ChristaRN (2,692 Views)
Joined Aug 9, '05.
Posts: 74 (59% Liked)
Really? All medical professionals should be able to expect that their team members behave themselves professionally and ethically within their scope of practice as outlined by their nursing/professional board. Expecting that the vital signs recorded into the patients chart are true should be the norm, not the exception. Are you saying you delegate nothing? It sounds like you are implying that the delegation of VS to a CNA (all my CNAs are CNA2's, even more qualified) is inappropriate...
Thank you, Thank You, THANK YOU! I have to say the posts you were referring to actually kind of hurt, I try my best to provide great care for my patients and relieve as much pain and anxiety in my patient's as possible. It stings to basically be accused of child abuse when in reality we are the ones trying to put so many abused children back together if you will. Thanks again for your support! :heartbeat
I have a little brother who had ALL. I worked for most of my career in peds, peds clinics and the "shot rrom". There is quite a bit of difference between a child who must have repeated painful procedures done and a child coming in for scheduled immunizations. We need to pull out all the stops to make it as less horrible than it inherently is. I am so thankful there are now Child Life specialists and drugs that are appropriate for sedating a child (not oral benzos for a 6 mo old). :uhoh21:
I really have no idea why you would think it's funny to accuse nurses who are using best practice of child abuse and put little smily faces on your comments. I don't find it amusing that someone reading this may have a child who needs these procedures to stay alive. How callous it is to say that they are subjecting their child to abuse when they hand their precious child over to the team who is constantly researching and attempting to find the most effective and least traumatic way of getting it done because not having it done is not an option in many cases. It isn't funny. It isn't cute.
I don't know if you are a nurse or not, but I do know your comments may be causing needless pain in people who may already be hurting.
I love the idea of a Psychiatric Medical Surgical type unit and while they do exist in small numbers it's unfortunately unrealistic to hope for such combination units in all nursing specialties so I don't think we'll be seeing any psych-OB, psych-rehab, psych-oncology etc. It would be great if we had more nurses who are experienced both in the medical aspects of patient illness as well as psychiatric aspects. I think alot of medical minded nurses are uncomfortable with acute psychiatric issues and I understand that. For a non psych nurse I think treating mental illness is quite a challenge. We can't measure mental illness and target a certain number and aim for that as we can with BPs and glucose levels. We can give medications but that's not always really treating the problem. We can be unsure how to communicate with a patient who is acutely psychiatrically ill. I don't think those nurses who are uncomfortable with psychiatric care are talking about a patient whose psych illness is currently well controlled; they aren't trying to cast all patients with mental illness off to an island so they can be avoided. I liken it to placing a patient with an acute cardiac problem on an oncology floor - those onco nurses likely would not be comfortable because it's an acute problem which they are not familliar with caring for. I see acute psych problems in the same way. It is NOT a good idea to keep a psychiatric diagnosis from your treating physician as that disease process or any medications that one may be on to treat it are important pieces of information and can effect current medical treatment or even easily explain a problem that the patient is currently having. I sincerely hope the previous poster will keep in mind that while there may be few colleagues of ours who unfortunately may still stigmatize mental illness most will not allow that to effect the care they give and may actually be able to give BETTER care based on that knowledge. We need to advocate for ourselves in all nursing disciplines to ensure that we get adequate training in all aspects of care that would should be expected to provide and some psychiatric training is certainly something that we and our patients would benefit from us recieving. Perhaps offering a shift of shadowing in a psychiatric unit would do a world of good!
She went to rehab for several weeks after leaving the hospital and then eventually went home with her dad and sister. I assume she's doing well because we haven't seen her since!
I most likely would too.
Crista, my hat is off to you for your ability to stay with that toddler. What a heart breaker of a story. Do you know what eventually happened to her?
