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madwife2002, BSN, RN Guide 98,771 Views

Joined Jan 17, '05 - from 'Ohio'. madwife2002 is a Clinical Service Specialist. She has '26' year(s) of experience and specializes in 'RN, BSN, CHDN'. Posts: 10,271 (21% Liked) Likes: 6,063

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  • Sep 16

    UK

    Hair had to be up, no hair could touch your collar!

    No make up

    Mainly younger students-we had an older lady in our class who was 40 and it was unheard of

    Student nurses were in abundance in the hospital before the education became University based

    1st, 2nd and 3rd year students nurses knew their place

    Urine was never left draining in catheter bags it was emptied hourly

    Every nurse/student nurse knew every diagnoses and test of every pt on the ward.

    Nightingale wards with 20-30 pts

    All beds made and all pts washed before 11am

  • Aug 15

    Unless you are wrapped in cotton wool and live in a fantasy world, we have all experienced or know somebody who has experienced problems at work. Sometimes the situation is self-made and sometimes the situation is pure and simple harassment or bullying. No matter what part of the country you work, if they want to get rid of you they will. You cannot imagine how easy it is to find mistakes and reasons to fire somebody, or to place people in situations where they shoot themselves in the foot or they volunteer to step down or move on.

    How do I know, it is simple really ... I was once in a position where it was expected of me to find a reason to fire somebody, if I was told to do it.

    If companies want to save money quickly, there is no quicker way to save money than by laying off staff! It is instant and their bottom line sees an immediate result.

    10) Constantly Berating Employees

    As we all know management can wear people down by constantly berating employees, this can be accomplished in various ways. A very successful example of this is when your manager begins finding every fault that you have made, then calls you out on these mistakes until you start second guessing yourself, once you start second guessing yourself, this is when the huge mistakes happen and management have won!

    There is no better way to 'get rid' of an employee, than to cause the worker to become self conscious and paranoid, they begin to start constantly questioning their working practices. Looking over their shoulders, and majority of the time will start looking for a new job, before they are fired.

    This kind of harassment can work on all types of employees, we are nearly all vulnerable to our inner voice!

    This takes the responsibility off the shoulders off the managers, they don't have to fire or lay off the employee because the employee removes themselves from the situation. Nice and tidy. Game, set and match.

    How it can begin!

    Many of us due to time restraints do not document or communicate as accurately as we would like to or we are just plain lazy, it doesn't really matter for this scenario, majority of the time we verbally hand over our patients to the next shift, we also will rely on good handover from the previous RN, which can lead to a trail similar to 'Chinese Whispers'.

    'Chinese Whispers' is a childhood game where a group of people stand in line, the first person whispers a message to the person next to her, that person relays the message to the next and so on, when you get to the end of the line that person will tell you what the first person said, 9 times out of 10 there is no resemblance to the message which started out! I can honestly say I have played that game many times, it is hilarious, In all the times I have played this game I have never know the correct message to get to the end, and sometimes it is hard to believe that somebody along the way didn't deliberately change all the wording! Unfortunately it is not hilarious if you are at the end of the chain at work and it all lands at your feet, to pick up and scramble together.

    What I am really getting at here is we are only as good as the original message and if it is not communicated to us correctly then potentially we could be in big trouble. If you work on a busy floor you do not always have time to review the previous days orders on a patient until later on, and sometimes even then it can be difficult due to emergencies which may occur on your shift.

    I guarantee that if they are watching you that they will find the one thing you didn't do!

    They won't listen to excuses, because they are just not interested.

    (Disclaimer this is meant to be series of articles, and should not be considered a stand alone one off, please read all of them over the next few weeks. I know some people have to be fired for poor performance and I will get there.)

  • Aug 14

    Unless you are wrapped in cotton wool and live in a fantasy world, we have all experienced or know somebody who has experienced problems at work. Sometimes the situation is self-made and sometimes the situation is pure and simple harassment or bullying. No matter what part of the country you work, if they want to get rid of you they will. You cannot imagine how easy it is to find mistakes and reasons to fire somebody, or to place people in situations where they shoot themselves in the foot or they volunteer to step down or move on.

    How do I know, it is simple really ... I was once in a position where it was expected of me to find a reason to fire somebody, if I was told to do it.

    If companies want to save money quickly, there is no quicker way to save money than by laying off staff! It is instant and their bottom line sees an immediate result.

