blue49

As many have said disciplinary action comes from a supervisor or manager, therefore your co-worker was following procedure and reporting a missed med: that means a doctor's order was not carried out. Your manager should have had you make a late entry and document what was not carried out (and why) to cover yourself. I am sure the doctor would have no problem co-signing this order. Yes-- some, in fact, many co-workers make it their business to try to find things to get others in trouble, and after over 30 years of nursing I wonder how they do their work effectively and properly. Night nurses are often given the job to go over the days events and check for errors so they do not go unnoticed, and as we are all human this is ok. Use this as a learning experience and stop beating yourself up. If you made it through the day with that many students under your feet and only eight months experience, you are fine. With time you will learn which nurses are just trying to *stir* and which ones are just doing their jobs correctly. We all make mistakes and because you care and are a good nurse it makes you upset. Please keep up the good work...:)

Most here are commenting on home care?private duty and that is a totally different animal. I recently, after 30 years ina hospital setting and not wanting to start over in another, was a case manager for a home care agency. My orientation was terrible.....given many videos to watch and take tests on things like wound care and even the lovely OASIS. Well i am a doer not a reader or watcher and so after taking my time doing this as i did not want to get out in the real world again because of what happened at the only job i had since graduating, but since i did not get paid for orientation until i began seeing my own patients (which the clinical supervisor that hired me failed to tell me this until i was watching and reading and trying not to fall asleep with the vids for bout a week) i stepped it up. This woman had been seeing the patients i was being given and she wanted to get me out there so she could be in the office as she was the supervisor. So after a day on the road with her i got the charts and waited for the next week as these were mostly medisets with a few others that had recently been seen. Soon after she told me that one of the 3 rn's had given her 2 week notice and i would be getting her patients as well that were in my area. well never having done homecare was i overwhelmed. No report from this nurse or the supervisor, just a list and what payer/s they had and frequency of the visits needed. As i have always been up for a challenge, i dove in. What i didn't realize until they were due was that most of the patients i had needed reserts at almost the same time...... long story short as i am rambling.... Take whatever orientation for field home care you can get as there are way many gray areas and if you have a supervisor like i did with every question i asked *you should have got that in orientation* My regret is i didn't resign sooner before establishing relationships with patients, families, and several goo hhc cna's. *sorry for the ramble*

Been a nurse 31 years soon, so I do have both stories (good and bad)... Yes reading the *bad* can be a downer, but when the situation is bad it so helps to hear/read that others have had and unfortunately may have the same problem, but foremost that if you are having the issue, to know you are not alone is so comforting. As it is human nature to talk about the bad before the good...misery does love company. This thread made me cry and i am having a difficult time career wise right now, and been there done that with many of these posts, so hopefully I can remember the good and get on with things. The one that won my heart was Peter and Rose.....omg how sweet. :balloons:

I hope that with the time involved and the caring and compassion from friends and family near and here you are doing as well as can be expected. I hope you have found that someone or just here to talk with and be assured that you did what was needed, but it was his time and he was ill. I am sure that you can now look back and even though you did not get to say goodbye like you wanted, you said he was your best friend and I am sure he knew this. That is why we must live every day like it may be our last and without regret. Comforting thoughts for you and yours from another nurse that would probably beat herself up as much as you have done.

I have been orienting with a small rural home care agency for 8 days. I have no home care experience, but I have been a nurse almost 30 years. Last week when I started there was one full time RN and an RN that has been there 6 weeks and a Per diem RN that is doing very little patient care. The clinical supervisor has been seeing patients since she had to let someone go right before I started because she couldn't turn in the dreaded paperwork anywhere close to when she is supposed to. I knew this going in, but on monday my first day to go with my clinical supervisor to see some of the patients that she is giving me, she tells me the one full time RN that has a big patient load gave her two week notice. That had me concerned but I hoped that the clinical supervisor would let me get a bit more orientation and at least feel more comfortable seeing patients before giving me something I am not familiar with and have not had proper orientation on. WRONG.....today i went with the clinical supervisor to open this case as I had not seen that done, and he has a complex wound that is actually a failed skin graft that the doc wants wound vacced...well the clinical supervisor isn't even sure if this can be done and consults the kci wound vac specialist......well the patient is upset with his situation and not happy we can't give him a definite answer.....he also said I hurt him doing his dresssing and so i told my supervisor i would not do this patient.....she asked on the way back ...."haven't u been instructed on wound vac's?" and i again told her no and she says u need the training.....U THINK???:trout: also she is wanting to divide the patients of the busy full time RN between us and the nurse that has been there only 6-7 weeks is already feeling pressured and frustrated as well......when i verbalized my concerns over this the other day her response was......"well another nurse is going to be starting soon for prn or part time........the going to be starting soon was my clue that she doesn't count as of yet......(am i wrong?) until today i was determined to learn as much and as quickly as i could to help and Monday is my first solo gig with some of the patients she has given me.........Also, i get no pay UNTIL i make my first patient visit alone....and she failed to mention this in the interview and said numerous times during the interview, "you can make as much money as you want." I knew she was needy when she hired me without any home care experience. but now she is just desperate and that scares me. The icing on the cake is that when i have questions she is either on the phone, doing her work in her office or when we are one on one talking about her social life and how she needs to get more social......also she is going to be getting a divorce soon........... I am sorry about her personal life, but don't we all have things outside of work that cause us stress? I recently was treated unfairly at the place i have worked at over 29 years and was hoping to make a fresh start and was ready for the adventure........I am so confused now.......Please assure me that all agencies aren't this way? Am i wrong to refuse and protect my license? Sorry for the long post......