I posted this story in another type of thread a while back. I think of this a little more as a story of undying love rather than a ghost story but I do think it fits here. Last year, I cared for a 3 year old child who had been in a MVA with her mother and older sister. Unfortunately, mom died in the accident. The older sister broke an arm and was admitted to the Peds unit for a night or two with an ORIF. The 3 year old had multiple injuries including two broken femurs, a broken arm and more that I can't remember off the top of my head. She was initially in the PICU so never got to be with her sister after the accident. I cared for this little girl when she was transferred to Peds. Now she was almost always alone. She had not yet seen her sister and her father I assume was busy with funeral arrangements etc. This child had not even been informed of her mother's death. She was a very stoic child, would never cry despite being in obvious pain I'm sure. She never showed ANY expression of emotion, wouldn't talk to ANY of the staff, wouldn't eat or drink even when we brought her some of her favorite foods. She just broke my heart. I would park my chair and portable computer in front of her room at night when things would settle down just in case I did hear her cry or anything. One night I heard her quiet voice starting to talk, in obvious conversation. She was saying "Mommy, I'm coming too now? Mommy, why can't I go too? ". I got such chills! I walked into the room and that little baby was wide awake, holding her arms out as if in a hug and focusing her eyes on a spot in front of her face. I am SURE that her mother was in there at that moment, being with her baby just as she would have in life. I cried the whole drive home that morning, thinking of the terrified child being comforted by her literal angel of a mother. I just wonder, with her undeniably seeing her mom there in the room that night, did she then know that mommy was gone from this earth?
I don't know how much Peds experience you have but in MY years in peds and PICU they are NOT always easier to care for. Many of my patients are adult size teens who either are severe MRCP that create messes as big as any adult or could be a teen on a vent for any reason that is unable to participate in their own care. The worst two "code browns" I have experienced in my nearly 7 years as a nurse have come from teens. Don't generalize Peds as easy!
For the OP, just realize that what you describe as the behavior you see from nurses you work with is NOT acceptable and not what you should aspire to be. I work on a unit which does not use techs/nursing assistants and the RNs are it for patient care. If you can't accept that you are (or should be) expected to be VERY involved in physical patient care, even the tedious things, then you have some thinking to do. Decide either that you WANT to be a nurse and are willing to provide that care for your patients or trudge through school and some experience until you can get a no direct patient care job. If neither of those options sound good for you then you may need to consider another line of work. I wish you the best!
I'm sorry; it must be very stressful for you. I think you should try another area of nursing or another facility. Pediatrics might be a little easier because they're easier to lift if nobody is there to help you. I am a tech right now and have to deal with all the things you talked about but my unit has supportive staff with coworkers who always ask if I am doing okay, need any help...so it helps a lot. Maybe you should look into another hospital? Good luck with everything! As far as cleaning up diarrhea and stuff like that, if you think about how it helps the patient feel much better, relief, that should make you feel better.
I hope your boss never went home and said they had a bad day. Ridiculous!
I have a page on a social network site. Mentioned that I had a bad night, for three nights. Recently, I got called into my boss's office. There were COPIES of my page sitting on the desk. I was told to watch what I say, because by saying I had a bad night, it was bad for the company image. Then I was told that my page would be monitered closely for the next few months I went home and immediately upped my privacy settings to and took down my place of employment. I felt completely violated.
Just want to gently remind everyone, be very careful what you put up on websites. I don't drink, smoke or get high. I never post any inappropriate pictures. If I can get called out for posting that I had a bad night, it can happen to anyone. Oh, the world we live in....
Since we're no longer in flu season I realize that my comment may be a bit late. I personally have no problem with the flu vaccine being required for me to work. I also realize that some people have to be exempt, especially for severe allergies, not just "it makes me sick". My hospital last flu season made the flu shot mandatory and in the case of people who refused for WHATEVER reason, they had to wear a mask AT ALL TIMES while in the hospital, not just while in a patient room. For those of you who object to the vaccine, regardless of the reason, how would you feel about being required to wear a mask for months every time you worked? Just curious as to some responses.
Back in my med-surg nursing days I cared for a relatively young man, 30s, who had the most severe case of chicken pox I could ever imagine. He seemed to be doing just fine, comfortable, eating and watching TV. The Infectious Disease doc came to evaluate his case and was extremely concerned as the patient had developed varicella pneumonitis. The doc told me to watch him like a hawk because he anticipated things were going to get alot worse and he was right. Within a few hours, that patient's call bell was going off and I entered to find him in severe respiratory distress. Within just a couple minutes I was rushing his bed to the ICU and just as I was entering the doors he went into respiratory arrest and then cardicac arrest as they were intubating. I had to leave then to get back to my other patients but was told a couple days later that this man passed away. As the varicella pneumonitis progressed he became increasingly difficult to ventillate and had numerous cardiac arrests. Of course, I know that when he was a kid, like when I was, varicella vaccines weren't available. And I know that likely most of us here had chicken pox and are just fine. I just feel that, hopefully one day I will be a mother and I'll be damned if this is a risk I would take for my child. After living this story as a nurse, I personally can't say that the chicken pox vaccine is "unnecessary" - it may save someone else from this happening. As for the flu shot, again, we may all live through the flu and be fine, but what about that innocent immunocompromised person that you infect in the doctor's office, the drug store going to pick up thera-flu and tissues. Make the decisions for yourself if you must but I'm not embarassed to say I wish these people would keep themselves and their children away from the rest of us. If some people don't care about contracting deadly diseases that's on them, but the rest of us shouldn't have to suffer too.
