Anna Flaxis, ASN 28,953 Views
Joined: Oct 15, '10;
Posts: 2,886 (67% Liked)
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Since I often seek and get good information at this forum I had an idea I can ask you for help with my current issue.
I am a psychologist working in a pediatric ICU. I am there mostly for parents and older children. But I am also supposed to be available for supporting staff with their professional or personal issues.
Head nurse asked me to prepare a talk about the importance of talking to someone and receiving help after a mistake while giving medications to a patient. This I can handle. I can talk about the importance of talk support or therapy. But I am having troubles with the other part which is the fact that nurses rarely seek psychological help or advice. Head nurse encouraged me to talk about reasons for that. I do have my explanations but I would be really happy to hear what you think about that.
So, to summarize: if you had an option to speak to a psychologist, working at your ward about your work or personal issues - would you do it? Why yes and why no?
At face value, this is a very disturbing story. Some questions I have are: Are you certain this patient has no indications for Vanco? Are you certain that the physician was being "honest" vs. making a sarcastic, jaded comment?
If the situation is exactly as you describe and there is nothing more to it, then I would have a couple of suggestions. You could take this up the chain of command and talk about your concerns, starting with your charge nurse and going up the chain from there as needed. Alternatively, you could skip that process if your work environment is such that you suspect that it will be futile and/or you fear retaliation, and make an anonymous report to risk management/the hospital's patient safety officer.
They could remove them and swallow them.
Piercings don't seem to pose too much of a threat to anyone, but people are creative and are already in the ED because things aren't going as well as usual. The typical thing with jewelery of this type is swallowing it, for instance.
Totally normal! If trial by fire works for you, you'll do well. Give it six months to a year before you don't feel like a complete idiot, cry your whole drive home, and lie awake at night re-living all of the things you did wrong. You'll do great!
Sounds like a real cluster, and you were thrown under the bus. I'm glad the attending apologized.
I would have made this patient a 2, but not because of the reason cited by your supervisor. Your supervisor is playing a dangerous game making triage decisions based on how often the patient presents. The reason I would have made this patient a 2 is that she had vitals in the "danger zone" and a potentially high risk condition, and did not require immediate life saving intervention.
I think it's appropriate to have patients expressing SI/HI dress down and to remove personal belongings from the room. This can include removing jewelry if the jewelry is of a nature where it could be used to cause harm to self or others. However, it is hard for me to imagine how the average nipple or navel ring could harm anyone or interfere with the plan of care in any meaningful way. As an ER RN, this is not a hill I'd choose to die on, and I'd err on the side of protecting the patient's rights.
On ine hand, it really isn't your position to tell her that her husband died..
In my experience, this is generally lip service.
I think it really depends on the way this is implemented. I see nothing wrong with an action plan, per se. If the director is participating in a supportive manner to assist the employee in coming up with an action plan, assisting with the formatting, suggesting references, etc., then it could be a potentially constructive intervention. If, however, the director is not providing any guidance, support, or assistance, and is letting the employee flail about in stormy seas, then no, I'd have to say it's not something I'd advocate for. And, I do not think the employee should be required to do this on unpaid time. It should be on paid time and in a supportive environment. Otherwise, it is punitive and may be actionable by the labor union if there is one, or if not, then by the State Labor Board.
I'm working in CVICU and just graduated last May. I feel like a crappy nurse because there is still so much I don't know. I leave work after a shift and the next morning when I show up for my shift the next day, my preceptor/ night shift nurse ambush me with things I did wrong or issues that they noticed (i.e. forgetting to hook a heparin line, mix my antibiotic, chest tube was off of suction, a med wasn't given etc.). I'm almost off my 12 wk orientation and I still feel like I can't do anything right and don't know if I'm just being too hard on myself. Anyone else ever experience these issues when they were starting out? Words of wisdom?
Well, then there ya go.
I would suggest applying to an agency, but I have really strong feelings about new grads taking agency work, so I won't. Good luck to you!
I am not sure if this is in the right topic...
I have been working with an increasing amount of nurses who FLAT OUT REFUSE to change or toilet their patients. Is this a thing? Do your hospitals have policies or guidance on this topic?
I've brought this up to a few people unofficially and one answer I got was (from a VP) "the nurse may be too busy and you just don't know it." My thought is "If you know they are soiled or ask them to toilet them, why are they taking the time to find a CNA and not just doing it?"
Years ago someone was talking to a group and the toileting issue came up (different hospital) and this person asked us rhetorically how WE would feel if our nurse was in the room and we were soiled and they would not change us? Or if we asked to go to the toilet and they walk out and send in a CNA? I know I would feel pretty small.
Suggestions, comments, HELP...? Anything?
If you've given it a chance for six months but still hate it, you're never gonna love it. Just my opinion. Start looking for work elsewhere.
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