MomRN0913 14,192 Views
Joined Dec 31, '10.
Posts: 1,195 (48% Liked)
This will be my last post on this thread. There are some people commenting who clearly don't understand what it means to be facing the approaching loss of a parent, or the actual loss of close family members.
Staking your entire identity and worth on your job is a mistake, but some people only learn that by living through something like what the OP is going through.
Respect for employers is a two way street. When employers have no respect for their employees, as is clearly the case here, they end up with people quitting and the rest looking to follow.
OP, I hope you get to go to the party or come up with an alternate solution that brings you peace. And look for another job. Seriously.
The patients are the responsibility of the agency/facility.
The facility has an obligation to hire, train, and maintain enough professional staff to safely care for their patients.
The professional staff are entitled to time off when it is requested according to their policy.
The facility is demonstrating in this current moment one of the reasons that they are having a difficult time maintaining professional staff; because they don't treat them with respect and honor their personal needs.
Don't guilt the staff nurse with the plight of the patients who are in that facility. That is obviously way above her pay grade, she can't even get a weekend off.
I've been a nurse for ~30y, and I've never called off so I could attend a social function. Never. Ever.
I would have a terrible migraine that weekend and have a doctor's note ready to prove it.
If a husband admitted to "palpating" his unconscious wife's genitals, he'd probably be getting accused of sexual battery.
And that's all I have to say about that.
I was in a similar situation. I left the ICU to work in an outpatient setting for a year and a half. I really missed critical care, and wanted to return to the ICU. I initially tried to do per diem ICU nursing at anew hospital and I'll admit, it felt overwhelming and I didn't stay. I then returned to my prior unit and spoke to the nurse managers. Having known me as a hard worker they were happy to have me back, and even offered me a couple of weeks of re-orientation. I definitely felt a bit rusty at first, but having the comfort of being in a unit I was familiar with and with equiptment and policies and procedures I knew, it all came back very quickly. I've been back six months and love it.
Being desensitized to death is not inhumane.
The general recommendation is to start anti-coagulation after 48-72 hours in A-fib, since the type of clot we're worried about won't "mature" until beyond that point. This is also why it's still safe to cardiovert someone who we know has only been in A-fib less than 48 hours. If the duration of A-fib is unknown, elective cardioversion is contraindicated with an echo (preferably TEE) to rule out a clot that could be thrown in SR.
And have an emergency rectal stickectomy! :-P
I think SOMEbody needs to swallow a huge old CHILL PILL...
My kid plays hockey.
He now tells his teammates to "rub some dirt on it, princess!"
How many of you nurses have told your kids this? LOL.
ICU nurses have to have strong personalities to advocate for their patients. In private hospitals, you have to be able to identify when you need a physician to eyeball your patient, list your reasons why and then call that physician at 3 AM and INSIST that he come see his patient. Even if he swears at you. That's difficult for a lot of nurses. A lot of nurses will back down, to the detriment of their patients.
In teaching hospitals, you have to be knowledgable enough to know when the intern is screwing up and confident enough not to let him do so. There are times why being shy is a handicap if you cannot overcome it enough to stand up for your patient and for what you know is right. One of the first lessons an intern is taught (in a good program, anyway) is that when the experienced ICU nurse asks you "Are you sure you really want to do that, DOCTOR?" you really don't want to do whatever "that" is. Not only do you as an ICU nurse need to know that "that" is a bad idea, you have to be able to stop the intern from doing it with a look and then explain to him afterward (in private) exactly WHY it was a bad idea.
If your patient's family is agitating him rather than calming him, you have to be able to stand up to the family and insist that they leave. Or at the very least stop doing whatever it is that is agitating him.
I hope this helps.
You know, this kind of thing... the hospital's "we have to do it this way because this is the way we do things" attitude is one of the reasons why I left hospital nursing. I can't deal with this kind of backwards rationale. "Why do we give the Prevacid at 7am? Because that's what time we give it here." If there's not a real reason why the PPI has to be given at 7am or at 6am, it's stupid to insist that it HAS to be given at that time. People who take this medication at home don't take it at precisely the same time every day just like I don't take my morning medication at the same time every day... I'm ddAVP dependent on BID dosing... I usually take my meds around 9 and 9 but if I sway from the norm, it's not a big deal. If I sleep until 10am on the weekends, I take it when I wake up. If I have to get up at 5am to drive 5 hours to New Jersey as I did on Saturday, I take a fractional dose (enough to prevent me from breaking through on the drive) and then get myself back on my normal schedule during the day. When I was in college, I would take my night time medication at 9pm on weeknights but sometimes not until 2 or 3 am on weekends.
If I was a patient on either of your floors, the nurses would probably label me a "difficult patient" as I'd be refusing this med if the hospital insisted I wake up at the crack of dawn to take it. The only scheduled PO medication I have ever woken a patient up to take is decadron... and that's for patients who were on it q 6hrs following surgery. But, even then... try to get them on a 9, 3, 9 and 3 schedule- give them the 9pm dose before bed and then wake them up between 3-4 and do everything... VS, neuro checks, meds, all at once. I rescheduled meds every day of my life as a hospital nurse... our system was so dumb that if a patient was admitted in the middle of the night and ordered for "daily" meds, it timed them all to be given at 3am (or at whatever hour was closest to when they put the order in). Not when they take them, so we retimed them to the appropriate times. For some patients, maybe these were night-time meds that they'd just taken at 11 or midnight... were we going to give them again because that's what time they were timed for? No. Were we going to waste our time calling the Resident (who we finally got to enter these orders for the patients' regular meds after physically handing them the list and reminding them 3x) and telling him to enter a different start time? No. And, you know, the system was so stupid that even if the MD ordered a "daily" med and wrote a comment "give at 12pm", if the order was entered at 3am, it got timed for 3am. It was always the nurse who did the retiming. All BID meds were automatically timed at 8A/8P but, again, for some patients that wasn't when they took their meds. If I'd had to call the MD every time I needed to retime a med, I would have done nothing but stare at the MAR for 12 hours on end.
I think that's a big problem with the way providers discuss goals of care with family members. The fact that we still offer options such as intubation/advanced airway, chest compression, and medication administration in a patient's code status as if they are separate parts of a cafeteria menu just doesn't make sense when we know that cardiopulmonary resuscitation in this age of sophisticated ACLS algorhythms prove that all of those steps go hand in hand.
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