shouldhavebeenanunRN 1,113 Views
Joined: Jun 30, '08;
Posts: 25 (44% Liked)
; Likes: 14
I'll agree with that as I have had the privilege of having worked with the creme de la creme of nursing professionalism during my clinical experiences..However, you have also crystalized for me what I have felt for some time.. that I work amongst unprofessionals in my current environment... but as my post reflects upon... how do I proceed and protect myself when working with those who would rather eat their young and entertain themselves at the cost of another's licensure?
Prime example of eating young ltc nurse: new nurse po'd that experienced RN refused to assist with unplugging a blocked jtube after hours of trying & calling DON who said ask next shift to assist prior to calling MD & sending out to replace (which would require an appt. NPO status & next day appt anyway)...experienced RN said why didn't person get tube feeding during majority of shift & why didn't I notify MD...I said I did what I was told by DON as I was not sure how to proceed considering myself and 2 others couldn't unblock tube over 3-4 hour period. Said RN was reprimanded for not assisting/refusing to assist and another RN said its my license not the DON if person did not get required feeding during shift. So...makes sense in hindsight that MD should have been notified, but it also seems that everytime another shift fails to flush a tube or refuses to do their job; and/or I discover it, I am forced to own it?? I am simply trying to do my job, and others refuse to accept accountability and responsibility and think its funny I'm stuck owning it.. ISN'T THAT BLATANT INACCOUNTABILITY?? AND HOW DO I COVER MY BUTT WHEN OTHERS FAIL TO DO THEIR JOBS?? LASTLY, am I wrong for seeking DON advice on how to proceed once I realized jtube was hopelessly clogged? I'm a recent grad, I am not always sure when to notify MD.. Or should I have called MD first?? But then again, should I have called at start of shift when I first realized it was clogged or mid shift when I called DON or prior to new shift coming on (before they had opportunity to try?) Thanks for feedback..
wow! very deep stuff... got my attention now! I'll have to read rather than skim next time. Thanks
Worked as charge in a LTC one night. A travel RN & Permanent RN counted and all was good @ end of shift. Travel RN comes on next day and says narcs missing since her last shift. Permanent RN said never counted particular narcs w/ travel nurse; and count was good until Travel RNs shift next day. Enter new DON .. who destroys wrong narcs w/ permanent nurse during shift (had access lets say and possibly destroyed narcs? but not case). I was on another unit that day thank god! No access.. DON gone for day too; and a full 80mg blister of oxycontins GONE! NARC sheet gone! SO, perm. RN did not recall any such narc on cart as she was forced to administer a prn 5mg prior to end of shift for same pt., claiming no knowledge of higher dose in narc box/count. MY role in the procedure as charge RN was to report to Administrator, ADON, DON and police if so directed by adminstrator. As I assumed/concluded permanent nurse was innocent/clueless of missing narcs as they were not incl. in count & fact she did sign out a 5mg prn before end of shift for same pt. Traveling nurse who reported narcs missing was my #1 suspect as she had direct knowledge of narc dosage & count and behaved suspiciously after I suggested a UA for everyone on the spot to administrator. Her eyes bulged for sure.. LOL! Anyway, could have been the new DON too.. but left before finding out how it all ended. I do know perm. RN was allowed to come back to work and DON still there, so I assume it was the travel nurse who was suspect in the end. I also know it is a federally reportable/investigatable offense and heads will roll. Glad I wasn't on shift with any of them... and I can only recommend if you have blisters... count every single pill/don't rush and compare to narc sheet #. If it is off, stop & report immediately. CYA!!
i have skimmed the key points of the book of the dead. it is very similar to the reverse of birth, except if i recall.. one of the first after death experiences which determine re-incarnation or purgatory begins with temptation vs. innocence and life experiences; and if successful through the phases/stages of death you choose you get to choose your parents/next life and are re-birthed; if unsuccessful, you remain in purgatory until you figure it out or are lost in purgatory forever?? Amazing!! I believe, the prophet monk who wrote it, also hid it for some 600 years and even named who and the exact date his book of the dead would be found--fearing it was too controversial for the time
written; and it is still being used by Siberian monks today I understand.
I agree with Selke on this one.. it is instinctive to nuture and guide a newborn as they are helpless and innocent, but it is equally important to give our dying support and permission to die; so they can move into the next stage of life....death! Great insight Selke! Thanks for post!
I agree.. as a new grad its a part of nursing culture where I work; I have worked with the creme d'la creme of nurses in clinicals; and I have worked with my worst nightmares in real world practice . I have already been chewed up and spit out a couple of times by more experienced nurses who are annoyed by my passion, eagerness but obvious inexperience.
Having quickly learned that nursing can be a burnout profession being able to smooze or rather stroke a more experienced nurse (even the nightmare nurses) the right way is essential to professional rapport and growth--even when some may prefer to eat you alive!!
