Kooky Korky 15,226 Views
Joined Feb 12, '10.
Posts: 2,650 (51% Liked)
online lecture yes, online unproctored tests and physical exam check offs, no
we do TBLs but its still not as big of a waste as writing papers and research fluff.
we aren't really comparing online vs BM. we are comparing sucky for profit education vs an actual challenging NP education.
all type of provider education should be difficult.
Medical school does one thing better than NP school in that it sorta forces you to know the stuff you need to know to practice. You can't pass without at least getting enough out of it to provide safe medical care. Some NP schools do this too, but many of these nitwitU schools do not. Sure, some docs do a bad job, but id say its usually out of laziness.
The happy medium for a provider really lies somewhere between NP school and MD school.
But if you want to be a good provider you can put the work in through either path and do a great job without learning every nerve in the body and what it does bc I'm sure the hell not gonna remember this **** 7 years from now when I'm done lol.
Oh, you're way too nice. If she's missing something, she needs to look within herself. What are we teaching people with "poor coping skills" when we give them exactly what they want for acting like jerks?
Well, Roggae, how did the talk with your boss go? I hope you told her all the things you said in your first post - like the pitbull (I know they can be very sweet, but you should not have had to be in the room with the dog. The dog could have spent the night with Security or in the Morgue or the Loading Dock area - somewhere where you would not have been afraid).
And the rudeness of the Charge Nurse and her practicing Medicine without a license are completely not acceptable. In her defense, doctors and supervisors and Admin might have implied that she go ahead and do whatever it takes to not wake the doctors up and I do understand that. But do not allow her to make you practice without a license. They probably figure the doctor will just give the order in the morning. At a huge university teaching hospital where I worked Open Heart post-op many moons ago, the nurses would just give Maalox or a laxative or aspirin or whatever relatively minor meds, order diets, order activity, order respiratory and labs because all the surgeons and house staff were scrubbed. The floor had, more or less, standing orders and the docs did sign them when they rounded after finishing in the OR. So it could be this Charge is working under this mentality.
I'm glad you understand that the Charge is supposed to do staffing, solve problems that staff can't solve, keep supplies and meds stocked, and deal with the dog type issues. Charge is not ever going to keep me from calling a doctor if I believe I need to do that. That is simply a tough but necessary part of the job, night shift or not.
Yeah, the old "I hate conflict" issue. No one likes it probably, but we all have to deal with it. Do not lick this woman's boots. Keeping the peace is good, but you must draw the line - respectfully but firmly.
Just tell her you do not feel comfortable doing "such and such" because a doctor must give an order - unless the place has written Standing Orders/Protocols for things like chest pain (VS, EKG, ABG's, nitro, monitor, IV access, 02, whatever), insomnia, constipation, etc. Even with written SO's, you must evaluate the pt and get a doctor involved if you believe it is right to do so, no matter what time the clock says.
They likely won't do it, but what if an NP could be on call at the hospital at night? She could see the patients as a hospitalist would, thus relieving doctors of a lot of calls they'd otherwise get and preventing the Charge from feeling she must know all the answers and practicing medicine without a license.
Good luck to you. Be brave and courageous. Check the Nurse Practice Acts as suggested. And stand your ground.
BTW, you were overridden. They overrode you. Affect your license, not effect. No rudeness intended, it's just that grammar is an OCD thing with me.
And it is, as stated earlier, common for there to be only an ER doc or no doc in a small community hospital. But the attendings are readily available (supposed to be).
People are people wherever you go. Some are awful, some you will love.
Sometimes you will find, much to your shock and dismay, that the very ones you like and enjoy working with are the ones who will knife you in the back. They will be the ones who put you down. And you thought they were your friends. That hurts and shocks.
I don't know what to tell you except walk quietly, do not gossip or discuss this sort of thing with anyone at work, mind our own business. Even then, someone won't like it or you and will then be after you to do you dirt. No matter what you say or do, someone will misinterpret it, misrepresent it, lie about you, and otherwise cause you trouble. That has been my over all experience with coworkers. I've had some great jobs and met some great people, but my trust in people was destroyed long ago.
