Latest Likes For Anna Flaxis

Latest Likes For Anna Flaxis

Anna Flaxis, ASN 21,418 Views

Joined Oct 15, '10. Posts: 2,840 (67% Liked) Likes: 8,466

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  • Jul 24

    I've never been in your position, but I have other leadership experience.

    First, listen. Just listen. Meet with each individual, like you plan, and just hear them out. Don't offer solutions or opinions. Ask them "What would you like to see happen?". Take notes.

    Look beyond specific issues to see what the over-arching theme is.

    Develop a plan to address the over-arching theme.

    Identify your informal leaders and try to get their buy-in to your plan by making it seem like their idea.

    Just my uneducated humble opinion. Good luck!

  • Jul 24

    I've never been in your position, but I have other leadership experience.

    First, listen. Just listen. Meet with each individual, like you plan, and just hear them out. Don't offer solutions or opinions. Ask them "What would you like to see happen?". Take notes.

    Look beyond specific issues to see what the over-arching theme is.

    Develop a plan to address the over-arching theme.

    Identify your informal leaders and try to get their buy-in to your plan by making it seem like their idea.

    Just my uneducated humble opinion. Good luck!

  • Jul 24

    I'm afraid I'm going to side with your unit educator on this one. Heart rate variability can be a strong predictor of mortality. Setting more narrow alarm limits can result in earlier recognition of deterioration, and thus earlier intervention, before the patient deteriorates into a code blue situation.

  • Jul 23

    Quote from relusanmi
    I have since found out that most of the MD's that are attached to the facility where I work get upset whenever you contact them about their patients, leading them to be rude in the way they address nurses.
    Can you define "rude"?

  • Jul 23

    Let her vent without offering your opinion. And foot rubs. Lots of foot rubs.

  • Jul 22

    Yeah, no. Of all the potential precipitating events, the fentanyl is the least likely.

  • Jul 22

    I'm afraid I'm going to side with your unit educator on this one. Heart rate variability can be a strong predictor of mortality. Setting more narrow alarm limits can result in earlier recognition of deterioration, and thus earlier intervention, before the patient deteriorates into a code blue situation.

  • Jul 22

    I feel your pain. I work with some folks who will spend 30 minutes fluffing and puffing a level 3 acuity patient while I carry the rest of the ER by myself, and then they look like deer in the headlights when three people show up to triage at the same time, and complain that they're not getting their breaks when I've told them, for the love of all that is holy, just go!!!

    I don't have any words of wisdom to share, just know that I can empathize.

  • Jul 21

    Quote from rubyagnes
    I definitely feel that I get hung up on "phrasing" - for instance instead of saying "patient walked to their bed" my preceptor tells me I should say "pt is ambulatory"
    Although I'm not certain that it's all that critical whether you use the word "ambulatory" rather than "walking", I tend to use language such as: "Pt ambulatory with steady gait to rm XX", or "Up to BR independently, urine spec collected", or "Ambulatory to BR with stand by assist", simply because "ambulate" is the technically correct term.

    I try to avoid language such as "Pt sleeping", "MD aware", "Call light in place, pt knows how to use it", or language that speaks to what others are aware of or know. Instead, I'll state "Resting quietly with eyes closed, respirations even and unlabored", "MD informed", "Call light within reach, pt instructed in use, verbalizes understanding". I don't have any way of knowing what someone else knows or is aware of- it's an assumption. I only know whether I've informed someone of something and what their response was.

    When writing a triage note, I try to avoid language such as "Pt hit head on door jamb", instead saying "Pt reports he hit his head on the door jamb". Even better is using quotes, such as Pt states "I hit my head on the door jamb". I don't know that the patient hit his head on the door jamb, I wasn't there. I only know what the patient is telling me.

    Make sense?

  • Jul 20

    Quote from whichone'spink
    Why isn't this post more popular?
    Because it was posted in the General Nursing Discussion forum, not the Emergency Nursing forum.

    OP, I feel you- and I guarantee there are many, many other ED nurses who feel you, too.

    Just as we're asked to understand the intertwined environmental and psychosocial factors that drive patient behaviors such as "non-compliance", drug seeking, ED and EMS abuse, etc, and recognize these behaviors as symptoms of larger societal problems, I see ED staff burnout as a symptom of these same societal problems, and I will not judge you for it.

    Understanding these things and providing compassionate care to people in need is not synonymous with enabling irresponsibility, learned helplessness, and lack of any personal accountability. It is a difficult line to walk, and can exact a heavy price when your defenses are down because you put your heart into your work.

    Thank you for giving of yourself to help others in need. I'm sorry the personal cost was so great, and I hope that you are able to find peace in the future, knowing that you did make a difference to someone. I know you did.

    Take care!

  • Jul 20
  • Jul 20

    Quote from MillennialNurse

    What really scares me is that this travel nurse that many of the "in-crowd" disliked had a hallway patient start to really decline, and the patient needed to be moved into a room for more aggressive interventions. People helped her physically move the stretcher into a room, and then they left her to perform/facilitate these interventions by herself. They just went back to the nurses' station. I'm terrified that the other nurses don't like me--and as a result, I won't get help when I need it.

