uRNmyway 23,174 Views
Joined: Jan 28, '12;
Posts: 1,163 (59% Liked)
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Registered Nurse; from
Hello all. Its been a few years since Ive posted on this topic, but I felt looking back I owed a status update to all those who supported me.
There are a few things I want to cover, but,
First let me say that Ive remained at the same Hospital in which I successfully started at in June of 2012.
Not only that: but I've thrived, just as I did in RN school
(for those of you who keep telling me that it doesnt matter how exceptionally well I did in RN school/clinical: I respectfully disagree because statistically history has a way of repeating itself)
I can tell anybody with full confidence, who has judged me with blunt rude comments or passive aggressiveness--That I have NEVER been written up as a working RN, never have caused harm to one patient, and last but not least, I not only moved up the ranks of becoming Charge Nurse---But now Im a newly promoted Nurse Manager as a member of my Hospitals Administration, overseeing 4 different units in the hospital (approximately 150 Nursing Employees).
I brag for the purpose of spiting every last RN here who judged someone like me...
Furthurmore as I am one of those responsible for hiring and firing at my Facility, and I truly hope that any rude poster comes my way begging for a job one day... I promise to give you what you deserve, give you what you have coming--which would be NOT simply evaluating your prospective talent or liability factors as if I were an RN assessing a patient in a "focal manner". Instead, I woukd take the time and effort to give you a fair chance at working for at the Hospital that so wonderfully gave me the chance I deserved.
Never did I initially believe I would be a member in Administration consulting with Risk Management and the CEO on a fairly regular basis, regarding the development and accoubtability of the Nursing Department, but I never gave up or saw myself as "less than"(just like that quack MRO from the "Puritan Facility"
Also since attaining a secure job, my anxiety decreased significantly, and now Im completely off the benzos (for over a year now). Sure if I were to take them now, which is when I no longer "need" them it would probably make me drowsy--but I never took them because I wanted to get anything more than healthy productivity.
(So in other words im compliant with the prns, because as I have no need--I never take!!)
I just needed to vent that out to all the narrowminded "improvisationally confident" judemental RNs who ever commented coldly about me, and hey, maybe you work for me--and you will never know it, because I wont treat you with the disdain you showered me with. (Its a small world
Now then, to every good Nurse who also believed in me: thank you for giving me the support I needed to help me realize my dreams to come true!!!!!
People are so narrow-minded when it comes to certain topics... I suffer from anxiety and panic attacks. I have an Rx for Xanax 0.5, which I usually only take for sleep. But this one day i on my shift, my anxiety was at an all time high, was in the midst of a panic attack, which i usually just try to power through. But this day i decided to take my xanax. And it was incredible what happened. The veil was lifted, i was back to normal and not just functioning, but thriving. I could think again, and saw things clearly. It was truly amazing. It wasn't until i removed the anxiety that i was able to see just how debilitating it was on my judgment, social skills, and every aspect of the job.
ANXIETY IMPAIRS JUDGEMENT. That is a proven fact. Research is plentiful. Go find me the research behind the "belief" that 0.5 xanax would impair judgement on a person who is used to the dose, and takes it for the management of anxiety. Yes if i popped 4 of them, then there would b a problem.
People who don't know what anxiety is like and have never taken a low dose of xanax therapeutically are ignorant on the subject, and really can't say that it would impair ones judgement. So when i read the opinions of the auto-naysayers who are throwing out judgments bc of their "value" that drugs are bad, i respectfully ignore them!
Jesus Pete. I don't care - I don't care - I don't care. A nurse is a human being and has a right to be on whichever medications she/he and her physician/hcp see fit. Period.
Whatever a nurse is taking should not impair his or her ability at work.
That said, I DO NOT BELIEVE that a benzo or some ambien taken the night before is going to cause the type of impairment which some of you claim. Sorry, I just don't. So then I have to wonder if YOU really believe that or if this is some other type of bias.
I take epo. Can't really make enough blood without it. Anti-hypertensives too. Because I want to AVOID having a stroke someday, I've always kept my blood pressure well under control. I exercise and eat well. Some things really ARE just genetic. But since when are patients, even nurses, supposed to be blamed for being ill? Or worse, blaimed for actually MANAGING their health? Isn't that what we want them to do? Or do we suddenly not believe in medicine/pharmacology when it comes to nurses?