Try to win the lottery so you don't have to work.
13 hospitals closed in PA in past 2 years. No new hospitals in my 5 county Philly in 30+ years. Many others merged. There are only 6 maternity units remaining in Philadelphia--prior had 15.
Within my health system in past 2 years: one out of 5 hospitals closed; other 4 closed maternity units; 3 SNF and 1 inpt rehabs closed.
All hospitals in my county closed their hospital based SNF/TCu units - total 5. Competing health system laid off 500 employees and closed 1 of 3 hospital based homecare agencies in 09......
all before Obama's health plan developed.
Closings, Mergers and/or Name Changes | PHC4
No more Captain of the Ship approach, it seems.
Thank God for brave nurses.
I would be hardpressed to let this doctor argue, shout, and demean where patients could hear him.
I once took the arm of a tantrum-ing doctor and said, "C'mon, Sir, let's go have a break", and pulled him into the locker room. He was stunned but complied.
These days, I know more is required - reporting to Admin, Board of licensing, CMS, etc., but it felt good to abort that particular incident.
Keep on keepin' on, y'all.
The trick is to act like you think they are asking you to do something that they think they aren't allowed to do themselves.
1. In a cheerful helpful voice say, "Oh, you can do that for yourself! That way you can set up the appointment at a time convenient to you!" <Big Smile>
2. Again, "Oh, you can do that for yourself!" < Big Smile> (Assume that they don't know that they can call ahead for a refill. You are just teaching them and empowering them. ) Most pharmacies have refill phone lines and allow patients to request refills on the web.
3. "Oh, I'm sure the state wouldn't let me request someone else's birth certificate. They are really concerned about identity theft now. " (You are just protecting them.)
4. "Oh, you can do that for yourself! <Big Smile>. I'm sure your Dr will have questions about your ER visit that I wouldn't know."
5. "Oh, you can do that for yourself! The trash can is right over there." (Assume that the patient is asking, because they don't know where the trash can is. You are being helpful.)
As the offgoing nurse I'd apologize, say I didn't realize, and that the docs had just left. If the ongoing nurse insisted I had to clean it, I'd agree, but point out I'd just gotten into my charting, I'd complete that, and then go tackle the mess. Most procedure messes are five minute jobs, but charting can go on quite a while. She'd get sick of looking at it and clean it herself, or I'd go do it in my own sweet time, and put in for OT, with a note about the reason why. If the boss states we cant do OT for clean ups, well, that ruling is not my fault.
I think everyone develops a reputation, hardworking, or not so much. Some days you cant stand to start out with a disaster in the room, and asking the offgoing nurse to take a moment to help would be ok, if you are the hardworking sort, and you ask nicely. Yes, I would help immediately, if the asker is a team player!
Just as veterans and current military personnel are thanked for their service, we need to thank each other and be thanked, too, by others for our service.
Let's start that new trend.
A guote from "West Side Story" for Been There 2012 - "Ya done good, Buddy Boy". BB was a Jet being thanked by her fellow Jets.
You really do those things? Sorry, but I'm just kind of shocked that someone would proudly admit to behaving that way! I'm sure that almost everyone has days that we are, shall we say, not our "best selves", but you seem proud of it....
For at least 12 years I have carried a Kershaw Leek everywhere I go (except flights you jerk TSA goons). Prior to this it was a different knife.
I used it to open blister packs every RN shift. Using my fingers made the sore, and I felt I had developed neuropathy.
I use an exceptionally fine-point pen (seriously, they don't sell them in stores, I have to order them online) for charting. The point is so sharp it's also good for opening even the toughest med wrappers. And given how bad it hurts when I accidentally stab my finger with it, it'd probably be good for self-defense too.
There are some pills that you just cannot open!
Does anyone remember and miss the days when every single pill did not come in its own individual little package?
And there was no need to struggle with wrappers because there weren't any!!
