decembergrad2011, BSN, RN 10,267 Views
Joined: Oct 7, '10;
Posts: 479 (51% Liked)
; Likes: 771
5 year(s) of experience
I think you did what would be logical for you in that circumstance; wait in the ready position...yes God forbid...but your role would be rapid triage, directing those assisting you, and tending to the injured afterward until help arrives.
Please allow me to insert my completely objective and emotionless point of view: I'm assuming you're a school RN. In your statement you say it's illegal. If that's in fact true and you know that to be the case, I'd stop there. However, as an RN you are licensed to communicate therapeutically so the conversation could be driven by your student/patient. If you believe that would protect you legally, do it. But what about charting to protect yourself? I'm assuming there is a chart of some sort on this young lady, given the circumstances. Could you cover yourself with a "student states, 'will you pray with me? so I bowed my head... Student felt more calm upon completion of prayer". Also, I would try to remove any of your own beliefs as much as possible. As with any nursing, it's not about our feelings, but the patient's needs. Just a suggestion.
Let's all be frank here, compared to PA or MD training, NP training is lacking. But that lacking training is predicated on the assumption that matriculants into NP programs have experience as a RN.
The problem now is that NP programs, by and large, are allowing students into the programs with no RN experience, but the programs have remained unchanged. There hasn't been an increase in clinical time, or credit hours, yet NPs are clamoring for more and more independence.
Education is valuable. Experience is valuable. And strict requirements to protect a professional field should be viewed as more valuable. As the market becomes ever more saturated and salaries for NPs drop we can remember that we did this to ourselves.
One of the great things about NP's have been the RN experience they generally possess. I personally feel the bedside nursing experience is invaluable and sets us aside from PA's.
Most NPs had to work during his or her schooling to support themselves.
I don't care for the salty undertone of the OP. Just because one can, doesn't always mean they should.
I worked in an adult day center and their policy was to watch the patient swallow the pill, but they were not allowed to request the patient open their mouth after swallowing to ensure they actually did swallow (regardless of past actions...those who routinely spit out pills later were treated the same as those who didn't). Actually they didn't call them patients, but "clients" - the idea was to respect them, and preserve their dignity. Interesting how differently we view a teenager. This brings up so many issues - most all of them have been covered in the comments regarding controlled substances, changing policy, transparency surrounding error. I think its also important to bring up the concept of patient rights. When you are under 18, do you have any right to dignity? Not advocating either way - its just an interesting question. The parents ultimately have the final say in how you deal with this child, yes? So talking to them is the most important step. You might also consider reporting this to the ISMP - they not only track and record medication errors, but can provide you with much needed support. Report Medication Error To ISMP
If a report is made to the board of nursing, promise me you will talk to a lawyer - too many nurses go before the board without adequate support. Thank you for sharing - this kind of thing is so hard to get through - all the feelings...sigh. I have been there. As nurses I feel like the culture is that we are supposed to somehow just know better and do it all right the first time - so little room for humanity! Keep talking about it.
I'd need a few more sources than the Washington Post before I believed anything.
Maybe it's just me, but I have a hard time seeing the point of it. If any crime has been committed here, it's that *this* is what they came up with to improve the healthcare process. It'll have no effect one way or another.
So a few choice words are banned from documents. So what.
People with opposing viewpoints on whatever issue will just get their point across with different words is all. Three months from now, no one will even talk about all this. In six months, no one will be able to quote what words were banned. In a year, hardly anyone will even remember this happened.
My time is too valuable to be spent debating whether a bad attempt at looking busy is effective or not. People of average intelligence could have been more productive with their time than they were, and could have duplicated these results in less than five minutes. So, I don't know what they were doing in those meetings but, they weren't discussing *the issues*.
I've already wasted enough time on this too lol.
Steve, I can't honestly figure out whether you're trolling us or that you don't understand why it is such an atrocious act to ban words...? The misuse of opioids are not the only legacy of the words "evidence-based."
It honestly feels like a distraction to get off topic...kind of like what the government is currently doing.
I don't think 5 weeks is enough time for a new grad, many new grad residencies are at least 8-12 weeks orientation. Also 8 patients is too much. I know it doesn't seem like it now, but you really dodged a bullet with that hospital! Dust yourself off and keep applying to other hospital positions you are interested in. Frankly ortho is pretty routine and lots of lifting and stress on your back anyway. Sounds like a cheap, crappy corporate hospital that doesn't want to spend the time to orient new grads but doesn't want to pay for experience and on top of that short staffing is routine.
I find it outrageous that they shortchanged you with a too short orientation and then told you to forget about ever making it. Who the hell are they, it couldn't be lack of time to learn and too many patients. Of course, it must be you! I hope by now you realize they are a third rate hospital system that doesn't support their nurses, don't even offer safe working conditions and safe patient ratios. Disregard their criticisms and keep looking for a better job and hopefully, a better hospital system where nurses are giving the time and training they need to succeed and decent staffing ratios!
It's usually not what you do, by what you don't do.
What if you had done that hourly round on time? What if you had called the doctor sooner when you weren't sure? Vitals were OK at the start of your shift, what if you had rechecked the vitals again? Did you miss something in assessment or assume symptoms were benign, when something bigger was going on?
It's usually these kind of mistakes that nurses are more likely to make than directly killing a patient.
she knew, she wanted confirmation.
This is all I have to contribute.
But, in the moment, the way he was treating me and everyone else (including our brand new, nervous little 19 year old tech), made me want to do everything but give him the coffee.
Yup. I'm the fluid restriction educator, not the fluid restriction enforcer. if the patient is A&Ox4, aware of the restriction and the reason for it. Educate. Document. Move on.
A power struggle with a patient is very unlikely to end well for you. Customer satisfaction, complaints, long, miserable shifts...I don't have the energy or the time. And I'm going to lose any way.
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