Nipper48

What would the lab drug screen show and is this used to confirm the diagnosis? I am thinking of the patient unwilling to disclose the extent of their use.....

This is the classic "Swiss Cheese" of small issues that become a big error... Your agency needs to develop a new protocol to follow up in these situations, especially if there are multiple field staff seeing the patient. You reported it off and you are the one that really found the antibiotics were never prescribed. This is not a Board issue for you but a complaint from the provider or family to the state or Medicare Hotlines could have resulted in an agency complaint investigation or a full blown audit from the state or your accrediting body.

PC in it's current version is another means of bullying and demeaning another to get your way. The complainant determines that their world view is the only correct one and anyone sharing it must be ignorant or unworthy. How else can you explain the foul language, verbage and videos of women presented in popular culture by multi-million dollar "A" list celebrities but a 70 year old song about 2 people flirting is worthy of condemnation and must be banned?

Sure, during an emergency or trauma heading south, we would make very cutting remarks, not for the faint of heart or tnin- skinned... but cursing and "F-bombs" were almost never part of it.... and never directed at a conscious, alert patient or family member... I got tired of hearing people say, 'I can't help it'... yes you can, you just rationalize it and give yourself permission to use it... it is a bad habit, no more...

We used to get real turkeys, then if was WalMart gift cards, then it was $15.00 added to our paycheck (which was taxed)... some of the physicians would give us gifts or cash bonuses but the hospital told them that was illegal under federal law (can't remember which one right this second), told us they would fire us if we were caught accepting them....

The patient is the definition of "Borderline Personality Disorder".... treat her professionally, do your job and carry on... if she got the other nurse, she would make a point of letting you how how much better she is - for about a shift, then she would be trashing her and demanding you back... use this a a learning experience with 'difficult patient's and it will become one of you 'what stories'.... this is the kind of situation you really grow from as a nurse....

Short answer is yes.. you work for the facility / hospital, not a specific unit... the only exception would be a move to a specialty unit you have no qualifications for... example would be med surg to OR or med-surg to L&D... a move to peds or nursery would also be questionable....and yes, the can write you up for refusing... we used to designate a float or use a list to take turns if we could..

The only times I ever wanted to assault anyone is when I was hit - either the patients were waking up from anesthesia, they were on drugs and incoherent, or they were psychotic. I too have been cussed at, called names, spit on, fired from the case for doing the right thing that annoyed someone, and seen patients' friends and family that were pure plain evil. The worst for me were the patients so very alone. I learned from a mentor early on, outrage and anger only wears you down.... you have to take that energy and channel it back into your care. I also learned to cry, work out, pray and simply scream or cuss like a sailor in the car. I did get verbally abusive once on the phone when about 2am I called a mother to tell her her son had been shot, was going to surgery and was asking for her (he was dying). She told me he was just no good and she needed to get her sleep - I could hear the party in the background. I said a lot of things in one breathless sentence. She just hung up. I said a few more choice words. I looked up and our trauma attending, who was a bit of a drill sergeant and stickler for protocol, just looked at me and said, "I could not have said that better myself." Then we proceeded to get to the OR.

That is a dream job - outstanding organization.... go, work hard.... a year from now, you will be writing it was the best decision you ever made ! Congratulations !

First, HR should be co-ordinating job postings, so I would be corresponding with them... Second, what was your work record before you left the hospital and does she have access to it either through HR or by asking your previous manager? If it was good, you are fine, but if you had issues during your previous position, that may be influencing her interest.

Just excel at your job.... do not let petty coworkers get under your skin or make you second guess yourself... this sounds more like a sad attempt to bully you and demean your success at getting the position... nothing would please some of these people more than continuing to throw shade on you... ignore them....they already are chipping away at your self-confidence and self-esteem...do not be afraid to be happy ... child care needs are a real issue... you let management know and they responded... it sounds like they value your work...good for you...

Report this to your manager immediately.. it is not abuse, it is unethical and beyond any professional scope of practice.. it can become a legal issue for the sub nurse and your agency.... document everything you know, hear or were told with date and time and give it to your manager...

Being able to extend life in these instances is one of the curses of modern medical care. If you suspect a monetary reason for prolonging treatment, take you concerns to your nurse manager. She should contact Risk Management and the Ethics Committee in your facility for guidance. Court action is an option in select cases, and I have seen that happen multiple times. If you simply disagree with the family's decisions, it is not yours to judge anymore than it is our place to judge based on gender, race, diagnosis, or any other category. You focus on taking the best care of the patient. The family is not 'failing' if they are doing what they consider to be the best they can do. Grief and fear drive many decisions. The family members are in pain also. Everybody must live with their own conscience in the end, so you will often hear "We told them to do everything." We do not know their story, nor do they know ours. Take advantage of any Social Work Services or Pastoral Services available for the family. They can be tremendous assistance. These cases are multidisciplinary team issues - utilize yours to the fullest extent. The hardest thing I ever did was discontinue care on my father. I knew it was hopeless and I knew what he told me he wanted. I knew I had been a nurse for 32 years and remembered all these patients. I did what he wanted. It was still almost more than I could bear. I felt tremendous pain for all the families I had judged, "Why don't they just stop this?" If nothing else, teach all of your patient's about making an Advanced Directive and to choose their representative wisely. My father chose me instead of my mother or my older brother because he knew they could not do what he wanted, no matter how much they wanted to. In the end, getting angry only hurts you and interferes with your ability to care for these patient's and families. Find you own best means to cope away from the bedside. Personally, I cried, I worked out - I prayed a lot. Find what works for you.