    Just reaching out to see if other new nurses have had similar experiences, and what they've done about it. Thanks!
    I've seen this happen, only it was a charge nurse that would pull resources away from the nurse she didn't like, so she'd be in the room by herself with a crumping patient. She also had "pets", people that she gave preferential treatment to, by giving them the most coveted assignments and putting others that she didn't like as much in the less desirable area, and then hammering them with ambulances all day/night long. The problem was that this person was besties with the unit manager, so any complaints to the manager just made things worse. Fortunately, I was never on her radar, but I observed this behavior very clearly, and yes, it is scary.

    We also had the "cliques"- those little circles of friends that all knew each other outside of work, were friends on Facebook, would go out drinking together, and would ask to be assigned to the same zones all the time. If you had the misfortune of being assigned in the same zone as one of the cliques, you were the outsider and couldn't rely on others to help out when you were drowning, because the cliques would be busy hiding around the corner gossiping, hanging out in the break room on potluck night, or standing around the charge nurse's desk talking about what cute thing their kid did, their vacation plans, horses, dogs, the next marathon they were training for, whether that hot paramedic was single, etc, while all hell was breaking loose around them.

    I think the advice in the post above is pretty good. I would avoid going toe to toe with the cliques- that would be like poking the bear. Just go to work and do your job the best you can, while cultivating supportive relationships with others who haven't been sucked into the toxic culture. Alternatively, look for work elsewhere. Not all EDs are like this.

  • Jul 20

    Quote from whichone'spink
    Why isn't this post more popular?
    Because it was posted in the General Nursing Discussion forum, not the Emergency Nursing forum.

    OP, I feel you- and I guarantee there are many, many other ED nurses who feel you, too.

    Just as we're asked to understand the intertwined environmental and psychosocial factors that drive patient behaviors such as "non-compliance", drug seeking, ED and EMS abuse, etc, and recognize these behaviors as symptoms of larger societal problems, I see ED staff burnout as a symptom of these same societal problems, and I will not judge you for it.

    Understanding these things and providing compassionate care to people in need is not synonymous with enabling irresponsibility, learned helplessness, and lack of any personal accountability. It is a difficult line to walk, and can exact a heavy price when your defenses are down because you put your heart into your work.

    Thank you for giving of yourself to help others in need. I'm sorry the personal cost was so great, and I hope that you are able to find peace in the future, knowing that you did make a difference to someone. I know you did.

    Take care!

  • Jul 19

    Quote from whichone'spink
    Why isn't this post more popular?
    Because it was posted in the General Nursing Discussion forum, not the Emergency Nursing forum.

    OP, I feel you- and I guarantee there are many, many other ED nurses who feel you, too.

    Just as we're asked to understand the intertwined environmental and psychosocial factors that drive patient behaviors such as "non-compliance", drug seeking, ED and EMS abuse, etc, and recognize these behaviors as symptoms of larger societal problems, I see ED staff burnout as a symptom of these same societal problems, and I will not judge you for it.

    Understanding these things and providing compassionate care to people in need is not synonymous with enabling irresponsibility, learned helplessness, and lack of any personal accountability. It is a difficult line to walk, and can exact a heavy price when your defenses are down because you put your heart into your work.

    Thank you for giving of yourself to help others in need. I'm sorry the personal cost was so great, and I hope that you are able to find peace in the future, knowing that you did make a difference to someone. I know you did.

    Take care!

  • Jul 19

    Quote from MillennialNurse

    What really scares me is that this travel nurse that many of the "in-crowd" disliked had a hallway patient start to really decline, and the patient needed to be moved into a room for more aggressive interventions. People helped her physically move the stretcher into a room, and then they left her to perform/facilitate these interventions by herself. They just went back to the nurses' station. I'm terrified that the other nurses don't like me--and as a result, I won't get help when I need it.

    Just reaching out to see if other new nurses have had similar experiences, and what they've done about it. Thanks!
    I've seen this happen, only it was a charge nurse that would pull resources away from the nurse she didn't like, so she'd be in the room by herself with a crumping patient. She also had "pets", people that she gave preferential treatment to, by giving them the most coveted assignments and putting others that she didn't like as much in the less desirable area, and then hammering them with ambulances all day/night long. The problem was that this person was besties with the unit manager, so any complaints to the manager just made things worse. Fortunately, I was never on her radar, but I observed this behavior very clearly, and yes, it is scary.

    We also had the "cliques"- those little circles of friends that all knew each other outside of work, were friends on Facebook, would go out drinking together, and would ask to be assigned to the same zones all the time. If you had the misfortune of being assigned in the same zone as one of the cliques, you were the outsider and couldn't rely on others to help out when you were drowning, because the cliques would be busy hiding around the corner gossiping, hanging out in the break room on potluck night, or standing around the charge nurse's desk talking about what cute thing their kid did, their vacation plans, horses, dogs, the next marathon they were training for, whether that hot paramedic was single, etc, while all hell was breaking loose around them.

    I think the advice in the post above is pretty good. I would avoid going toe to toe with the cliques- that would be like poking the bear. Just go to work and do your job the best you can, while cultivating supportive relationships with others who haven't been sucked into the toxic culture. Alternatively, look for work elsewhere. Not all EDs are like this.


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