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Joined: Oct 18, '07; Posts: 246 (26% Liked) ; Likes: 101

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  • Jan 17 '09

    Wow, well, when I come as a traveller to your hospital I hope you cut me some slack on pronounciations because a lot of the ones I see complained about in this thread, I am guilty of.

    Oh, and when I say "out and about" I hear it that way, so you insisting that I am saying "oot and aboot" and having me repeat it over and over, for your listening pleasure, doesn't help anyone.

    Just something to consider, for what it's worth.

  • Aug 21 '08

    It's ironic how some members are so critical of others "spelling / speaking it correctly" while their posts contain several typo's for the rest of us to navigate through. Careful . . . While you're busy pointing out someone's errors, perhaps pause to consider there are four fingers pointing back at you.

  • Aug 21 '08

    Okay, I find that words like "spelt" when not referring to the grain but referring to the word "spelled" to be as funny as when someone in cyberland knocks someone else's "grammer" instead of "grammar." "Wether" is not a word, whether you like it or not. Nobody's "prefect," even us grammar police and wannabes.

  • Aug 20 '08

    The medical community is an interlocking set of hands, Hernando. We help each other as best we can, no matter our level of education, or the position we might hold within the hospital chain of command.

    The tone of your posting seems overly-aggressive towards LPNs in your hospital (or LPNs in general), which makes me think that your grievance with LPNs runs deeper than simply their "scope of practice."

    Do you also have grievances with the EMTs who bring the patients into the ER, lab techs who run the lab work for you, x-ray techs who get your patient's x-rays, etc. ad infinitum?

    I think you need to re-evaluate where your aggression is coming FROM, rather than directing it a a group of professionals who are only ALLOWED to work within a specific scope of guidelines (much like yourself.)

    Good Luck.

    Michael

    Quote from HERNANDO-RN
    I Certainly Hope So. In My Opinion, Lpn's Do Not Belong In The Acute Care Setting Due To Their Limited Scope Of Practice. There Are A Few Remaining Lpn's At My Hospital...and It Is A Burden Working With Them. They Cannot Take Telephone Orders, Do Admission Assessments Or Iv Pushes....that Gets Dumped On The Rn's Working With Them.

  • Aug 20 '08

    Quote from HERNANDO-RN
    I Certainly Hope So. In My Opinion, Lpn's Do Not Belong In The Acute Care Setting Due To Their Limited Scope Of Practice. There Are A Few Remaining Lpn's At My Hospital...and It Is A Burden Working With Them. They Cannot Take Telephone Orders, Do Admission Assessments Or Iv Pushes....that Gets Dumped On The Rn's Working With Them.
    Well, I am sorry that you have been burdened. I am not even saying this to be rude...I am. Now, of course, I, as an LPN beg to differ with you, though in what things LPNs can do within our scopes of practice in certain areas of acute care. I can see the difficulty of LPNs working in specialized settings such as Labor and Delivery, ICU, NICU, and such, however, most of us are a help to RNs working in med-surg by administering the majority of the medications, treatments and tasks such as catherization, dressings, tube feedings and such. And, there are ways around some of them, because LPNs can assist. A small example is that LPNs at my facility cannot accept adnormal labs. But, many of us will assist the RN by sending the telegram (in my clinic setting), paging the physician, contacting the patient to arrange for follow up visits, and in some facilities, they are doing initial assessments, but the RN has to countersign. Yes, this is light stuff compared to what you may have to deal with in your daily battles, but the point I am trying to say is that many of us try to work around the framework of the scope of practice to create team unity rather than animosity. Of course, I have to protect my license the same as you do yours, but this doesn't mean that I would watch you kill yourself if there is some portion of the burden I can legally take off of you. It is almost the same as saying that a CNA can't help you, either...they can do even less than we can.

    It does depend on the place of work and the scope of practice within the state. I can see how this would be a possible burden for an overworked RN, but if some LPNs still exist in your place of work and you get along with them, see if they can or will meet you halfway in getting your tasks done. Hope it gets better for you.

