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monkeybug 7,853 Views

Joined Feb 26, '10. Posts: 726 (60% Liked) Likes: 1,614

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  • Jun 22

    Quote from classicdame
    we were told once to not call into the patient's room if their favorite show was on. Really?
    And how are you to know that? Is their favorite show part of the admission assessment?

  • Jun 13

    Quote from Chrishi
    The only complaint I know of was from a family member. I was in the middle of a long treatment on another patient. This lady wanted me to come listen to her husband's cough, despite the fact that I hadn't heard a cough for the first 7 hours of my shift. It took me probably 20 to 30 minutes to finish the treatment that I'd been doing, then I came to listen. No cough. I stood in his room for fifteen minutes (that I didn't have) just to hear his 'cough'. His lungs were clear on auscultation.

    The next day she complained to the administrator that she had to wait for 2 hours for the nurse to come listen to her husband and then the nurse 'didn't even do anything.'

    I think she wanted me to get an order for cough syrup or an antibiotic that he didn't need. Or maybe she just wanted me to act all excited. I don't know. Needless to say, I didn't get in trouble. But it's annoying when you're doing everything you can to help people & families have these unrealistic expectations of you.
    You're probably right about them wanting you to act excited. It makes families really angry sometimes when we don't respond in the way that they think we should. Like the pregnant patient that comes to L&D triage with no complaints of pain, leaking, or bleeding. Their only "complaint" is that they lost their mucus plug. I respond very calmly, and assure them that it's ok. Upon exam, I discover that her cervix is maybe 0.5 cm (if the examiner is generous), no contractions, and the baby looks beautiful on the monitor. Pt's mother has a come-apart. "But she lost her mucus plug!!!!" Omg, rawr, rawr, rawr, call the rapid response team! It didn't get any better when I calmly told her that I didn't have any to replace it with. Yeah, I should have held back, but come on! You can lose a mucus plug 2 weeks, 2 days, or 2 hours before labor starts, so big freaking deal. And NO! I do not want to see it (if I had a nickel for every time someone fished their mucus plug out of the toilet and brought it in a paper towel, ziplock bag, or baby food jar I wouldn't have to work. I'm happy to mitigate ignorance and educate, and I did attempt it in this situation, but the patient's mother wasn't accepting any knowledge. Her mucus plug came out, and therefore the nurse must....what? I never figured out what she wanted from me. I guess I was supposed to run around in circles in the room, throwing my hands in the air, screaming, "Lawd Jeebus, help us! She's done lost her mucus plug!" Maybe if I'd done that she would have taken it down a notch. The mother was very resistant to discharge, and I had to have the OB come in and speak to them. Said OB had been up for hours doing deliveries and had finally gotten a chance to lay down, so he was none too pleased and it showed. I'm sure she told everyone she came into contact with in the community that her daughter lost her mucus plug and we did nothing and didn't even care!

  • May 9

    Quote from salvadordolly
    Off three days for IV Abx for a kidney infection. Too many back to back UTI's, you know the story.
    DON: I sure hope you have your Dr's excuse.
    ME: Yes, here it is.
    DON: (looks at it) Kidney infection? Goodness sakes! Are you wiping properly??

    Another classic. I got fired from my case management job on a Friday afternoon. At the end of the termination speech, "you are on-call this weekend, you know".

    Are you kidding me? My response would have been, "I DARE you to call me." And as for the kidney infections, how inappropriate!

  • Apr 25

    Quote from nrsang97
    Seriously that is dumb. Management has lost all common sense. I am so lucky I have the manager I have.
    My first manager RUINED me. She was as good as it gets, and she spoiled me. I expected all other managers to be as good as her. We were at a tiny rural hospital. As long as we did our jobs and the patients got good care, she didn't sweat the small stuff. You and your husband both working night shift and you didn't have anyone to keep your kid? She'd let you put them in an empty room overnight, as long as it didn't happen often. I also saw her come in at 2 am in a nightgown, scrub a c section because we were busting at the seams, and then go back home to bed and make it back at 8 am to help out again.

  • Apr 25

    Quote from Testa Rosa, RN
    Awe Monkeybug--so sad to hear about the reduced milk supply because you were unable to pump. I used Fenugreek myself when I started back at work to keep my supply up and then we shifted to night nursing which you know meant I was dead tired at work the next day. Sounds like you are a great Mamma and Nurse. Nurse Managers are LOCO
    I tried Fenugreek without much results, then Reglan, and it made me want to crawl the walls. Very unpleasant drug! I did research and ended up ordering Motillium from a Canadian pharmacy. I had so much trouble with latch, nipple confusion, and supply that once I got good at it I didn't want to stop! I -let him self-wean. Every day I would think we were done, and then he'd drag the Boppy over and sign "milk" so it would continue. I actually did miss it when he got too busy and distracted to nurse. Thanks for the compliments. I tried for so long to have a baby, I want to do everything right and get the most joy out of parenthood that I can. I think I'm doing ok. He's 3 and reads on a kindergarten/first grade level, and he's chock full of personality. Last night I told him I saw him throw a toy at the cat, and he better not do it again. He said, "well stop looking at me and finish cooking supper!"

