She/He Did What?!

tyvin, BSN, RN · Aug 24, 2011

This happened while working with an older experienced foreign RN. The place I worked had a plethora a foreign nurses and some of the things that happened were pretty unconventional to say the least.

I will tell of this time when a patient who was passing had an order for sc morphine as a comfort measure. Ok, the guys huffing out 48 breaths a minute and an aid gets me because she knows the nurse assigned to him will not give the morphine (after all we could get him addicted) anyway, after I go assess the man I go to the nurse and alert her to this man's plight and her duty to give this man relief via the morphine or I will report her. I don't like to resort to threats but this man was in obvious distress and there was absolutely no reason for it.

Long story short she drew up the morphine with me as the witness for sign off and we proceeded to this man's room (I didn't trust her to actually give it so I trailed her the whole way). So, she wipes his deltoid with the alcohol swab and prepares to inject ... she barely puts the needle in sideways maybe 3 mm in and starts to inject. She continues to put the whole fluid amount of a half cc/ml in that position. The man although he was fighting for every breath started to moan painfully in between breaths. I was shocked that the skin did not burst under the pressure.

The bubble that resulted looked like a small balloon sitting on his deltoid. I couldn't quite believe what I just saw and waited until we went out of the room to say anything. I asked her what the blank was that? She said that the order called for it to be sc/sq not IM therefore that's how a subcutaneous is given. I went back in the man's room with a warm compress and eventually the medicine went down and the surface was flat again. Come on ... I couldn't quite believe but I saw it with my own eyes. Poor guy, a bruise resulted from the incident and I ended up writing her up anyway with recommendation for an in-service on administration of sc medications.

As for insulting new grads ... I believe these types of stories help everyone out. It alerts to the potential things that can happen. I didn't take the OPs post to be harsh or picking on anyone at all, in fact the opposite. Some people need to lighten up a bit for their own sakes. These stories hold solutions for many.

mazy · Aug 24, 2011

Since the OP started two threads with similar themes, I think it's a valid point. I would never potentially embarrass a co-worker by posting about him/her on a public forum. I'm sure I've made some bone-headed mistakes. I'd hate to come here and read about myself and know people were getting a laugh at my expense.

Yes, two threads, same OP, with similiar themes, here is the original AN thread, which was started in 2005, entitled "no she/he did not" and which pretty much ran it's course.

https://allnurses.com/general-nursing-student/no-she-he-98972.html

No problem with laughing at ourselves and our goof-ups, but the OP isn't a nurse from what I can tell, and hasn't started nursing school yet, or is just starting, so probably he/she should wait and get some real experience before poking fun at others.

onthejourney · Aug 25, 2011

At a place I used to work at I heard some CNAs got fired over:

1) smearing ketchup on a napkin and telling a confused resident they were bleeding (why:uhoh3:)

2) prentending to pull gummy bears out of a confused resident`s brief and telling them they pooped gummy bears

Some mistakes I`ve made:

1) using a commode bucket as a bedbath basin (eww i know! it was clean of course! It was my first week of clinicals and I thought it was just a basin. the nurse who found me was so nice and corrected me without making me feel completly stupid!)

2) near miss med error- almost gave a sublingual tablet to an NPO MS patient, which was supposed to be crushed and given with the rest of all his meds through his gtube. I didn`t give it at the time because he was sleeping, which I told the nurse, and she educated me.

learn from my mistakes!!

on the journey

walkingonthestars · Aug 25, 2011

No, I’m not yet a nurse. I like learning and I like knowing history. I like learning from my mistakes as well as others mistakes, which was why I posted this. I feel I’m a bit eager and want to start learning already on what I should do/what I should not do. Maybe I wanted to poke my head in the door a little too soon. This was never really intended to humiliate anyone and I probably should have used a different term other than “craziest.”

I know one day I will mistakes, but I also know that I will LEARN from them too. If you fall, you get back up and next time look where you’re walking.

As for my other thread, I don’t think there is anything wrong with questioning the intelligence/skills/degree of those who take care of us or those who take care of OUR families. We make sure to know so much about who governs our city, state, country, why not in healthcare?

To those of you who were willing enough to share your experiences, thank you.

libran1984, ASN, RN · Aug 25, 2011

I want to give major kudos to the user, tyvin, I completely needed to read something like that. I needed to know there were other facilities that had other nurses witnessing bad practice and yet what is being done? I want to read more about these "She/He Did What?!" situations because I so often see them happening at one of my two work places.

When I see these "She/He Did What" moments occur, I often feel so shocked or unsure of how to respond that I sometimes just stand there with my mouth dropped wide open. Please allow me to share some of my own personal examples.

The first thing I should do is provide some background about myself. I am a young 20-something LPN (having graduated just 10 months earlier) and I am, without a doubt, a good one! I work as an LPN at a prison making approximately $18.50-$22.75 / hr and a local Hospital's ER (taking patients and performing very similar tasks as an RN) making approximately $13.60 - $18.20/hr varied by shift differentials. Both facilities are similar in the respect that the clientele come in with the exact same dilemmas - anxiety, fatigue, staph (MRSA), constipation, chest pains, seizures, hypo/hyperglycemia, and lacerations. Both places are treat-em and street-em facilities and it both are, without a doubt, unbelievable fun.