  • Aug 20 '08

    I received his mother, AA, to a room on our floor shortly after midnight one night. She had presented to ER at 15+ weeks gestation with ruptured membranes and intermittent vaginal bleeding; the OB staff suspected chorioamnionitis as the culprit. Rather than risk the infection becoming overwhelming, the decision was made to do a dilatation and evacuation later on in the morning. She was accompanied by her mother and father; her baby's father was at home.

    I settled AA into her room, showed her how to use the call bell, and let her and her parents know that I was there if she needed anything. Her assessment was within what I would have expected for an early second-trimester rupture of membranes. She had received 1000mcg of Cytotec in the Emergency Department and had received 2mg of Morphine IV for pain prior to arrival on the floor. She was not in any pain and I was hoping she would be able to sleep a little before going to the OR for her procedure, as this was her first pregnancy.

    About 20 minutes later, AA's father came rushing out of the room and asking someone to go to the room immediately; the only words he could get out were "the baby". I knew instantly what was happening. I got her into bed (she had gotten up to void), called for help, and could see her baby's tiny legs hanging from her vagina. We got the OB resident to the room and she delivered the baby. Five minutes later, the placenta was delivered as well.

    Throughout the entire situation AA was amazingly calm. I talked to her as soothingly as I could and reassured her that she would be taken care of. The OB resident was very professional and reassuring to the mother, and I had great colleagues who helped me more than I can articulate.

    After the delivery, I asked AA if she wanted to see her baby, and she said that she did. AA's mother did not want to see the baby, nor did she want her daughter to. When things calmed down, we talked about this some more. AA's mother asked me if the baby was well-formed, and I said that he (she delivered a little boy) was, albeit he was very tiny and his eyelids were still fused. She continued to be adamant that no one should see the baby.

    This opened up an opportunity for us to talk about the grief process. I made it clear that we would not force anyone to do anything, but that often, families experiencing a fetal loss are greatly helped by seeing the baby that they have loved and cherished. Having something concrete to grieve so often helps them incorporate that soul into their lives in a meaningful way. I think, though, that more than anything, this lady was afraid that the baby was grossly malformed and did not want to see that. I think this because once we talked about how he looked, she seemed more comfortable with the idea of her daughter seeing the baby, though she herself still did not want to. That was okay by me, as long as AA got to see the child she had tried to four years to conceive.

    I weighed, measured, and took pictures and footprints of this baby for her, and told her that whenever she was ready, I would bring him to her. She was ready right then; I got the baby and before handing him to her, described him once more so she knew what to expect. She cradled her son and touched him, and her eyes welled up with tears. I could tell she wanted to be alone with him. I left the room and allowed them their time and space to say goodbye. I felt very privileged to be able to give that to her.

    What I will remember most, however, is this baby's father. He came after AA's parents had gone home, and after AA was finished holding her baby. I was in the room going over some paperwork stuff with them, and it hit me: I need to offer him the opportunity to see his baby if he wants. To the surprise of both of us, he said yes without a second's hesitation. I gave him the choice of bringing the baby to the room, or having him come with me to where the baby was. He wanted to come with me. I'm not sure why, but I guess it doesn't really matter.

    I took him into the room where his son lay wrapped in a tiny blanket, and let him know it was ok to open the blanket and touch the baby. Almost immediately, this strong, macho, man's-man burst into tears. He asked me to leave; I was happy to, and told him to please take as long as he needed. I stood far enough outside the room to be available but not intrusive. I heard the sound of his weeping in the hallway and it was one of the most heartbreaking sounds I have ever heard. Tears began to roll down my cheeks in front of God and everybody, and there was not a thing I could do to stop it. I didn't really want to anyway.

    Shortly thereafter, the baby's father came out and allowed as how he was finished saying goodbye. I walked him back to AA's room so they could be alone together and went to prepare the baby to be taken down to pathology. If I live to be a hundred, I don't think I will ever forget what I saw when I walked back into that room. Beside the body of this beautiful tiny boy were wet marks from the tears that his father had cried.