I'm not opposed to vaccines AT ALL, my children are vaccinated, but I am opposed to shooting my child up with 22 vaccinations by the time he/she is 3. And I am also opposed to vaccinations I feel are unnecessary (like chickenpox and flu shots).
First off, please don't attempt to be a nurse manager without a MINIMUM of 5 years (10 is better) as a bedside nurse. No nurse has ANY business trying to be another nurse's boss without having been in their shoes for a significant amount of time. Secondly, sure, there are some nurses who don't have the best attitude but I would rather the crabby old nurse who knows her stuff over the customer service puppet with the sunshine personality who couldn't resuscitate their way out of a paper bag. Sorry, but the whole customer service thing is a joke. We are nurses, not servants and that's what the whole customer service movement wants, for us to be servants.
Please, go into nursing for the desire to care for patients, not the desire to get away from the bedside ASAP while telling people how to do the job YOU don't want to do. I firmly believe that ALL managers should have to keep their clinical feet wet.
I have a degree in management and tons of management experience, as soon as possible it is my goal to become a nurse manager and guess what, It is going to my mission in life to bring customer service back to nursing care. Remember the customer? Yes, the one in the bed, yes, thats right, the patient.
Good point. I hadn't thought about that side of the coin; my only response to your post is that, if she was a professional, good supervisor she should have come to the OP and said something along the lines of "I recieved a phone call from xyz hospital regarding obtaining a reference for you as a potential employee. I wanted to let you know that I feel that you are a valuable employee to our company and am open to any feedback you might have as to why you felt the need to seek another position. Since you are a valuable employee, I sincerely hope that you are considering our company for continued employment once you complete your nursing program".
Just to play the contrarian, perhaps your supervisor really liked you as opposed to other student nurse assistants, was expecting to hire you, and is now bitter that you are leaving and she will be stuck with the other prospects (but that doesn't excuse unprofessional attitude she has displayed).
I personally LOVE whoever it is who is sitting with my confused/suicidal patient (in my hospital sometimes a NA, sometimes a dedicated "sitter") They are helping me be able to get all the rest of my work done which I wouldn't be able to do if I was sitting with that patient all the time. Sitters are very valuable to nurses, they are our eyes and ears when we can't be with the patient and on more than one occasion I have had a patient who felt comfortable enough with their sitter to really open up (such as a teenager who had OD'd on a medication, at first insisted it was an accident but admitted to the SITTER after hours that he was indeed trying to kill himself). If it weren't for that sitter, would he have felt comfortable enough to open up? Would that teen have gotten the help he needed if it weren't for the sitter who made him comfortable enough to open up? I'm sorry that you've had some bad experiences - most of us love you and people who do your job. When you're a nurse, I'm sure you'll be the kind of nurse who will respect all of her coworkers and they will respect you too!
I work part-time as a patient safety attendant. We sit with patients who are suicidal, confused, depressed, fall risk, etc. I know we literally "sit" at times, but it is still a job and I took this job to help me during nursing school. I work at different floors all the time. One shift, I overheard the nurse say that all she does is watch the tv. I was with a patient who was a fall risk at a cancer floor. He had the news channel on even from the night before and when I asked him if he wanted me to turn it off, he said no, he likes that channel. He slept most of the time while I was there, so since the tv was in front of me, I saw it at times. At another shift, the nursing assistant told the nurses in behind the counter where they sit in front of the computers that she was going to relieve me for lunch, and they said,"go relieve her from her chair and giggled." I just went on my break, but I was very offended. I know we can't do much, but it is still a job, and if the nurses think it's so worthless, why call the sitters to sit with the patients?
