NurseScribe

Have you considered REPORTING the hospital? Those are unsafe practices that are endangering many people. You would be doing the public a favor if you found the local hotline number and gave a detailed report. It can often be done anonymously. You might even cause a change in policy. It's worth a try.

Davey, Davey, Davey........? thank you for the laughs!

Taking vital signs gives the patient a few minutes of attention. Documenting them covers the nurse. I had a patient who kept yelling about her abdominal pain and telling her family she might have appendicitis. Took her vital signs every hour for 6 hours-all normal-and I could tell her family we were monitoring her closely.

You keep using the term "care home." Is that the same as a nursing home? "Better pay, shorter hours and more time off"?? Where? I have worked in 5 different nursing homes during my career from CNA to LPN to RN. The staff/patient ratio was usually 1 nurse/15-25 patients, depending on floor acuity. The CNAs were taking care of anywhere between 6-12 patients each-assisting, dressing, bathing, toileting. Each nurse was responsible for all the medications and treatments for one hall of patients. It was extremely busy and if one person called in there was no float staff to cover, so everyone else worked harder. It WAS rewarding-I loved my patients-but "better work/life balance" was not one of the benefits. It was at least as hard as hospital nursing with less supplies and less medical support.

My first job as a fresh LPN at an LTC facility in early 1984, when providing hygienic measures for the residents, we didn't wear gloves. Just used good ole handwashing techniques. Like you, Davey Do, I worked in LTC in the early 80's. As a CNA. We changed patients and beds and cleaned up everything without gloves and then washed and dried our hands at the room door. Every room had a sink next to the door and the head nurse would check to see if the trashcan was full of used paper towels-that meant we were washing our hands. We were probably exposed to all manner of bacteria and body fluids but back then it was part of the job. You learned to turn people and roll up soiled sheets without touching anything. The only time we were given a pair of gloves is if we had to check someone for an impaction. (CNAs were allowed to do that then). I don't miss the good old days-but I'm not gonna die if there's a hole in my glove. As long as we have soap, water and sanitizer we'll be fine.

You wake up and realize you drove home and fell asleep right after you parked the car. It's over an hour later. You're still sitting in the car. Time for nighty night!

NO. I'm not a hero, I'm a nurse, doing what I was trained to do. That's all.

One of the principles of nursing is nonmaleficence-"Do no harm." If a hospital allowed staff with no symptoms and no vaccine to be in contact with patients and later found out they were carrying the virus to every patient they came in contact with, would that not be harming the patients?

"IMHO physical attacks and aggressiveness has a lot to do with how staff manages patient behavior. Especially now that we can't just put someone in restraints anymore. Physical attacks are rare in our facility but our staff is tops." I'm not comfortable blaming any staff for not "managing patient behavior" well enough to decrease aggression. Connecting and communicating with a psych patient is a fine art and not something you can just take a class on. The risk of violence is always there.

Thank you for your honesty and candor talking about your experience with having Covid. I think a lot of us nurses would go along like you did thinking "It's not that bad..." until our O2 level tanked! The part that affects me the most is how long your recovery has been. Wishing you all kinds of good health!

I agree with Speedynurse and some others-it depends on the unit. Where I work now (psych ward) the day shift nurse will pull out the scheduled medications for the evening shift and put them in the locked patients drawer. I have no problem with this since I scan every pill and bottle. The evening shift then pulls the night shift nurse's meds and puts them in the drawer. Teamwork saves time.

Your charge nurse did the right thing by changing your assignment. That family was probably not going to change and they would just burn you out with negative responses. Don't doubt that you are a good nurse when you get an impossible patient. I had a semi-conscious patient on a tube feeding who had constant diarrhea. The CNA and I changed him and changed him multiple times. When I finally went on a meal break his son showed up....and found his dad in a bed with diarrhea. He went off like a hostile napalm bomb, accused me of neglect, threatened to have me fired and called the State. My HN took me off the assignment and gave the patient to another nurse-who continued changing him multiple times. The State eventually investigated and found no negligence. Sometimes the family is so focused on the family member they can't quite see the real situation.

Good article with much food for thought. Nurses sometimes take care of everyone but themselves. Thank you!

The fact that she is accusing you/spreading rumors about you making narcotic errors is a red flag. I believe the legal term is slander and libel. You don't mess with another nurse's professional reputation. It would make me wonder if SHE is diverting narcotics and going to try to pin it on you.

Keep looking...

I noticed in the first problem it only gives the IV fluid as running at 100 cc/hr from 1600-1900. So it would be 100 x 3 hours, not 100 x 12. ( In real-life nursing, of course, it would probably run all day...) The second problem is tricky-it is asking for the 8 hour intake ONLY between 3 pm to 11 pm. So you would only count the lipids from 8 pm-11pm. Anything not between 3-11 doesn't count. I hated medical math. The best advice I can give you is read each question at least 2 times and look for tricky details. Good luck and may the Force be with you!

There needs to be a hard limit on the amount of patients one nurse is responsible for. I really enjoyed being a nurse for years-until the amount of patients kept getting slowly increased, more and more duties were gradually added, and LPNs and CNAs were quietly phased out. It became a nerve-wracking, undoable job where I was driving home every night scared to death that I missed something critical. I don't care how good your time-management skills are-there is a limit to how many people you can pay careful attention to while performing multiple tasks and still be aware of changes. I would take a job with less pay if they would guarantee a limit on number of patients and some auxiliary help. A CEO at the hospital once asked in exasperation ,"Nursing is never satisfied. What do they want?" My answer would be-"To do a good job." If you create the conditions where a nurse can NOT do a good job, no matter how hard they try-they leave.

Tweety I'm impressed that your hospital is actually working with you a little bit! Don't stop what you're doing. Keep writing letters and stressing how unsafe it is for patients when the nurses are stretched too thin. We all have to keep working for change.

Fecal Ova and parasite screen?

"The Joint Commission does not include, "A. Handwritten orders," as an example of medication safety practice." Good to know. Although facilities without EHR are still using them.

This was an excellent article, especially the part about having your antennas on high alert. Good job spotangel!

Loved the Fraggles!

Been working in mental health for the past 6 years-I agree with everything Davey Do has posted. Good advice. Be not overwhelmed! You are not the only nurse that has anxiety and depression. We all carry different kinds of baggage and the past year has been traumatizing. The best advice I can give you is "You have to take care of you before you can take care of anyone else." Don't let the feeling of depression talk you out of getting counseling, medication, or anything else you need. Pay attention to how much sleep you are getting-sleep deprivation is a trigger for depression and anxiety. If the medication you are on hasn't helped after a couple of months, your doctor needs to try something else. It's your life and it matters. Stay in touch with us on allnurses-we're rooting for you.

So- Mr. Smith? You told the doctor you had a pain level of 11 and no one was helping you?

I see nothing wrong with telling them you have no knowledge of the situation if you have no knowledge of the situation. JKL33 said it very well. Don't be tempted to try to make yourself look better-stick to the facts and don't volunteer any more than what you are asked. It's pretty scary being investigated but it happens to all of us. There are no perfect nurses on the planet.