DNR'ed from hospital

mattsmom81 · Feb 14, 2003

I agree if the facilities want good agency nurses to help them, they must treat us fairly and respectfully. We all have our 'limits'. After a dumped on night I may tell them...'OK once, but never again... next time I won't come back to help you so best watch how you treat me.' We DO have to stand up to the bullies.

One of my pet peeves is when I am forced to listen to repeated 'stories' of agency nurses ad nauseum...and threats about "We'll DNR you if you don't do this, or don't do that" , or how this agency nurse screwed up and they DNR'd this other one, etc.

I let them know enough is enough...orient me properly and I'll do my job...but this game they're playing is finished...and if I hear it again after that, I tell them on the way out the door I won't be back.

Now I'm in a good situation...don't really HAVE to work much anymore thanks to the grace of God... and I figure don't need to work badly enough to put up with silly, spiteful games. If staff was doing their JOBS they wouldn't have the time to play games with the agency staff and I've been known to tell the supervisor this on the way out the door.

Of course I always do my very best...and I recognize that if I ever do get DNR'd, it would be due to jealousies or spiteful reasons...they would be hard pressed to find fault with my practice, and this is probably true of 99% of us...if we were not extremely competent we would not brave agency nursing. :)

I HAVE made errors of omission because the orienting nurse didn't do a good job orienting me to strange or unusual paperwork duties...and made sure the supervisors know this.

And if they don't want me around I'm glad to comply. Life's too short. I'm just so thankful to have some control back in my life after being on staff for the past 5 years. :)

nursem1 · Feb 28, 2003

I've worked agency for a good five years+. Seems a little harsh that you are asked not to return especially if you agreed to a second shift. BAsically I found that if you're at a facililty that's new for you, it's best to do everything you can while you're there (refusing because of lack of experience in a area sheds a bad light) mainly hospital staff expects agency nurses to have been through alot of technical experience, just because they are agency. For this reason, they may feel you need more before you can go back. I'm suprised that they didn't empathize with you for doing a double though and traditonally someone who doubles gets a tray from the kitchen for lunch. ( you said you had to ask to go to lunch.)

Actually it sounds like the day you had was hard for everyone there, so take it lighter whjewn you run into the situation again and don't do doubles until you know you won't burnout.:)

eddy · Mar 4, 2003

One 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.

wolfie · Aug 25, 2003

I 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. :confused:

mattsmom81 · Aug 28, 2003

Sometimes 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.

asil · Sep 5, 2003

I 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)

dragonfly954 · Sep 14, 2003

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.

lynlpn · Sep 16, 2003

Well,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

mattsmom81 · Sep 20, 2003

Originally 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 would have LOVED to have been a fly on the wall when you oriented her. LOL!

I have also encountered the staff nurse who submarines you because she wants your hours.

Hope things get better for you Lyn!

RN4321 · Sep 20, 2003

Gosh 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 , 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.

BarbPick · Sep 27, 2003

Union 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

rn 2b lnc · Oct 1, 2003

I'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...