Ambersmom

I want to add when you file your police report make sure you get a case number. Im sorry this happened to you.

I know in my state, nurses have taken their complaints with doctors who act unprofessionally by reporting them formally to the board of registration. I worked for a town and had similar experiences with a coworker who created a hostile work environment. I would talk with human resources, what you describe certaintly is a hostile work environment, get people to back you up, you also have the right to file a complaint with the state or federal board of discrimination.

No, nursing management in other places is not like this(nor is it usually like this outside of nursing). I've seen people terminated for relatively minor infractions but I believe in this case the reason why nothing official has happened is because nothing has officially been reported. Going to the manager and saying she doesnt do that, or I found 2 vicodin in a cup is not the same as putting it into an incident report and sending it through proper channels, in that case management is forced to act because risk management is also looking at those forms. I personally had to defend myself when someone did an incident report on me: I was having a hell night, 2 CBIs one of whom was actively bleeding, another patient who had a seizure or reaction to a med, so my 4th patient I hung IV APAP and forgot to unclamp the line, the pump never beeped but the night nurse wrote me up (I personally wouldnt have written someone up for that but que sera sera), anyway the point is with the OPs nurse, management won't likely do anything until there are several incident reports on file and risk management says hey... And I don't necessarily think this nurse should be fired. I think she should be counseled and either some remedial training or given an official warning and a chance to clear up her practice, and if it continues then kick her to the curb.

Hi, thanks for the suggestion. I agree, my intention isn't to use the book as a resource during shift hours, but as a resource I can keep in my locker or at home if I need it. Thanks.again

Thank you! I'll see if I can order it

This is my Amber, she is the dog who humbled me, and has cost me more in vet bills then my last dog and 2 horses combined.

Hi, I have finally landed my dream job and am starting an ER transition program (my past experience includes emt, paramedic, and burn/trauma, med/surg). I'm both excited and terrified. Can anyone tell me of a good pocket book I can get to use as a resource? I know I'll likely be getting alot of material in orientation, but too much material probably can't hurt. Thanks.

Not everyplace is a good fit for everybody, mourn the loss for a little bit then remind yourself that somebody else's opinion matters naught, its just that their opinion... If you have any clinical instructors or profs. you had a good relation with contact them and see if they will discuss with you, the job, your feelings, etc. There are alot of nurses who lose their first job for a variety of reasons, you're not the first, nor will you be the last. Best of luck to you.

But in the case where you found meds, including IV meds at bedside and still not given 2 hrs later that is a med error and a time change would need to be done, as well as an incident report. So if blood was found at the bedside 2 hrs later, would she have been told to just give it? I would take the opportunity to ask her (when you are charge or resource) what she is struggling with, if she feels overwhelmed or totally stressed out. and I'd inform her that any future occurences will result in notification to the NM. Perhaps, you're unit is super busy and she just cant keep up? Perhaps she is overwhelmed on the unit? Maybe she'd prefer not to float to your unit.

So if I'm reading this correctly, Ibuprofen and Tylenol weren't given based on the assumption they wouldn't do anything? Typical SOC, is that you give the medication available, the tylenol/ibuprofen (which if wasnt available as a PRN was the first ordered medication. Then you re-assess the patient after a period of time and see where their pain is at, then and only then would you seek an order for breakthrough pain. The other thing is how often was the APAP/Ibu being given? These meds should be given round the clock for optimum effectiveness particularly the nsaid as the antiinflamatory effect can take from 5-10 days for the full benefit to kick in. I think your advocating for the patient while well intended was misinformed. The hospitalist should have been advised the med s/he ordered was not given. Lastly, the psych doc yelling profanities over the phone is completely unprofessional and behavior I would take issue with. jmho.

This is a very hard lesson to learn, sadly. Sometimes even when the symptoms are there we are distracted, overwhelmed, caring for other patients that we sometimes don't see the bigger picture until its too late. You said you were thinking pt was a sbo, just remember nurses don't diagnose because if you convince yourself shes this, often she'll be that. Your role is to report signs and symptoms to LIP, which you did the day before. And sometimes they don't listen, so its up to us to keep calling and paging until someone listens. So you ask how do I prevent this from happening again, the simple answer is don't forget that patient. Remember that patients don't read textbooks and nothing is cut and dry. If you are unsure if something is off and needs to be reported go check with a more experienced nurse, I've been a nurse for 13 yrs and I still will go to a more experienced nurse to troubleshoot so to speak. I am very sorry for your loss, its a hard thing to live with but don't let it stop you from nursing. I would recommend talking to a counselor to help you move on. Best of luck to you.

One thing to understand here is that hip fractures in an elderly patient result in an average life expectency of 1 year or less, this is NOT a harmless mistake, if this patient is over a certain age it just may be the beginning of the end for them.

in my state we do have RN's in assisted living, and some do take total care patients, rules and patient acuity are changing, at least where I live.

report the no lunch to the labor biard, if you don't get one they have to pay you. Facilities need to be held accountable for these impossible work situations and the only way that will happen is if some speaks out. When people just tolerate it, it only encourages the facilities to tack mord and more onto your duties. Patient care has gone out the window.

Well Neats, before you comment perhaps you should look at my other posts. My situation had almost nothing to do with negative comments; it had EVERYTHING to do with me losing my job because I filed patient safety reports for sentinel level events, it had everything to do with me being singled out and punished over something dozens of nurses had done without punishment or beratement, it had everything to do with a manager who thought she could violate labor laws and union rules. It had everything to do with costing me my career and livliehood because I chose to do the RIGHT thing and try to protect patients from further harm, sadly I didn't learn the truth of who really loses when you try to protect patients, and that would be the person who reports it (sure there are 2 sides to every story but I don't think they'd be giving me a fat check if I was the one in the wrong). In my case, the facility admitted their negligence and we have agreed to a fat little settlement but that will never take the place of the job I loved. Yeah, lol, I wish it had just been a comment.