TriskixRN, ADN, LPN, RN 768 Views
Joined: Aug 20, '03;
Posts: 12 (0% Liked)
My weakness.... still the same since nursing school in 93-94... everything is still pretty much "black and white".... still having trouble with working in "the grey". To me, things are either right or wrong. I am a perfectionist by nature and nursing is sometimes difficult because I don't like to mislead anyone and think things should be done "by the book" in most every circumstance. I am getting a little bit better... I even have gotten to where I don't feel guilty for giving the siblings of my patient a little snack out of the "pantry" on my floor even though the snacks "are for the patients only". Love kids too much to give just the patient a snack and let the siblings "starve".
from a place on the peds floor lost somewhere in the deep south...
Serious topic... I'll share my experiences... I haven't been asked to list any specific meds I am on or any specific Dx however, I was informed right before the drug test to name any Rx that might show up or suffer the consequences. So I named the Narc strength meds I was taking and I was then asked why I was taking meds that strong and for how long, and if I planned to stop anytime soon.
I have found if I volenteer any medical information they "hire inside the company" suddenly or I get lower pay; and then there is discrimination and constant remarks / comments b/t the other nurses behind my back or straight to me about my conditions and their not wanting to work with me or accusations of me not providing good care.
I have worked under one supervisor whom told me I was not to report to work if I am taking pain meds or anything perscribed for depression or anxiety. I have found it very frusterating at times b/c I believe most of my health concearns are directly related to my career and my career is exacerbating the conditions.
Who among us has never experienced stress or anxiety or after a while depression caused from nursing? I have been in this proffession 10 years and I never had these problems untill about 2 years ago. I have had lowered pay and worse schedules and more horizontal hostility since being in the hospital I work at a year ago than I had experienced before! Now everyone I work with and the management know my Dx and are constantly critical of my every move and I truley feel they are triing to get me to quit.
So in answere to the original question, YES it can be used agianst you. and as previously stated in this thread just remember and repeat... "I am healthy" and if you don't have to don't take anything that can show on a drug test and only tell them the bare minimum or you will "suffer the consequences".
I have yet to find a way to take my breaks or lunches since I quit smoking. I usually start my shifts on a dead run and end them the same way. I try to find time, and once a moment appears, I am called to a room/phone/family/doctor ectra even when I tell people "I just need a minute; can this wait 'till I can use the bathroom"? I usually get the responce "oh this will only be a second and then you can go." by then I am running agian. I can't say that when I smoked I got out any earlier however, I did find that others were more accepting of my smoking than relief of an over filled bladder.... I have pretty much quit drinking fluids while I work to avoid having this extra stress. I rarely take lunches (it has to be a real slow night) and I may have to stay over a bit to finish charting and all but I gaurentee I haven't wasted any company time and My patients are all happy and contented for the next shift. surely there are a lot more nurses out there like me.... who put the patient before the nurse in order to assure great care and a job well done. I don't think I am slower than my collegues, but I know they take alot more breaks and so I care for the patients they have too. Could this be the problem?
From my perspective nursing pay changes not only from area to area, facility to facility, but with education; There is no acounting for experience..... I started in 1994 as a new LPN and made just over $8.00 / hour at a county home in the midwest.... changed to a private LTC facility and skilled rehab increasing my pay to roughly $11.00 / hour in just one year... then after 4 years in LTC was up to roughly $14.00 / hour... moved to the deep south and at first b/c the pay they were offering was nothing like I was getting went back up north to work for 5 years as a PRN nurse for four diffrent facilities and increased to $15.00 / hour during that time I got my IV therapy training and was certified and increased pay rate to an hourly max of $19.00 / hour of course I expected to lose some of the hourly rate when I agian moved south but never imagined would have to tolerate aproximately a 50% pay cut.... worked FT at LTC and made $10.15 per/hour went to the hospital and got $11.00 per hour (FT) left the hospital and went to the clinic and am back to $10.00 per hour with the LPN 2 liscencure and this is sopposed to be including payrate adjustment for being a nurse for 10 years! Its day shift and that makes a big diffrence to me at this time. All other wages were mainly eves or nights.... its what was most available.
