NurseKatie08, MSN, RN 11,809 Views
Joined: Jun 26, '07;
Posts: 754 (36% Liked)
; Likes: 557
Why did no one else on your floor check in when they heard the code paged? Thats crazy. You were alone. You did the right thing by attending to their respiratory status.
They were planning on pulling the plug the next day, so I presume they had determined his eligibility.
2) reporting 16 count respirations on every patient. Even a dying man who was at least 32 a minute.
It is hard to say. Look at what statistically counts as the average family income in your area with the average nurse pay.
It helps to define "luxury". Personally I define luxury as something still out of reach to most middle-class people like a private plane, fully staffed second or third home, impractical careers supported by a trust fund etc.
Other people might define it has having a stable life with a house, car, bills paid and enough left over for some fun. In most areas nursing will provide that, but there are many variables.
No, amberrenae, you weren't wrong. When it comes to heavy duty meds or procedures, the nurse taking the order should follow through with the process.
On routine stuff that doesn't involve controlled substances and the like, if the nurse is busy or wants to go home, I'll enter the order but always enter the other nurses initials and then my own.
I would interpret the "2 tabs" as being irrelevant to the dose, but if that is actually how the order is written by the Physician then I would interpret it as: this physician is an idiot.
That was now YOUR patient, you acted correctly.
Your co-worker does not administer /or seek pain control for sickle cell patients. YOU must write Nurse Ratchet up.. and advocate for future patients.
I'm sorry, does she OWN her patients for the day? When they are passed on to you they are yours to take care of. What if one of her patients developed SVT? Would she have been upset that you treated it without "consulting" her first? She sounds a bit possessive.
Also, just because someone is an addict, it doesn't mean that she is not in a horrendous amount of pain.
You did everything that you should have done. Don't doubt your judgement.
Have you spoken 1:1 with the instructor? I think that should be your first step. You both have some blame to bear - and it sounds like the relationship could be mended.
Yes. You should take it. The alternative is to be unemployed and do no skills for $0 per hour.
We have one thoracic surgeon who comes in the evening day 0 and orders the patient to be stood at bedside. He watches you do it!
As a former state surveyor, I say this is ridiculous. No one who has ever done a med pass in LTC would agree with such a regulation, and that includes many surveyors. I feel sorry for the ones who have to enforce it at the local level, to say nothing of the nurses and med aides who have to follow the rule. Shame on the authorities for coming up with this one.
1) If you yell "HELP!" one. more. time. without a really, really, REALLY good reason for it, I am going to come down there, shut the door, and give you a good dose of pillow therapy.
2) Sure, go ahead and sign out AMA. It's your choice. Just a reminder, though: if you leave, your insurance won't pay for your stay. Better yet, you won't be my responsibility anymore.........and believe me, I won't miss you.
3) I don't give a rodent's rump that you're related to the hospital administrator! The AMI patient down the hall who just went into V-tach needs me more than you need another blanket.
4) Thank you for asking me to check out your grandchildrens' photos, but I have a strict policy of never touching patients' wallets, and frankly, I don't have the time to breathe, let alone stand here looking at pictures of people I don't even know.
5) Yanno, when MY doctor prescribes water pills, I take them no matter how much I hate having to pee every 20 minutes. That's why I'm not in here for CHF, and you are.
6) No, "Mamma" is NOT going to get better, and if I were in her shoes, I'd haunt you for the rest of your days for keeping me 'alive' on a ventilator with my wrists tied down so I don't yank on the tubes coming out of my every orifice. She's had two major strokes and an MI, she's full of osteoporosis, and she has an advanced directive saying she didn't want any heroic measures if she ever got into a situation like this. What part of 'Do Not Resuscitate' don't you understand?
7) Please don't come to the ER for a sore throat that you've had for two weeks, demand refills on your soda pop every five minutes, and then complain loudly to your companion about the "lousy service" you're getting.
8) Yes, I have seen something like that before. In fact, I've seen things you can't even imagine that are a whole lot worse.
9) It is NOT my job to: answer your phone/find you some napkins/take out your trash/send out for pizza/pick up after your visitors/run a message to your friend down the hall/go to the kitchen to fetch a tray for your brother/cater to your every whim. (I've done all these things and more for my patients; it's just not what I was educated and trained for, and you need to know that.)
10) I apologize for my cynicism, but experience has taught me that multiplying the number of drinks/pills/hits you admit to having taken by three or more tends to give me a more accurate picture of what's really going on with you.
11) I'm actually a very kind, compassionate, caring individual, but some folks make me wonder if God made man NOT in His own image, but so that skunks wouldn't think they've been given a dirty deal.
Have a nice day...........
I think it is better to give an ABX late than to skip a dose unless absolutely necessary. For a BID abx giving it a few hours late and then getting back on schedule would be appropriate. I think a few hours with a TID would be okay as well, but giving a QID abx a few hours late would be pushing it and I would likely skip the dose and get back on track with the next scheduled dose. Even home abx the pharmacist usually says if you forget a dose to take it as soon as you remember, but if you are close to another scheduled dose to skip the missed dose and resume at the next doses time. Use your nursing judgement and call the pharmacist for clarification/recommendation if there is doubt in your mind.
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