I am also confused.....*she may have* *she did* and if you have no knowledge of ANY of the particulars; ie date, time, content of order, you should have nothing to worry about...case closed. also question why a lawsuit??...........

dumb question........since my icu days were so long ago and we did not use prop drips/occasional boluses.........even if the patient is ventilated are u not concerned about the other overall concerns mentioned, like pt's cardio status, resp status, etc.? that seem to be concernes with the non-vented patient? anesthesia only give prop in my setting(pacu) and not sure if they use drips in icu and who or how they are managed....and we use versed/fentanyl for conscious sedation in er which i left 2 years ago and i used ketamine once on a ped conscious sedation and it is scary stuff. i think i made the dr give it.:trout: very informative thread too btw.

In 1976 in rural southeastern Indiana ina small county hospital I started at $4.96/hour and in the *city* Cincinnati I was offered a job at $5.13 an hour. After almost 30 years I am only making $26.81...... seems like from 1975 to 1985 there wasn't much increse in nursing salaries was there?.................sad

You mean ER DIDN'T cure them????...................lol,j/k.

i feel your pain........i was given a verbal/written warning in dec 05 and after a *meeting* in jan we all decided to play nice together......thw actual write up was for petty bs too........then i decided that i wanted this job and hoped it would be my last till retirement........so being totally unaware, on 4/11 (which was my old wedding anniversary before divorce), i was given another written warning and a 3 day unpaid suspension and made to do the Earn program (mandatory counseling) .......and the counselor agrees the crime does not fit the punishment.......everything i was accused of had been and is done by the others i work with too, but i do not play that game......so i left that day and got my dr to sign for an fmla and i am using my sick time and pto which i would lose if i didn't work out my proper notice for resignation......i am looking for a new job and there are no lawyers close to me that handle work problems.....that day the DON sat there with a smug smile on her face and said..."you know if u are here it isn't good" and that my job was in jeopardy... and after almost 30 years there.......well they won......i hope i can make myself find a job soon.... :angryfire:angryfire:angryfire:angryfire

seems to me that most of these boil down to 1) those of us who care 2) and those that do not. Thank God for those that do care re:not doing their jobs completely, not working together and remembering the patients come first, restocking what u have used, helping others with worse assignments and many more that for those of us who care would not leave undone routinely. My biggest pet peeve is nurses that obviously do not have enough to do and are always critiquing others, to the point of discipline and suspension of the one that did her job. Also where did the *worker friendly* management go. All my manager cares about is looking good for administration. Sad

oh i forgot.......scc=suicide completion course........sorry

I agree with you jessica and that is why I miss ER..... Non-medical or floor nurses look at me so weird when I say I love a GOOD trauma and a successful TPA for and MI or stroke......of course when they do well and survive it is so much better....but I am one of the few that do handle dealing with grieving families, I bet they miss me in ER.

An Er doc i used to work with said when he was first out of school (years ago) they used to write on the bottom of selected charts.......FOAD=f**k off and die.....Bad i know. Also one we used especially when a babe or child was brought to er, obviously not acutely ill.....they suffered from DMS=dumb mother syndrome and were there for a *well checkup* another we had to use too frequently was........shallow gene pool or puddle. a patient coming by ems.....true story, unconscious but breathing=butt breather..... Amber.......i do so understand your feelings and i to do not want these acronyms attached to my loved ones, but unfortunately when life stops it stops. After a few years as a nurse you will understand these stress relievers and they are not charted or said in front of anyone but peers, but do pick which peers have a sense of humor and which ones do not......and that comes from experience. Jessica i loved overserved,it is so PC ina great way.