    Daddies lose babies too, and I am forever grateful to the baby that taught me that.

  • Aug 20 '08

    First of all, I'm sitting here wondering how an e-mail meant for another instructor got sent to a student by mistake. What kind of instructor makes that kind of boo-boo?

    So, I'm thinking this was either

    1. deliberate (and very childish)
    2. or, this is instructor is not the brightest bulb in the box
    Choice #2 is not likely or she wouldn't be teaching. I suspect it's #1.

    Make a copy of the e-mail and attach it to a letter of complaint about the way this instructor is treating you and send it to the head of the nursing department as well as the dean of the college. She is bullying you.

  • Aug 15 '08

    deb, it sounds like you handled the situation quite well.
    good job!
    if someone yells at me, i interrupt them and quietly tell them i will talk with them when they're done yelling.
    then i walk away, and update the boss.

    sounds like this doctor has issues.
    don't let her drag you down.
    you showed her who the bigger person was.

    leslie

  • Aug 15 '08

    for the first time yesterday i was yelled at by a doc. i have been "waiting" for this day because i was really worried about how i would end up responding, but i am so proud of myself for not losing it. i am, however, so upset about the situation...

    i had a pt being d/c'd to home, 88y/o, confused at times, difficult to communicate with. she was on bedrest for 1 wk, could not even turn on her own. when her daughter got to the unit i asked if pt had been ambulatory prior to hospitalization. yes, with a cane. i asked about her home/care...(stairs, does daughter have help, etc...). anyway, myself and pct get pt oob w/ walker to a chair. obviously very difficult for pt to even walk 2 feet. daughter looks nervous. :uhoh21: i ask if she thinks she would be able to care for her mom at home. no. tell daughter i can call md and ask for mom to transfered to snf for pt/ot. daughter wants that. well, md happens to be on the unit d/c'ing another of my pts. i go to md and barely start to explain situation...and she flips out!!

    "why are you telling me this last minute when pt is supposed to be d/c'd?"
    "you don't think the pt is appropriate for d/c...then hold d/c!"
    "i came here in-between pts at my clinic to only see this other pt and you harass me...you have been harassing me all day...you called my office 4 times."
    (me) "no, i did not, i called once." (her) "you called 4 times." (me) "no, i didn't, i called once." that went back and forth about 4 times. i had called her office once b/c the other pt was going to go ama and she called me 4 times to ask if pt was still there and to update me on when she would get to the unit.

    anyway, she grabs my id and says she is going to write me up and blah, blah, blah. she leaves the unit, charge rn comes to ask me what happened and as i am telling her md starts coming down hallway again...yells at me to hold d/c, walks up to charge and yells at her to hold d/c and leaves again. now, case manager is telling me pt has to be d/c'd and i need to call and get order for transfer to snf as a rep is on the unit saying they can take pt today. also, for other pt, md wrote no rx after writing to continue new meds. charge rn pages md x2 with no return call. i call her office and receptionist says she is with pts, is it ok if other md calls me back...yes...please!!

    so, other md calls back, i explain about the pt and how deconditioned she is and that daughter (although for the last wk has been saying she wants mom home) states she cannot care for mom at home and she would like for her to go to rehab first. md (who is obviously not aware of what had happened) is happy daughter decided that and says, "of course, that is perfect."

    fast forward 2 hrs..... "mean md" calls me to yell at me some more. :angryfire she is saying that she should have been aware long before d/c that pt is deconditioned (duh...you are the md) and that it is my responsibility as a nurse to make her aware...which i respond that i had only had this pt this 1 day and until i talked to daughter did not know her pre-hospital condition. she then says that pt has been ordered the first day pt arrived, and why had i not done my job and followed though on the orders. i flip through chart and tell her there is no order for pt for pt and again, if there had been i only had this pt this 1 day! she keeps telling me how wrong i was and keeps asking, "do you see why i am so upset?" to which i respond, "no, i do not. i am sorry you perceive this situation the way you do, however, i feel like i was a great advocate for my pt, was being proactive and i do not understand how you do not see that." she tells me what a nice doc she is and how i am the only nurse she has ever yelled at (this is where i realize not only is she a *itch, but a delusional one at that)and she is so upset at me for causing her to get so upset and how unprofessional i am..... i tell her i am done speaking about it, i know i did nothing wrong, if she has anything else, call my manager as she is already aware of the situation. to which she replies she absolutely will.

