drkshadez

The United Methodist Church takes this very seriously. Now you will have outliers in any denomination, but for the most part The United Methodist Church is asking every member to get vaccinated or wear a mask indoors with social distancing protocols. This goes back to our Wesleyan roots, John Wesley who founded the Methodist Movement in the 18th century. He was a very practical person in his faith and theology. A Wesleyan/Methodist perspective is that science is a gift from God, and vaccines are an act of love of neighbor, because the vaccine is not about "I need to protect myself." The vaccine is about, "I need to make sure I have the vaccine to stop the spread of this virus to others." I usually do not talk religion on here, so I apologize if I ruffle some feathers. For Catholics, some are not happy with the Pope's stance, which is everyone needs vaccinated. Again, though, these are outliers, as with any group. Basically, you do what you need to do to stop the chain of infection. That is an act of selfless service.

Dr Moja should not be allowed to practice anymore. Period. No question. Even after the first incident he should have been able to practice anymore. What was described here is too far and unacceptable. HOWEVER, I do believe some people take “sexual harassment” too far to translate into “no physical contact” whatsoever. I remember one night I was frustrated with what was happening with my patient and not getting anywhere with the dr about treating his condition. A female nurse came up to me and gave me a hug. I thought nothing of it. I just thought it was a friendly gesture to help calm me down. About an hour later she came up to me and apologized I asked for what? She told me she should not have hugged me because of sexual harassment laws and such. i was more offended that she would think I would have taken this friendly gesture that way. There was nothing sexual or harassing about it. One way to avoid this is to ask if it is appropriate first. One time something happened to my patient and I was really visibly upset at what happened. Another nurse talked to me and asked me “are you s hugger?” I said yes and she helped calm me down by giving me one. We work in a very stressful and sometimes very emotional environment. I had a cancer patient initiate giving me s Hug once because I sat and talked to her for 45 minutes in the middle of rounding and med passes- she was newly diagnosed with a terminal cancer and gave her 6 months. She initiated the contact and thought nothing of it. People also say don’t bring religion to the workplace either- but I have had patients ask me, “Can you pray with me?” - we need to honor those requests to give patients a sense of peace- and hope. Things have become so uptight in our society right now. What Dr. Moja did, though, crossed the line and must face the consequences of thst.

Do not think about which is the correct answer. It’s multiple guess- so think about ruling out answers. 1) do you have to act immediately while calling the doctor (is, life saving measures)? 2) do you have to call the doctor before taking any action? 3) which choice will bring the patient HARM? 4) which choice involved INACTION? 5) is this s task I can delegate? And to whom? Don’t fret. I was an honors student. Took me 217 questions. I had to take an unscheduled 30 minute break to gather my thoughts because I was sensing anxiety and felt like I was not doing well. Take an unscheduled break if you need it. It’s what helped me. Gauge your anxiety level- because this test can be stressful.

So what do folks think about this? New Cedars-Sinai initiative illustrates how using Alexa technology can make healthcare easier

It takes 2 seconds to drop it in the sharps container...unless you keep having level 2 suicide precaution patients every shift...

If the soles inside are coming loose There is s tear on the side If you accidently leave them in your house and your cat is draped over them PURRING ... time to get new ones

Next time ask. If it's the manager I usually ask "May I wear scrubs or business casual?" Most of the time managers want you to put on scrubs- color matters not- because if you get an in person manager/peer interview most likely you will shadow. But always ask. If it's an interview with HR,definitely seek out dress clothes like you are going to church. If I meet with HR I always use dress clothes and tie.

I see this problem a lot. When I entered nursing school I did so with one end goal in mind: I want to be in a teaching hospital and be involved in clinical nursing education. I want to teach the next generation of nursing students and new nurses. Of course things change in our lives and we kind of wonder not really what we want to do with our lives, but redefine where our current career is leading us to do. For me, "I don't know what to do with my life" means thinking about a major career change- as if moving into a completely different field (like business manager to civil engineer as an example). But people who want to stay in the same type of work are more apt to ask "how can I redefine my current role?" I am assuming you want to stay in nursing but you want a position that will give you flexibility with your family. And, if you really love teaching and have a heart for leading nursing students no matter what age, then education is for you - NOT management and here is why: Management is long hours filled with meetings after meetings after meetings. The first hospital I worked at, when I was on day rotation, I saw my manager maybe 3 or 4 times a month... MAYBE. When I usually sad her, she was coming on the floor to get her stuff and leave. Then when you go home you worry if everything is ok on your floor. You might decide to come in on a Saturday or Sunday to have "face time " with staff. Even nursing management these days is not simply a 9-5 or a 7-3. It's much more involved. It sounds to me like education is your best choice considering all the variables you mention. Either at a University setting or as a clinical nurse specialist. Some hospitals hire clinical nurse educator to cover a few floors in the hospital as mentors or preceptors. Hope this helps

Agreed and documented. So here is another question. What if the DON in the facility is known to flip the script sort of speak. For example, mentioning the discrepancy documenting what happened and the the DON says "It's your responsibility to count with her not hers." - but i was not doing meds, the other nurse was. I'm not too worried about it now because I already have a new position starting soon. I am meticulous with my charting and documentation. I learned that as a new grad fresh out of orientation and had a root cause analysis done- and documented everything that happened with exact time stamps :)

What happens if a nurse leaves without counting medications and you count with another nurse on shift but there is a discrepancy? Who is responsible? More context: she told me she finished a patient's dressing change, and was going to chart some more. I answered a call light, the third nurse was passing meds. I went in the back room when I was done and a set of keys was laying on the desk. Neither of us knew she left.

