katierobin23 3,216 Views
Joined Dec 31, '12.
Posts: 150 (44% Liked)
Yeah, happens a lot. We call it " oh, by the way" in my facility. Always a head shaker.
You do realize that this hospital is violating Federal labor laws? If you contact the Wage and Hour board, they can give you more information.
I ran into this when I worked nights on a Gero Psych unit. Staffing was one RN and one CNA. This meant that the RN could not leave the unit to eat, and had to be available for anything during meal break.
Because of this, I put "No lunch" on my time card each and every time I worked. I also contacted Wage and Hour, and had them sent me the rule, that if you are hourly and required to perform any job duties, or be available should any arise, then you are on the clock and must be paid that 30 minutes.
During a staff meeting, some little pissant suit decided to get in my face and scream at me that I was NOT to ever do this again.
I calmly handed him the statute, said "If I'm required to be available for work during my meal break, yes I will."
Never heard another word about it.
By port holes, you're talking about the arm holes, right? I can't imagine an infant being able to manipulate itself through that.
I've seen preemies end up in all sorts of positions (and places) inside an isolette.
Nursing school is not that stressful. I was working nearly full time while I went to school and still kept my GPA at a 3.4 which is considered excellent for my program (you have to perform miracles to get an A in any nursing course). Working 32 hours a week at Walmart was way more stressful than school would ever be able to be. Some people shouldn't be allowed to adopt pets or have children if they can't figure out they need to take care of them after that.
Well I just reread your post. I didn't realize you already got rid of her. I think in this case it might be best. It's one thing to feel overwhelmed, it's another to actually dump your new dog because your tired or stressed or whatever. If you decide to have a baby, don't forget to take advantage of the safe surrender laws when having an infant proves to be too much for you.
My first job - KCL was considered a drip and running it as a secondary was against policy. My second job - if you ran KCL as a primary your coworkers would make fun of you for being an idiot. Every job's policies are different.
Anyway - I hate seeing new ICU nurses without a sense of urgency. If you hear an alarm, go see what it is. If a pump beeps and someone doesn't get it immediately, jump out of your seat and investigate. Just because it's not YOUR patient doesn't mean that patient wouldn't die without it. People on pressors can be really sensitive sometimes - even dropping their pressures and/or coding if the pumps beep for long. That O2 sat alarm could be because someone self-extubated and was in distress. Heck, if it's not normal lab time, even go check on an art line disconnect alarm - usually nothing, but I've walked into a room with a disconnect alarm to see blood gushing out of the femoral artery while the patient held the (formerly) femoral art line in his hand.
I hate seeing new nurses prioritize the tasky things that need to be done over the critical ones. Yes, that new admit is covered in stool and needs a bath. No, the patient does not need to be rolled if the systolic is in the 40s at the time. It can wait. Pick saving the patient's life first and doing the other things later.
I also hate seeing new ICU nurses not asking others about their patients. What's going on next door is absolutely need to know - especially, with the above example, if the patient is going to die if the neighboring nurse doesn't add volume to the pressor if the primary nurse is stuck in the other room when the pump beeps. You should know whether your neighbors' patients are okay or if they are circling the drain, at least.
Even if you have MD next to your name and you are an adult brain surgeon...if your kid is in my PICU -- hands off!
Meh. It's Fox News. They aren't out to report the news accurately; they're out to get the ratings.
It can be silly or serious. Just what task or patient type is it that really pushes your buttons irrationally?
I can handle most any task handed to me as long as it doesn't involve dentures. I suspect this is because I had a couple different family members that would chase me around with their dentures when I was little and would use them to terrify me. To this day I just can't. I can digitally remove stool from a patient or handle their sputum and not bat an eye but if they need me to handle their dentures I have to put on the biggest of my big girl nurse panties and really put my mind in a special place to do it.
As far as patient types go, I used to think my weakness was OBGYN and pediatrics-- but I quickly came to realize that it was just a matter of educating myself and I found myself not nervous while caring for these populations.
But no matter how much educating myself I do, I seem to have emotional bias against obese patients and their families when they remain non-compliant and refuse to take any ownership in the position they have found themselves in. To paint a picture of the scenario I'm talking about; When you have a 40 something year old very obese patient and family who get extremely angry with the healthcare team when we aren't able to undo 40+ years of abuse done to their body with one procedure or hospital visit. When they buck and refuse nearly all of the interventions we offer (a heart healthy diet and the family sneaks in 2 fast food meals every day, non-smoking policies and the patient sneaks off the floor coming back reeking of smoke) and then get angry when they aren't in much better shape on discharge than admission. I KNOW I have this bias against this type of scenario and it takes conscious effort to ensure that I give just as good of care to them as any other patient. These patients make me irrationally angry and get under my skin like no other. I seem to take it personally when things don't go well. Again, I think much of this comes back to my own personal fears regarding my own parents being very unhealthy people and their unwillingness to acknowledge their contribution to their health problems.
There are all kinds of patient scenarios that annoy me (asthmatic kids coming in several times a month with parent's 'unable to afford' their Rx but perfectly able to afford the cigs they chain smoke in the closed car with their kids inside) but I don't really think those are as irrational. I think MOST people would be annoyed by them. I want to know what scenarios get under your skin in a "disproportionate to stressor" type of way.
The best thing you can do, in my opinion, is to self-acknowledge these areas and be prepared for them and make sure at the end of the day you can say that regardless of your emotions, you treated the situation as you would have treated any other situation. How do you deal with these weaknesses?
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.
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