mopsi

I'm starting Micro next week ! EEK ! I'm so glad I found this thread. I know I will be needing all the great links that have been posted. This is really a great support system!:monkeydance:

I would prefer to addressed as Mrs.X or Nurse X...It is more professional . In our profession , anything to give some repect and an slight advantage to the nurse would be welcome. We don't say "Hey Donny, how are you?" When we see a MD we know. Nor do the patients address their Doc's by first names. Policemen are Officer Brown, not Joey. The teacher is Miss Tucker, not Tammy. Now the WalMart cashier is Becky, but that seems OK! ( no offense to the cashier)The return to formality to establish a line of respect and role capacity might be something to consider.For those who fear stalking by someone who is unbalanced, there is no guarantee that they would not wait outside of work and follow you, even if they only knew you as Susan. If someone is going to get you they probably would not be discouraged if they could not find you in a phone book.Where I work of course we are all first names..I would like it to change.

Being a student is great. It may give a more current perspective. Are you taught to chart what you do? Not what you want someone else later to perhaps do. Are being taught to put in initials when refering to another staff member , not their full name? Are you being taught that an RN gives verbal orders to an Lpn and must be followed? Are you being taught that when something serious or irregular happens you contact the doctor before doing your own thing? I have been an LPN for 15 years and have returned to school to get my RN, so it's not like I have limited experience with scope of practice. I am truely puzzled by myself and another nurse having such a vast difference on what to chart and how to chart. I can not find any resources stating what I have adopted as a standard, not putting in someones name and not charting what someone is supposed to do, is correct. I am also puzzzled by the statement that an RN gives orders to an LPN and they better be followed, or my license is endangered. I can not find anything other than a LPN is under the direction of an RN, which is a little different than taking orders as from an MD. In 15 years I have never had a conflict even remotely like this so I am really at a loss here. I hope someone with some experience can give a little input here. I would be delighted if you posed this situation to your instructors and got back with their feedback. Thanks So Much!

I am confronted with a situation and would like some input from the "Virtual Community". I am under the belief that when we do our charting we are to chart what WE do. Period ! I am also under the belief that we do not put other nurses full and legal names in the charting. Examples: I DO chart "Foley 16F30cc reinserted without difficulty. 100cc of lt amber urine noted with foley insertion. Pt tolerated proccedure well." I would not chart " Stna reported to me foley out. Told 3-11 nurse Suzy Washington LPN to reinsert it." The is a fabricated scenario and the proceedure was far more serious. It was the reinsertion of a trach. The RN supervior who elected to put a new trach in, after the old one was found out. There is no order in chart that says Trach to be reinserted by staff. Prior dislodgements have resulted in Pt being sent to ER. (We are at a LTC facility, no house MD, no Resp. Therapy, just LPN charge nurses and occasional RN supervisor) I had discussion with the supervisor who charted pulse ox to be performed q 15 min by (me) Full Name. This was as a follow up intervention . I was told that to protect his license he had every right to document whatever direct order( verbal) he gave any LPN, and it was their problem and License that was in trouble if they did not do it. Yet when I asked if it was appropriate to chart "Paged supervisor Joe Supernurse, RN to floor at 10am , no response. Rn supervisor paged to floor 10:05am, no response, supervisor Joe Supernurse, Rn paged to floor stat", he said no, that would make him look bad, took the nurses notes and made his note before I could chronologialy chart , not with the blaming, just straight forward charting,what happened. I told him numerous times I think we should call 911 and send the PT out as has been done before. I also know that the proceedure was done incorrectly by him, with many errors.He is fond of telling everyone how he was a Paramedic before becoming an RN and they are was more skilled than any RN he has met. The dynamics of Paramedic charting may vary from nursing, but I know nothing about their Regs. I do know he is working at the LTC under the license and capapcity as an RN, not a Paramedic. So help me out here, smart ones! I think the MD should of been notified and subsequent orders recieved. The supervisor insits that I am working under his RN license and must do what ever he tells me. I think hiding things in the charting and hoping someone stumbles accross them to chart to protect their license is poor practice. I think charting what someone else is supposed to do does not relieve you of the responsiblity of doing it.I have seached extensively for something to back me up on these ideas I have and can't find anything to support it, yet all my long time Nurse friends agree. Am I off base here? There seems to be many things wrong with the entire situation and I would like something to validate my concerns.