For me, and I am saying that this is just for me, my satisfaction as a Registered Nurse comes from knowing I gave the best quality care to patients throughout my shift. it is an internal satisfaction and I have never left a shift where a patients or another nurse have said, "Thank you for your help" at least once throughout the shift. Those words are just secondary to the internal satisfaction, as is any material form of "thanks." I remember my first nursing job my manager asked if I got my "gift." i said "What gift?" She said for Nurses week - and then I replied, "This is nurses week?" We had a good laugh over that. It was a nice sized tote bag. There were individual bags with our names on them. I never thought of it as some type of recognition or "thanks" - because I really do not expect anything. I do take issue with the CEs though. The best way to hanlde that is ask for time off without using PTO to take those CEs in lieu of shift work. If you are in a large MAGNET hospital, surely they have a float pool. It is very difficult to think of a manager, especially in a MAGNET hospital, who would deny an RN the opportunity for CEs. Whenever I had classes or CEs to go through, that was always figured into my 36 hour work week, because managers don't want to pay you overtime for "clocking in" for CEs :) . Sometimes we base things off of assumptions ("I cannot attend these CEs because I work night shift") rather than discussing it with the unit manager. I am the type of person that, if enough CEs were offered to meet my contact hours requirement for RN license renewal, I would ask to not work that week so I can fulfill these requirements.

Different states have different laws. Usually those laws allow some flexibility due to geographic location. Let me explain. Here in Ohio, Medical Assistance are able to dispense medications and give injections, but only under the direction of a physician. In other words, it is not a task that a registered nurse can delegate. It can only be under direct physician supervision. Here is why that law is in place. In rural communities or small towns, you have medical assistants working in physician offices, as well as some RNs. Medical assistants help fill the gap to meet client needs and flow efficiently. In a major hospital setting, such as Cleveland or Cincinnati, even though the law is there, hospital administrators are really weary about allowing MAs to dispense medications and give them to patients because of liability to the hospital. It is a law in place that has "Just because you can, does not mean you should" stigma attached to it. The law is in place to allow certain facilities that are really short handed in health care to help with patient flow. As you migrate into larger urban areas in MAGNET hospitals, for example, they most likely will not allow MAs to dispense and pass meds - not because they cannot do so legally, but because of concerns of liability as mentioned above. Now, in the state of Ohio, STNAs can actually take courses to be certified in passing certain pills to patiets. They have to be certified to do so through a series of classes. As an STNA you can also become a "Certified Medication Aid." Some people do not even have to be an STNA to become a CMA. RNs can delegate non-invasive medication passes to CMAs (no IVP, for example) - and I believe there are certain stipulations for high alert medications as well. I would not worry about state laws like this unless your facility utilizes them, then I would read up on the rules and regulations of delegation to said personnel. I know in Ohio, RNs cannot delegate med passes to MAs - only under direct supervision of an MD or DO.

As far as speed let me tell you what happened to me after 6 months at my first job, the model of care changed. I was on a med-surg unit where the acuity was really high, people were one acute event from going to the unit, and the model of care was going from nurses taking 6 patients instead of 5, and this was after I got my flow down I was comfortable I was able to split my time up face on the Acuity of the patience I had. It took me another two months to adjust how I did things because taking on an extra patient really was difficult. Some going to have there were nurses taking shortcuts mistakes were being made for medications a sentinel event happened it was a huge mess. Being a nurse is not about getting better faster. This is a long haul profession. It will take time to get better. The worst thing a nurse can do, in my opinion, is rush things. Something else as a new nurse and i shout this because all of us often forget... NO QUESTION IS A DUMB QUESTION :) Make sure, if you doubt yourself, find that nurse you trust and say "here is what i am thinking about in regards to my patient and here is what i think i should do." That informs the other nurse you have good clinical judgement and can offet insight if you are missimg something.

Doubting yourself is normal as a new nurse. You go through school, you are taught "ivlry tower" nursing ev n when taking the NCLEX. You are taught the purpose of the NCLEX is to protect the public from unsafe practices. Clinicals do not help - it ill prepares you because you have one patient. You are young. Nothing wrong with that. But you may not have enough life experience related to time management. You want to be thorough and that is great, but only so many hours in fhe day. Find a nurse or two willing to teach you, willing to share with you, willing to show you the ropes. Here is the best advice i received out of orientation from my first job: just because you're out of orientation does not mean you're alone you have a whole team willing to help you and willing to bring you up to speed to where you need to be. Find one or two nurses that you can really go to as a resource that will help you and learn from them and really listen to them.