The hospital is always professional, offering continued education and further certifications for the nurse (RN and LPN alike). The patients (even non-emergent patients who believe their anxiety, blister, or dizzy spell from standing up too quickly to be an emergent-urgent need) are treated with respect and the nurse (should she or he) wish to keep their job, must respect them with the utmost professionalism. The hospital is always erring on the side of what would be best for the patient and it is an amazing environment.

The prison.... oh... lordy lordy.... the prison...

The prison hires primarily LPNs with few RNs since they are all privatized and my state has such a liberal practice act for LPNs the prisons figure they can pay less money for an LPN and get similar, if not near identical work out of them. I mostly work in the clinic, 1 of 3 nursing sectors in the prison hospital unit. It is fast paced, primarily ambulatory, and near 100 patients come through in a single day with most visits lasting only 5-15 minutes. These visits are insulin lines, breathing treatments, dressing changes, segregation evaluations, Emergency visits, regular infections and general medicine. The nurse and only the nurse can provide permission for the doctor to "review" the patient's case or with any luck, the Dr will even physically see the pt.

1. I had been treating an offender for a post-surgical infection. For 4 days straight I had been treating this wound and watching it heal. I was cleaning it and removing excess exudate and purulence. I was disinfecting this sucker and providing a bid dose of IM Rocephin. I was in overtime this particular day and leaving early. I was providing a hand off report to another LPN that we'll call, McCarthia (Obviously a made-up name). I don't know why I even bother with hand-off reports, so few people ever do them or care. The offender came for his bid IM Rocephin and dressing change as expected. I'm informing McCarthia of the events throughout the day as she rips off the offender's bandage. The ripping force was so great and irregular that very small beads of blood began to well in the tiny skin tears created. My mouth just dropped as I saw her just slap on another ABD pad and tape it down. No cleaning or anything.... ok... well, she was busy with 4 other offenders waiting to be seen and a priority sharps count looming over her. I see a lot of nurses not effectively cleanse wounds and yet the human body still recovers. Alrighty then!! But....

McCarthia grabs the Rocephin and injects the proper amount of diluent into the abx, as I suggested, and instead of waiting for the reconstitution to occur, McCarthia immediately draws back on the plunger, leaving caked abx at the bottom/top of the vial. I speak up and point out to this nurse that perhaps she should let it reconstitute and sit for 1-2 minutes. The offender also spoke up and said after it sat the serum usually looked yellow-orangish and fairly thick. McCarthia looked at him and then at me and said, "I got this." She proceeded to injected practically straight lidocaine into his L butt cheek. The next time I worked, the offender said to me - "I can't believe she did that! I've asked every nurse that works days to prepare two doses instead of just one so when she comes in I actually get my medication. That shot almost always hurts but she was shooting just the numbing stuff into me and i'm worried I'm gonna lose my arm". Of course the losing his arm was an exaggeration on his part, but it was a nasty infection that when healed, left an even nastier scar.

I thought of reporting this act to our DoN but decided it would be of no use. Her and the DoN were quite friendly and if McCarthia could get away with what I'm about to tell you next then I knew I couldn't even possibly approach my DoN about a poorly mixed abx.

2. We had been having a heroine problem at the prison. Either the heroine was too good and the offenders couldn't handle it, or it was so bad it was literally killing them. I worked Sunday and Monday day shift consecutively at the time and on a Monday the MD approaches me to inform me that I don't have to call him to start CPR.

I balk at him and say, "Duh!! I did pass boards, doc!"

The doc squints his eyes at me and looks away with a deep sigh. He looks at me and shares, "Well, when things happen like on Saturday you need to know you can act on your own instinct and you don't need me for a final approval on those kinds of situations."

My eyes switch side to side as I furrow my brow. I'm at a complete loss and have no FN clue what he's talking about. "What on Earth are you talking about? The training here is ****-poor like you know, but I know the basics of Emergency care."

"Oh, I thought someone would have told you about the offender on Saturday..." he replies.

"What offender?"

"Oh dear." The doctor leans in as if confiding a deep secret to me, "McCarlia was working and it would appear the offender stopped breathing. She called me earlier that day to tell me his 02 was at 54% and she gave him a breathing treatment which bumped him up to 96%. I informed her to continue monitoring his progress and minutes later I get a call from her asking what I want her to do since he has stopped breathing." The doctor takes a deep sigh and shakes his head, as if still in disbelief. "I told her to call 911 and begin CPR."

I gasp in shock, "Are you serious!? She did that and she's still working here? What kind of breathing treatment was that? A magic breathing treatment to go from 54% to 96%!? Seriously!?"

The doctor gravely nods his head in dismay. "Yes, I just want to make sure everyone else is also aware that they may call 911 and transport a patient to the ER if things go south."

The offender had died. As it turned out the correctional officers at the clinic were smart enough to know to start CPR from basic CPR / first aid classes DoC offers; McCarlia eventually grabbed the AED and watched as the CO's did everything. From other C.O.'s stories, it would appear McCarlia just stood there and watched as another CO called 911.

The following weekend I raise a small hissy fit with my responsible, weekend night shift nurse who I rely on for hand-off reports of earlier weekend material about why she never informed me of the offender death.

"huh?! What death?" she responded in pure confusion.

"The guy who died of an," I pause and put emphasized air-quotes around the following words, "asthma-attack".

