Out of work too long having doubts(way long post)

[bellcollector]

Hi all, This is a bit more personal than I have chosen to be up until now. I just don't know where else to turn. The story is kind of long but necessary.

I had been working in a facility that was a pure nightmare pretty much all the way around. Management pitted coworker against coworker and it worked. Doodoo rolls down hill and we nurses were always getting splattered. Unit managers were often keeping vital patient information from us floor nurses. For example pts being put on hospice, floor nurses not being informed, family calling for info, we look like idiots. A major topper was we had a resident on hospice who had been on hospice for sometime with no signs of decline. Suddenly without warning he took a turn for the worse on my shift. My coworker and good friend was the residents nurse that night. Res needed morphine for respiratory distress and general discomfort in a hurry. My coworker read the mar and gave what she thought was the correct dose which equalled 20mg. I happened to have given this resident morphine recently and realized the syringe she was giving him the med in appeared to hold too much medication. I stopped her, she immediately stopped administering, he was spitting the liquid out anyway. Another coworker and myself cleaned the res up and wiped up quite a bit of the orange liquid. There was no way the resident ingested even half of the 20mg she had drawn up. She immediately called our supervisor and the MD to report the med error. MD simply said to hold all morphine for 6hrs and to give a shot of rocephine. This was for an illness that the doc and management was aware of but failed to treat. The floor nurses had no knowledge that the resident was ill or that management and MD knew it. At any rate the resident did fine for the next 6hrs resps never dropped below high 20's no problems. Suddenly 6hrs later res began to show signs of distress again so we called MD and management and sent him to ER for eval. of course we reported the med error from 6hrs previous. The resident expired shortly after arriving at the hospital. The facility suspended my coworker/friend and then put her through a med class and rigourous retraining. She did it all like a trooper never once trying to sherk her responsibility. However a lot of managements tactics with her and many other employees were intimidation and humiliation tactics. A few months after this all happened she and I both resigned with notice and left on good terms to our knowledge. Now a year later she was investigated by the BON and is now told she is going to have disciplinary action taken against her now a year later. It is all very frightening, I was there and the mistake she made was a mistake I believe any other reasonabley prudent nurse could have made. As a matter of fact the MD at the emergency room read the MAR exactly the same way that my friend did. Yet the nurse manager who took and wrote the very unclear order was not so much as reprimanded.

Ok so that is the first part if you are still with me thank you for your patients. Second part. After I left there I went to a LTC facility I had been there just short of 3mos when I was injured on the job taken to ER and everything. As soon as I reported in that my MD had written me off of work for a week and possibley more the DON called me back and terminated me effective immediately. That was about 9mos ago. I am still of on medical leave and have won all the workers comp appeals but even when I am released to work I have no job to return too. I am currently part way through the excelsior ASN program and doing well. However with all that has happened with nurse friends of mine and with myself I am terrified of returning to nursing. The areas I am interested in are hospice and case management. Unfortunately I don't have much experience to hope for a case management job and with hospice I am terrified of med errors. I have only had one in my 6yr career and it was not serious however it does happen we are human. I guess I have just had too many bad experiences myself and around me. I am not even sure I want to stay in nursing but it is all I know so I keep plugging away toward my RN when I may not even want it. Believe it or not I started out in law but gave it up because I could not stand the ethics funny thing is I think they are just as bad if not worse in what I have seen in nursing. The cover ups, changeing documentation, falsifying yet those folks are just fine but my friend who did the stand up and ethical thing with her error is going down. Just boggles my poor widdle mind.

I don't know what I am looking for advice? encouragement? support? Someone else seeing and experiencing the same or similar things? I don't know but there you have it. Thanks for listening if you made it through all of this.

[nursemary9, BSN, RN]

Hi

I read thru your post. I don't know what to tell you. I know things in Nursing seem to be going downhill.

Number one, you have my complete support. I know how down you must feel.

Do you live & work in a small town or a big city?

Why not try an acute care setting? I have been a nurse for 38 yrs. For the last 28 yrs I have work Med/Surg/Oncology.

I love oncology nursing. We do get lots of non-onc pt's tho.

Now, I know you seem extremely fearful of making med errors, but really, I'm sure what you need is just practice to lift your confidence level.

Presently, I don't work on the Best of floors & the management is on the poor side, but nothing like you describe. In fact, I have not seen anything like you decribe.

Our management & our Hospital are very honest about everything--as far as I can tell. We're forever made to fill out incident reports for things that we have done. But only for things we ourselves have done. Maybe I'm naive, but after all this time, I don't think I am. As much as I get aggravated with things, the things that bug me seem much more superficial than you.

I work in a large trauma hospital in Chicago. We are very busy all the time. We are usually short staffed. I have never seen co-workers pitted against each other here.

Our communication while not always great, we do at least communicate pt stuff good.

In fact, when a patient goes from a regular admission to hospice, we have to admit the pat. all over with a different chart & all different numbers.

I don't think I am being much help to you, but I will say that after 38 yrs. in this business, I still LOVE nursing. I love what I do; I love working with patients & there families. I love teaching patients new things. I just love every bit of it.

However, I don't always love my job--mainly because there are so many picky things.

Good Luck

Lets here how it all works out

Mary Ann

[SmilingBluEyes]

Wow my heart goes out to you. If it were me, I would change facilities/jobs. Maybe you just still need to find your "niche" (we all do). You did not have much time to do so before. If the unit/facility politics and business are half as bad as you suggested, you have no choice but NOT to go back. The poster before me is right to suggest another place----say acute care/hospital unit. We are all afraid to "go back". I took time off after the birth of my daughter----it was only 6 months, but I was scared as hell to start again. It felt like I had to relearn everything for a while there.

But a good match between job and employee helped me. I like my job, enjoy coworkers and LOVE my speciality. It was not easy to go back, but necessary. The leap into faith is hard, kind of like jumping in a cold pool, but once you are in there, you discover "the water is fine". Try another facility/area. One that is willing to take people and orient/train them. It is probably not YOU, but the place you were.

But DO try.

Good luck.

[GingerSue]

try another facility, keep an open mind, you have invested a lot of effort already in your education - they are lucky to have you in this profession

as mentioned above, it's probably that place, not you