DNR'ed from hospital - page 3
I just wanted to know if any other agency nurses have been put on a DNR list in the past. I have been an agency nurse for 3 years and go mainly to one hospital and once in a while to their sister... Read More
Mar 3, '03One particular facility I really enjoy going to has more "DNR" people than you could ever imagine. I do well here, and it's a fun place to work. So I wondered why all the DNR's? I had worked with probably 80% of the DNR's at some point somewhere, and a lot of them were awesome nurses. Well, I got curious and went on a quest to find out what the deal was. I paid close attention to EVERYTHING to try and discover why. In the course of my 6 month "investigation" I came to discover a few reasons why many people became DNR.
The top 5 reasons for DNR ranked from most common to least (keep in mind that these are NOT my opinions, just observations):
1. Shy nurses. If they couldn't stick up for themselves, they got dumped on pretty bad. When they made errors (usually very minor) due to being overwhelmed.... DNR. If they had spoken up, they may still be around today...
2. Ugly nurses. I swear.... (so sad but true) ugly nurses almost always got the boot regardless of their skills.
3. Night nurses. You were probably twice as likely to get the boot working nights. I concluded that the day shift (made up of mainly staff nurses who've been there for years) liked to complain about every little thing they could dig up on the night crew.... meanwhile leaving TONS of stuff from their shifts for the night crew to catch up... go figure.
4. LPN's. Poor LPN's always seemed more likely to be DNR'd for something an RN could generally explain their way out of. Not talking about ability to explain things in relation to the two... it just seemed more often the case they would TAKE an excuse from an RN than an LPN.
5. Prebook people. People who picked up late calls often were generally far less likely to get DNR'd. I guess there must be some jealously for those nurses who would work pre-scheduled shifts week in and week out.... but a bit of respect for those willing to come in and help out in a pinch, regardless of nursing skill or volume of workload. What a crock... hehe.
Anyway... just some off the wall observations. Thought I would add it to the discussion.
Aug 25, '03I was just DNR'd from a hospital and the agency can't find out why just"clinical reason". I've worked for this hospital for over a month and received good evaluations. They didn't DNR me for over 2 weeks after the last time I worked there. (I went on vacation) I don't remember any problems the last time I worked there and I bet I could walk right in and get a job. I had worked agency at this hospital two years ago and never had a problem. I feel that they should have to tell the agency specifically why especially if it's a clinical reason. They can DNR me but I feel I deserve to be told why. It's as if, since your agency, you don't have the rights of other workers.
Aug 27, '03Sometimes its nothing more than a personality conflict behind a DNR, with agency making easy targets. Hang in there.
I see this is an old thread ressurrected...LOL...but feel I have to comment on the OP's predicament with the Labetolol IV.
It is policy at my home facility Labetolol needs to be given ONLY on a direct cardiac and NIBP monitored unit,(NOT a remote location)and BY nurses TRAINED to give and monitor this drug's effect. Popping Labetolol IV on a medsurg unit is a dangerous policy, IMO, if they are not setup to monitor closely enough.
IMO You were absolutely correct to question giving this drug in the situation you were in, especially at these dosages.
Now I'm an ICU nurse, but if I had been working a medsurg/remote tele and encountered this order as an agency nurse, I would probably have asked the charge nurse to assume this responsibility too. I don't think we should ever be afraid to say "I've never done this, and I'm not comfortable"...this is what charge nurses are there for . And I'm an old charge nurse...if a staff nurse says this to me I listen.
They tried to dump on a good nurse, tried to bully you, and because you balked, they DNR'd. No great loss for YOU: the loss is THEIRS IMO.
Sep 5, '03I have been working agency for the last 3 weeks, and I think we are treated terrible and the working conditions are unsafe. I say union is the way to go!! I also feel it is very sad to be treated rudely by others in our profession.(staff nurses)
Sep 13, '03I was dnr'd from a nursing home a couple of years ago because I said no to a 300 pm admission.I settled the lady,put her on o2,gave a good report on her,etc.Told the oncoming agency nurse that she had an admission but the pt was ok for the moment.She raised so much hell after I left that I was not allowed back!Turns out she just happened to be available for all the hours I was to be scheduled.I didnt think I did anything wrong.Imagine the look on her face when we ended working together at another facility and I had to orient her.