"What are you talking about?!" This nurse is one of the few nurses at the prison I truly respect;.... for all her hard-core attitude, I know she actually cares about so many of these offenders and after almost two decades of prison work, she still has hope they will see the light in their life be it through God, the Earth, a loved one, or even themselves. She still has faith through such turmoil. Her confusion in this matter dumbfounded me.

"The kid... the one who died last Saturday. I came in Sunday morning and you never told me about it. The Doc told me about it Monday morning saying stupid stuff like, 'you dont have to call me before you call 911'. "

The night nurse still has no clue and says, "I don't know what you're talking about."

I actually believe her but I think something was lost in translation somewhere. This is a huge event. Something just wasn't conveyed properly. That has to be it. I respond to the night nurse's confusion and say, "McCarlia was working Saturday and this offender died right here in the clinic, over in the breathing treatment room."

The night nurse shakes her head with wide eyes, "McCarlia has probably never said more than 10 words to me in the last few months since she started working here. Last Saturday I came in for my shift. We counted and verified the sharps and she left. I haven't heard anything about this until now."

The night shift nurse and I both looked up the nursing notes of the offender's encounter....

They were disgusting.

If you were to take the Signal 3000 (ie the Emergency Nursing call from the prison dorms) and the actual 911 event together, someone would be lucky to form just ONE... yes just ONE paragraph from all stated information including vital signs. It was absolutely sickening. I knew I had to bring this to my DoN's attention. Someone had died and it was because this nurse, McCarlia didn't give a damn. I talked to my DoN about this event and showed her everything I had learned and provided all documentation.

The DoN said, "McCarlia called me up crying later that day when everything happened. She was terribly distraught and I'm sure she just forgot to hand off to the Night nurse." The DoN left it at that. She made no comment on the documentation other than the privatized prison company simply didn't provide adequate training for those situations and the necassary documentation that even she, the DoN wouldn't necassarily know what to do.

After that, I realized that McCarlia could get away with murder and it could be overlooked because the offenders, the child molesters, the murderers, the rapists, the drug addicts and even the drunk drivers are less than second class citizens. They can die and it is ok...... What a disgusting system.

When the state ran the prison system, the prisons had to comply to JCAHO standards with proper staffing and regulary scheduled CQI's. Presently, staffing has been cut down to 2/3 of the original JCAHO standards. Supplies are minimal. Instead of using ACE Wrap we frequently use Coban. Instead of finger or wrist splints we use craftily taped tongue depressors and worse yet, hand soap has become such commodity that only good nurses are secretly sneaking it into the prison and housing it in their private lockers for use on their shift / area of the hospital wing- hand sanitizer is not allowed because it contains alcohol. Reimbursement for hand soap is not provided.

3) Another time I was working when an offender was allowed into the Med Room to clean. This is the biggest no-no a nurse can make. The med room door is like a vault door and requires a 5 lb key to enter. That key is sooooo huge, it cannot be hidden or carried inconspicuously easily. It makes it very difficult to lose. The key is necassary to ENTER and LEAVE the med room. When the offender was in there at approximatey 1015 - 1035 with both the Healthcare Admin, the DoN, the Med room nurse, and the MA.

I was attempting to fax a release of medical information paper to an offender's PCP on the streets without success. The Medical Assistant invited me to the Med Room to use their fax machine since the lab fax machine was not properly working. I entered and I spoke to a nurse I will call Lila. Lila was focusing on at least 4 different things. She was tracking offender MARs, she was looking meds up on the computer, she was tasking different renewal orders to the MD, and she was talking to a guy I had never seen before from a computer tech agency that was apparently attempting to repair our printer connection. On top of this I was asking her how to use the fax machine. I asked, "Do I face the paper up or down?"

"Down" she responded.

"Do I have to dial 1 before the area-code?"

"No." she quips.

And then I think I noticed a confirmation and I was like... cool. (Truthfully, to this day I still don't understand or trust fax machines).

A few hours go by and at 1315 I hear an alert shouted over the Correctional Officers' walky - talkies. The hospital wing is to undergo lockdown. My eyes brighten up. All Nurse Sick Call (NSC) and MD sick call (MDSC) is canceled for the day, as well as all chronic care visits. This is awesome. For once I have a free day and I get to see how a real lock down is done....

oh how a real lock down is performed..... so sad.

The hospital unit was to under lock and key but for almost the full 90 minutes that it was on lock-down, offenders were walking in and out of the front doors. Seg evals were still coming in through the back doors. I don't think one door in that entire building was locked. The only thing seemingly enforced were all the NSC's and MDSCs that were canceled so people kept walking in like a revolving door. In and out, in and out. All in a matter of seconds. Then, of course, around 1423 I see that computer network-tech guy with our neighbor prison's DoN just walking around after having used an underground tunnel to gain access to our oh, so, secure locked-down hospital unit. Apparently, he was networking both neighboring prison's printers... or something.