In a perfect world, it would be nice to have nurses who were not on any meds AND who weren't impaired due to anxiety, depression, etc....
We do not live in a perfect world. Every profession is touched by these diseases. I would rather have a legally medicated nurse than one who had major issues but was afraid of a drug screening.
Hope is never lost, but it can change. At some point, we can no longer hope for cure, but we can hope for comfort, honesty, and the knowledge that our loved ones will be OK after we're gone. It is perfectly OK to say that, because people almost always know death is around the corner, and that's not their biggest fear.
One of my toughest questions was from a nine-year-old whose mom brought him in to see his daddy, who was going to be gone (brain death having been determined) pretty soon. She knew. She wanted me to answer all his questions. The last one was the hard one. "Is he ever going to wake up?" I looked over at her and she nodded. "No, sweetie, we don't think he will," I said.
I agree with NightCrow to a point. But I feel I should point out that the environment you describe for your clinicals and previous workplaces is actually quite a luxury. Many facilities cannot afford to have all the bells and whistles such as individual patient med drawers on your COW, EMARs, bar-code scanning and so on. There are still places where there isn't CPOE, places where charting is still done on paper (yes, even in high-prestige teaching hospitals), places where nurses prepare ALL of their own infusions and meds.
There's no way you can make your workplace fit your ideals, so you're going to have to do the adapting. Personally, I don't think I'd want to be carting around 5 pages of electronic med sheets for each of my patients everywhere I go, or printing and reprinting all the time in case something has changed... but that's just me. I'd rather make myself a list of what meds are due for whom and when, then check the EMAR just before I prepare to give them. Charting as you go is a good habit to develop and now is the time to do it. Use that explanation for your preceptor and I doubt you'd have any blow back. "I want to develop good habits, so if it's all the same to you, I'd like to chart as I go. I'm less likely to forget things that way." And leave it at that.
There is always more than one correct and safe way to do things. In my experience as a preceptor, as long as the orientee followed the principles of whatever s/he was doing and the patient was safe, it was fine. If I offered to show them a quicker or easier way to do the same thing while following the principle of that task, it wasn't to make them look stupid or to make myself look like a super-nurse, it was to help them streamline their work flow. Each of us has to try things a few different ways before we find the one we're most comfortable with, and even then, we may refine that process over time. If PATIENT SAFETY is the main goal, then it's all good.
SWAB those vials! When the cap is popped off you have no way of knowing whether you touched the rubber seal or not. Better safe than sorry. I even swab the necks on ampules. If you suggest to your preceptor that she's doing anything wrong all you're going to do is get on her $#+ list... even if you're absolutely right. You're only responsible for your own practice. "Good habits from the beginning" is the correct response to just about everything.
Before I forget, keep in mind that it's not always going to be possible to do everything exactly as you were taught in school. Everybody knows hand hygiene is required before patient contact, and everybody knows not to touch any body fluid without gloves, but if you walk past a room and see a patient vomiting blood while flat on their back, odds are you're going to run into the room and turn the patient to one side, hit the call bell and THEN wash and glove. Same thing if you saw a toddler going over the side rail. And there will be times when it's impossible to chart as you go and to sign for your meds immediately after giving them. Good habits. Not always realistic.
What kind of a rat hole do you work in? Guide wires left in when central lines are started, people fabricating vital signs, and this? You either have the worst luck in the world when it comes to picking jobs, or you're trying out your hand at a career writing nursing fiction.
I'm an APRN and in one of the hospital systems I am credentialed at, we log in under our own name/password but we have an additional level where we then log in with the MD/DO that is going to co-sign the chart (required at this hospital). That way the MD/DO knows which charts/pts he has to see.
The MD/DO has two sets of log ins: one for when he sees a pt by himself and then another one where he can see which pts I've seen and that he needs to co-sign.
I am NOT logging in as the physician per se because my notes are attached to my name. However, when you look at the note quickly, it could appear that way.
If this is the case, I can assure you this is perfectly legal and acceptable. Why not just ask the NP?
"sudden onset speech difficulties, headache and right hand numbness."
I am hoping that you know you did the right thing, and are only asking to feel better about the choice.