    10) Constantly Berating Employees

    As we all know management can wear people down by constantly berating employees, this can be accomplished in various ways. A very successful example of this is when your manager begins finding every fault that you have made, then calls you out on these mistakes until you start second guessing yourself, once you start second guessing yourself, this is when the huge mistakes happen and management have won!

    There is no better way to 'get rid' of an employee, than to cause the worker to become self conscious and paranoid, they begin to start constantly questioning their working practices. Looking over their shoulders, and majority of the time will start looking for a new job, before they are fired.

    This kind of harassment can work on all types of employees, we are nearly all vulnerable to our inner voice!

    This takes the responsibility off the shoulders off the managers, they don't have to fire or lay off the employee because the employee removes themselves from the situation. Nice and tidy. Game, set and match.

    How it can begin!

    Many of us due to time restraints do not document or communicate as accurately as we would like to or we are just plain lazy, it doesn't really matter for this scenario, majority of the time we verbally hand over our patients to the next shift, we also will rely on good handover from the previous RN, which can lead to a trail similar to 'Chinese Whispers'.

    'Chinese Whispers' is a childhood game where a group of people stand in line, the first person whispers a message to the person next to her, that person relays the message to the next and so on, when you get to the end of the line that person will tell you what the first person said, 9 times out of 10 there is no resemblance to the message which started out! I can honestly say I have played that game many times, it is hilarious, In all the times I have played this game I have never know the correct message to get to the end, and sometimes it is hard to believe that somebody along the way didn't deliberately change all the wording! Unfortunately it is not hilarious if you are at the end of the chain at work and it all lands at your feet, to pick up and scramble together.

    What I am really getting at here is we are only as good as the original message and if it is not communicated to us correctly then potentially we could be in big trouble. If you work on a busy floor you do not always have time to review the previous days orders on a patient until later on, and sometimes even then it can be difficult due to emergencies which may occur on your shift.

    I guarantee that if they are watching you that they will find the one thing you didn't do!

    They won't listen to excuses, because they are just not interested.

    (Disclaimer this is meant to be series of articles, and should not be considered a stand alone one off, please read all of them over the next few weeks. I know some people have to be fired for poor performance and I will get there.)

  • Aug 10

    I go home from shut the door and I am done with socializing
    My daughter and hubby are my BFF's

  • Jun 29

    One night in the UK on a very very old ward the PCT told me about the gray lady who walked around the hospital when death was near or had just happened. How I laughed to hear her storys so I asked and how do these ghosts walk? Like us? No she said they sort of floated and she claimed to see ghosts all the time. About an hour later we heard the running of feet upsatairs and we knew there was a cardiac arrest. So I said smartly I expect the gray lady is walking then.
    About an hour later I went out into the corridor to use the bathroom when I looked up the dimly lit stairwell I saw this vision floating down the stairs. I couldn't help myself I screamed really loudly and the vision screamed too I had frightened the life out of the PCT from the upstairs ward who was coming downstairs to borrow something.!!!!!! So much for my ghostly encounter.

  • May 8

    There needs to be some sort of discussion going on between you and your manager. This is a form of bullying and cannot be allowed to continue. The potential for causing patients harm could be occurring here, if they do not do the vital signs and sign them off.

    Your FA ot HR needs to stop this behavior now

  • Apr 17

    An OB/GYN staff nurse is a registered nurse who provides direct care to women. OB-GYN nurses may work in hospital labor and delivery and post-partum units, as well as at birthing centers and maternity or outpatient clinics. Their duties include admitting patients, taking medical histories and assisting physicians during procedures. They may administer medications, apply fetal monitoring devices or perform ultrasounds. They may also lead childbirth preparation classes or educate women individually about sexually transmitted diseases, birth control or prenatal care.

    Gynecology/Obstetrics Nurses care for women from puberty to menopause. Not only do they help women during pregnancy, labor and childbirth, they can work with women who have health issues with their reproductive system. They may also lead childbirth preparation classes or educate women individually about sexually transmitted diseases, birth control or prenatal care.

    Work Environment

    OB/GYN nurses can work in a doctors office, pre or postnatal floor, OR and the labor ward. Many nurses who want to work in labor and delivery will often start off on the pre/postnatal floor, then move to L and D once an opportunity arises. It is normally expected that you will cross train, to enable you to work in all areas. This is a huge speciality and for the purpose of this article, it is impossible to touch on all areas where an OB/GYN nurse has the potential to work.

    Opportunities

    You do not have to have nursing experience to work as an OB/GYN nurse, jobs can be few and far between for inexperienced nurses, and some facilities can require previous nursing experience. Many facilities will offer 6 - 12 months orientation for the inexperienced nurse.

    There will be extensive on the job training for new OB/GYN nurses.

    There can be lots of opportunities for advancement for nurses with L & D background, including lactation specialist, Certification as a Nurse Midwife, NP in women's health.

    Education and Requirements Depending on department

    • Registered Nurse
    • LPN
    • BLS/NALS/PALs/NRP
    • Fetal monitoring
    • Experience in Lab/Delivery
    • Analytical Ability
    • Visual, hearing and sensory touch acuity

    Responsibilities can include but is not limited to:
    • Care of the laboring woman
    • Antenatal care
    • Post natal care
    • Monitoring FHR
    • Monitoring contractions
    • Support
    • Pain management
    • Cervical exams
    • Induction of labor
    • IV infusion therapy
    • Documentation
    • Education for the new parent
    • Contraception
    • Breast feeding education
    • Scrubbing for C/Section
    • Care of the newborn
    • Sexual health education

    Salaries

    L&D RN salaries are on a par with other nursing specialties with a median salary of $64,690 as reported by the Bureau of Labor Statistics Occupational Outlook Handbook. RN salaries may be as low as about $44,000 and as high as $95,000 depending on several factors including work experience, state, employer, and specific nursing role

    https://www.awhonn.org/awhonn/

    Staff Nurse - RN - Obstetrics Salary | Salary.com

  • Apr 14

    The eyes of the world are watching the new experimental POT shops, which have recently opened in Colorado, selling legalized Cannabis for everyday consumption, for everyday people. Who would have thought that this would happen in our lifetime! The lines went round blocks and shops feared they would run out quickly.

    It is estimated that 37 shops opened their doors 1st January 2014, and by January 6th 2014 speculation is mounting that shops will soon run out of supply.

    It is estimated that over 1 million dollars was spent in the first 24 hours on legalized Pot.

    Do we think that people want cannabis to be legalized, do people think we should be allowed to buy 'pot' from shops, yep I think we can safely say if this past week has shown anything, that everyday people want to buy pot.

    Although it has to be pointed out that in all photos, videos and media shows there appeared to be a huge population of men shopping and buying pot than women! I did not actually see a woman in the shops, I am sure there were some?

    I can see it now, 'Honey can you pop out to the pot shop for me'

    Alcohol companies are fearful for a drop in profits, and I think they should be! For the addictive personality swapping one addiction for another may well be the way forward.

    As healthcare professionals we should consider how this might actually benefit our patients, the cost to lives, reduction in violent crimes, reduction in ER visits and all the other health care benefits we are lead to believe happens if you smoke cannabis.

    There are many research projects out there, attempting to prove that cannabis is safe, that cannabis has many health properties.

    According to one source there has never been an overdose of cannabis because you have to consume 20,000 to 40,000 times the amount of THC (short for Tetrahydrocannabinolin),which is present in a joint to be at the risk of dying.

    Police worry that using cannabis increases the chances of moving onto harder drugs, but there are no scientific studies to date that support this claim. Police also worry that using cannabis will increase violent crimes, behavior and suicidal tendencies, again at this time there is no scientific study to confirm this belief.

    In 2010, overdoses were responsible for 38,329 deaths. Sixty percent of those were related to prescription drugs. In the same year, a total 25,692 died of alcohol induced issues , including accidental poisoning and disease from dependent use.

    Benefits to our patients include but are not limited to...

    • Antiemetic for general patients
    • Increased Appetite for the chronic sick and elderly patients
    • Decreasing neuropathic pain, especially with MS patients
    • Reduction of pressure within the eyes of glaucoma patients
    • Some studies have shown reduction in tumors in cancer patients (although studies are not conclusive but we can expect a lot more studies in the future)
    • Reduction of nausea in chemotherapy patients and increase of appetite

    Side Effects

    Short-term (one to two hours) effects on the cardiovascular system can include increased heart rate, dilation of blood vessels, and fluctuations in blood pressure

    Short-term memory loss

    Increase in psychosis (newer studies are disputing this)

    Schizophrenia (newer studies are disputing this)

    Drop of about 8% IQ in patients under 18, although starting after 18 does not appear to cause an IQ drop

    Driving is impaired and studies in the UK say if you drive within 3 hours of smoking cannabis you are twice as likely of having an accident.

    An interesting side note, shares in one cannabis growing company increased their share prices by 53% overnight!

  • Mar 31

    Majority of quality improvement jobs in health care can have many responsibilities that fall into specific categories, including but not limited to evaluation, analysis, training and education, regulatory and compliance responsibilities, and risk management. A quality improvement health care specialist would ideally be responsible for gathering and evaluating clinical data from the organization; analyzing data for patterns and trends in the delivery of healthcare; researching root causes for specific patient care trends; training and educating staff to promote good quality practices and ensure compliance with all applicable laws and regulations; working with leadership and staff to create policies and procedures to ensure good quality care and minimize harm to the patient; keeping up to date with all federal and state laws and regulations.

    Quality improvement can be defined "as systematic, data-guided activities designed to bring about improvement in health care delivery in certain settings and particular situations".

    A quality improvement strategy is defined as "any intervention aimed at reducing the quality gap for a group of patients represented by those encountered in routine practice".

    Gaining a more in-depth understanding of the role that nurses play in quality improvement and the challenges nurses face can provide important insights about how hospitals can optimize resources to improve patient care quality.

    Educational Requirements

    • Registered Nursing License in State of
    • 3-5 years clinical nursing experience
    • BSN preferred
    • Experience with NCQA, Medicaid and/or commercial regulatory requirements
    • CPHQ- Certified Professional in Healthcare Quality (preferred)

    Duties and Responsibilities

    Participate in design and implementation of Quality Improvement projects for HMO patients.

    Assumes project lead role and develops project plan identifying all aspects of the project including timeline's for each task. Assures timely collection, processing and reporting of data per project.

    Collaborates with IT and Analytic staff to facilitate design and development of appropriate database tools and reports.

    Serves as a proactive liaison to Medical Leadership to facilitate physician engagement in projects, timely completion and submission of QM projects and HEDIS data collection and development of interventions for improvement.

    Investigate patient complaints/grievances received from patients, family and HMO's.
    Conduct QI audits/surveys as a way to recognize and/or identify potential quality issues or trends.

    Attend various interdepartmental meetings as the QI RN representative, to support the departments' requirements.

    Opportunities

    Improving health care quality and patient safety are currently high on the nations health agenda, a focus that will only intensify going forward. Patients are demanding better health care, and who can be placed better than the nurse to be the leader of quality.
    In other countries, it is the expectation that all registered nurses are actively involved with improving quality initiatives through research, changes are made through the hard work of floor nurses who strive daily to improve quality outcomes.

    We need to be given the recognition of being change agents, quality improvers and educators. Self identification of issues and problems should be the norm rather than the exception. We should be identifying areas of improvement, making plans of correction and auditing the plans are effective after they are implemented.

    The stakes for US hospitals to demonstrate high quality is increasing; at the same time resources are becoming more and more limited. Therefore, hospitals will have to become more skillful and sophisticated in discerning and pursuing activities that substantively contribute to the achievement of their quality.

    This evolution also will require increased sophistication by the hospitals to optimize available resources to carry out their work.

    Nurses are at the forefront of improving quality care, although it is considered everyone's responsibility to improve quality of care. Nurses often find themselves in the unique position of being the change agent for any patient quality event, we have a high stake in the game and we need to cash in on all opportunities that could improve the quality of life for our patients.

    Resources

    National Association for Healthcare Quality (NAHQ)
    National Committee for Quality Assurance (NCQA)

  • Mar 27

    Funny thread and I am happy it is not just me who stresses over the mistakes.
    When I lived in the UK there was a show about visiting home nurses who delievered twins it was a joke.

    How about every laboring woman who screams and pushes screaming-impossible to do adequate pushes whilst screaming.
    Plus the placenta never ever gets stuck LOL infact no postnatal women ever has a placenta on TV.

    How about shocking flat liners???

  • Mar 5

    Thank you for sharing the article, through the darkness of the last 5 days this was a light to my sadness. The Brian I knew had a dry sense of humor and was always had a quick return. Generous to a fault, always smiling and had the most incredible inventive mind-his business accrue was amazing and he was always open to idea's and listened to any ideas you talked with him about. He loved his gadgets especially Apple products, you always knew he would have the latest that technology had to offer.

    I want to share with you a funny story, In may some of the Allnurses team, Brian and my daughter went out on SEGWAY's. The guy who took us on the tour told us that somebody always falls off. We rode the SEGWAY'S for 90 mins and I had a couple of close calls but managed to stay on. It was so much fun and laughter-one of the highlights of my year. We completed the tour and returned to the tour office and i drove into a tiny wall outside the office and went flying off the SEGWAY falling hard to the ground. I remember lying there laughing (i wasn't hurt thank goodness) looking up to see Brian standing over me, saying "Can you do that again so I can video it'!! We all laughed so hard, and that is a memory I carry with me and smile

  • Feb 27

    Wonderfully written, being a preceptor is not a game it is a serious responsibility where you help develop a RN who is one you want to look after you or a member of your family

    You are not there to be a best friend, but you are there to support, mentor and teach

    I imagine you have some successful New Grads who were under your wing

  • Feb 25

    So you have decided to leave your current job, you've had enough of working hard, no teamwork, you don't like your boss, co-worker, management, the drive is too long, the acuity is too high, you never get a break and you hate bedside nursing. Yes there are numerous reasons why you want to leave and get a new job, I could go on for pages for the reasons nurses are leaving their job but this article is about how to manage yourself while you are working out your notice.

    Whatever the reason I personally believe there is a way to give your notice in and leave gracefully. Don't shut the door behind you, leave it ajar. Trust me you just never know if you might need to go back, or how your reputation could follow you.

    Do not let your work slide during your notice period, make sure you maintain your high standards and do not slack off. Hold your head high no matter what the circumstances are that caused you to leave your job in the first place. Remember you are still being paid to do your job, and it is no excuse to say 'it's not my problem, I'm leaving'

    Employers will be contacted for references; most HR departments will only provide dates of employment and will not get involved with lengthy discussions, however they are allowed to answer No when asked if they would rehire. This one word speaks volumes, sometimes new employers will take their time obtaining references, so how you behave in your notice period could have a devastating effect.

    Make sure you give the required amount of time as specified by HR, this can be anywhere from 2-4 weeks depending on your position. Inform your manager as soon as you can, so they can prepare for the inevitable. Schedules may need to be changed, they appreciate as much advanced notice as possible. Put your notice in writing, giving your last working day. Keep it simple and to the point, you do not have to give a reason for leaving.

    If they allow you, sign on PRN which will let you keep that foot in the door!

    No matter how much you hate your job, work your notice! you should not just walk out without working the required notice. People talk and talk follows, you would be surprised how small the HR community is within healthcare and heads up is often given. I often read on allnurses.com that RNs hate their job so much that they walk out without notice which is just not professional.

    Do not under any circumstances 'bad mouth' your current employer, it is not tasteful and causes concerns that you do not have loyalty. It is suffice to say that it wasn't the job for you and you are moving on because you want new opportunities. Be professional at all times, I know you will want to run through the halls singing and shouting at the top of your voice about the news of your new job, but try some restraint.

    Be positive during your notice period, the weeks will soon count down and before you know it you will be heading through the door for the last time. You have choices; you can either slam the door shut or gently pull the door to, allowing it to creep open if you need it.

    Do not commit professional suicide by being miserable, and informing all and sundry how you have to wait for weeks before you can leave, be upbeat and cheerful. I cannot tell you how many people I have worked with who begrudge working their notice and let everybody know that they don't want to be there. There is often huge sigh of relief when they do go, which is a poor reflection on that person. Being resentful has such negative connotations especially with your co-workers who chose to stay

    Think before you slam, your current position may be not what you want but you have a long career road in front of you, life tends to be full of twists and turns so you can never say never!

  • Feb 22

    To clarify when doing your charting in the EMR regarding the normal day to day care of the patient you are looking after you should complete the documentation before the end of the shift. (remember check your facilities P&P to double check)

    With this being said, BDP is to document as soon as you can in your shift. Normal practice is within one hour

    If there is an unusual occurance you need to use the exact times that this occurance happened when you document.

    If you give a medication late-you need to acknowledge that. Your hospital will have guidelines of how early or how late you can administer the patients medications, usually within the hour of the time. Some hospitals have tighter rules and it can be 30 mins either way. You will have to check.

    Normally nurses are not out to commit fraud-fraud tends to be a concious decision.

  • Feb 16

    Quote from rnintwo
    I dont realistically see being able to find quality child care to cover nights, weekends or holidays for a hospital job. It just isnt going to happen, especially for holidays.

    As for salary, Im not sure where any of the previous posters live but here in NY, RNs that work in the hospitals start @ 80K, so I thought it was completely reasonable to expect 60K out of the hospital.
    How old are your children? I am a long time nurse and have always had children, I agree it has not been easy over the years to manage both effectively but I have managed it both as a single parent and later on with a husband in the military.
    I respect that your children come first but you may need to compromise one or the other-nursing is a very difficult profession if you have no back up support or good child care. You cannot drop everything and run home especially if you have patients to take care of.


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