I eventually find out that ~50 vicodin had gone missing since the time of the morning count and the afternoon count. The offender that was in the med room for those 15-25 minutes was taken into custody and sent to seg. He never broke or admitted to fault. The nurses were all being pointed fingers at. The offenders in the ICU / Med-surg portion of the hospitals had all their beds turned inside out and upside down. I decided to assist because I'm COMPLETELY ENAMORED by this process and begin showing the CO's how to stand on tables and lift up ceiling tiles - something I was taught to do in training that these other CO's had forgetting and I found myself a great lunch of Ramen noodles......... ok, not a big deal, but we don't server ramen noodles at the hospital and basically, out of 12+ CO's hunting for drugs, I was the only person (and non-CO) to find contraband. I was really proud of myself. The CO's then called the Captain saying they turned the hospital unit upside down and still could not find squat. The captain yelled at the CO's and said, " That is BullS**T , You did not search the entire hospital in just 20 minutes. Call me back in 30 minutes."

Sadly, the Capt gave in after 15 minutes because the officers in the hospital unit just stood around unenthused, only speaking of how awesome it would be to raid the offenders' person dormitories.

Later on in the day, schedules resumed their normalcy and I was disgusted by the intensity of the lock-down. What a shame it truly was. I was called in to Internal Affairs (IA), like every other staff member that had entered the med room that day and was forced to take a drug test like all others. No big deal. I told IA what my purpose had been in the med room and they were cool. I was turned loose to go pee in a cup and then came back as scheduled a few days later.

THIS IS WHERE IT GOT GOOD..... strictly story-wise; it was actually extremely humiliating.

At 0600 I clocked in.

At 0703 I finished insulin line.

At 0759 I finished dressing changes and hung out front for my Nurse Sick Call patients to arrive.

There was a seizure pt under observation on a mat from 0500 in the hallway. The medroom nurse came in at 0800 to clock in. She said in a very loud and ostentatious manner, "Oh! There's that Fa**ot! I look her way and think, that sure is a rude way to refer to an offender. I continue talking to one of the RN's up front, and the seizure patient is trying to wave the Doctor who had just also entered the hallway down when Lila, the med room nurse quite vocally states, "Oh is that *aggot talking?"

I'm so shocked at Lila's discriminatory use of words, particularly being a young black female herself, I thought she'd have more empathy for stating such hurtful and discriminatory words.

I gently pat her shoulder and say, "hey, I don't think those are such appropriate things to say to anyone- even these guys."

Abruptly, "Don't touch me, F**got! I'm talking to you! I wish you'd have just died and OD'd."

I'm shocked....

huh?

I look to the RN next to me, i look at the doctor, CO, the freaking offender, and the new nurse, which was, quite frankly, her first day of orientation.... Lila said all of this to me in front of them all. Wow......

I didn't know what to say. I was stunned. What?!

I talked to the MA as soon as she came in and I asked why what Lila was talking about and the MA said that the tech guy never remembered seeing me in the room and that Lila never remembered seeing me in the room. The MA said the tech saw me leaving the med room after the building was placed on lock down when he was with the other DoN from the other prison..... which makes ABSOLUTELY NO SENSE!!!! Thank god there is video record of all coming and goings from the med room that I was 100% cleared of any suspicion. But Lila has no recollection of me being the med room and for several days that I was off believed that I had been in the med room unattended... which also makes no sense since only 2 ppl in the entire building have access to that five pound key to let them in and let them out. It just not possible.

The RN reported the harassment to the DoN upon her arrival. The DoN came to me after asking Lila her side of the story first. The DoN said Lila had very little to say so she wanted to know what my take on it was. I said I was just shocked and embarrassed. I wasn't sure what to do. Like really.... someone comes at you with such emotionally charged racist words..... what are you to do. Shouldn't that qualify for immediate termination? I guess not. Besides, the prison is so short staffed that Lila is the only effective nurse to run the med room and I'm one of the few who understand the ferocious pace of the clinic. The DoN let it be a stalemate and no further actions were taken.

Thank god I found a different job in a hospital 6 months later.... sadly LPNs simply don't make good hospital money at a base of $13.60ish an hour.. like really.... So I continue to keep the Prison job PRN at the said rate and earn a decent amount while I work towards my RN.

4) As an LPN, I do often worry about my nursing license, but then I have kept in touch with 4 other LPNs who experience similar problems. One friend wrote me just days ago about how he felt another nurse was framing an oncoming shift nurse for lost narcs. He said in just 5 months two nurses have come and gone on just his hall. That's from being fired... seriously... Long term care is messed up. He's also trying to get his RN rt now and has been accepted into a community college program. Its is just like prisons, tho... under-staffed and pts are poorly treated.

My other buddy is in LTC an states all the days just blur together. He hates his job but makes RN money of $21/hr so he is content to be unhappy b/c he hates school more

Another friend works at the local jails making almost $24/hr as an LPN and she is spit on, cussed at, and has nothing nice to say.... every. She is also in an RN transition program- bless her soul.

My other friend is LTC and seems content. 3 days a week on weekends at $22/hr as an LPN and she loves it. Wow.

Some days.... I just wonder if an LPN is an inferior nurse, as demonstrated by McCarlia, and other days I wonder if I'm inferior b/c I'm an LPN. I suppose as long as I have hopes and dreams I can get further in life. I am the only one I know of in my graduating class to get a real hospital position and still act as a REAL NURSE (not an RN but you know... perform real nursing duties and not just pass meds or just act as a tech). I hope that has to count for something. I need that RN just as bad as my buddies! Let's get it!!