Soooooooooooo been there, and i really admire your ability to *nip that in the bud*....ER's do not need to show patients how to abuse us. When I worked in ER, one of my doc's was the same way with people that made the most noise in the waiting room. Although I understand his reasoning to a point, I so hated triaging when he worked and being the one to have to explain why someone was taken out of order and it was apparent to the uneducated he/she should not have been seen first. We should not have to explain the reason, only the meaning of triage. I do feel bad for NP's or PA's when the doc puts them in the middle, kinda. An employee with strep throat at the end of her shift got that kinda treatment once and the NP saw her and ordered the bicillin and wanted her done before others waiting longer....I told her if she wanted her treated first to go right ahead (after all she is a nurse, though she tended to forget this way too often) and other nurses weren't pleased that she wanted this patient to be done first and she let her wait.......I had to work with the doc all night so I made my point and did send her on her way a bit early, but not enough to make the Doc or patient or NP think they got away with anything.........:uhoh21::wink2::icon_roll

That is the first thing that came to my mind,why wasn't he aware that she was intoxicated? and if the officer didn't persue the issue for whatever reason so be it....we are not the law in the ER....when i left ER 1.5 years ago, if it was ordered medically the police had to subpoena the results.....and the doc's had a relationship with the law enforcers by ordering it medically *wink*...i must look into the state law as to whether i would be responsible to relay that blood value to them or not, but i no longer work in the ER. But knowing that she probably drove drunk before and will again does get emotional as I have children driving the roads too. that makes for a sticky situation........ also when working in er and i had medicated a patient after asking them if they have a ride and them saying yes and even producing someone from the waiting room......later to leave and let the patient there alone and to drive.....after discharging the patient i followed them outside and watched them get into a car and drive and i promptly called the police....and one time an intoxicated and very obnoxious *big man* ripped his iv out and walked out and i followed him and watched him drive away and called the police and they brought him back after picking him up for a bac.....tg he was too mad and drunk to think about why he got popped, but he was driving left of center they said......boy was he mad :uhoh21: but as i said there may have been someone i cared about on the road that night and for that matter i do not want to see anyone hurt.....

the one patient that comes to mind here and there are so many from my 10 years in er........i have seen many like u all have experienced......i was triage on an always busy sunday eve/night was a lady c/o hemorrhoid pain......it was obvious it was painful to sit.....and while in the waiting room he mother called to tell me she was in pain and needed to lay down.....so i went to the back after my triage time was over and yes, i got her chart.....well she was already ina treatment bed and was going to xray for a chest film......she had a congested bronchitis/smokers cough on exam.....so after the Dr had me put her in the gyn room so he could examine her hemorrhoid complaint.......well when i put her feet in the stirrups and spread her legs with the doc seated appropriately this tan oooooooze flowed and i mean flowed not from her hemorrhoid.......she denyed any knowledge of lady partsl discahrge......omg i didn't breathe because i didn't want to know if it had a smell or not......the doc was like Woa.....then after obtaining cultures he finally lanced her smal thrombosed hemrrhoid.......would love to see the drg/insurance people on this chart......all of the above could have been treated by pcp.. also while in er i used to say at triage we needed boxes for pt.history forms that they complete for 1)work excuse...2)drug seeking..3)really sick....4)others......of course admin says *educating* the public will not do any good......it couldn't hurt. finally in my area ambulances now charge for taxi runs and really has cut down on the abuse. as i read i am sure i will remember many many more stories...

i would like to share what *critiquing other nurses* has done to me..... i have almost 30 years experience, and no that does not make me anything but experienced......but the co-workers i have been with for 1.5 years decided about 6 months ago that they were going to critique my every move......that resulted, much to my surprise, in my verbal/written warning and then after i thought everything was cool i got another written warning with suspension, that caught me more by surprise...........sorry about *hijacking* this thread, but if more nurses, regardless of experience would do their own jobs and only report gross malpractice of nursing and use only their good habits work places would be less stressful.......now for my bad habits that i will admit too.......uncapping with my mouth, and u think getting stuck years ago with the flimsy tubex toppers would have stopped me, but no.....lol...finding a mess when turning a patient or repositioning and not gloving except for bm.....and i have never had a shortage of soap and water at work.....i try to keep the linens on the bed, but why change the patient if u might get what u are cleaning up right back on them????.......in a small area like er or pacu drag the dirty linen receptacle with u to the bedside.....and i still cannot start iv's with gloves or draw blood or do fingersticks....none of us are without fault, and we must be able to pay the consequenses if needed.

oops...didn't need two of the same...

fellow employees tend to forget whether you are on your regular shift or unit or what have you, that we are all being paid for an 8 or 12 hour shift way too often......the days of working *together* unfortunaltely are gone and many use way too much of their paid time worrying about what others are doing and finding ways NOT to do the job they are being paid to do..... A loser would not have cared how the job was done as you did.