pedsRN121

Hope you can help, I need to find some information about nursing care for end stage Cystic Fibrosis. Unfortunatley, on my floor we do have a lot of great CF patients that we all get to know and love. But they are not always that healthy and some do end up leaving us forever. We have dealt with it the best we can. But I am wondering if there is any information about nursing care and end-stage CF, I could not find much when I googled it. If anyone can help, I know I would appreciate it and so would my coworkers. We love these kids and want to help them however we can.:redpinkhe

Can anyone tell me where I can find with ER blood draw order and tube color?

Thanks for the great advice. It certainly is scary to try to do the right thing. As for my situation, she has NOT returned to work, the NM just keeps getting float nurses to fill for the bad nurses scheduled shifts and the NM has not said one word about the situation. :icon_roll It has been over 3 weeks now. My feeling is that the nurse has probably quit by now or is going to fight the management about termination. She had books and personal things around the break room which are now gone. I am not sure what the policy would be but I would think my NM should atleast tell us that the nurse is off the schedule atleast. She keeps leaving her name on the schedule and everyday crosses it off at the last moment to put in the float nurse. I know she is probably not a fan of mine now. She had her favorites and while I was not one, I wasn't on her list either. But I know she probably is looking for any chance to nail me on something. Well, atleast I know she has to have some respect for the fact that I would go this far, since I am a basically easy-going, don't stir the pot kinda girl. So my update is that nothing is new. No sign of the bad nurse, no news of anything either and no response from the nurse supervisor I addressed my letter to. But on the other hand, no having to work with her has been great.:cheers: Thanks again, I can't say enough about how all of your correspondence has helped in this difficult time!!

Thank you to everyone for all of the great suggestions and most of all the support. It has been a stressful addition to the holidays. I hope things happen soon, my nurse manager did contact me on the telephone to request more detailed information about several of the incidents and I know from other staff she has approached them for more information or details to support my claims. So hopefully something is in the works... I can only pray that it is.. I have not heard from my nurse managers superior, the manager of several units in the Maternal-Child Division yet and my documentation was actually addressed to her. I am going to email her to see if she recieved it just so I can see if she is involved or just letting my NM do everything (remember my NM seems to be the one with the soft spot for the incompetent nurse). Our hospital policy does state that the problem resolution process entails one week to respond in writing about an employee problem- so I feel it is within my rights to expect an answer from this division manager. Thanks again and I will keep you posted. It has been a great relief to read all your responses!!

Thanks for letting me know I am not the only one that has had to go through this. I have been backed up with many of my complaints from the other shifts, others have complained about being scared to work with her, mentally and in a clinical sense. I tried to work with her to make her a better nurse but now she is out of control, with whatever is making her personality change. She was out of line with some of our doctors and residents recently as well. I am not offended by the prayer suggestion, thanks, I think praying is always an alternative too. I don't want to leave my job, I love the pts, the facility and my other coworkers. But it is getting old to hear everyone always tell me" how can you work with her" and "I feel sorry for you". I am hoping something is in the works from my manager and that it will cause some positive effect. I still dread working with her.

Things have happened with pts and she manages to squeak out of trouble. I have corrected her many times, catching her errors before they happened or telling her the right way to do things. She had a bad infiltrate of an infants hand, so bad the skin was sloughing off, but she somehow convinced the parents and the manager it started on the previous shift. Bottom line was she wasn't checking it q hour like required. But somehow she gets by.. We are just lucky nothing life threatening has happened yet. I have told my manager that I fear it will and she just nods....

I do think there may be some substance abuse-more along the lines of prescription drugs, especially since her odd behavior and more manic symptoms really increased in the last month or so-she went from being dark and depressing to wound up and laughing hysterically about nothing. But underneath it all, she was always an incompetent nurse which I hoped would get better. Since it never did and I continued to update my manager with the bigger issues, I just kind of hoped it would work out with her quitting or hanging herself. Since she has been guarded by my manager, I stopped bringing things to her attention. My manager just kept sweeping things under the rug. I dread working with her again, but I feel better getting alot of the issues on paper and in the hands of my managers supervisor. Maybe you are right and something will finally happen. The worst part is the impaired nurse thinks she is funny,(she has even made racial comments to another nurse, which she thought were totally appropriate) and a great nurse even though she realizes she doesn't know much! She has spoken of going to work in a PICU at one of the major Childrens hospitals in our area. Atleast there she would be discovered and dealt with. I thank everyone for all the good advice-document, go farther up the chain, and even look elsewhere- they are all good ideas.