A patient has rights and are paying for services. If the patient says its ok for someone to lay in bed with them, have at it! If I or my family members were in the hospital, if anyone would talk to me in the manner stated above, I would send them out in tears and notify every administrator possible! We as nurses DO NOT have the right to repremand a patient as though they were a child! Just saying!
The whole "which specialty is harder" topic is something I really, really dislike and am sick of. Through my almost 7 years of nursing I have worked Med-surg, Peds and PICU full time (and of course floated here and there like most of us have to). I consider my current job in PICU to perhaps be the most technically challenging for me (vents, CVPs, Alines, ICP monitors etc) but Lord have I heard how easy my job is from some others (our monitors tell us everything, we only have one to two patients so how hard could that be etc). I personally think that no one regardless of how many specialties they have worked can give the definitive answer to the question of which specialty is harder or more important because it IS so subjective and honestly ridiculous to argue over. I am going to use this time to give some kudos to some of my nursing colleagues and show some appreciation for their specialties:
ER nurses - I really appreciate how you never get more then maybe a few minutes notice from an ambulance call of what is coming into the door (if you even get that). I appreciate the stress of having to balence patients of various acuity (newly intubated, psych, kids, crazy demanding patients and family etc) and trying to get people moved as fast as you can so you can be hammered again in a second.
Med-surg - I've been there and I think you don't get enough credit! I have worked on M/S units evenings and nights with 8-12 patients and the challenges of getting their 900 meds out on time, full physical assessments, charting, incontinent care (no CNAs arent that plentiful to the point where these nurses don't have to change massive code browns too), admits, discharges, postops, AMAs, needy patients and families who you don't have the luxury of shipping off to another floor..... oh yeah, and the random death/code blues/patients who go down the tubes while the rest of the unit doesn't stop. Not easy at all!
ICUs (adult, kids, neonatal etc) - Any of your patients could decompensate at any minute, care is complete and heavy in many situations, family stress is at a high, drips, monitors, vents, codes, almost codes, admits, transfers in or out, and sometimes everything seems like it should be the priority.
Tele/Step-down - I really feel for you here because as people are getting sicker and ICU beds are taken up so many of your patients really should be in ICU and you don't get to just have one or 2
Psych - Wow, I give credit to you guys! You're trying to treat things that you can't see or measure like a blood pressure or a blood sugar and you never know when a patient is going to go off. And from my times floating to behavioral health I know your ratios are ridiculous many times!
Peds - How many times have we been told that kids are "easier"? Never mind that just as adult are getting sicker so are kids; there are many 14 year old 100 lb plus MRCP kids, trach and G tube dependant, total care. Oh and the chemo that many peds nurses give on top of caring for a child like the above, the 2 year old who won't let you get an assessment done, the teenager being difficult, the parents being more difficult... oh and of course kids go down the tubes way more quickly then most adults!
L&D - As much as many of your cases end up great, when things go bad they go really bad and most other nurses would have no clue what to do with your types of emergencies (a good friend who is an ED nurse once told me that an obstetrical emergency is the one type of emergency that she feels most helpless in).
I realize I didn't touch on most specialties - I'd be here all night, and this post is already too long. If you made it through reading the whole thing thank you! To the others I didn't mention (OR, PACU, Pre-op, School, Home Health, Hospice, Rehab, office/clinic, long term care) you guys are as important as any other nurse and your job is just as vital to the health care system we all work in. Remember, if it wasn't for the ED nurses we'd all get our patients dropped off in a second's notice and unstable and if it wasn't for the rest of us the ED nurses wouldn't have somewhere to ship everyone off to once they're done with them. I appreciate all my fellow nurses!
Lets fast forward to when/if you become a nurse - you have a little old lady with signs/symptoms of CHF, doc is notified and wants no changes to therapy. You decide a little Lasix wouldn't hurt and go ahead and give some Lasix. Patient experiences an allergic reaction to the med that you gave without a license to practice medicine. You WILL lose your license, no Good Samaritan law protects someone PRACTICING OUTSIDE THEIR SCOPE.
ok i see how you are comfortable with letting other make decisions but that is not the type of person i am. not that there is anything wrong with that. but if i see my patience like that amd someone fails to make a desicion i will. and i doubt anyone will try to revoke my liscense because of the good samaritan laws.
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