KaringOne · Aug 25, 2011

I want to give major kudos to the user, tyvin, I completely needed to read something like that. I needed to know there were other facilities that had other nurses witnessing bad practice and yet what is being done? I want to read more about these "She/He Did What?!" situations because I so often see them happening at one of my two work places.
When I see these "She/He Did What" moments occur, I often feel so shocked or unsure of how to respond that I sometimes just stand there with my mouth dropped wide open. Please allow me to share some of my own personal examples.
The first thing I should do is provide some background about myself. I am a young 20-something LPN (having graduated just 10 months earlier) and I am, without a doubt, a good one! I work as an LPN at a prison making approximately $18.50-$22.75 / hr and a local Hospital's ER (taking patients and performing very similar tasks as an RN) making approximately $13.60 - $18.20/hr varied by shift differentials. Both facilities are similar in the respect that the clientele come in with the exact same dilemmas - anxiety, fatigue, staph (MRSA), constipation, chest pains, seizures, hypo/hyperglycemia, and lacerations. Both places are treat-em and street-em facilities and it both are, without a doubt, unbelievable fun.
The hospital is always professional, offering continued education and further certifications for the nurse (RN and LPN alike). The patients (even non-emergent patients who believe their anxiety, blister, or dizzy spell from standing up too quickly to be an emergent-urgent need) are treated with respect and the nurse (should she or he) wish to keep their job, must respect them with the utmost professionalism. The hospital is always erring on the side of what would be best for the patient and it is an amazing environment.
The prison.... oh... lordy lordy.... the prison...
The prison hires primarily LPNs with few RNs since they are all privatized and my state has such a liberal practice act for LPNs the prisons figure they can pay less money for an LPN and get similar, if not near identical work out of them. I mostly work in the clinic, 1 of 3 nursing sectors in the prison hospital unit. It is fast paced, primarily ambulatory, and near 100 patients come through in a single day with most visits lasting only 5-15 minutes. These visits are insulin lines, breathing treatments, dressing changes, segregation evaluations, Emergency visits, regular infections and general medicine. The nurse and only the nurse can provide permission for the doctor to "review" the patient's case or with any luck, the Dr will even physically see the pt.
1. I had been treating an offender for a post-surgical infection. For 4 days straight I had been treating this wound and watching it heal. I was cleaning it and removing excess exudate and purulence. I was disinfecting this sucker and providing a bid dose of IM Rocephin. I was in overtime this particular day and leaving early. I was providing a hand off report to another LPN that we'll call, McCarthia (Obviously a made-up name). I don't know why I even bother with hand-off reports, so few people ever do them or care. The offender came for his bid IM Rocephin and dressing change as expected. I'm informing McCarthia of the events throughout the day as she rips off the offender's bandage. The ripping force was so great and irregular that very small beads of blood began to well in the tiny skin tears created. My mouth just dropped as I saw her just slap on another ABD pad and tape it down. No cleaning or anything.... ok... well, she was busy with 4 other offenders waiting to be seen and a priority sharps count looming over her. I see a lot of nurses not effectively cleanse wounds and yet the human body still recovers. Alrighty then!! But....
McCarthia grabs the Rocephin and injects the proper amount of diluent into the abx, as I suggested, and instead of waiting for the reconstitution to occur, McCarthia immediately draws back on the plunger, leaving caked abx at the bottom/top of the vial. I speak up and point out to this nurse that perhaps she should let it reconstitute and sit for 1-2 minutes. The offender also spoke up and said after it sat the serum usually looked yellow-orangish and fairly thick. McCarthia looked at him and then at me and said, "I got this." She proceeded to injected practically straight lidocaine into his L butt cheek. The next time I worked, the offender said to me - "I can't believe she did that! I've asked every nurse that works days to prepare two doses instead of just one so when she comes in I actually get my medication. That shot almost always hurts but she was shooting just the numbing stuff into me and i'm worried I'm gonna lose my arm". Of course the losing his arm was an exaggeration on his part, but it was a nasty infection that when healed, left an even nastier scar.
I thought of reporting this act to our DoN but decided it would be of no use. Her and the DoN were quite friendly and if McCarthia could get away with what I'm about to tell you next then I knew I couldn't even possibly approach my DoN about a poorly mixed abx.
2. We had been having a heroine problem at the prison. Either the heroine was too good and the offenders couldn't handle it, or it was so bad it was literally killing them. I worked Sunday and Monday day shift consecutively at the time and on a Monday the MD approaches me to inform me that I don't have to call him to start CPR.
I balk at him and say, "Duh!! I did pass boards, doc!"
The doc squints his eyes at me and looks away with a deep sigh. He looks at me and shares, "Well, when things happen like on Saturday you need to know you can act on your own instinct and you don't need me for a final approval on those kinds of situations."
My eyes switch side to side as I furrow my brow. I'm at a complete loss and have no FN clue what he's talking about. "What on Earth are you talking about? The training here is ****-poor like you know, but I know the basics of Emergency care."
"Oh, I thought someone would have told you about the offender on Saturday..." he replies.
"What offender?"
"Oh dear." The doctor leans in as if confiding a deep secret to me, "McCarlia was working and it would appear the offender stopped breathing. She called me earlier that day to tell me his 02 was at 54% and she gave him a breathing treatment which bumped him up to 96%. I informed her to continue monitoring his progress and minutes later I get a call from her asking what I want her to do since he has stopped breathing." The doctor takes a deep sigh and shakes his head, as if still in disbelief. "I told her to call 911 and begin CPR."
I gasp in shock, "Are you serious!? She did that and she's still working here? What kind of breathing treatment was that? A magic breathing treatment to go from 54% to 96%!? Seriously!?"
