katierobin23 2,542 Views
Joined Dec 31, '12.
Posts: 147 (44% Liked)
The diversion is reportable and you should consider yourself very lucky if getting fired is the only problem these mistakes have created for you. You might need a lawyer for defense, but I don't see what you would sue for.
My work sends text blasts, but with individual calls I used to just not answer. Don't feel bad about that or about saying no -- the fact that they need to call you q day means they are failing to staff the unit.
Tonight I got a 20 y.o. pt from the ED who came in saying he tried to harm himself by benzo OD. A&O drug screens neg. I went to his room to check vitals and get his admission history done. He was talking to his friend and did not stop to respond or even acknowledge that I had entered. he complained that he wanted to be released ASAP in the AM and that he didn't even have his cell phone charger with him. When I asked for his emergency contacts he sighed and rolled his eyes at me then went back to talking to friend. Then mom came in from the hall. Pt then started playing with his cell phone and would not make eye contact. Just incredibly rude and snotty. I asked him to please put his phone down, show some respect and make eye contact so we could get this done He rolled his eyes & sighed ugh fine is that better. At that I told him it looks as though he has a lot of growing up to do and said that this is unacceptable behavior how he is acting towards me. I reminded him that he is here because of a choice he made and not to get smart with me as I'm trying to help and it's not my fault that he's here. His mom then told me that I shouldn't be talking to him that way that he just tried to kill himself (which he really didn't) and I should be more understanding. I said that's what I'm trying to do my job and no matter he still should not be so rude. It's not ok for him to be talking to me like this. Then pt started screaming at me sayin you ***** you don't know and punching himself in the head. I stood back and watched and said this is pathetic how you are acting this is terrible behavior. Other staff heard him screaming & security was called. I then left the room and family requested another nurse and acted as though I was in the wrong. What do you all think? I just felt that his behavior was awful and inexcusable- needed to be brought to his attention that this is not the way to behave.
Wow. My advice is to grow a filter and grow it fast. Of course the mother wasn't going to side with you. Any snot-nosed punk who would DARE act like that in front of his mother is not going to hear him Mom go "against" him. Mentally, I agree with what you said, but it was NOT your place to SAY it. Expect an HR contact in your future!
I was hoping the mom would back me up and help remind him of basic manners. This has worked in the past but not this time. I know if my child was acting this way I would be embarrassed and definitely tell them to knock it off.
I would have documented his behavior, deferred the admission history, assessed him and moved on. Remarking that he's got a lot of growing up to do, especially in front of his mother was a sure fire way of ramping him and the mother up.
Obviously his mother has never told him this is wrong and I beleive that SOMEBODY needed to let him know this is not right.
You had a patient that presented to the ED stating they had attempted suicide. You seem to think that because his drug screen came back negative, he doesn't have a psych issue. Just the fact that he went to the ED and said he had attempted suicide should be enough for you to assume a psych issue.
Then your behavior toward him caused him to escalate from ignoring you to screaming and punching himself in the head.
You stood there and mocked him by saying he was pathetic and his behavior was terrible. How did you think that would de-escalate the situation?
Other staff had to call security for a patient who had been calmly talking to his friend until you started lecturing him and demanding he respect you.
What part of this interaction do you think you handled well?
Yes. His behavior was inappropriate. He is not the professional. You are.
There's a time and a place to have someone face the consequences of their actions. This wasn't it.
By setting up a you-against-him atmosphere, and lecturing him in front of his mother (did you really think she was going to thank you? That's a family dynamic you aren't going to get close to unraveling in an acute care setting), what you did was ensure that he wasn't going to tell you anything, and mom was going to request another nurse.
You say he wasn't really trying to kill himself. Maybe not, but something happened to induce the behavior. That's what the Psychiatrist and counsellors are for.
Believe me, over the years I've had rude, obnoxious, and snotty patients and family members. I've practically shredded my tongue at times holding reactions in. Yes, he was rude and disrespectful. Sounds like it's pretty much his MO.
1. So the pregnant nurses are new employees that started after your request?
2. And because they are due in the summer (June/July/Aug) NO BODY can go on vacation?
Yeah hightail it to HR but let the PTB know that you are doing this, send emails to your boss, their boss etc etc.
Reminds me of when I was an RN, I was pregnant and my dad wanted to take my mom & me out for lunch on mother's day since I was about to be a mom soon. SO I request Sunday Mother's day off.
