That said, the only one who is going to have to give a hoot about your safety is ... you. And you alone.
Sadly, that also means you face the almighty consequences for the "bad apples" that use the storm as an opportunity to shirk their work duties. Which means you don't get to use your PTO for a "snow day." Would they have allowed you to use PTO if your car had broken down? If so, that might give you a bit of a 'plead your case' situation. If not ... it just is what it is, like it or not.
I understand the point of being essential personnel. Believe me, I do. But sometimes I think hospitals take it too far. Nurses are human too. We fall ill. We are unable to drive in inclement weather. We have family emergencies. We are not immune to the occasional call-out simply because we are nurses.
Denying PTO because the OP can't get to work in the snow is punitive. I might add I find it childish and mean spirited too.
How would any of us like it if our employer decided when and how they'd pay our PTO requests?
If the OP is given PTO with every other absence, then the weather shouldn't be an exception.
The boss can write you up, lay you off, or give you points, but denying you what's yours isn't right.
News flash. Hospitals DON'T care about the safety of it's employees. We are worker bees, and our only value is how much work can be extracted from us on any given day.
ED has little to no control over what the admitting physician chooses to record in their h&p.
Changing out a field stick while still in the ED is not a good use of ED staff's time.
Routinely taking temps when they don't present out of range or with noted clinical changes is also not a good use of ED time.
Fluid bolus(es) and other orders may have been given by the admitting doc vs ED docs, which CAN be more easily overlooked.
Vitals should have been recorded per a protocol for pts waiting for admission.
From an ICU perspective, the ED drops the ball A LOT.
But then again you have to realize how hectic the ED can be, some things get overlooked because of the nature of the environment.
Really, I feel bad when I sometimes have to send a patient up to the unit with a dirty gown and sheets. I wish I knew all his/her history. I wish I could give you an ICU level report. But I just didn't have the time.
I was busy putting in every line and tube that you document intake and output from.
I was titrating up his sedation so you can have a sleeping patient instead of a bucking one.
I was busy stabilizing the patient's vitals signs
Dealing with truly sick patients in the ER (people that belong to be hospitalized) is like having a rapid response again and again and again. That is the amount of work and interventions and meds and IVs and labs and tests. Imagine having to put in multiple lines on your patients each shift, everyone has labs ordered, give meds every hour, do vitals every two hours (or more often and sometimes less) and discharge half of your group of patients and get 4 new ones each shift, sometimes two new patients at a time. Not to mention having an unstable patient thrown in here and there. And these people are all hungry, tired, and thirsty and you can't get them food and half of your patients are in severe pain. In addition to all that hands down one of your patient is either psych, drunk, critical, or demented and trying to to climb out of bed. Then your tech is pulled to sit on the psych, drunk, or demented patient and you have to do all the valuables sheets and take all your patients to the bathroom (and there are no bathrooms in the room).
It is funny that this is a thread for dumb things doc's say (granted sometimes they do) but often RN's don't have the answers. There would be absolutely no way I would give 2% or 3% to hyponatemia. Granted I don't know all the details but correcting someones hyponatremia rapidly (unless they are seizing) is a recipe for disaster. I will take the bag of chips over hypertonic saline (unless you want CPL).
PO Metoprolol is not a bad treatment for SVT that is stable. Once the patient gets off their Dilt drip they will be transitioned to it anyways. Dilt drips will just prolong length of stay.
Amio for A-fib with RVR is controversial. Some believe in it some don't. I have yet to ever start someone with A-fib with RVR on amio since it is really slow to take effect. If they are truly dropping their pressures and are already on a Dilt drip its time to introduce electricity.
Sorry to pick on one post. Anyways carry on.
Well apparently you need to school the attendings on my floor, as I have seen 3% saline given for hyponatremia. In fact, I double signed the MAR with his primary nurse. I believe I read that the key is slow correction with extremely close monitoring.
Brian created something with allnurses.com that has left a positive impact on the nursing profession and the future of nursing. He will be remembered with deep respect for his role in that. We are all shocked and saddened by this news.
I wish all of you mods could have some peace today. Having to babysit the site with grief in your hearts must be awful; especially for you, madwife2002, on this thread.
Thanks everyone for your input. Patient was re-assigned. I understand that the CN wanted to de-esculate ( excuse my spelling) the situation, but I still think that later on at some point security should have been spoke with the patient and documented the incident. I'm still very disappointed.
We have a situation in our hospital in which specialized nurses are the only ones who can complete a particular nursing task. Bed availability sometimes dictates that the pts cannot be immediately put on the floor where these nurses usually work, but we try to get them to the appropriate floor ASAP so that the specialized nurses do not have to leave the floor to perform the task.
Lately, the pts have been dictating when and where they are moved because of their room preference, just like a hotel. One pt was initially placed on another floor, was moved to the appropriate floor, complained about the size and view of his private room, so he was allowed to move back to the inappropriate floor. This should absolutely not be allowed, but the culture of the facility is "pile everything on the bedside nurse" and "the customer is always right."