The doctor gravely nods his head in dismay. "Yes, I just want to make sure everyone else is also aware that they may call 911 and transport a patient to the ER if things go south."
The offender had died. As it turned out the correctional officers at the clinic were smart enough to know to start CPR from basic CPR / first aid classes DoC offers; McCarlia eventually grabbed the AED and watched as the CO's did everything. From other C.O.'s stories, it would appear McCarlia just stood there and watched as another CO called 911.
The following weekend I raise a small hissy fit with my responsible, weekend night shift nurse who I rely on for hand-off reports of earlier weekend material about why she never informed me of the offender death.
"huh?! What death?" she responded in pure confusion.
"The guy who died of an," I pause and put emphasized air-quotes around the following words, "asthma-attack".
"What are you talking about?!" This nurse is one of the few nurses at the prison I truly respect;.... for all her hard-core attitude, I know she actually cares about so many of these offenders and after almost two decades of prison work, she still has hope they will see the light in their life be it through God, the Earth, a loved one, or even themselves. She still has faith through such turmoil. Her confusion in this matter dumbfounded me.
"The kid... the one who died last Saturday. I came in Sunday morning and you never told me about it. The Doc told me about it Monday morning saying stupid stuff like, 'you dont have to call me before you call 911'. "
The night nurse still has no clue and says, "I don't know what you're talking about."
I actually believe her but I think something was lost in translation somewhere. This is a huge event. Something just wasn't conveyed properly. That has to be it. I respond to the night nurse's confusion and say, "McCarlia was working Saturday and this offender died right here in the clinic, over in the breathing treatment room."
The night nurse shakes her head with wide eyes, "McCarlia has probably never said more than 10 words to me in the last few months since she started working here. Last Saturday I came in for my shift. We counted and verified the sharps and she left. I haven't heard anything about this until now."
The night shift nurse and I both looked up the nursing notes of the offender's encounter....
They were disgusting.
If you were to take the Signal 3000 (ie the Emergency Nursing call from the prison dorms) and the actual 911 event together, someone would be lucky to form just ONE... yes just ONE paragraph from all stated information including vital signs. It was absolutely sickening. I knew I had to bring this to my DoN's attention. Someone had died and it was because this nurse, McCarlia didn't give a damn. I talked to my DoN about this event and showed her everything I had learned and provided all documentation.
The DoN said, "McCarlia called me up crying later that day when everything happened. She was terribly distraught and I'm sure she just forgot to hand off to the Night nurse." The DoN left it at that. She made no comment on the documentation other than the privatized prison company simply didn't provide adequate training for those situations and the necassary documentation that even she, the DoN wouldn't necassarily know what to do.
After that, I realized that McCarlia could get away with murder and it could be overlooked because the offenders, the child molesters, the murderers, the rapists, the drug addicts and even the drunk drivers are less than second class citizens. They can die and it is ok...... What a disgusting system.
When the state ran the prison system, the prisons had to comply to JCAHO standards with proper staffing and regulary scheduled CQI's. Presently, staffing has been cut down to 2/3 of the original JCAHO standards. Supplies are minimal. Instead of using ACE Wrap we frequently use Coban. Instead of finger or wrist splints we use craftily taped tongue depressors and worse yet, hand soap has become such commodity that only good nurses are secretly sneaking it into the prison and housing it in their private lockers for use on their shift / area of the hospital wing- hand sanitizer is not allowed because it contains alcohol. Reimbursement for hand soap is not provided.
3) Another time I was working when an offender was allowed into the Med Room to clean. This is the biggest no-no a nurse can make. The med room door is like a vault door and requires a 5 lb key to enter. That key is sooooo huge, it cannot be hidden or carried inconspicuously easily. It makes it very difficult to lose. The key is necassary to ENTER and LEAVE the med room. When the offender was in there at approximatey 1015 - 1035 with both the Healthcare Admin, the DoN, the Med room nurse, and the MA.
I was attempting to fax a release of medical information paper to an offender's PCP on the streets without success. The Medical Assistant invited me to the Med Room to use their fax machine since the lab fax machine was not properly working. I entered and I spoke to a nurse I will call Lila. Lila was focusing on at least 4 different things. She was tracking offender MARs, she was looking meds up on the computer, she was tasking different renewal orders to the MD, and she was talking to a guy I had never seen before from a computer tech agency that was apparently attempting to repair our printer connection. On top of this I was asking her how to use the fax machine. I asked, "Do I face the paper up or down?"
"Down" she responded.
"Do I have to dial 1 before the area-code?"
"No." she quips.
And then I think I noticed a confirmation and I was like... cool. (Truthfully, to this day I still don't understand or trust fax machines).
A few hours go by and at 1315 I hear an alert shouted over the Correctional Officers' walky - talkies. The hospital wing is to undergo lockdown. My eyes brighten up. All Nurse Sick Call (NSC) and MD sick call (MDSC) is canceled for the day, as well as all chronic care visits. This is awesome. For once I have a free day and I get to see how a real lock down is done....
oh how a real lock down is performed..... so sad.
The hospital unit was to under lock and key but for almost the full 90 minutes that it was on lock-down, offenders were walking in and out of the front doors. Seg evals were still coming in through the back doors. I don't think one door in that entire building was locked. The only thing seemingly enforced were all the NSC's and MDSCs that were canceled so people kept walking in like a revolving door. In and out, in and out. All in a matter of seconds. Then, of course, around 1423 I see that computer network-tech guy with our neighbor prison's DoN just walking around after having used an underground tunnel to gain access to our oh, so, secure locked-down hospital unit. Apparently, he was networking both neighboring prison's printers... or something.