I believe I have posted this story in the past, but it may be worth the rewrite. This takes place in an inner city nursing home up on the third floor. The hall is to the left of the nurses station. Very nondescript with rooms on each side. Just a dull rectangle shape. The only access to this area is the elevator which is across from the nurses station and a stairwell on the other side of that, more towards the other unit. The shift is 3-11, and its about 7P. Most of the staff is off the floor for dinner. I am getting ready to begin my evening med pass with all the crushes for the tube feeds. I have a male orderly on the floor with me. This unit has several loud patients with one in particular, a female who says a name of someone repetitively. All the time. I think the name was Mary. So along with other assorted dementia sounds there is the constant background noise of "Mary, Mary, Mary, Mary, being chanted. The orderly is facing towards the end of the hall next to me and my med cart. I am about half way down the hall. The patient who keeps chanting Mary is the second last room on the left. He is asking me a question when the is a sudden SILENCE. The chanting woman has stopped. The silence makes us both look down the the hall towards this woman's room. We both see a little girl who literally skips out of her room and enters the last room on the right which I know is empty. We both know there are no visitors on the floor but still don't want an unescorted child running around. Plus we have noticed she was dressed kind of odd. I lock the the cart and go down the hall together. No one is in any of the rooms except the bedridden patients that were supposed to be there. We then check on the quite chanter who was not dead , just inexplicitably quiet. The little girl we saw was dressed in a salior like outfit. A popular style at the turn of the last century. A midi blouse with a large collar and necktie and having a long waist. It was over a dark pleated skirt and dark sockings. Her hair was blonde and pulled back into two braids that bounced as she skipped. She never turned towards us, just skipped purposely into the empty room. The patient stayed quite only for a few days then resumed her endless calling to someone she wanted to see and "Mary. Mary, Mary" filled the dismal halls again, but no reappearance of the little girl from the past who seemed to have given her some comfort, if only for a short time.

LTC in Ohio. 7A-7P..35 patients 1LPN ..2 STNA"S, sometimes 3 STNA"S... at least 4-5 skilled Pts with full Vs and q shift charting..4 of this are qid acuchecks..1 Trach and Tube feed...assorted very demanding A/O group with phone calls every hour(and a system with 1 cordless phone you have to find and run to the next patient with a family memeber calling) A wound that has dressing change Q 4 hours with administration putting little markers under the patient to make sure you are doing it You are expected to feed as many people that you can..13 total feeds...The morning Med pass takes 3 plus hours and since state is coming they plan to change the time on 1 hall to 8A and the other to 9A so lucky you will be in compliance.I read a post earlier about a negative co worker and I think it could of been written about me..Gee is it time to step back and re-evaluate this job before the burnt out me just turns to dust and blows away?

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Wow..some of these same N/A's must be crossing over the border to Ohio..and Management must attend the same seminars!!....You know N/A stands for..not available!But for shame, because this negative behavior also burns out the great STNA's..It is so unfair..but I caught a glimpse of a tax incentive paper..and the employer is getting extra$$$$ for the new Nasty Nellies..makes them get even porkier with the long time staff..Why pay that vacation pay ect...and the patients do suffer..I can no longer maintain eye contact with administration when they start crying "BUT WE ARE HERE FOR THE RESIDENTS"..The depth of their lies surely will earn them some horrific Karma if not reservations at Satan's Nursing Home..........THE PITS ...The Eternal Long Term Care Facility

1. Small City in Judea 2. Colorless Yuletime 3. Singular Yearing for Twin Anterior Incisor 4. Loyal Followers Advance 5. Righteous Darkness 6. Weather: Cloudless... Arrival Time: 2400 hours 7. Far Off in a Feeder 8. Array the Corridors 9. Bantam Percusionist 10. Monarchial Triad 11. Nocturnal Noiselessness 12. Father Christmas Enroute to Borough 13. Initial Christmas 14. Frozen Precipitation Commence 15. To Descry Matriarchal Oscultation of Yuletide Anthropomorphism 16. The Quadruped with the Vermillion Proboscis 17. Query Regarding Identity of Decendent 18. Delight for this Planet 19. Give Attention to the Melodious Celestial Beings 20. Endocarps Vesicated in a Conflagration Ready for the Answers...... 1. Little Town of Bethlehem 2. White Christmas 3. All I want for Christmas is My 2 front teeth 4. O Come All Ye Faithful 5. O Holy Night 6. It Came upon a Midnight Clear 7. Away in a Manger 8. Deck the Halls 9. Little Drummer Boy 10. We 3 Kings 11. Silent Night 12.Santa Claus is Coming to Town 13. First Noel 14. Let it Snow 15. I saw Mommy Kissing Santa Claus 16. Rudolph the Red Nosed Reindeer 17. What Child is This 18. Joy to the World 19. Hark The Hearld Angels Sing 20. Chestnuts Roasting on an Open Fire Merry Cristmas to You All....MOPSI

