn't have alarms matter? Would this fall under my shift given that I'd already endorsed the patient?
I should note that my employer is a huge corporation and that we are not provided sitters (not that an aox3 patient needs one), and we are unable to use restraint of any type except chemical if patient is agitated. Should I have left this patient in bed all day since we had no alarms? Moreover I pointed out today that the nurse being IN the room meant she was able to respond much faster than anyone would have upon hearing a chair alarm. No dice.
I feel this is going to become an issue and it looks very bad considering my newness. Would appreciate feedback.
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