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Emergency RN, BSN, RN, EMT-B 9,320 Views

Joined: May 24, '06; Posts: 570 (65% Liked) ; Likes: 1,901

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  • Mar 23

    I find it stunningly ironic, that a nurse who makes a living undermining the livelihood efforts of other nurses, is here asking for advice in how to obtain more of such employment. If you want to be a nursing mercenary, that's certainly your choice and right; but I for one would never assist you (or those of your ilk) in such efforts. You're not the only nurse who needs to eat; IMHO, your employment strategy of stabbing your colleagues in the back is akin to cannibalism.

  • Mar 7

    Quote from AlmostABubbieRN
    Dude. I AM the supervisor. And while the practice alert is nice, nowhere does it say you can walk out without someone to cover.
    The legal requirement is to tell the nursing supervisor that the nurse is at the end of their shift and that there are patients that will need coverage; you, as the supervisor, are now responsible for that patient (or to provide the needed coverage). This is what is meant by "providing notification" insofar as state BONs are concerned.

    Quote from GooeyRN
    But WHY should it fall on the off going nurse to find coverage or have to stay? She/he did their 8 or 12 hours already. They aren't the ones that called off. WHY should they be the one punished for doing what they were supposed to do? Sure they will get paid, but money really doesn't cover certain hardships. Again, like elderly parent care, child care, sometimes pet care, etc. Many people have obligations outside of their 40ish hours a week to work. There really should be a PLAN in place for WHEN, not IF something like this happens. Like PRN staff, agency, etc. Requiring people to stay when their shift is DONE is just going to create more burn out and PLANNED call offs if they know if it their turn to be mandated on a certain day when you KNOW the oncoming nurse is famous for call off's.
    Legally, such an argument is pointless. Your obligations outside of the institution don't matter, nor are the perceived sick call patterns of another employee. The only thing that matters to a state BON is what labor law is, and whether there was violation of professional conduct. In certain states (like NY) it is actually illegal to have an RN work longer than 16 hours continuously. Further, that RN must then have at least 10 hour rest before being returned to duty. In essence, that would mandate the next day off. Again, unions know the law and hold the employer to it. Employers have traditionally taken advantage of employee ignorance to openly flout labor laws while they fear monger employees into docile submission. They throw out words like "abandonment" and "license revocation" to cow nurses who don't know any better into doing what they want.

  • Dec 17 '17

    Like JoPACURN stated, the differences is in not knowing what the other side does. This is why it's always best to give report to someone who has worked the other side, because they inherently understand the differences in arena focus. Not that one is more important than the other, but rather, that the patient's needs evolves from emergent medical diagnosis, rapid treatment, selection of nursing priorities, and immediate stabilization in the ED; to the fine tuning of differential medical diagnoses, continued treatment, and consolidation and refinement of nursing care in the ICU.

    IMHO, I believe that ALL emergency and intensive care RN's should routinely work the other areas because in the long run, it actually makes you a much better RN. One begins to see and understand that one's own iron clad rules, are perhaps not so iron clad after all.

  • Sep 28 '17

    Sometimes, you just need to resort to brass tacks. Try something along these lines:

    "I'm sorry that you need to come back so often for something as ridiculous as an asymptomatic rapid AF, but unfortunately, the protocol here requires that I notify you for the change in rhythm. Further, if you don't respond, then I'm forced to call your senior (the higher resident, or the first's doctor's boss); if your senior also fails to respond, then I'll have to call the attending cardiologist at home. If you don't like that, then I would suggest when you're promoted to director of clinical medicine, please keep those dislikes in mind, and change the god damn policy so that us poor nurses don't have to bother the poor residents with such 'meaningless' things. I mean, it's really a waste of our time too, you know. But until then, when I call, I expect you to be here. Oh, and btw, if you don't show up; don't worry, you can read all about it in the chart; ie. who I called, how many times I called, how many minutes elapsed, what was ordered, et cetera; and have a nice day."

    Advice to the OP. Don't worry about it. Stick to your guns. You already have a license, so you need to protect it. A medical resident doesn't have a license yet, and is still in training. Whether he or she passes their training in large part, depends on how they conduct themselves on the floor during their residency. Your job is to protect the patient, not the medical resident. Frankly, their convenience or work load isn't even on my radar. Sometimes, these "doctors" forget that we don't work for them. Sure, we will follow their medical orders, but we work for the hospital in delivery of care to the hospital's patients. Ultimately, my employer makes the rules. If the rules are to call the MD for a rhythm change, then that's what I will do; the resident's likes or dislikes are not my concern. We are not there to make friends; just do your jobs. Period.

    Further, from your follow up post, the patient sounds like a train wreck to being with. Someone with such an extensive history, in new onset Rapid AF, really belongs back in a telemetry setting, regardless if they were asymptomatic or not, IMHO.

  • Jul 12 '17

    not responding in particular to this op's question, but wanted everyone to note this other case, in which a psychiatric patient was sentenced to five years for assaulting a nurse and giving her serious injury:

    http://www.timesunion.com/local/arti...aw-2251960.php

    typically, if it would have been a police officer, the patient would have been arrested for attempted murder (as had happened in other cases in the past), as he bit and his saliva could have potentially carried the aids virus.

    nurses have traditionally been used as various forms of punching bags, and the usual reaction from employers is to shrug and say "so what?" nurses and nursing needs to get together to help defend ourselves, both legally and physically, even as we're doing our jobs. hospital systems have to wake up to their legal responsibility to employee safety under osha.

    imho, once a patient attacks someone, then continue to treat them, but change their status to "prisoner" with police in attendance. then, once they're medically stable for discharge, they should be transported into and processed by the criminal justice system.

    large hospitals deal with police prisoners all the time. having a patient become one in the midst of his admission isn't so strange. in large cities like new york city, there are what are known as "prisoner wards" which are locked facilities like a psych unit, with corrections officers always in attendance.

    we as a society have to realize that crime and criminality does not stop when the criminal gets a cold. to ignore that facet of their life begets danger not just to nurses, but to society in general.

    support your nursing unions!



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