  • Apr 22

    Quote from nrsang97
    Seriously that is dumb. Management has lost all common sense. I am so lucky I have the manager I have.
    My first manager RUINED me. She was as good as it gets, and she spoiled me. I expected all other managers to be as good as her. We were at a tiny rural hospital. As long as we did our jobs and the patients got good care, she didn't sweat the small stuff. You and your husband both working night shift and you didn't have anyone to keep your kid? She'd let you put them in an empty room overnight, as long as it didn't happen often. I also saw her come in at 2 am in a nightgown, scrub a c section because we were busting at the seams, and then go back home to bed and make it back at 8 am to help out again.

  • Apr 22

    Quote from classicdame
    we were told once to not call into the patient's room if their favorite show was on. Really?
    And how are you to know that? Is their favorite show part of the admission assessment?

  • Apr 20

    Quote from KelRN215
    "The hospital always errs on the employee's side"... A lie told to me by management attempting to explain why I wouldn't be getting paid for the extra hour I worked on the fall back night in 2011.
    We never got paid, either, but it was okay (to management) because those that worked the spring forward got paid 8 hours. Never mind that it was not always the same nurses.

  • Apr 19

    Quote from salvadordolly
    Off three days for IV Abx for a kidney infection. Too many back to back UTI's, you know the story.
    DON: I sure hope you have your Dr's excuse.
    ME: Yes, here it is.
    DON: (looks at it) Kidney infection? Goodness sakes! Are you wiping properly??

    Another classic. I got fired from my case management job on a Friday afternoon. At the end of the termination speech, "you are on-call this weekend, you know".

    Are you kidding me? My response would have been, "I DARE you to call me." And as for the kidney infections, how inappropriate!

  • Mar 25

    Congratulations! And yay for you for breastfeeding! After my baby was born, I was working on L&D, some 8s and some 12s. I breastfed for 15 months, but stopped pumping after he turned 12 months and could drink whole milk when I was at work. I tried to pump every 3 hours, but it didn't always work out. One of the best things you can do to insure success is to have a really, really good pump. The better the pump, the better your supply will be. I initially rented a Medela pump, but once we had breastfeeding well-established and I knew that I was in it for the long haul, I invested in a Medeal Pump In Style. As for the coworkers, you'd think being in L&D would mean absolute support, but that is absolutely not the case! In fact, one memorable day, I'd worked 9 hours without being able to pump and I was in active pain due to engorgement. My nurse manager was sitting at the desk doing some paper work, and I asked if she could keep an eye on my patient's monitor strip so I could go pump. She refused. I have never forgiven her for that. One of my coworkers was headed out the door, but threw her bags down and told me to go pump, that she didn't want me uncomfortable and leaking all over the place. She got a nasty look from the manager for that one.

    You will usually find that your best support comes from coworkers who breastfed their own babies. I have found that bottle-feeding coworkers tend to get huffy about it, especially after your child is about 6 months old. Maybe they feel guilty? Or maybe they feel like their own choices were being impugned? My pumping brought me a beautiful friendship. There was a nurse on the unit that I could never get along with. We were like oil and water. But, when I came back from maternity leave, I made a point of asking her about her experiences (she had just finished nursing for a year) and she was the one I could always count on to relieve me so I could pump. When she had her next baby, I returned the favor as often as I could, and now we are best friends.

    Don't get discouraged, and don't let a lack of support stand in your way. Look up your hospital's policies on breastfeeding, and see what your state law guarantees you. Our policies said I should have a private place to pump that was not a bathroom. I ended up in the locker room all the time, which wasn't very private, but I would sit in the corner with my back to the door, because I never had time to go out to the nearest pump room.

    I would pump at home before I left for work.

  • Mar 16

    Quote from PMFB-RN
    *** Ya I too have been and am lucky enouh to work with similar physicians and there's nothing the nurses woulnd't do for them. Still doesn't mean I won't question their orders if needed. Once recieved and order from just such a doc for "baked potato PO BID". I wasn't even sure when I called if he was actually awake. I waited 15 min and called the great doc back to say:

    Me: "Hey Brian just letting you know I am holding your last order for baked potato PO BID"

    Brian: Oh man I didn't order that did I?

    Me: Uh ya man you did.

    Brian: How about Lopressor 5mg IV now?

    Me: SURE! Will get right on it. BTW thank goodness you said PO cause who knows what I would have done with it.

    Brian: LOL!, see you in two hours PMFB.
    I got an order in the middle of the night for "20cc of saltine crackers." I had called with ABGs expecting vent setting changes for a NICU baby. I paused, asked if they were really awake, and then asked where they kept the saltines in the NICU. This woke them up! I got a laugh, a thanks, and reasonable order.

  • Mar 13

    I just recently left the hospital setting. I worked in a labor unit that was sort of a hybrid. Most of our patients came to see a group of private MDs, and the rest were patients of the local medical school. If I wrote down all the good things about the private MDs, I'd overload the server! When I resigned, 4 of them sought me out and asked me not to leave. One said several times to other physicians and my manager, that she knew her day would go better if I had her patients.