I eventually find out that ~50 vicodin had gone missing since the time of the morning count and the afternoon count. The offender that was in the med room for those 15-25 minutes was taken into custody and sent to seg. He never broke or admitted to fault. The nurses were all being pointed fingers at. The offenders in the ICU / Med-surg portion of the hospitals had all their beds turned inside out and upside down. I decided to assist because I'm COMPLETELY ENAMORED by this process and begin showing the CO's how to stand on tables and lift up ceiling tiles - something I was taught to do in training that these other CO's had forgetting and I found myself a great lunch of Ramen noodles......... ok, not a big deal, but we don't server ramen noodles at the hospital and basically, out of 12+ CO's hunting for drugs, I was the only person (and non-CO) to find contraband. I was really proud of myself. The CO's then called the Captain saying they turned the hospital unit upside down and still could not find squat. The captain yelled at the CO's and said, " That is BullS**T , You did not search the entire hospital in just 20 minutes. Call me back in 30 minutes."
Sadly, the Capt gave in after 15 minutes because the officers in the hospital unit just stood around unenthused, only speaking of how awesome it would be to raid the offenders' person dormitories.
Later on in the day, schedules resumed their normalcy and I was disgusted by the intensity of the lock-down. What a shame it truly was. I was called in to Internal Affairs (IA), like every other staff member that had entered the med room that day and was forced to take a drug test like all others. No big deal. I told IA what my purpose had been in the med room and they were cool. I was turned loose to go pee in a cup and then came back as scheduled a few days later.
THIS IS WHERE IT GOT GOOD..... strictly story-wise; it was actually extremely humiliating.
At 0600 I clocked in.
At 0703 I finished insulin line.
At 0759 I finished dressing changes and hung out front for my Nurse Sick Call patients to arrive.
There was a seizure pt under observation on a mat from 0500 in the hallway. The medroom nurse came in at 0800 to clock in. She said in a very loud and ostentatious manner, "Oh! There's that Fa**ot! I look her way and think, that sure is a rude way to refer to an offender. I continue talking to one of the RN's up front, and the seizure patient is trying to wave the Doctor who had just also entered the hallway down when Lila, the med room nurse quite vocally states, "Oh is that *aggot talking?"
I'm so shocked at Lila's discriminatory use of words, particularly being a young black female herself, I thought she'd have more empathy for stating such hurtful and discriminatory words.
I gently pat her shoulder and say, "hey, I don't think those are such appropriate things to say to anyone- even these guys."
Abruptly, "Don't touch me, F**got! I'm talking to you! I wish you'd have just died and OD'd."
I'm shocked....
huh?
I look to the RN next to me, i look at the doctor, CO, the freaking offender, and the new nurse, which was, quite frankly, her first day of orientation.... Lila said all of this to me in front of them all. Wow......
I didn't know what to say. I was stunned. What?!
I talked to the MA as soon as she came in and I asked why what Lila was talking about and the MA said that the tech guy never remembered seeing me in the room and that Lila never remembered seeing me in the room. The MA said the tech saw me leaving the med room after the building was placed on lock down when he was with the other DoN from the other prison..... which makes ABSOLUTELY NO SENSE!!!! Thank god there is video record of all coming and goings from the med room that I was 100% cleared of any suspicion. But Lila has no recollection of me being the med room and for several days that I was off believed that I had been in the med room unattended... which also makes no sense since only 2 ppl in the entire building have access to that five pound key to let them in and let them out. It just not possible.
The RN reported the harassment to the DoN upon her arrival. The DoN came to me after asking Lila her side of the story first. The DoN said Lila had very little to say so she wanted to know what my take on it was. I said I was just shocked and embarrassed. I wasn't sure what to do. Like really.... someone comes at you with such emotionally charged racist words..... what are you to do. Shouldn't that qualify for immediate termination? I guess not. Besides, the prison is so short staffed that Lila is the only effective nurse to run the med room and I'm one of the few who understand the ferocious pace of the clinic. The DoN let it be a stalemate and no further actions were taken.
Thank god I found a different job in a hospital 6 months later.... sadly LPNs simply don't make good hospital money at a base of $13.60ish an hour.. like really.... So I continue to keep the Prison job PRN at the said rate and earn a decent amount while I work towards my RN.
4) As an LPN, I do often worry about my nursing license, but then I have kept in touch with 4 other LPNs who experience similar problems. One friend wrote me just days ago about how he felt another nurse was framing an oncoming shift nurse for lost narcs. He said in just 5 months two nurses have come and gone on just his hall. That's from being fired... seriously... Long term care is messed up. He's also trying to get his RN rt now and has been accepted into a community college program. Its is just like prisons, tho... under-staffed and pts are poorly treated.
My other buddy is in LTC an states all the days just blur together. He hates his job but makes RN money of $21/hr so he is content to be unhappy b/c he hates school more
Another friend works at the local jails making almost $24/hr as an LPN and she is spit on, cussed at, and has nothing nice to say.... every. She is also in an RN transition program- bless her soul.
My other friend is LTC and seems content. 3 days a week on weekends at $22/hr as an LPN and she loves it. Wow.
Some days.... I just wonder if an LPN is an inferior nurse, as demonstrated by McCarlia, and other days I wonder if I'm inferior b/c I'm an LPN. I suppose as long as I have hopes and dreams I can get further in life. I am the only one I know of in my graduating class to get a real hospital position and still act as a REAL NURSE (not an RN but you know... perform real nursing duties and not just pass meds or just act as a tech). I hope that has to count for something. I need that RN just as bad as my buddies! Let's get it!!

