Latest Likes For Lev <3

Latest Likes For Lev <3

Lev <3, BSN, RN 40,647 Views

Joined Jun 3, '11 - from 'Another planet'. Lev <3 is a ED Registered Nurse. She has 'A few' year(s) of experience and specializes in 'Emergency - CEN, upstairs, troll bashing'. Posts: 2,519 (52% Liked) Likes: 4,667

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  • Aug 22

    Report it anonymously.

  • Aug 22

    What a great discussion! The things everyone mentioned is what I feared, that nurses are just too busy to fill out another checklist and we just need to hire more staff. Unfortunately, hiring more staff is less likely to happen than more things for us to document. Some people have mentioned that the nurses assessment is more important than vital signs and even the vital signs alone don't mean something is wrong. For example, with baseline bradycardia or hypotension. The tool incorporates that. I made up the tool sort of like an algorithm. It is pretty complex but could take 10 minutes to fill out once someone is used to filling it out. However, some other form of "petty" documentation would have to removed before another form of documentation is added. I will post the tool when I am not typing on the phone.

  • Aug 21

    It sounds like you may have been the topic of conversation and she was letting you know in a slightly roundabout way. Make a point to engage - even something as simple as "I have to take care of some education modules. If you need anything I'll be at
    my computer."

  • Aug 20

    First off, I would not discuss this case with anyone unless you are ready to accuse this nurse of diverting. You don't want to be caught in the middle of the situation where someone else reported her to the BON and it was was obvious that you were suspicious sooner. That being said, you should document each encounter with your suspicions to build a case once you have actual proof. People who divert can be manipulative and cause you to doubt yourself. If you have actual proof you should approach her with the evidence and tell her that she must enter some sort of program or you will report her to the BON. She may be diverting for a family member and may never appear impaired. The goal is to get her help not punish her. She should also be suspended from work until she is done the rehab program. It could be that if she checks herself into rehab she has to self report to the BON, however, this is better that her employer reporting her. I would tread very carefully.

  • Aug 19

    Dear Hospital Administrators,

    Hello, from one of your high or low performing hospital’s staff nurses.

    Who? Oh right…the nurses who keep my hospital running but I don’t even see what’s in front of my face, that’s who.

    The abused, the yelled at, the under compensated, the stressed out, and over worked nurses.

    Yes, all of the above is true.

    Nursing shortage?

    Your outer excuse for not allowing your nurse managers to post and fill staff nurse positions which they ask for weekly.

    Nurses don’t bill for services. Too bad for us, because if we did, we would be treated better. We are lumped together with the dietary aids, housekeeping, and those who stock the storeroom. Easy to fire and replace at will.

    Healthcare is a business, people. Hospital administrators don’t care about you; they care about your money. Doctors and nurses do care about you, but they are just caught up in the system. So what do we want from you, our boss’ bosses?

    We want reasonable expectations from hospital management and we want someone to be on our side. We don’t want another lunchbag or pen for nurses week; we want our voices to be heard. We want to feel like we own the hospital and not just work there.

    Patient satisfaction is huge, but it’s not because hospital administrators care about their patients. They care about the reimbursement tied to patient satisfaction. They will make the job of their nurses harder to please their customers or patients. This makes the nurses unhappy because they can’t do their job as well and their satisfaction with their job lessens. Add this on to other on the job stresses and your nurse retention rate suffers. Which probably doesn’t bother you that much, since nurses are replaceable, right?

    If you want to improve customer satisfaction you must make sure your nurses are happy. Ask any nurse and this is what he or she will tell you. Happy nurses equal happy patients. The majority of you are in violation of labor laws which allow your hospital’s nurses to get an uninterrupted break each shift. From my personal experience, which you lack, the only way this will happen is if you staff for a relief nurse on each unit on each shift who is there solely to cover other nurses when they take their well deserved breaks.

    Staffing is another issue which is in your control. Hire more nurses and lower your ratios! No nurse should be taking care of seven plus acutely ill patients. It is not safe.

    I’m an ER nurse. I have seen the abuse against nurses from patients. Screaming, yelling, hitting, biting, spitting, profanity, sexual comments/groping, twisting arms, throwing objects, and punching are just some of the experiences nurses go through daily. This has to stop. This should not be tolerated. There should be zero tolerance for this type of violence and assault. If this were to happen outside of the hospital, charges could be pressed. Every hospital should take this type of abuse seriously. All cases of rude, inappropriate, and dangerous behavior should be reported immediately and a police officer should be available at all times to file a report about the occurrence and see if charges can be filed. There are laws in place protecting healthcare workers. Many hospitals have police officers staffed in the emergency department and following up on such cases can be an extension of their role.

    I hope you take these points into consideration and make nursing better for us.

    Sincerely,




    An anonymous nurse on her way to burn out and orthopedic surgery who will NOT give up on this profession.

