Paperwork or punches?

[LibraNurse27, BSN, RN]

Hi all, looking for feedback on any who have left a difficult job for a job that is not their "dream job" but felt it was worth it. I've made posts about the violence on my Stepdown unit, mostly due to altered mental status from meth and alcohol intoxication or withdrawal. Many have answered that my hospital's response is inadequate. Last month I got talked to for giving a dose of valium 3 mins early to a patient on a PRN protocol for etoh withdrawal. The pt was a large man out of control, swinging at people, about to fall out of bed, etc. I should have double checked the charting though, and technically it is an error in terms of "right time." I've seen a lot of people give doses early and scan later when pt is out of control, but I know it's not right.

I'm not in trouble, but I feel like working in this type of environment might lead to making more serious errors because it is hard to carefully examine orders when you're being attacked. I know some people just run and give the med and scan everything when the pt is calm later. I don't want to have to resort to work arounds, I want a safer environment where we have security to safely restrain the pt while the nurse can read the order and scan. 

I have an opportunity to work in an outpatient surgery center that pays more and doesn't have a violence issue. It would be mostly pre-op phone calls/chart prep with some shifts in the hands-on pre-op area. I could still work once a week at the hospital to keep up skills. I don't like desk work, but it's sounding better than being frequently attacked and then instead of being supported having my charting picked at. Looking for opinions/advice. Thanks so much to everyone who has responded in the past, the responses have helped me see that the job I'm in is not safe and validated my concerns. Thanks AllNurses!!

[Wuzzie]

I left a flight nurse position due to the toxic culture of the staff and took a position in an oncology clinic. I feel like a human again.

[Jedrnurse, BSN, RN]

3 minutes early??? You have GOT to be kidding me!

[JKL33]

1 hour ago, LibraNurse27 said:

I know some people just run and give the med and scan everything when the pt is calm later. I don't want to have to resort to work arounds [...]

Not nitpicking, but let's be clear this is not even a legitimate work-around but rather falsification of a medical record. It also bypasses the opportunity for provider review of the patient's situation and provider consideration of tweaks that might be made to the plan of care.

If, in a proactive and positive way, you can find a place to work where administration is a little more focused on things that are actually important than the matter over which you were spoken to, then by all means go for it. You shouldn't even be sitting there pretending you made a "wrong time" error as it can hardly be called that in any seriousness whatsoever.

??

 

[Daisy4RN]

I think I would take the job in the out pt surgery center. The step down unit sounds horrible (I worked in a place much like you describe). I cant believe they even talked to you about giving a med 3 minutes early!! I have left a horrible job to work at a less horrible job and was glad I did. At least it gets you closer to where you want to be (in a better place). You may end up really liking the new position and want to stay. But if it doesn't work out you can always keep looking. I hope you find a place you like!.

(Also, alot of this nonsense is bc of computer charting, not a fan).

[canoehead, BSN, RN]

THREE MINUTES???? Get out of my ER.

Your administrators arshole is tied tighter than a surgeons knot. What does one say when called into the office for something like this? 

[LibraNurse27, BSN, RN]

Well... in my case one apologized for the "med error" and promised to follow orders exactly LOL. But I got a new job in outpatient PACU! All pts alert and oriented, no one withdrawing or punching LOL. But still keeping per diem at this crazy place for job security in case things shut down again, and because I don't want to ditch my team during this pandemic. Gotta keep donning and doffing LOL thanks everyone for your support and responses!

[SarHat17, ASN, RN]

On 11/20/2020 at 10:58 AM, LibraNurse27 said:

I'm not in trouble, but I feel like working in this type of environment might lead to making more serious errors because it is hard to carefully examine orders when you're being attacked. I know some people just run and give the med and scan everything when the pt is calm later. I don't want to have to resort to work arounds, I want a safer environment where we have security to safely restrain the pt while the nurse can read the order and scan. 

I think you have answered your question right here. You are acknowledging that this is wrong, and since the policies/facility is not actively changing the way these situations are handles, I would leave ASAP. This is an environment where both your job (in case future situations continue to be documented as not following current policy) and your safety are at risk.