This nurse has gotten many many complaints from parents especially at the beginning. They have died down, but many times parents would request that I be their nurse instead of her. The NM's reply was that the nurse was just different and perhaps people didn't quite get her style. She also stated to me recently that the # of complaints are down on her, to which I replied that it didn't mean they weren't there, just that everyone unhappy doesn't always make the effort to complain. To the last outburst the RN had recently with the secretary, my NM said she believed it was from the stress of the holidays, our unit being more busy lately and recent tragedies for our staff (including my father who passed away suddenly several weeks ago- but I am glad my manager feels this is a good reason for this nurse to act crazy)

Thanks for the encouragement. Day shift has spoken to the NM about the employee but I do not know if they officially documented. I will probably continue to go up the chain if nothing happens but it seems exhausting to go through all this because they can't weed out a bad employee. I guess management would rather just bury the problem than deal with it. So far, no major consequences from her actions, but this nurse is a time bomb, loose cannon waiting to go off. I have expressed this since the beginning when she told me it didn't matter if her insulin dose was a couple units off!!

I have read a couple of previous posts regarding incompetent and unstable coworkers. I have worked the night shift on a pediatric unit with this one other nurse for over 3 years now. She got her nursing license in 1980 and then practiced for a few years as a visiting nurse in Alaska. She then went into the corporate world until 2004. She took a refresher course and my NM hired her instantly to fill a void. The problem is she has no recollection or retention of information. Every night she asks me a basic nursing question. She has asked me recently how to assess bowel sounds, she wanted the CNA to hang her meds and do her assessments, she did not know if a post inguinal hernia pt would have an incision!! This is only the tip of the iceberg. Her lack of knowledge is only compounded by her attitude. She was surly for years. She makes no effort to retain or learn nursing information. Her attitude has recently become very manic. She is calling the unit at all hours to see what is going on, she has become very animated and uses loud foul language on the floor (it is a peds unit). She has a terrible temper and recently went off on a secretary to the point the witnessing nurses on day shift paged the manager out of a meeting. Unfortunately, the manager arrived after she was gone. I have reported many instances to my manager and little is ever done. For some reason, she has a soft spot for this individual and does little to correct her behavior. On learning of the recent tirade she did on the secretary, my manager gave her 10 days off -- and since it is the holiday season, she got to be off her required holidays and have a lovely week off at a time the hospital restricts vacation. This is also paid time off. Upon learning this I went to my manager and her manager with a documented list of this nurse's proffessional and employee lackings. She is chronically late for work and has not been giving meds because she said she was too busy at 5am, so the day shift could do it at 0730 or 0800. She was not busy and all my meds were given. I know I now need to continue to document all her incidents. I do not know if any further action will be taken. But now I have to work with her when she returns later this week and I am sure she will have it out for me. I know she is aware many of the accusations came from me. I am nervous since it is just her and I on the night shift. What can I do?? I am nervous she will confront me in her raging anger and I am also worried she will just continue on her way without much repercussion since I don't think my manager wants to be bothered with filling this position. Should I leave or transfer?? Continue documenting or go higher up the chain-it is a large metropolitian city hospital? Help!

I think you can be allergic to anything. I am allergic to Vitamin E, the gel but only topically. I had a foot surgery, put some vitamin E gel on the scars. My feet swelled up so fast and so bad. Yikes.

Thanks for your help. I did find out about a website called Nurse Builders which was recommended by someone else answering my post. It helped alot and I have already passed. I did not know the PCNB website had practice tests, that would have been helpful too. I did use Lippincott Review of Pediatric Nursing too. I am glad it is over, but thanks for the info. I will pass it along to my coworkers who are going to take the test. I was glad I passed since I was the first CPN on our unit ever.

Here in Chicago at my hospital the starting RN pay is ~$23.00 as a base. PM shift pays +$2.00 and nocs pays +$3.25, weekend differential is an added $2.00. I did precept a nursing student who was returning to Minnesota and had accepted a job at Univ of MN starting at $26.50 for days. Guess it is all dependent on where you are.

well, my hospital is right in there. We all feel they should appreciate the RNs instead of finding lots of money for the waterfall in the lobby, the gold mirrored elevators and the piano in the lobby. It is a VERY nice place to look at and in a nice area. But upper management finds little money to appreciate the nurses with. We got a plastic mug with the logo and 4 coupons for a free coke or coffee but only if you bring in the mug and fill it and only for this week. They should be SO thankful that so many great nurses and docs stay there. a bonus would be heavenly. There is also a "tea" but only for the day staff on Tuesday.

Thanks for the website, it looks like it will be helpful. I just hope I get the materials in time. I had trouble finding any good information, THANKs for coming through!:studyowl: :monkeydance: