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gonzo1 18,507 Views

Joined Jun 8, '05. Posts: 1,713 (45% Liked) Likes: 2,441

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  • Apr 25

    I have an idea, guys... like the what I learned this week thread (which was amazing, it's a shame that sort of went away). How about every single one of you take a minute, think about the most recent new thing you learned/saw/did, and consider writing an article about it?

    I've never written an article before, but I promise I'll work on trying to come up with one this week if some of you guys promise me the same.

    We all work in dramatically different environments, even if some of us work on the same type of unit. We all have different physicians, who have preferences for different drugs/techniques/etc. I bet each of us has a ton of interesting, specialized knowledge.

    For one of my classes in school right now, I had to come up with an environmental chemistry-related topic for a research paper... and what I came up with was antibiotics in the water system contributing to the prevalence of MDRO bacteria. I had to put a healthcare spin on it. xD When I actually write the paper (it's due next week and I haven't started!!!), would anyone be interested in reading if I submitted it as an article?

  • Apr 25

    Quote from Ruby Vee
    I remember you from way back!
    Yup I have seen a lot of familiar names. It doesn't seem like it has been THAT long, but I was looking back and I was a part of this forum Pre-Nursing, Nursing School, New Nurse and now I have 6 years under my belt. It's nice to see so many familiar names still around though.

  • Apr 25

    I've noticed that there are so many "articles" here now instead of threads by and for nurses. Some of the "articles" are just rants about how awful is everything from the nursing school admissions process to the terrible preceptors, horrible first jobs and miserable colleagues . . . .

    I miss the good old days.

  • Apr 19

    I agree with all about this. I used to really enjoy learning things from experienced nurses working in areas different from mine.

  • Apr 19

    I have loved this site, but as I check , "Today's Posts", as is my wont, more and more, there are only student related topics.

    What has happened here? Has anyone else noticed this? I have no problem with lots of students here, but I also want to participate in lively discussions with peers!

  • Mar 26

    Right strategy ... wrong tactics. Nurses and doctors are a team. Particularly in the emergency department, this team works under stressful conditions where mutual trust and respect are critical.

    The reader should consider ... how would an article sound if the title was "Confronting Nurses With Wrong Plans?"

    Crew resource management is a process where everyone on the team is empowered to speak up if a potential hazard is observed. Anyone -- doctors, nurses or techs -- can call a time out if something seems amiss. The focus needs to be on the action that is possibly incorrect -- not on the superiority of one career field over another that was suggested by the comment, "Be kind to nurses. We keep doctors from accidentally killing you." We can all make mistakes, and we all should be watching out for and supporting each other.
    Did you read the preceding comments? The majority of your content has already been addressed. Of course we are all human. Nurses make mistakes, and there are multiple discussions and articles on this site addressing how we can improve. If you are interested in addressing bad care plans, please submit an article. You would likely generate a useful discussion.

    Let me clarify again, the point of this article was not how to confront doctors; it was reminder that nurses--even those who feel intimidated--have an obligation to do it. As I and several others have duly noted, the actual level of familiarity between staff evolves as we work together. No one is advocating disrespect or pitting one profession against the other.

    Yes. We are a team. There is no superiority, but there is hierarchy. Doctors give orders. Nurses follow the orders. Nurses are ultimately responsible for everything we do, and a doctor's order never releases us from that responsibility. Because we are responsible, we become a potential safety net for doctors and a last line of defense for patients. The difference is that because we are the point of delivery, there is no one left to prevent a mistake. Crew Resource Management, Just Culture, and every other theory aside, when we get to the bedside, we are it: educated, capable, responsible, but alone and highly vulnerable.

    Funny thing, several have questioned the nurse for her choice of how to confront the doctor in the shock value, attention-grabbing opening scenario in the article. So far, no one has questioned the doctor for declaring the patient "is just full of BS." Humm...

  • Mar 26

    Robin, IMHO, you wrote a seriously needed article. You hit the bulls eye in my case. Here's a little personal history I had with a doc who was assigned to me when I became his new patient. He doubted what I was telling him, and after having me for some time, my illnesses and hospitalizations increased. After giving him a ten year trial as my primary Physician, I left him after I heard him speak loudly to his nurse: "I don't believe you."
    I now have a wonderful Primary Care Physician who believes me when I tell him about how I'm feeling. He has saved my life twice. God Bless him and all of you nurses who are our front lines of defense.

  • Mar 26

    Many times I created bad relationships with some highly arrogant and equally not so good doctors. Patient leave, doctor stay. As I stay as well. Working with that doctor. Who treats me with hate, humiliates me and is generally nasty to me. And he does not care I actually pretty much saved the patient.
    I think good doctors appreciate us when we save them from glaring mistakes, even when they don't show it. Short term, I have experienced some ill will when I misjudged the best way to confront a doctor or even when I made a careful presentation to a doc with a fragile ego, but over time they usually respect us for getting it right. But, yes, we do risk offending egos by questioning mistakes. The more fragile egos have to be treated with kid gloves. Normal, healthy-ego docs respect us for having their backs.

    You were right to save the patient from inappropriate care. Our first moral obligation is to ensure their safety.

  • Mar 26

    To me that seems unnecessarily confrontational; especially as you didn't state that you told the doctor what your assessment of the patient's pain was. It sounds as though you either hadn't assessed the patient when they asked for pain medication or you had done this but hadn't communicated this to the doctor, and that both you and the doctor needed to determine/discuss the patient's current pain assessment to understand why the patient wants pain medication.
    There are a lot of things that are not stated in any simplified illustration. This is a short, simple article in support of the point that we are the last defense. Your assumption that I did not assess my patient's pain is odd since the story opens with me relaying her request for pain medication. Reminding him of the $8,000 worth of tests he had just ordered simply highlighted the duplicity of his statement that "she's just full of BS."

    You are correct that there is no point in being unnecessarily confrontational. Check the wording again though. He "retorts." I "ask." This was actually a real life encounter with a doctor I know well. It was included for shock value and to make the point that it is easier for some nurses to question doctors before adding the disclaimer that not all interaction can, or should, occur on this level of familiarity. Persuasion always works best within an atmosphere of goodwill.

  • Mar 26

    *Update* I wanted to Thank all of you who have responded. It appears as though it would be three additional semesters for me to obtain a DNP. At this point, I am not willing to spend that extra time in school. After considering all of the additional classes, I just don't see the clinical value in them. Again, thank you all for the input! I'm just ready "get my feet wet." I have no doubts that I will go back for a terminal degree, but at this point, I am just ready to get into practice! I appreciate all of you!

  • Mar 25

    I get to throughly chart... I love the satisfaction of having all the t's crossed.

    Theres a good code on another unit and the team rocks it. (I don't want you to code, I just want to be there if you do!)

    My patients are tucked and fluffed and my room is pretty and stocked at the end of the day.

    That hot cup of coffee tho' --- time for that makes it a GREAAT day

  • Mar 25
  • Mar 25

    When I get to eat during my shift.

  • Feb 25

    Not much you can do about it when the same person falls asleep every shift right in front of the house supervisor and nothing comes of it. You can guess how the talk heated up when layoffs were announced and then Sleeping Beauty kept her job while conscientious employees were let go. That was one for the books.

  • Jan 16

    Quote from Emergent
    And what is ADN, ASN, CNA, LPN, RN, EMT-B, EMT-I, can you answer me that?
    It's making little checkmarks in certain little boxes.