New RN, Is my license in jeopardy??

[emeraldbutterfly,RN, RN]

Hi everyone!

I'm a new RN, and just took my first job 3mos ago. I'm off of orientation for just about 4wks now. I always hear "i don't want to put my license in jeopardy" from many nurses....what exactly does this mean? I've read most of my 'Nursing guide to practice' booklet that came w/my license, lots of legal mumbo jumbo, but i'm still confused. I work on a telmetry unit, also COPD, with 10-12 pts at a time. Union contract says no more than 10 (which I think is to many but whatever!), the other night they tried to give me 13!!!! OMG, I said something, & they took one of my isolation rooms away which left me w/12, and that's the best it would get, is what I was told. I have so much to complain about & will try to make this short, but it will be hard. first off I feel extremely overwhelemed w/10-12 pts. I work on a tele flr w/50 beds, come to work the other night, get myself ready to assess my pts, go to find a BP cuff, can't find one, finally find out, THERE ARE ONLY 3 ON THE FLR!!!! (and they are manual, we don't even have 1 that's automated, lovely right??? and we only have 1 pulse ox) anyhow, I got nervous, pissed off and every other emotion known to mankind. I improvised and just worked backwards, did my FS, poured my meds, did the flowsheets and then when a cuff was free I grabbed it and continued on w/my work for the night. Another gripe I have is this narcotic cabinet! We have a double locked box for narcs, and they need to counted at the change of each shift. UGH!!! how very annoying. so I come in and they tell me it's my turn to be in charge of the keys, this means I count (w/the other RN changing shift) then I have to check the code cart, make sure its up to date, nothing expired, defib in working order, suction equip in working order. OK, I count all those narcs w/the other RN (takes forever) check the code cart...this is lovely, it says low battery, OK NO BIGGIE, I figure, I know how to plug something in, I'll just plug it in. NO PLUG!!!! unfreakin believable!!!! test the defib, its out of paper, EVEN MORE BEAUTIFUL!!!! no one know where the plug is or the paper, oh boy I was pissed off. :angryfire THIS IS A TELE FLR, OMG!!!! don't want to ramble to much but I have too, sorry. I really hate this narcotic situation, every time I need something from the cabinet I have to find those stupid keys from whoever has them, go to the cabinet, unlock the 2 locks, get the med, lock up again, sign out the med in this stupid book, very time consuming. Also my hosp is always running out of supplies, most importantly, 0.9NS, and the other night nitro (remember where I am, tele unit :angryfire ) OK, I think this is really to long, anyone have advice on protecting my license, what does it actually mean?? should I look for another job, and what do I look for in another job if I look??

thanks for reading and any advice!!

[gr8rnpjt, RN]

This sounds dangerous and unsafe. Is this on nights, or 3-11? I would really be concerned about the defibrillator, and no nitro on a tele floor? Unbelievable!

When I worked nights on tele, we had 2 RNs to split a floor with 32 beds, so we had 16 each. But that was nights. And we had an ICU unit around the corner, so when we called codes, the ICU nurses on the code blue team were there in seconds.

I think you are too inexperienced to have so many patients. How was your orientation, and how are the other nurses to work with?

[pagandeva2000, LPN]

I am also confused about the information sent with my license; it is very vague. I have basically come to the conclusion that the protection of our licenses depends on what happened, who caught you, and who is willing to cover for you.

In terms of the blood pressure machine situation, you may have to consider purchasing your own blood pressure apparatus and keep it with you. I have both, a compact automatic one as well as a manual. They SAY that the hospital's equipment is calibrated but, I know for a fact that it is not done in my facility. Bio-Med comes and just places their stamp of approval and just keeps it moving. At first, I felt guilty about using my own automatic, but, there is not enough time to chase around for equipment, and I will just do what I have to do to ensure that I took my own pressures.

I also have a situation with narcartic prescription pads. I am an LPN that works in a clinic. Lately, I have been working with an RN that tells me to count them (alone), and she will come and sign it later. I make it my business to count them several times to be sure that I got the count, because I can't make her do it, and at least, I know what was there. Most of the horrible people working here get away with murder, so, speaking to the supervisor or administrator will fall on death ears.

I have been a nurse for a year, now; and am still as confused as you are. But, I do remember how to cover my butt to the best of my ability. Will it last forever...not sure...but, nursing is a vicious world.

[dijaqrn]

What state are you in? This is unsafe and accepting this type of assignment is what gets nurses in trouble! Contact your union or find a better i.e. safer job!

[MrsMommaRN]

it kind of sounds like the people before you were slacking. the paper being out? low battery? low supplies. what kind of hopital runs out of normal saline? i feel for you and wish i had some magic words that would help you through this. i hope you will find something better.

[llg, PhD, RN]

It sounds to me as if you are working in a terrible environment. What does your union rep have to say about the issues? Step 1: Talk to your union rep and find out how much support they will be. Gather your information before you make any huge decisions.

But I suspect that you should probably work somewhere else. I wouldn't put up with such conditions myself and I can't honestly recommend that anyone else tolerate it either.

The "license in jeopardy" issue is probably not as bad as you think. A lot of people use that phrase, but in reality, few people actually lose their license. Most who do, lose it because of serious mistakes THEY THEMSELVES have made -- not because of generally poor conditions where they work. Just be sure you report and document everything appropriately to protect yourself. Be able to say that you reported the lack of supplies, etc. and have documentation to back yourself up.

But once you've reported it ... If the hospital doesn't fix it, then you have only 3 real choices -- tolerate it, fight it, or leave. As you are a new grad, I would recommend the 3rd option.

Chalk it up as a learning experience. Now you will know what to look for in your next job, what types of questions to ask, etc.

[Mommy TeleRN, RN]

Wow I would run run run the other way. First off I don't think ANY nurse needs 13 pts. OUCH. Much less a new one, much less on a tele floor. We typically have 6-7 on nights and we have a unit sec., monitor tech and 2-3 CNA for 40 ish patients (sometimes even 4 cnas on days)

We USUALLY have a manual BP cuff in every room, and we typically have enough dynamaps for every nurse to have one. We have an emergency pulse ox locked up but most of the dynamaps have one. If you have COPD pts you DEFINITELY need more pulse ox. We are a bit old fashioned with a narc cabinet too, but our charge nurse keeps the keys so if we need them they are at the desk with the charge.

How can you give meds without properly assessing a pt? A BP is a MINIMUM. I would be very scared to work in a place like this.

I will gradually get more patients but I will not have a full load for about 9 months. I will have many classes and observation experiences and will work side by side with my preceptor. This sounds like a highly abusive and poorly run environment in my humble opinion. NO way..not as a new grad, not as an experienced nurse.

[ArizonaMark]

quit !!!!

mark :smackingf