Standing at nurses station when BossLady hands out the May schedule. Oh,Of Course I am scheduled to work!! So grabbed the request book and in front of all standing at nurses station asked why when no one else from any shift requested Mother's day off, why am I scheduled to work? Here response, "Oh well just switch with someone". My response: "NO, I requested it off, I have plenty of PTO, It is a legitimate request and I expect you to honor it. But since you chose to ignore my request, I am notifying you that I am calling in for Mother's Day, I will not be coming in. You have been notified as per policy (call in must be 4 hours prior to shift) I am calling in today/4 weeks in advance." I am also going to HR right now to file a complaint about this". As I head to the elevators with the brand new schedule & request book, she tells me to stop, she will reconsider. "Do what you want I am still filing the complaint about this". And I did. Got back to the floor, she had changed it so I was off. This is passive/aggressive crap and should not be tolerated. Same boss lady once commented as I submitted vacation request for 6 months from that day, ;a couple weeks after I returned from vacation to Europe. "What's this? You just went on vacation?" "Yup sure did and I'm going again got plenty of PTO". Always made copies, always asked her to sign & date she received it. Also made copied of request book periodically.
6 miles. Mon-Fri 9a-5:30pm. This is the farthest I have ever lived from my primary job. I think people who commute over an hour each way are nuts.
Personally, I am GLAD that nurses who choose to not vaccinate themselves are not welcome to work in hospitals.
This article was sketchy at best. Not once did it provide a concrete source of research, only alluding to "studies shown". It also said that there is not a pneumonia vaccine available when in fact, there are currently 2 types of pneumococcal conjugate vaccine (PCV13 or Prevnar 13®) and pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax®).
This article, like many other anti vaccination articles provides dangerous misinformation. If any nurse decides she doesn't want to vaccinate, then she should not be welcome in the hospital. ESPECIALLY during flu season.
I live by the mantra that I am there for my patients, they are not there for me. Not being nasty, but feel that any cologne/ perfume/ body lotions may cause reaction to my patient trumps me smelling good. People also smell differently, my wife and I smell the perfume Fendi as roach spray, we honestly can't understand why people wear it, we are sure it doesn't have the same effect on others. A good bath, deodorant and you should be good.
I thought I would update .... I received the job offer for the clinical data analyst position, and start Feb 1st!!!
There may or may not be a thread like this but I couldn't resist sharing. This weekend I was digging through my patient's chart trying to learn more about his history when I came across a note by the attending cardiologist. It said, and I quote: "Patient is stable, no complaints. Was screaming 'Kibbles and Bits!' repeatedly upon my arrival. Of note, patient does not have a dog." I couldn't help but laugh. Anybody else come across some interesting notes in their charts?
As MMJ said, a lot of the psychosocial stuff is done on the fly. And often the same information has to be reframed and restated multiple times. With the kids, having a good "kid" vocabulary is important. You'll be telling the 4 year old, "Okay, you have a tube in your nose that's helping you breathe. That's why you can't talk. And it has to stay there for now. You have a tube in your (private parts - ask for terminology from family) that drains your pee away, so even though it feels like you have to pee, you're not going to wet your bed. And it has to stay there for now. You have some little tubes in your arm that let me give you medicines and take samples without having to poke you. And they have to stay in there for now. You had an operation to fix your (whatever) and that's why your (body part) hurts right now. I have some good medicine that will help you feel better." Things along that line. The older they are the more complex your descriptions can be. Most shifts I talk almost continuously to someone... patient, parent, orientee. But this is important: Make sure you know what you're talking about before you say something. I once heard a nurse who was not new on the unit describe CPP (cerebral perfusion pressure - the difference between the mean arterial blood pressure and intracranial pressure) as "central" perfusion pressure and didn't explain what s/he meant. And one of our educators (!!) taught a group of new grads that Cushing's Triad was HYPOtension, TACHYcardia and apnea, and argued with several very experienced nurses that his version was correct. So don't ever make things up just to have a response to a parent or patient question.
Another aspect to PICU's version of psych-soc care is that there will be a maelstrom of emotion swirling around the bed. Fear, guilt, distrust, shock, pain, grief and many others will manifest themselves at different times and in different ways. The best way to deal with the shoulda-coulda-wouldas is to tell the parent they did everything right and nothing they did or didn't do would have changed what happened. (Unless the kid is a non-accidental trauma, and then you'll be dealing with a whole lot of other stuff.)
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