    Good stories about the medical school are few and far between, so I'll share a couple of them.

    We had a pt. delivering who was a mulitp and preterm. The attending was a bit of a nervous Nelly and was really worried that the baby would just fall out if we left the room, so we kept the patient in stirrups with everyone in attendance for about 2 hours. One of the residents was really reveling in lording it over his student. Rather than taking off his gown and gloves, he made the student go get him a cup of water and then hold the straw to his lips. I nearly gagged, and my eyes nearly fell out and rolled across the room I was rolling them so hard. The attending noticed, and made the resident get up and give me his exam stool! I was tired, so I enjoyed getting to sit, but I really enjoyed seeing him taken down a peg or two. I think the student enjoyed it.

    We had a fellow who was turning out to be pretty good, and he really confirmed it for me in one of my deliveries. The private doctors would let us push on our own. We only called for them if there was absolutely no progress, some sort of distress, or the baby was about to pop out. Oh, but the residents.... No peace with them! They would insist that we start pushing the minute the patient was complete, and would insist on gowning and gloving and sitting on the exam stool while the nurses were left to stand at the side and try to coach without really knowing what was going on. After about an hour of this one day, the fellow told the resident to get up and let me sit there. "There's something the nurses do, I wish I could figure it out. Let Monkeybug have a go, and I bet we'll have this baby out." I sat down and did my usualy thing (perineal massage, pressure down towards the rectum, and dircected coaching "No, that's not quite it. Yes, just like that! More of that!" and we were crowning in 4 contractions. All the residents and the student were looking at me like I'd just turned lead into gold, and the fellow said, "see, I told you, the nurses know what they're doing."

  • Mar 5

    Quote from aachavez
    You're a new nurse and have never done an IV stick? That scares me a little bit... I'm in my RN program now and would be terrified if I found out we wont get some exposure to that! Then again, maybe I won't? Has this happened to many others?
    I graduated 15 years ago, and the first IV and the first Foley I ever did were in my preceptorship. So, I hadn't graduated yet, but I didn't get to do them in clinicals. I have acted as a preceptor for nursing students for the last 4 years, and most of my students had many "firsts" while they were with me. I expected that, and made it my goal that by the time they left me (and graduated) they would be proficient in Foleys, IVs, and straight caths.

  • Feb 15

    I truly get that cathing pregnant women can be difficult if you don't do it multiple times on a daily basis. Still, I was ready to murder a couple of postpartum nurses. At the hospital where I used to work, scheduled C-section patients would be prepared for surgery on the postpartum unit. We would then get them, do the section, recover them, and then take them back to their room on PP. First of all, the nurses out their acted like placing Foleys was equivalent to scaling Mt. Everest, and would do anything to avoid it. They acted the same way about IVs. Yes, practice makes perfect, and we got a lot more practice than them, but that could be remedied if they would just do them. I know they were busy, so were we, just doing different things. And nothing thrilled the doctors more than standing there scrubbed and waiting while we scrambled around to do prep that should have already been completed. The absolute worst, though, happened to me twice within a month's span, and I could not figure out how it was happened. I had a patient come back for her section. Foley bag is hanging from the bed, Yay! I'm happy and assume all is well. We get her spinal, get her prepped, docs waltz in and begin the incision. I turn my back to the field so I can start my mound of paperwork, and I hear an exclamation and then my name, loudly called. I turn around and observe what appears to be a huge balloon emerging from the incision. No balloon, it's the patient's bladder, which had miraculously escaped being nicked by the scalpel. "Why does this patient not have a Foley?!" Ob asks. "She does! She did!" I reply. "Well, obviously not in her bladder!" he snarls and gestures toward the distended object waving in the breeze. He and his assistant (the second most impatient, difficult OB--#1 was wielding the scalpel) then raise the drape so I can investigate. Foley is nicely secured to the leg, but one gentle tug reveals that it was placed in the vagina. I throw another one in while the two OBs tap their feet and sigh. I make a point of telling them that I was NOT the one that did this. OB declares that he will get to the bottom of it. I become hyper-aware of urine in the tube and bag. If the bag is empty on one of my sections, I begin to investigate before the OB hits the OR. I do not want a repeat performance that included the surgeons putting baby formula in the Foley and then pushing methylene blue to double check for nicks. Two weeks later I get a scheduled section with an empty bag. I investigate, and find, ta da! Foley in the vagina. I remedy the situation before the doctors hit the OR. It is the same two from last time. I tell them about it, and get a "thank you for checking." The results of the OB's questioning about the first incident? He's told that it's a float nurse. SO??? A urethra is a urethra regardless of the location in the hospital. You place it, gently tug, make sure you've got a return of urine, then tape.

  • Jan 12

    What the young nurses should be worried about is the status of their personal malpractice insurance. You are much more likely to be sued for something that stems from a med error or understaffing than you are to have your license revoked. The BON doesn't worry me too much (not dealing or diverting! ) but trial attorneys worry me plenty. In our state the bar is set pretty high for even getting a med mal case into court, but who wants to deal with any part of a lawsuit, even if it's eventually dismissed?


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