I am assuming your "code stroke" triggers a rapid response for a patient who has an acute onset of neuro symptoms. Sudden onset speech difficulties, headache and right hand numbness, for example.
BTW- The whole "it's your license" thing usually comes up in these threads. Nobody lses a license over stuff like this. Continue to do the right thing because it's the right thing to do.
Then there are the children who have aged out of foster care systems ... people and families - often women with children - who finally fell off the edge of the minimum wage cliff ... homeless veterans ... people who just can't find work or who work for so little that they can't pay rent and eat, too (and, yes, it does happen). People for whom getting out of the weather right now really is a matter of life and death. If I was in a situation like that, I wouldn't much care who got upset or what law was broken, as long as I, or my kids, don't freeze to death overnight.
That's why it's a mistake, I think, to talk about the homeless as "these people" and accuse them all of acting like out-of-control junkies or sub-clinical criminals.
And yet ... there are out-of-control junkies gaming the system just as the OP described. There are people who don't know any other way to survive than to manipulate, lie and steal. There are psychopaths who just don't give a care who's hurt as long as s/he gets what s/he wants. And they all home in on the social services and health care systems because that's where the money and chemicals are.
I don't think there's any one-size-fits-all perfect solution.
Lots of us work in areas where the gamers first enter the system and then settle out: EMS, emergency rooms (sorry - I'm old), acute medicine, psych and surgery, ob/gyn, peds. LTAC, LTC and home care nurses catch the ones who've made it a career.
No one having to deal with that kind of behavior, day in and day out, can be unaffected by it. Boundaries can get pretty battered. Much damage can be done. How do we take care of these people? Our employers certainly won't and it's not the job of our clients to take care of us.
Not that I want either my boss or my patients that involved in my life.
It's important, I think, to share survival skills. What I wouldn't give for a good old-fashioned 1970's self-help group ... but that's just me.
Are you still a student? I'd really hate to think someone who hasn't even graduated would be so jaded already.
I echo what some of the other posters said: It is not our job to judge our patients. It is our job to care for them, to treat them like human beings, and to put away our personal feelings while we are at work. You don't know what those people's lives are like. You haven't heard their stories. And they all have stories, some of which might teach you something.
This is a big sore spot for me because I too am mentally ill and am losing my home because my illness makes it difficult for me to hold a job. I've worked hard for many years and it kills my soul to have to ask for food stamps, medical, housing assistance and the like. Mental illness is devastating and you just can't know until you're battling one yourself how far, and how fast you can fall. I didn't know. I do now.
It appears the school officials are doing you a huge favor. You are currently failing the nursing program because you are not meeting the minimum requirement since you have not reported to a sufficient number of labs.
At this point it is either withdraw or accept a permanent failure on your record. The school officials are urging you to withdraw because it will look better on your record than the failure that will inevitably result if you refuse to withdraw.
The school officials are not obligated to accommodate your missed lab portions, and if they are urging you to withdraw, they have already made up their minds. They are not going to work with you, so either withdraw or fail. Good luck to you.
With people waiting two and three years to get in, it seems to me the seat in the program should be given to someone who will take it seriously.
Here is the thing. You knew the requirements before hand and you did not meet the minimums. You must learn from this situation and understand that requirements and rules are there for a reason. If you are working in a hospital no one wants to hear excuses. You complete the mission. If that means coming in with a broken leg so be it. Being responsible and reliable are HUGE in nursing. There is nothing worse than having a coworker who is supposed to relieve you who does not show up for work or is late. Not showing up for work or clinicals...is totally unacceptable...especially if you do not have a legit reason other than "feeling like I wanted to withdraw." This is a grown up profession and no one feels sorry for people who are not in the mood to work. If you do get to continue LEARN from this.
I jinxed myself on this thread saying I can handle any form of poop. I met my match in a brand new, c-diff-ridden colostomy bag. It wasn't the smell initially. It ended up being the smell plus the look of it. I've seen colostomy poop at all stages of the intestines. This looked like nothing I've ever seen and smelled so terribly foul. The horrible state of health this patient was in, partially I wonder if it was so horrid because of some decomposing. Have any of you ever seen poop that is burnt sienna in color, with what looks like goldschlagger flakes in it? With a smell unlike any other? Seriously, what is that?
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