MunoRN 40,601 Views
Joined Nov 18, '10 - from '.'.
MunoRN is a Critical Care.
She has '10' year(s) of experience.
Posts: 7,920 (70% Liked)
Nurse managers are typically salaried, and as a result it's not unusual for them to have to work well over 40 hours a week. Ours work about 65 hours a week, they split weekend coverage but that still means they usually work 6 days per week. On an hourly basis they get paid less than many of the floor nurses they oversee.
As religious nurse I also could not work Saturdays. However I ended up working every Sunday of the month.Even though I did my weekends they're still were some nurses who did resent the fact that I do not do any Saturdays even though I did my share of weekends. I understand the op frustration but as long as that nurse was open in her interview period.She should just let it go and speak to the management about the staffing issues w/o bringing up this nurse.
When I went to crna school this issue came up again when I had to take call on weekends. While the PD did not make any special accommodation I was able to switch my Saturdays and Friday night's calls with some of my understanding classmates. But let me tell you when that call schedule came out I literally would break out in a cold sweat and would not calm down until I was able to switch my call.
I think it is important to note that if an orthodox Jew was driving his car and sundown came he would lock his car and walk to where ever they had to go, Orthodox Jews are that committed to keeping the Sabbath.
I acknowledge that this can be a stressful situation for everyone involved.But if there honest open communication these issues really can be resolved to (almost) everyone satisfaction.
I'm not sure what there is to make him "comply" with. The whole idea behind pleasure feeding is that you're accepting the likelihood of aspiration, since aspiration as well as lack of eating are normal effects of late-stage Alzheimer's, and if the decision has been made to allow the normal disease process to occur then there's no reason to fight either one of these effects, and doing so could bring unnecessary misery to the patient.
If the patient is eating because they want to eat then there's nothing to address, if the spouse is pressuring the patient to eat more or faster than they want then some education is in order. It's not unusual for a patient's family to see a reduced appetite as something that needs to be fixed in order for the patient to be comfortable, even though a patient often stops eating to avoid the suffering that can come with eating. So I would find the common understanding with the spouse, which is (hopefully) that he doesn't want the patient to suffer, and remind him that reduced appetite is something the body often does to avoid suffering.
I've seen a similar situation where a manager got all bent out of shape because everyone was charting their medications as given in the EMR before the pyxis said the meds had been removed, I asked her to come look at what time the pyxis thought it was right now, which turned out to be 3 hours off.
If the child has medical issues that may occur in the classroom then the teacher and other staff working with the child need to be aware of what to watch for, sharing that with them is not a HIPAA violation.
From the description, it sounds as though the LPN went into the classroom to take the child's BP, which is inappropriate unless it's a clear emergency.
It should be spelled out in your contract or job description, if it doesn't say that you get the premium for Mondays as well then you've really got no argument to make. No facility I've worked at has paid weekend premium pay for weekday work, and I'm not sure why they would since Monday is not part of the weekend.
I guess you could, but I would be wary of putting so many meds through one peripheral IV together. If you really need that many ports I would start a second IV.
These extensions are sometimes "daisy chained" together to provide the number of ports needed, open hearts typically come back with 5 or 6 triple spliters daisy chained together.
Changing the cap after blood draws isn't supported by evidence or by recommendations, both the INS and CDC recommend changing caps every seven days. There are reports of organizations that have switched from changing caps after blood draws to only every 7 days that have reported reduced CLASBI rates as a result, although these were not controlled studies or large enough to like identify any variation in infection risk. Changing the caps unnecessarily often presents the opportunity to introduce bacteria at the cap/hub connection, without any benefit to offset that risk, so based on the net balance of risks, caps should not be changed after blood draws.
It is important to properly flush not just the cap but the entire line after drawing blood or checking for blood return, which includes the need to push/pause flush particularly for valved/displacement caps and lines.
How on earth do we know what "means" they used when having that conversation with management or HR?! What grounds are there for saying it was unethical?! Making their availability clear and having that agreed to does not imply they did something wrong.
Considering the OP got their license in 2011 I'm not sure how it is we're assuming they are a student.
It's actually pretty important for nurses to discuss their workloads so that: 1)other nurses on the floor are aware of the overall workloads so that they can prioritize their care and their assisting of other nurses appropriately, and so that those doing the assignments can have a better understanding of how to divide the workload more equally. I can't help but find the OP's response to a standard question between nurses ridiculous. I get that the OP would have preferred "small talk", but "how many patients do you have" is introductory small talk for a large group of nurses. I don't think it was the nurse who asked what her load was that was looking to be difficult.
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