I floated to an orthopedic floor for two shifts. Granted, I was not hired for that floor, but I felt it was boring. Most of the time I was just passing pain medication and a glorified physical therapist. I floated to a cancer floor one time. Loved it and learned a lot on that shift. I was not familiar with some of the medications so I had to do patient education. I actually learned about patients conditions and histories. That's just not own impression from very short times on both floors. If it was me I would choose oncology.

PS: feelings aside. I will tell you what I know some of us who were non traditional new grads did if we felt like we were being snubbed by preceptors. Talk to your manager about it in an objective way. For example,: "I have lots of questions and sometimes a preceptor doesn't answer them for me and if I had someone that could take the time to answer these questions, I will be better prepared for taking assignments when I am out of orientation." Something like that. Even though my first nursing job I learned a lot about patient care and organization and tech skills but some very rough and snubbing nurses, I've always had really good preceptors selected for me. Usually people who have had 10+ years experience

This sounds VERY familiar. If you don't mind, message me and tell me what hospital... this sounds too similar....

In fairness, it was night shift and the daughter came out of the room and I promised to talk to him if I had time. I was done my first round of antibiotics on 4 different patients and routine meds + pain meds ... and it was 1130 pm so I had the time. More importantly, he was still awake.

Thank you for this insight. I agree with most of what you said. But I need to flush something out here. I don't have time to go into the intricate details of how I provide quality patient care. At one facility, there was a nurse who was awful to patients and I'm not being subjective here. The patient and the nurse had a bit of disagreement and the nurse said to the patient "Well you don't like me you can leave AMA if you want." At the same facility we had a meeting where we were told discharges will happen within 72 hours of admission so that we can use that bed to generate more revenue for the floor. A patient of mine was about to be discharged in the afternoon and called me out of concern of blood clots in stool. Pages doc and they said they were keeping her and assistant manager asked me why said patient was still here because we need that bed. I have encountered patients who don't want that interaction. I am fine with that and just do what I can not just to save lives... but prevent harm and promote safety and comfort. So I am not knocking the technical skills or organization / tasks. Before I talked to the cancer patient, I made sure all my antibiotics were hung assessments were done and charted and the other 4 patients were taken care of before their next doses.

Ok just a bit of clarification I am sorry. Limited in time not in scope. I've given this med I used in this example 100s of times. I learned so much from my first year at a very large hospital but after my first year my wife and I went on vacation to the woods... I realized I needed something different. So I chose a regional hospital with the same company but with less drive time.

Also I am being proactive. Some are not interested in teaching others, some are. There are some things I am not yet really good at, and some things I am really good at. So the things I am not good at I ask those willing to teach me if they can show me and let me do it under their supervision so I can learn a more efficient way to do those things. I tend to gravitate towards those willing to help me learn to get better at those skills I am weakest in.

By the way, everyone has given good advice and valuable input so far, and I am grateful.

Ok. Sorry I didn't mean to say the other stuff isn't important. They are. But when I was in school I remember one of the nurses I followed for community nursing at a public school who said to me and another nurse that she was sitting at her sister in laws side in the ICU and not one nurse said a word to her while they came in the room- and there were three different people. Her question was, "don't new nurses know how to interact anymore?" I cannot even imagine walking into a room, not smiling or not saying hello and introduce myself... at the very least. I didn't mean to be flippant about skills. They are necessary. But without the human touch aspect, what is the difference between us and just being a machine ? To add to this: if I have a choice to sit and talk to a patient for an hour about their anxiety over a new diagnosis, or make sure someone's protonix po is given exactly at 11:30 at night, and it is 11 pm- I'm going to choose the former

Thank you. But I am not s traditional new grad. Real nursing to me is not technical skills or med passes or even being anal about organization. It's sitting at the bedside and talking to a patient about a new cancer diagnosis who just wants to give up on life - talking for an hour and in the morning patient decides to try therapy. It's comforting someone who has all these chronic diseases with a new diagnosis of heart failure and making sure you advocate for the plan of care they are to receive. It's listening to their story to understand the patient as a whole- not what their illness is and treating their illness safely or without question. It's defending yourcpatients rights no matter what the cost.?most patients I've encountered in just a limited -year time frame: LISTEN- really LISTEN to them - be mindful of their needs , goals, and preferences. I admit I could be wrong, but this is what my limited experience has taught me so far.

Ok maybe I took it too personal. But the experienced nurse asked me to make sure I told the patient side effects of a medication I have given 100 times at my previous facility. Also I have a reputation of not only telling the patient side effects, but also putting on the white board the side effects of high alert medications the patient is receiving in terms they understand (example: insulin: shaky and sweaty- call nurse)/ that's just an off the cuff example. No arrogance here. Always willing to learn and grow (not a traditional newer nurse with an arrogant I know it all attitude). As I reflected on it, I think a lot of it has to do with personalities. There are some nurses who will say to me , "have you given this before" and if I say yes the follow up question will be "can you tell me some side effects" and if I cannot I will say I will look it up - but if I know them I will say them. But other nurses approach it as if newer nurses are beneath them. I hope that makes sense. Unfortunatelyy I don't care much about personality conflicts. I just provide the best care I can for patients under my care.