I hear (and have said) that pts and their families seem to think they are at a hotel instead of a hospital. The truth is, though, if a hotel guest behaved the way that gentleman did, he would likely be asked to leave. Very frustrating that we are expected to take so much.
It doesn't help that hospital admin. (often people who have been far removed from the reality of nursing for many years), encourage the hotel mentality. Between being told that hospitals should run like Disney World or Toyota, the bedside nurse just can't win.
I hear (and have said) that pts and their families seem to think they are at a hotel instead of a hospital. The truth is, though, if a hotel guest behaved the way that gentleman did, he would likely be asked to leave. Very frustrating that we are expected to take so much.
No, they sure don't.
That said, the only one who is going to have to give a hoot about your safety is ... you. And you alone.
Sadly, that also means you face the almighty consequences for the "bad apples" that use the storm as an opportunity to shirk their work duties. Which means you don't get to use your PTO for a "snow day." Would they have allowed you to use PTO if your car had broken down? If so, that might give you a bit of a 'plead your case' situation. If not ... it just is what it is, like it or not.
I understand the point of being essential personnel. Believe me, I do. But sometimes I think hospitals take it too far. Nurses are human too. We fall ill. We are unable to drive in inclement weather. We have family emergencies. We are not immune to the occasional call-out simply because we are nurses.
Denying PTO because the OP can't get to work in the snow is punitive. I might add I find it childish and mean spirited too.
How would any of us like it if our employer decided when and how they'd pay our PTO requests?
If the OP is given PTO with every other absence, then the weather shouldn't be an exception.
The boss can write you up, lay you off, or give you points, but denying you what's yours isn't right.
News flash. Hospitals DON'T care about the safety of it's employees. We are worker bees, and our only value is how much work can be extracted from us on any given day.
ED has little to no control over what the admitting physician chooses to record in their h&p.
Changing out a field stick while still in the ED is not a good use of ED staff's time.
Routinely taking temps when they don't present out of range or with noted clinical changes is also not a good use of ED time.
Fluid bolus(es) and other orders may have been given by the admitting doc vs ED docs, which CAN be more easily overlooked.
Vitals should have been recorded per a protocol for pts waiting for admission.
I was busy putting in every line and tube that you document intake and output from.
I was titrating up his sedation so you can have a sleeping patient instead of a bucking one.
I was busy stabilizing the patient's vitals signs
Dealing with truly sick patients in the ER (people that belong to be hospitalized) is like having a rapid response again and again and again. That is the amount of work and interventions and meds and IVs and labs and tests. Imagine having to put in multiple lines on your patients each shift, everyone has labs ordered, give meds every hour, do vitals every two hours (or more often and sometimes less) and discharge half of your group of patients and get 4 new ones each shift, sometimes two new patients at a time. Not to mention having an unstable patient thrown in here and there. And these people are all hungry, tired, and thirsty and you can't get them food and half of your patients are in severe pain. In addition to all that hands down one of your patient is either psych, drunk, critical, or demented and trying to to climb out of bed. Then your tech is pulled to sit on the psych, drunk, or demented patient and you have to do all the valuables sheets and take all your patients to the bathroom (and there are no bathrooms in the room).
Perspective.
Brian created something with allnurses.com that has left a positive impact on the nursing profession and the future of nursing. He will be remembered with deep respect for his role in that. We are all shocked and saddened by this news.
Amen
You never know what brings someone to that point. It doesn't make them unworthy of compassion.
Thank you to all members who keep reporting the posters who want to derail this thread-Too many to send individual thank you PM's at this time
Ditto on the (((hugs))).
I wish all of you mods could have some peace today. Having to babysit the site with grief in your hearts must be awful; especially for you, madwife2002, on this thread.
I'm so sorry.
Thanks everyone for your input. Patient was re-assigned. I understand that the CN wanted to de-esculate ( excuse my spelling) the situation, but I still think that later on at some point security should have been spoke with the patient and documented the incident. I'm still very disappointed.
Psych issues or not, assault of a health care worker is a crime. It's not okay no matter what.
We have a situation in our hospital in which specialized nurses are the only ones who can complete a particular nursing task. Bed availability sometimes dictates that the pts cannot be immediately put on the floor where these nurses usually work, but we try to get them to the appropriate floor ASAP so that the specialized nurses do not have to leave the floor to perform the task.
Lately, the pts have been dictating when and where they are moved because of their room preference, just like a hotel. One pt was initially placed on another floor, was moved to the appropriate floor, complained about the size and view of his private room, so he was allowed to move back to the inappropriate floor. This should absolutely not be allowed, but the culture of the facility is "pile everything on the bedside nurse" and "the customer is always right."
I hear (and have said) that pts and their families seem to think they are at a hotel instead of a hospital. The truth is, though, if a hotel guest behaved the way that gentleman did, he would likely be asked to leave. Very frustrating that we are expected to take so much.