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Kooky Korky 16,884 Views

Joined Feb 12, '10. Posts: 2,845 (52% Liked) Likes: 3,770

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  • Jan 13

    Quote from Kooky Korky
    While that might help 7-3 shift, the educators and other specialty nurses (wound care, MDS Coordinators, Admissions Nurse, Unit Managers ADON, DON) are not usually there at 1900 or 2300 to relieve 3-11 or 7a - 7p shift, nor are they usually there at 0700 to relieve 11-7 or 7p - 7a.
    On nights we rearrange the teams or work a team alone (we have rn/lpn teams in most facilities and units), or there will be float coverage (not necessarily someone on the unit though). We also have evening and weekend managers who can approve calling in people from other units, close beds, or sometimes they will help if the situation warrants it. Still we're not expected to remain after the shift is done. Rural is a little different due to having less staff, but usually the oncoming nurses are expected to figure out how to cover all patients if relief isn't found.

    Eta: additionally our union just won a fight to enshrine in the contract language that gives charge the right to call out overtime in the absence of a nurse manager. This is because the regions are creating planned shortages and not calling out shifts, hoping that people won't notice or something. They don't really want to give people that much OT.

  • Jan 13

    Quote from morte
    smart mouthed answer to a serious question.-
    It was actually semi-serious. We diagrammed sentences when I was in school -- it was part of English class. My friend, whose grandchildren are in elementary school now says they aren't learning sentence diagramming or cursive writing, but they're getting a lot of "Study sessions" and recess.

  • Jan 13

    Although I am fairly liberal, certainly not a prude or possessing delicate sensibilities, I have noticed that crude/vulgar speak is much more common today and seems, almost fashionable in some circles. I, personally, am not offended by colorful language (not in the presence of clients/patients), but understand those that may be and do think that it is somewhat unprofessional and unbecoming to the person-just my opinion though!

  • Jan 13

    Whether we like it or not, "retarded" has become a distasteful word to use. At one time, it simply meant "delayed" or "late in learning," innocent enough. But the behavior associated with using the word became ugly, and so the language use followed. It even became politicized, with words like "libtard," in a deliberate attempt to insult and denigrate people on the left side of the spectrum. I think "cretin" used to be a clinical term too. It will be interesting to see how current language evolves. But for the moment, my opinion is that a nurse or doctor who chooses to use this word shows a lack of understanding of verbal boundaries, empathy, and professionalism. The popular belief is that the word is derogatory and demeaning, and when you are in a position of power, being paid to treat vulnerable patients, that is not the time to promote your freedom of speech, especially knowing that it is perceived as cruel and abusive.

  • Jan 13

    Only if you can do through a professional agency. You must protect yourself.

  • Jan 13

    This gives the RiskManager the vapors. You are essentially providing nursing care in this scenario. You don't have the regulatory and liability protection of doing this as an employee. I am not certain that taking instructions/orders for the parents in providing some degree of skilled nursing/healthcare services is permissible. If something goes south, I would wager that the BON would be parsing that difference between instructions versus orders. What if the child has a medical emergency whilst in your care? A babysitter would just call 911. Are you going to do only that, or call the provider for orders or take whatever actions you deem appropriate based upon your experience, training and nursing assessment?

    You would clearly need to have your own healthcare professional liability coverage for this; your employer will not be covering you for this sort of 'off the clock' work. For that matter, even with my own policy, I would want to run this past the insurance company underwriters/risk/claim manager to get their opinion as to if the individual policy would provide coverage.

    Were I in your shoes, I would refuse to do this. I would tell the parents that due to regulatory, legal and liability reasons, it puts your license, livelihood and assets at risk. If the parents want to contract with your employer for pediatric nursing homecare and ask to have you assigned, that would be the only way I would provide services to the child. Even then, seeing as they are fellow church-members, could you maintain your professional boundaries sufficiently?

  • Jan 13

    Graciously accept their letters given to you personally. If you choose not to use the letter(s), that is totally up to you. It is nice that these people think so highly of you and your work.

  • Jan 13

    Quote from smartblnde
    I have to get it from the provider.

    I agree with llg both with not inferring the reason why the physician isn't sending it, and that you should ask the patient to get the labs and bring them to class.

    Is the clinic large, small? Do they have a separate medical records department? If so, I would go directly through medical records or the unit secretary, rather than with the physician directly.

  • Jan 13

    I think it is a mistake to make assumptions about why the physician doesn't send the lab. There may be other reasons that haven't occurred to you. It may be a problem with his office staff & he may think that labs are being sent. He may be sending the labs to the patient and counting on the patient to share them with you. There could be lots of reasons.

    Since you are trying to promote the patient's "self-management," I don't see anything wrong with asking the patient to take responsibility for their own labs. They can send you copies of the results they receive from the doctor. (I've certainly carried my own X-rays and lab reports to consultants before.) But if you have some objection to that, then talk with the doctor. Schedule a meeting (or appointment - and be prepared to pay for his time) and discuss the situation with him. Find out what the real reasons are. Don't be assuming things that you have no evidence of.

    As the old saying goes ..."When we a-s-s-u-m-e things, we make an a** of u and me."

  • Jan 13

    Quote from Sour Lemon
    Crying is great, isn't it? I even managed to get out of jail once by crying.
    I managed to get a car dealership to take a new car back that I'd taken delivery of and had for the weekend.

  • Jan 11

    I am not a lawyer so I cannot really give a legal advice. You may want to consult a union rep, if you have one. But from the common sense point, it does look like it might be illegal, or, at least, unethical to "force" you practice with limited training given. Also, the simple math is in play here. Some odd number of peds nurses left, so now, and OB nurse with your own responsibilities, are forced to do YOUR direct job, as well as the peds job when necessary. Will that JOB be on top of what you already have to do, thus, overtime, and, therefore, paid for it? I hope so, if not, you definitely have to do something about it.

  • Jan 11

    You're not obligated to answer any calls from work when you aren't on the clock. Regardless of why you don't answer or don't want to pick up time, it's the facility's job to make sure the unit is fully staffed, not yours.

    If people talk about it, let them. That kind of pettiness will be present in any job you happen to take in the future. You'll do well to learn to ignore it now.

  • Jan 11

    I don't answer the phone on my day off. I let it go to voicemail and I'll call back if warranted. It is not my responsibility to staff my unit and it's not yours either. I pick up shifts only when it works for me and I decide I want to. Do not feel bad for knowing your limits and setting them.

  • Jan 11

    No, not answering the phone is your right. I wouldn't let that make you feel bad. If they have staffing issues, you are not the answer to them all.

    Focus on studying and work as much as you need to and let the rest roll off your back.

    I regularly screen my calls. And don't answer.

  • Jan 9

    They're not teaching it anymore. Have you seen the curricula at many district schools these days?

    My kids go to a charter school where they're taught for two solid years how to diagram sentences. I never even got that in Catholic school. The school also has a structured, rigorous writing curriculum that starts in junior high and culminates with an extremely demanding senior thesis. But this is rare across the country.

    The people you're interacting with here literally did not get the kind of instruction they should have had. My dad graduated from a public district school in 1970 with a really good, thorough basic education. It was enough to make him successful in both the military and law enforcement. He only earned a bachelor's degree in his mid 20s to enhance his paycheck. These days, you couldn't pay me to send my children to the high school he attended.