Sep 16, '03Well,reading all the posts and replies has really helped me to understand a little about agency nursing.I am very new at it.Last night was my first time and they gave me the worst patients,and i didn't get a chance for a break,at all.Some of the nurses were friendly,but some,not.They were very disorganized.I hope it gets better,and not worse
Sep 20, '03Originally posted by dragonfly954
I was dnr'd from a nursing home a couple of years ago because I said no to a 300 pm admission.I settled the lady,put her on o2,gave a good report on her,etc.Told the oncoming agency nurse that she had an admission but the pt was ok for the moment.She raised so much hell after I left that I was not allowed back!Turns out she just happened to be available for all the hours I was to be scheduled.I didnt think I did anything wrong.Imagine the look on her face when we ended working together at another facility and I had to orient her.
I have also encountered the staff nurse who submarines you because she wants your hours. <sigh>
Hope things get better for you Lyn!
Sep 20, '03Gosh can I relate to everyone's posts....the worst night I ever had was one of those "Oh, I asked each nurse to give up a pt and that will be your assignment"....you guessed it, they ALL gave up their problem patients. So I ended up having FIVE problem pts spread across 3 halls.
My other pet peeve is when you are trying to CYA and call the doc about a change in condition and the charge nurse gives body language to other staff people that clearly says "Gawd, can you believe her, WHY is she calling the doctor". Well, hello....are YOU going to back me up when this pt crashes..will I be covered by saying "well, the charge nurse told me not to call"...HECK NO! I have heard the phrase "oh, it was the agency nurse who had that pt and WE had no idea what was going wrong". I tell new agency nurses all the time to do the following...first call the doc about the change and then tell the charge nurse and DOCUMENT that the charge was told so she/he cannot go later "I didn't know", etc...if necessary I ask the charge what they prefer my next step be and I document that the charge was my resource person when taking that next step. But meanwhile I want to knock the staff people upside the head.
If they are obviously dumping on me and I know that I will be getting out late becuz of it <and they know that I will get out late and don't give a rat's butt>, I casually mention that my check gets to be a little extra padded that week since I will get to charge the facility for my extra time there. I love the cringing the charge nurse does when they hear that.
Sep 27, '03Union is not the answer. I have been in practice for 28 years. My opinions are very different than those stated here.
First of all Danvet, I would like to speak with you privately. Things that you mentioned could violate the state nurse practice act. You do not want to put your license in any danger. I sat on my State Board of Nursing for one term, one term was enough.
Your charge nurse was in violation as well. I am new to this message board, I don't know how others communicate, I can be found at this name, @aol.com
Oct 1, '03I've just started agency nursing after being both staff and management in LTC. My first assignment was a double: the first shift was on an extra-easy LTC floor, the second on a specialty unit. The staff coming and going on both were really nice. My second assignment there, on the specialty unit... the oncoming nurse was incredibly cold and rude. This I had to deal with after a shift being short a nurse, having someone go sour on the other assignment and giving that nurse a hand with her load, and having a nurse aide that started the shift in a rotten mood. I'm half-afraid/half-hoping they don't want me back! But I'm just not ready to go on-staff for a specific facility...
Oct 3, '03I've worked agency for 12 of my 16 years as a nurse. I love the work. Over that time, I've been DNR'd from 2 places and have DNR'd myself from 2 (in other words, I refuse to work there). Neither were from nursing skills. I will not work a double in a place I am not familiar. That's asking for trouble. In my state, the law prohibits a nurse from working patients more than 16 hours. I never liked 12 hour shifts anyway as a agency nurse. What patient in trouble wants a tired, stressed nurse who's been on the go for 11 1/2 hours? My agencies treat me as a "independent contractor" (self-employed). I pick and choose where and when. Though I've never done it, I have the option to refuse a shift, after report.
Oct 4, '03So you were DNU'd from a hospital that could have cost you your license. It is they that should be reprimanded, trust me.
Why not be a travel nurse? It is so way better than what you had to work with and trust me, you did the right thing that evening to ask for help.
I can only say that what they did was unethical but you know that you had hit your threshold and knew something would have happened in a negative way giving a drug and not knowing what it may do to a patient you couldn't monitor properly.
It may help to ask your agency to submit a letter from you but once these hospitals DNU (do not use) you, very hard to get into their good graces.
Move on and know that no one died and no med error had happened. That would have been worse and remember, you had a conscience and we Nurses have to have that and protect our license as well.