I fought with one today for a full minute before it gave way.
Not to mention there was a whole lot less trash when we did not have to unwrap, break through, dynamite every pill out of its own wrapper.
I am going to let the manufacturers of the ones I find the worst know how they could make nurses' lives a whole lot easier.
Yes, I do have scissors and a pen. Maybe switch to karate chops?
Hello fellow Nurses!
I am in need of some advice and alternate opinions. I am experiencing difficulty making a decision on what to do. The situation is as follows:
I am an LPN working for a General Surgeon and Nurse Practitioner. I am the only clinical employee in the office; so, needless to say, the work load is WAY too much. They recently hired a medical assistant for me to help. I was so excited to have a partner/coworker; and, even more excited to have a Graduate Nurse from an RN associates program. She graduated six years ago; however, she is not licensed. She failed the NCLEX five times and decided she was done trying. This was the reason she gave in the interview for not becoming licensed, "Family is more important to me and I didn't want to work RN hours." At first, I was perplexed but thought that maybe life handed her some higher priorities. Now I know she lied about it. I wouldn't have thought any different of her had she told me the truth.
I guess I am rambling so I will get straight to the point. She has made multiple comments to me, the providers and the my other coworkers about her superiority compared to my LPN status. She has tried to tell me how to do my job ( mind you it is only her second week working ). She will cut me off mid-sentence when trying to teach her how to do something in order to let me know she is already aware of how to do it; however, she does it incorrectly.
There are so many other things this person has done that disappoint me greatly. I would never ever disrespect a fellow RN or LPN and I have never been treated as a lesser equal by those RN's I have worked for. It is quite the contrary: They have asked me for help/advice in areas I was more knowledgeable in and vice-versa. Friends are telling me I need to assert my authority right away but I am a very passive person. Plus, I really wanted my assistant and I to have a great working relationship. Like police partners...sharing the load and having each others backs.
I guess I am hesitant to assert my authority because I do respect her for graduating from RN school (even though she is not an RN, Not even a certified medical assistant) I know it is drilled into LPN's during school to always report to their RN;so, maybe that is why I am lacking in putting my foot down. Maybe in my mind she has some authority over me??? I am a bit surprised in the lack of her basic nursing knowledge for a graduate nurse, for example: not knowing what warfarin was, or knowing that Mycin antibiotics are not Penicillins. ( Maybe those are just some things she forgot right? I mean....I don't remember everything ) I feel so indecisive and confused. I guess what I really want to know is this:
Would I be in the wrong for treating her like a medical assistant and not a graduate nurse?
I gave her my trust and the privileges of a graduate nurse but now I am thinking the better of it. She doesn't respect me at all and has made that quite clear. I am so bummed out. Any suggestions, reassurance, advice or opinions would be MUCH APPRECIATED!
There's a lot of comments on here, but I would like to comment as well. Before I became an LVN I was a certified medical assistant. Yes I passed California boards and I am proud of it. However, because of my title, I would only work in my scope of practice and never ever disrespect or put authority over others that are clearly licensed professionals. I worked as a MA at an outpatient surgical center in PACU and Pre op for a few years, and I worked great with the RNs. I assisted with everything they needed, and in return they would help me out also (there were a few RNs who would sit around the nurses station and just talk, not helping as if they are beyond helping stock or clean...which are basic duties. There were only 2 MAs and about 8 RNs...if there are no patients PLEASE help.) Anyways, there would be new grad RNs or LVNs not knowing the procedures in PACU...or which doctors would yell at you if you asked for help, so that's when I would help them orient to make work a little more efficient. They were mostly very kind and thanked me. However, as far as clinical duties, I never acted as if I knew more, or did more than my scope. All in all, RNs/LVNs are licensed...and I am not getting my butt burned if something wrong happens to the patients! All in all, she should still respect you because you obviously went to school, passed your NCLEX, and are licensed. She is not. I don't care if she went to RN school. She did not pass her NCLEX, therefore she is not an RN and has no authority over you.
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