I've maintained unlisted phone service forever..Just cuz I've been a single mom and didn't want that out there..Plus every bad guy figured out that listings like M. Jones or K. Breeze were single women anyway..unless you tried to get cute and put Jr. after it.....M. Jones,Jr...As far as work goes I think some formality is needed to infuse the nursing profession with a little more Professionalism..Now just mull this concept over before you all pounce on me..The doctors are addreses as just that ...Doctor Patel, Doctor Stein, Doctor Mc Laughlin...Not Amad,Hymie and Scotty.....Back in the previous century..LOL..It was common place to address nurses in two forms...Mrs. Robinson, Miss Tingle, Mr Parker ....or....Nurse Robinson, Nurse Parker ect...Patients still call out to you as nurse..."Nurse, can you help in here?" The military are the masters of Rank and order..Titles are important and you fall into a pattern of respect when you address people more formally..I am not friends with my patients..I am not friends with the doctors...and I am certainly not friends with administration..I give up some of my power and and loose professional ground when the lines are crossed and I am addressed in familar terms verus the formal..Think about it...A judge is addressed as Your Honor..a politician..Senator...a policeman ..Officer..a teacher continues to prefer Miss or Mrs or Mr......These are their professional titles and they uphold their professionalism from the begining, by the form in whick you address them...All public people long ago found the need for privacy or personal annonimity a valued preference..A trend towards more formal salutation may suprisingly reap more needed repsect in our professional roles...Are you getting butterflies just envisioning the response at work if you dared to be "Different" and requested a formal title...No more Suzys or Tashas or Joes...but..Nurse Jones or Mr. Anderson...I think the deranged would have a harder time stalking you if they didn't even know your first name, let alone be less inclined to feel so familar with you that you wouldn't mind a phone call or home visit..Trust me on this too...It's much harder for administration to belittle you when the have to call you Mrs. or Mr. or Nurse...Rethink those name tags...NURSE ANDERSON, R.N. MISS KINGSLEY, L.P.N. MR. PRITCHARD, RN-C picture a nasty patient tring to yell at you but for starters its Nurse Anderson not Suzy...It really would make a difference..Ok exiting soapbox...FEEDBACK????

I have to agree too....The race thing is getting real tired along with the age thing...Now importing foreign nurses to take jobs is another issue...When work conditions deteriorate and managements solution is to bring over foreign nurses and for all intents and purposes have indentured servents....This becomes an issue to me...But to continue to raise emotions on the race/color issue is just uncalled for...I believe it is time for NURSES to stand together and reap some power from UNITY....The obervations and opinions overheard do have some merit as nursing becomes a more impossible profession...however the solution does not lie in the destruction of the mainframe of standards of practice. Each and everyone one of us needs to start our own positve PR and image campain..Treat each other with respect..Challenge those who demean the Title..NURSE..and act with the assurance of a skilled caring professional even in places where we think no one is hearing.like lunchrooms).anyone have any ideas on how to start a National Union with retirement, Low priced good healthcare and fair wage scales????This seems more productive to me than tring to keep race issues as a block for advancement of all NURSES.. Just a little soundoff from OHIO..

We have it where I work...Most of the time eveyone just puts down their days they want to work and the next person goes accordingly..On a conflict the people usually work it out..If not they both just put in for the day and mgmt. decides like they usually do..It is a whole lot better than just being scheduled if everyone is fair..If someone wants to be a PIG and pick the primo stuff and to heck with everyone else there's usually some comments made to that person..PS....It's usually the same person who got to the scheduler and got all their requests in and poop on you...I think you'll like it and at least feel a little more control over things..Gee What A Concept In Nursing!!!

rolling on floor laughing my ass off........roflmao

the setting...an inner city hospital....the patient , a middle aged black woman. dressed poorly. poor hygeine. address the projects..assorted diagnosis...h/o drug use ,etoh. iddm, pvd. presenting with c/o pain in foot and leg. very sweet lady and tearful at time..some commentary going on with doc's..probably drug seeking...i get her in exam room undress and into gown..vitals okay ..notice she has a haphazzard dressing on right foot and leg which was the source of her pain...okie dokie...gotta remove the dressing to see whats there and......maggots start falling all over...poring out..falling on the floor..wiggling on the gurney....crawling off the dressing which i was still holding......we had to get bug spray to get em all before we could even clean the wound....the patient kept saying i thought something was moving in there....i almost really passed out...i think i might have post traumatic stress syndrome from this one......yuck!!!!!! needless to say i spent a huge ammount of time trying to teach this gal before she was cut loose.....big picture breaks my heart....how can this be happening in the richest counrty in the world...i still am opposed to sending bucks to afghanastan when theres so many here ...so disadvantaged...may god bless us all...

I am an LPN with 11 years experience..Multiple settings over the years...IN MY OPINION...There is no standard mold to make a wonderful nurse...Any type of education is always a plus..from CEU improvment to higher degree...You can go to any state, to any unit,to any faclity...You can take out 10 nurses with the same title and will have an amazing varience of skill, personallity,work ethic,and overall competence...There is no singular solution or answer other than do what you want to do,can afford to do and try to learn the most and do the best you can..May God Bless you and good luck in your choices.....