  • Aug 17

    As a new grad, no matter the setting, med-surg, ICU, LTC, clinic, etc you will be learning. If you work for 1.5 years on a familiar floor and then transfer to ICU is that so bad?

  • Aug 17

    That sounds like a very tough disciplinary action for pulling a med under the wrong patient's name. It was a simple easy mistake that didn't lead to any harm. I personally would not have filed an incident report and I see no reason for notifying the MD. I would have taken the med out under the right patient's name and then "returned" the med for the "wrong" patient.

  • Aug 13

    Wait til you have a year of experience and then reassess. The first year of nursing is tough.

  • Aug 13

    Quote from downsouthlaff
    We all know how hospital ERs are. You convince your hard headed mother to take a trip to the ER because she has some chest pain. So during the ER visit, CPK, Troponin check out okay. Other labs WNL. Maybe an elevated B/P but the doctor wants to admit for observation.

    We all know that sometimes ERs are overused by some of us LTC Nurses. Most of us are guilty of it and some time or another. We are quick to send out for eval sometimes forgetting to check hx and PRN MAR. But we are nurses just being safe.

    But after specific instances I just can't help but be a little appauled. A few weeks ago I was the LPN/Charge Nurse on a corridor with a very frail very elderly man. He had a new C/O chest pain and general lethargy. Manuel B/P of 152/98 (not baseline) T=100.2 R=24 P=120. 2:30am couldn't get ahold of PCP or N/P so of course use nursing judgement to send out to local ER for eval.

    Get a call from the ER Nurse at about 4:30am saying that she was calling to give report. ER Nurse stated that doc was dx with UTI and wrote orders for Bactrim DS X7 days. Well as a Nurse I was a little suprised that this patient did not get admitted at least for observation with new chest pain, and whacked out V/S especially with no cardiac history but hey as an LTC Nurse I also kept in mind that UTIs can cause major havoc for the elderly. Res arrives back B/P has decreased a little bit still not the same old "Mr Jones" (not real name).

    Next day our Ward Clerk happens to need current labs on this man so she calls the hospital and asks if as a courtesy she can obtain the labs they drew on him at the hospital for there records. When she received the labs via fax she was shocked. Critical elevated Troponin level and a few other labs that were not WNL. She immediately gives to DON and DON notified PCP. PCP is angry and appauled and immediately orders the resident go out to a larger cardiac hospital.

    Resident admitted and hospital nurse reports to us some cardiac damage has occured but patient stable. My question how could this happen ? Do some emergency departments really stereotype older nursing home residents and look past some things they wouldn't on the general population because of there lack of a voice? Because they are a little more needy and demanding due to physical limitations?
    This story doesn't sound typical. No ER that cares about lawsuits would send a patient with a significantly elevated troponin home to LTC. Keep in mind that some patients "leak" troponin, which means they have chronically high troponin from some other health condition. An elderly patient with chest pain would have troponins drawn every couple hours before they are discharged if the decision is made to send them back to LTC. In your situation, all the vital signs are due to the hyperdynamic state which is present with infection. If his vital signs were better and he was given IV fluids and antibiotics there is no reason to keep him for UTI if he can go back to LTC. The chest pain however.... Would be a reason to keep him.

  • Aug 13

    It sounds like you may have been the topic of conversation and she was letting you know in a slightly roundabout way. Make a point to engage - even something as simple as "I have to take care of some education modules. If you need anything I'll be at
    my computer."

  • Aug 12

    It sounds like you may have been the topic of conversation and she was letting you know in a slightly roundabout way. Make a point to engage - even something as simple as "I have to take care of some education modules. If you need anything I'll be at
    my computer."

  • Aug 11

    I push it as fast as I can - and develop my hand muscles in the process! For a short time our code carts were stocking vials of Dextrose that had to be drawn up with a syringe - it was torture to try and draw that up - especially during a code.

  • Aug 11

    Well....10 is the worst pain you've ever had so how can your pain be a number higher than the worse?

  • Aug 10

    The code you witnessed was unusual because you were able to have empathy for the family members who were staff nurses at your hospital. To see a fellow coworker going through a painful experience, you may automatically put yourself in their position. They also reacted with a lot of emotion - yelling and screaming, etc. Not all codes are like that. Many patients who code are critically ill anyway and in ICU may already be intubated. The family is already grieving their family members (hopefully) from the time they enter the ICU. Codes on Med-surg floors are more unexpected because "they (the patient) were fine." i don't think crying during one emotionally charged code should keep you away from ICU. However, make sure you are competent in your current setting before moving into critical care.

  • Aug 9

    It sounds like you may have been the topic of conversation and she was letting you know in a slightly roundabout way. Make a point to engage - even something as simple as "I have to take care of some education modules. If you need anything I'll be at
    my computer."


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