Good thing I love to care, like nursing, and arn't in it for the money (although I miss the higher pay I had in the midwest / north. The cost of living in my area now is actually more than it was up there. I have to stay here due to family health concearns so moving is not an option at this time.) I found even searching the wages on line was not accurate for what I found in person.
Just b/c a hospital or other facility says they implemented a patient staff ratio doen't mean it is upheld. 8 - 12 on nightshift .... is what I often had when I worked OB - GYN on nights and the RN wasn't required to take patients. At times I had that many patients and was running my self to death d/t 3+ of them were fresh c- sections or other surgeries. It was too demanding and I couldn't keep it up .... went for a position in the clinics.
Acuity, I believe, is the most important factor for staffing. I could have handled that many vag dels (regardless of para) without much difficulty but throw in those fresh surgeries and Wham! No breaks, no lunch, no time to do real accurate charting, less patient satisfaction, and no time to work with the other nurses if they needed help (they didn't have time to help me if I needed it either -- raising the safety risks). The lack of acuity considered staffing causes a decrease in teamwork, decreased patient and nurse satisfaction, and worst of all decreases effiecient / effective nursing care and increases stress / risk.
Its not a watch your back I'll watch mine world.......
If we don't watch out for each other and help each other we all lose! We all watch each other so lets watch out for each other. :wink2:
Just some insight ...
All the classes I had taken through college were "expired" and I was informed to go on and get my RN I would have to take all of them over after only five years of nursing as an LPN... I am still working towards the RN however I do have to take all the courses over . Very frusterating, but I think it is wise; We forget alot from school over time and our field is ever changing and every day technology advances putting older information out of date.
I think you should contact the board of nursing in your area to find out for sure on the testing issue; I believe the states I am licensed in have a specific amount of time you are allowed to take the test from the time you graduate nursing school.
Best of luck and wishes in your situation. No Procrastinating Accepted in this field, move fast in your ambitions!
Wish I had!
I agree wholeheartedly:wink2:... JACHO should make their visits unannounced or more random so there is no "prep-time" for the hospital to get their stuff straight. I think that might help a bit.
As for staffing ratios ... so far the ones I have dealt with have been terrible in LTC; skilled rehab; Alzheimers; and hospitals!
8 - 12 hour evening / night shifts in LTC would have b/t 25 and 45 patients to 1 nurse (and one or two CNAs).
8 - 12 hour shifts in skilled rehab were roughly the same with an RN either on a special unit or on call.
8 - 16 hour shifts in Alzheimers were 6 - 20 patients to 1 nurse (plus one or two CNAs on eves and one on nights for over 8 patients)
12 hour nights in OB-GYN would start with b/t 5 and 7 patients and at 11pm, oftentimes change getting a whole new assignment and/or the patient load would increase from the existing patients being divided up by the charge RN (whom was not required to take patients) and then to top it off I had to take any new admits as well; the load was up to 10+ per nurse at times regardless of acuity. More than once I found myself at 2 a.m. with three or four fresh c-sections (or gyn surgeries <12 hours s/p) and no CNA or unit clerk to help and still had 5 to 7 vag dels to care for regardless of what Para or problem they had. Talk about being a hotel! I never saw so many women unable to do anything for their selves! They ran me ragged with little things.
What is approperiate? In my opinion and experience : No more than four in the hospital; no more than 8 in skilled/rehab; no more than 6 in Alzheimers; and no more than 20 in LTC per nurse not per staff member! We need our support staff ie: CNAs on every shift if we have more than 4 patients or if we are in Alzheimers units!
That is my limit for efficient quality and safety... every patient over that caused my effieciency to drop, and safety / satisfaction was comprimised for all involved.