OMG...what an experience! Some people just have no respect for their jobs, themselves, or other people. BTW, I'm working on my RN too & I hope that u get yours soon (& that u get the job that u really deserve).

xtxrn, ASN, RN · Aug 25, 2011

That if we keep putting each other down, then there would be no one left to build up.
Words matter and words hurt and knowing we have students on board should make a difference. I see threads on bashing nursing student/coworker, I am yet to see one on praising a nursing student/coworker,who did something well or made your day easier.
Let's buildup and not tear down:)

This is an excellent point. :) Start a good one ! (don't want to steal your idea, or I'd go ahead and do it) :)

I do see that there can be some learning from the ones who make mistakes, all of us have made them, and expressing those experiences in an educational manner vs being rather mean and cold would give better overall information. :idea:

It's good for nursing students to know that seasoned (or not so much) nurses make mistakes- but not in a way that belittles them. :up:

xtxrn, ASN, RN · Aug 25, 2011

KaringOne- wow. Offenders or not, it they're a nurses' patients, they deserve appropriate care. I'm sorry you had to deal with all of that. :heartbeat

OCNRN63, RN · Aug 25, 2011

If I want my co-workers to have my back, they need to trust that I have theirs. That includes not posting mistakes they made on a public forum. We nurses feel bad enough when we make a mistake; how humiliating it would be to come here and read a post about a mistake I made so people could make sport of it. ("I would never do that! How could she be so stupid?, etc.)

There are countless threads and posts here about nurses being "eaten." To me, this is no different. I don't for one minute believe this is all about an opportunity for a learning experience. It's more about "Look how dumb this person was." It boggles my mind that these threads are now being started by someone who is't even a nursing student. It makes us look like all the negative stereotypes you hear about nursing: catty, gossipy, back-stabbing, etc.

You'll never read a post from me about a mistake that was made on my unit. We learn from it among ourselves, sure. But I have too much respect for my co-workers to make their (and my) mistakes fodder for a MB.

CareteamRN70 · Aug 25, 2011

I hate to say it but these kind of post rarely educate.

They may give us a sense of "there but for the grace of God go I" and put our own experiences in focus, but for the most part they are sensationalist.

I have decided, since becomming an RN, that we folks are indeed aliens. People from the outside, including students (because i was one as well), find our more extreme experiences as both entertaining and morbidly curious.

I watched countless hours of "life in the ER" and any other reality based medical shows when I was a student. Now they barely keep my attention past the intro credits. For many people our stories fill in for those tv shows.

You never see many "good" stories about good nursing in the news..even in AN news section it is the sensational and extreme stories that get commented on the most. I have no problem with this, and I have no problem with nurses posting their experiences, but I don't pretend that someone asking us to spill all of our most gross/painful/strange/weird/humiliating/off beat tales is doing so from an academic point of view, they are basicly looking for all the entertainment of "Strange but true nurses tales" cue spooky music.

There are countless post here that someone can search for if they really need to know what kind of experiences they may encounter. Everything from the funny, the heart warming, the heart rending, the mundane, and the outlandish.

KaringOne · Aug 25, 2011

KaringOne- wow. Offenders or not, it they're a nurses' patients, they deserve appropriate care. I'm sorry you had to deal with all of that. :heartbeat

@xtxrn Huh? Did I miss something? :confused: I could have sworn that I posted:

"OMG...what an experience! Some people just have no respect for their jobs, themselves, or other people. BTW, I'm working on my RN too & I hope that u get yours soon (& that u get the job that u really deserve)."

I never said that offenders didn't deserve appropriate care. I would never say/think that. What my comment was referring to was the totally unprofessional conduct of libran1984's coworkers regarding the missing narcs. No one should act/talk to anyone that way, regardless of what happened. Now if I'm misreading your comment, then I wholeheartedly apologize for misunderstanding.:)

And I don't think it's easy for anyone to talk about mistakes that they may have made in the nursing field or any other field in that matter. But if just one person could learn from it, maybe it wouldn't be repeated or would be dealt with differently. I don't look @ the OP's starter post as being negative @ all. :twocents:

lrobinson5 · Aug 26, 2011

@Libran, long read *phew* I only had one question: are you allowed to look at the nursing notes that others write? I've only heard from the mantra in nursing school that you can't access anything that isn't yours. I'm guessing it is a totally different ballgame for prison staff?