Example: LTC G-tube pt. w/gunked up Gtube.... nurse says to new nurse (me).. you didn't flush did you? yes, followed MAR.. no way! come with me.. (she doesn't know I am new grad)... okay.. after a couple hundred cc flush.. i mentioned Mar states only 50-60cc flush..eyebrows furrowed, looking at me like a moron, i show her MAR.. she shows me a pt. flow sheet (not the legal document). We agree that MAR should reflect flow sheet flushes, so needs clarification..back to gunked up gtube.. SODA POP!! --Gtube goes pop anyone?? Yikes!! Anyway, lucked out & she had standing order to flush w/coke; and she elaborates saying miralax works too; but to make long story short, although not a legit nursing intervention for all us newbies, it is done frequently by nurses before contacting an MD in many cases, per nurse... So, okay.. I assist at bedside, applying pressure with a towel to length of gtube as she tries to flush tube, so tube doesn't burst r/t ballooning/pressure of push/flush. She shows me every little artery clogging like curdle that appears; and about 30 mins later we cleared it. Now, back to the smoozing... I praised her expertise the entire time, thanked her for going out of her way and the extra time she was taking to teach me how its done, b/c noone else had; and apologizing for any inconvenience I had caused her, offering to help with other patients past my shift to make it up to her. I asked if I could come to her with any future questions, or if she had any feedback regarding my techniques, etc. Just as quickly, her furrowed brow turned to enthusiasm in no time; and she even went the extra mile, from every curdle...to how to avoid bursting the tube, why 50cc would never be enough, how and why to clarify orders, importance of pt. positioning, assessing for gastric irritation/pain during/after.. and no kidding I needed it the very next day, but I was able to use warm water in a similar way, having had a visual/actual on hands experience; and thanks to her instruction, I not only made it look easy, I gained a supporter! I even sought her out to ask her to evaluate how I did with the next pt.; and her pride was apparent by the smile on her face.. VALUE & WORTH! We all need to know we belong. And for all of us rookies and long-timers alike... remember tact!! Definition of tact? Consideration in dealing with others without giving offense!!
okay.. i'm a rookie... what is a swan?
My only hospital setting experiences occurred during clinicals. I am in LTC now, worked in home health as a CNA for 12 yrs and although told case managers were generally MA prepared, I have found that you can work with a BSN in community/public health setting as a case manager, or as a new grad with min. hospital experience. Besides, expectations and training varies from setting to setting. You may even be eligible to work in a office/outpatient/ambulatory setting without being as wordly as a 2 yr experienced med-surg nurse... fyi.. one month in a nursing home or ER and you may surpass an experienced med-surg nurse in many cases... good luck!
I totally connected with this thread as i skimmed sentences, such as: I sang to them, I talked to them, etc.. I work in LTC as a new grad; and its no picnic. I also lost my mother the day I graduated with my BSN; and skipped ceremonies to hold my mother in my arms as she died; and I am eternally grateful for the opportunity to look into her deep green eyes one last time; knowing she knew the person who loved her the most on this earth was there with her as she took her last breath and that she wouldn't die alone (her worst fear). FYI, statistically, 97% of us die alone.. according to some research I've read.
Needless to say, the experience has impacted my nursing practice forever.. I could go on an on about my mom, but in reality, I have lost patients as a student and new grad too. I like to believe it prepared me for the loss of my mother to some degree, but to this day, I still work in a LTC facility, and it pains me to see the lack of compassion within my profession for the most vulnerable.. the dying.
However, unlike my peers, I like to believe that I am a pioneer for the reform of LTC nursing practice and palliative care; and I lead by example. I am by no means a "super" nurse, trust me, but I am deeply passionate about what I do. I always go above and beyond, as if serving the needs of Jesus himself; and I hope that in the lives of people whom I touch everyday they can go to God knowing I gave them my best as both a nurse and compassionate human being .
I too have also found myself singing to them, stroking them gently, telling them stories, making small talk, fluffing a pillow, washing the dry crust off their lips, soaking their moldy dentures, or in those last moments, simply giving them eye contact and letting them know a kind soul is there for comfort or last words if that is what they need. I have lost several patients my first few months as a RN who have looked to me in their last moments for comfort/closure in their last moments, including my mother.. However, that may be my personal experience.. but I can't be honored more in this lifetime than to be someone's link to this life and a trusted guide into the next rdnrs:
With that thought in mind, I thank you --those who take their purpose/profession seriously and may I be so lucky as to hold your hand and look into your angel eyes with my last breath as I seek God's redemption or the next life !!
gen chemistry goes into the whole electron, structure of chemicals, elements, etc. If I recall, biochem elaborates on it with a focus directed more towards lipid molecules, permeability, nutrient absorption, how dna strings together, how molecular composition can be manipulated to create new molecules/drugs. all i can say is when you get to isomers, and if you get stuck there -- remember use my spoon trick noted in another reply earlier. Good luck
no reimbursement, but I hear they want me back. I'd have to pursue through legal means to get back pay. No legal fees as I have malpractice insurance but didn't need it; as the BON threw it out during screening process seeing it was bogus!! If I ever get the opportunity to visit Israel I'll have to contact you for a tour of your facility and see how its done in your country. Blessings all!!
Now that is info I am so glad you mentioned - THANK YOU! Its true too, even for me. I had to ask and clarify the difference between Novolin and Novolog myself. A nurse working there for 40 years didn't know the difference. We called a pharmacist to clarify it. But I don't know what you know, I'll remember your words the rest of my career. If you read on, complaint was unsubstantiated and closed. I am so relieved. Regards
Great news all...complaint filed with BON was found to be unsubstantiated and that I was not in violation of any standards or statutes...also, started another job (not my dream job), but I am beginning to believe that nursing home orientation and training is sub-standard period. However, I am looking for a RN position in the mean time where I can be appropriately precepted/trained and can learn the right way to do things. I am told I could fight for my position back, but why would I want to go back after that? I'll have to start a new thread on my experiences thus far as new nurse in LTC-its mind boggling. THANKS FOR ALL THE SUPPORT EVERYONE - I WAS BESIDE MYSELF!!
documentation is a weak point for me as I learned on an electronic system, so when it came to hand documentation, I struggle. I am actually going to take a seminar soon on nursing documentation strategies as it has been a thorn in my side as a new RN. I obviously need it:smackingf
I feel the exact same way.. I too am procrastinating... now I know how a ex-con or disabled person feels when they desperately want to work and will be judged on pass offenses/disabilities which may or may not impede work expectations.
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