The system won't improve if we don't force it to. I don't know how to force the changes (I am better at ideas). I think if there are enough of us out there that truely love our people we can cause change by not accepting second-rate caregivers. There has to be a line drawn somewhere... and it isn't pay... it is quality of care and additude. We need to assist the caregivers who fall short and need guidance and throw out the ones who are in it soley for the money or are being forced into this proffession by a government whom doesn't see people for who and what they are but as a conglomerant that they can mold into what they want.... Why on earth are they pushing "welfare cases" into this field?
CNA s are not the only ones coming from this group and I am by no means critisizing anyone on welfare whom desires to become a nurse or CNA (God knows I was one) but if the person going through the program doesn't have the right heart they will only make it so much worse for the rest of us who really do care and despite the bad wages are still doing our best to be the best at what we do.:angel2:
I agree the pay is terrible. One of my friends is doing phlebotomy now. After a short course last summer; she went from making as much as I do (as an LPN) to making more than I do by nearly two dollars on the hour (she was working at Wall Mart and now is working at a local hospital.) After the LPN 2 liscensure pay increase I almost have caught back up to her! She had intended to go on for her Nursing but after seeing so much in this last year and being fed up with nurses and their "poor practices" she doesn't want any part of it now. She says that as nurses we should be monitoring each other more and doing more reporting on each other rather than doing so much "covering up for one another". I tend to agree. But, if our supervisors aren't going to do anything about our complaints and reports why bother? Alot of the nurses I have worked with lately share this additude and want to just get thru the shift and get outa there! I was even instructed in my orientation at one facillity that "if you don't say anything you'll be allright, just mind your own business and watch your back." Scary isn't it? If you see somthing I am not saying it shouldn't be reported ... I just don't see any positive changes lately.
From a patients' family stand point I was really disgusted and infuriated by the nonchalant /I don't care / "its not my fault" additude stated to my Mother and I when we reported the poor patient care she was recieving. Besides the fact that nothing improved. Mom was in the hospital for about 16 days and was on three diffrent floors and four diffrent "units". Even in ICU, she wasn't recieving care as she was soppposed to get. The nurses were so "run" they didn't provide ice water to Mom for the first 13 days (she was on I and O). I gave her the only bathes she recieved and had to go get her some help b/c the callights were being answered by a unit clerk and Mom was unable to speak to tell them what she needed before they shut the intercom/callight off! The most common remark was "I'll be there in a minute." Acceptable, except that "minute", in some cases, include the weekend the nurse was off!!
On the over all I remain strong in my feelings that my family will never be thrust into a nursing home b/c of my experiences there and now I am adding to my belief --- for safety reasons, my family will not be in a hospital room alone agian.
The worst was that over the entire experience not only was there nothing done about the situation, there was no hint of empathy or appologies offered.:uhoh21: If I werenot a nurse, and had not took on the suctioning that day, I believe Mom would be dead; from the plaque (I removed) being so large had it completed the sideways turn I believe it would have occluded the trach; it was the largest plaque I had ever seen suctioned out of any trach.
Before becomming a nurse; I was very nieve. In nursing school when we did our rotations in LTC some of the patients I remember were so sweet and kind and terrified. I asked them about what they were afraid of and it seemed absurd... why would they be afraid of their care givers?