    :angryfire:angryfire:angryfire i am just sooo annoyed/mad/disappointed. there are things i wish i would've said, but am so proud of myself for remaining calm and professional, as i have a tendancy to say what i think w/out thinking about what i'm saying!! i know i did nothing wrong and only made sure my pt was safe. i feel really good about the outcome for the pt/family. i just do not understand why something so simple had to be such so stressful and upsetting.

    thanks for "listening" :d

  • Aug 14 '08

    I have actually "evicted" residents because of their families.I have had residents whose families had taken up exhausting amounts of my time over lost socks, imaginary abuse, and absolutely normal events. I had one family member who interrupted a phone call my husband(a doctor who was on a call to an emergency room )was making-she had the operator break into the phone line-to demand why her mother had fallen asleep at the nurses station. When I called the home to check on her vicious insulting complaint I discovered that the nurses had had her mon in her wheelchair at the nurses station to provide her with some social interaction, and the little old lady had fallen asleep. The nurses, passing their 268 night meds, simply had not had time yet to put her to bed. I have had the state,and the states attorney general's office,and private investigators in my building accusing us of client abuse because an mentally retarded quadriplegic resident had told his sister via Ouija-board communication that someone had hit him. He rescinded his statement the next day, but that did not keep me and the staff from being tied up with an investigation for TWO months.I have had a mentally ill gentleman who routinely called 911 (we didn't stop him) and alleging abuse, a well documented practice of his for the last 12 years. That fact did not stop the state from investigating the building for 6 weeks,discounting all evidence that the gentleman was mentally ill and was, as one of his psychiatrist had documented "at baseline with constant allegations of abuse and neglect"No one looks at facts in a nursing home with any realism, and anything any one says is grounds for investigation and fines and make it almost impossible to identify and meet the other residents needs. With these families, when their loved one goes to the hospital, you simply say you "can no longer meet their needs" when they apply for readmission.Families who are angry for their loved ones decline, which is inevitable in a frail elderly person, should realize that they cannot scream angry accusations with spittle flying and threats made without consequences. I am sorry if this sounds cold, but these are the facts of reality. I do not discourage legitimate complaints and struggle constantly to see that these delicate old residents get the best care they can, but angry family hysteria definitely WILL affect their family members ability to remain in their home.However,financial status and return has never been a factor to me.

  • Aug 14 '08

    Why has this thread devolved into yet-another "blame the OP" session? I know that not everyone is blaming the OP, but like so many other times, there are unconstructive comments by people who seem to think everyone should always act perfectly. And the OP is getting blamed for the other person's bad behavior, because she "let" that person treat her badly. :angryfire I'm unsubscribing to this thread.

  • Aug 13 '08

    Congrats on saving your brother's life. That must have been very scary. I'm sure he will appreciate you saving him. I pray he concentrates on saving himself now for his sake and that of his son. You will all be in my thoughts and prayers. I hope this gets him on the road to recovery with the help of medical professionals and loved ones lending plenty of support.

  • Aug 13 '08

    AWESOME!!!!!!! Great job, and I pray for your brother and that he is going to be OK and able to kill the demons that are plagueing him...

  • Aug 12 '08

    If the woman was past childbearing, then probably fine. If not, I would think this however slight increase in scarring would increase the possibilities of complications during a subsequent pregnancy--placenta accreta and uterine rupture both come to mind, since both are increased in the presence of a uterine scar.

    This is going to sound a bit odd, but I think the uterus too much disrespect as it is in the medical community. i don't know that we need to be doing surgeries through it.

  • Aug 11 '08

    Safety first always. A little pee on the floor is nothing compared to a broken hip.


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