However, in these years I have seen RN/LPN/CNA "caregivers" due to "short staffing" / just spite or purely just being mean... refuse patients more at meal times, tell the patient to wait a minute and then the caregiver goes and takes their break or just sits at the desk talking on the telephone (personal calls) and when I reminded the caregiver the person was still waiting... I was informed they can wait till h--- freezed for all the caregiver cared. (I took care of the patient my self); pureed food mixed with liquids and poured into a patients' mouth and the cup tilted ever upwards untill the patient started choking or the mixture poured all over (in which case the caregiver yelled at the patient and informed all of us the patient "did it agian" and now we had a bigger mess to clean up), I have seen people treated like "babies", tricked into taking meds, the worst was during an orientation the RN shoved the applesauce laden PRN antianxiety med into the patients mouth and then while the patient was yet on the bed on the floor the RN held the patients mouth and nose closed to force swallowing and then let the patient get a quick breath as the RN dumped water down the patients mouth. I was so horrified I couldn't hardly breath myself and then really terrified I might be indicated since I was there and saw it happen (however frozen from horror). I was very distraought; I almost walked out of the facility right then. i reported it. The patient suffered a bruised face and the RN left the facillity to work at another one (some kind of punishment huh?) I have seen patients coersed into doing things they didn't want to, families lied to about the patient / patient care ( terrifiingly often the family will take caregivers words over their own family member), clothes swapped with and between patients (others seem to just vanish). And so much more I have tried to push out of my head and can't...
Nursing is sometimes quite treacherous. To speak up you may find your work sabotoged or some story made up that points fingers at you and the worst is when to retalliate another caregiver treats your patient without telling you and then reports you not doing that specific thing. I have been in many facillities and would love to believe this is isolated practices but it isn't; each facillity has it's specific "flaws" and "tolerances" that they accept and coverup. We all want to pass the state inspections don't we? I believe that is why some people have sickness or take suprise vacations convieniantly at those times... I used to love state inspections they were the only times the facillities really ran correctly and patients had the care they deserved and paid for.:roll
I have worked alot in LTC facillities unfortunately what is being described is not that uncommon. I have seen first hand too many abusive caregivers and it has appalled me so much I moved my whole family, sold out of my livestock and farm, and worked about a thousand miles from them in order to make enough money to keep my grandparents and mother in their homes untill their death. My observations have shown me what "poor staffing/short staffing" does in both LTC facillities and in the hospitals. I have been concearned for the patients in every facillity I have ever worked at. There is so many things that get over-looked and left undone or "passed on" I sometimes wonder why I have stayed in Nursing so long. My answere came very surprisingly this last December.... Mom had to have a trach placed and I was the "nurse" that took care of her in the hospital doing the patient teaching / drsg changes / suctioning / cleaning, I also did her bathes, got her meals corrected from the dietary department, and in general did all I would have for any of my past patients even though I was there for her "moral support" I became so frusterated by the lack of care being provided that I stepped in at her request; after the first suctioning I did on her (my finding dried on mucus plaques and at a week s/p trach placement her telling me I was the first to take her cannula out since the surgery) :angryfire I let the whole nurses station know that I expected them to provide a little better care. Even though I told the supervisors and kept climbing the chain nothing was done to really correct the problem and we were discharged with less teaching than I recieved from the kennel owner when I picked up my new puppy! :chuckle It is sometimes frusterating to be in this profession but love it... the patients really need good nurses!
Yes, if you want to call it that. We are not staffing for acuity. We have a staff to patient ratio of six patients to one nurse (dayshift) and it drops accordingly for each shift. Not bad for hospital staffing. However, I believe everyone would be happier if the aquity were taken into consideration.
Do you cover up for collegues that you know are in error according to JACHO or OSHA?
Recently I have experienced being patient family whom has not been able to get approperiate care for my Mother and the Nursing staff and facility are covering it up..... among the offences: No bath, ice water, assistance to the bathroom, suctioning at anytime in the first 7 days of a new trach placement, no patient teaching, lack of VS being taken, falsifacation of med administration, falsification of patient education sheet, callights being shut off without response from remote location, flat bed when soposed to be HOB up do to back problems, and even the ENT doctor is T.O. d/t the lack of patient care. In the last two weeks we have been very disappointed at the abilities of not only nursing but the respitory staff at this facility. I have covered for collegues but also it was in cases where they were ignorant and taught them approperiate care / tequniques. My experience as a family member has changed my mind. Why in our proffession of caring and protection are we tolerating such behaviors? Short staffing is not an acceptable excuse.
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