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LatinGirl

LatinGirl

Rehab, Peds Psych
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LatinGirl has 2 years experience and specializes in Rehab, Peds Psych.

LatinGirl's Latest Activity

  1. LatinGirl

    What would you do?

    We were informed by administration that we would be receiving a 13 year old client who is diabetic and has an insulin pump. I work at a free standing psych facility. We have a NP who comes in once a week for minor medical complaints otherwise all other issues are directed to the psychiatrist on call. None of the nurses have ever seen a pumped let alone worked with one. We have voiced our concerns to both the CEO and DON about not feeling comfortable with taking on this client and her care. She not only will have her medical issues to contend with but also will have some behavioral/mental issues as well. We received some basic training via an online module, but not enough to really feel comfortable. Our support staff has not been and will not be trained on signs and symptoms to report which worries me since they are on the units with the clients most of the night. (It's a locked facility and the nurse's station is off of the units....just to give you an idea of how it's set up.) If we refuse to take the assignment I am sure they will send us home, so what are our options at this point?
  2. LatinGirl

    This doesn't seem right to me....what are your thoughts?

    It was transcribed correctly, that is what I don't understand. The DON said she would have made the same assumption as the day nurse and the the evening nurse should have called and verify the order to make sure it was correct. The thing is the doc always writes orders this way....to split doses twice a day instead of one larger dose once a day.
  3. I work nights at a psychiatric facility. The facility has had a rough year with the constant changes in administration as well as several citations from the state. Last week I was doing chart checks and came across an order for a client to have Concerta 27mg qAM. The client was already on Concerta 27mg qNoon, but the doc did not a D/C order for the original order of Concerta. I saw the nurse took it off the way the doc wrote it, chart checked it and continued on with the rest of my night. The next night I saw the day nurse gave the Concerta qAM, but D/C'd the qNoon dose, but there was no order to do so. In the AM I asked the nurse about the order and told her I did not see an order to D/C at which point she replied well I just assumed. I told her we as nurses can't make assumptions and if the order was confusing in any way she should have called the doc to clarify....which she eventually did just to find out the doc never wanted the original order D/C'd...the client was supposed to have 2 doses each day. Fast forward a week and the nurse who originally took the order off and transcribed it to the MAR is fired and the nurse who D/C'd it without a doc order is not. The reasoning according to my DON is that it was an error in transcription that led to the med error...the client missed 2 doses before the order was corrected. Does this may sense to you? The nurse transcribed it as written....how is he to blame for what the other nurse did or did not do?
  4. LatinGirl

    Can't prove it! Very frustrating.

    Thanks for all your replies.....I just needed to vent a little. As I said before I am sorta stuck there at the moment in which case I am going to try and make the best of it.
  5. LatinGirl

    Can't prove it! Very frustrating.

    @canchaser.....no its a psychiatric facility and the CEO makes himself invisible to staff members with complaints.
  6. LatinGirl

    Can't prove it! Very frustrating.

    @delilas we are expected to sweep and mop the med room and nursing station as well as defrost the refrigerator. Makes ya wonder what exactly housekeeping's role is.
  7. LatinGirl

    Can't prove it! Very frustrating.

    I agree! The DON lets him manipulate her and so he will keep doing it.
  8. LatinGirl

    Can't prove it! Very frustrating.

    Ok....just venting! I work at a facility that didn't have a DON for months. The last one we had lasted about 1 month due to his nasty attitude and numerous complaints lodged against him. During the whole time of not having a DON and the month we did have one we have had a supervisor of another department trying to run nursing. We contacted the BON about issues we were having including this non-medical supervisor who at that point was claiming to be the acting DON and the BON called the facility to let them know this was not legal nor acceptable. He backed off for a little while and now he's back at it only he's using the new DON to implement his changes in nursing policy and procedures. We have no way of proving this, but its apparent to us what he's doing. He has told many people at the facility he has major changes happening in the nursing department, but of course any memos or policies are signed by the DON with no trace of his being involved. He doesn't like nor respects nurses and has us doing menial (sp?) things that takes us away from our real duties as nurses. Its frustrating knowing there isn't much the nurses can do unless he slips somehow, which I doubt. I have been looking for a new job elsewhere since this all began with no luck, so basically I'm stuck there for now.
  9. LatinGirl

    Ever hear of such a thing?

    Thx for all the replies guys. I have been doing as I was taught in nursing school and documenting in black ink ignoring his new policy much to his dismay. @ canesdukegirl....yes he is really out of his mind on a lot of things. We showed him the nursing practice act to prove our point on yet another one of his crazy policies and he looked at it and said well that just has to be changed. We sorta just looked at one another and just shook our heads. He is clueless! Hopefully he gets a clue real soon or is replaced by someone who actually knows what they are doing.
  10. LatinGirl

    Ever hear of such a thing?

    classicdame.....we never put the dietary orders on the MAR until this new DON decided they needed to put there along with other things that have no business being on the MAR.
  11. LatinGirl

    Ever hear of such a thing?

    We discussed the point of the MAR being a legal document with the DON, but his attitude about it is this is the procedure and that's how it will be. I do not agree with him and so have been writing in the dietary orders in blank ink just like any other order. He said that nurses who do not comply with the way he wants it done are considered insubordinate. Oh well.....just will have to be insubordinate then.
  12. LatinGirl

    Ever hear of such a thing?

    Thx for your reply. I guess I just don't like the idea of erasing anything on a MAR.
  13. LatinGirl

    Ever hear of such a thing?

    We have a new DON and a new administrator at our facility and as such they are implementing new policies and procedures. Our DON sent out a memo last week informing us that the new procedure for documenting dietary orders on the MAR is to do so in pencil and when the order changes to erase and right the new order in pencil again. We have refused to do this and have called the BON for advice, but have not gotten a call back as of yet. This DON seems to think that his policies...not just this specific one, but all... supersede(sp?) anything the BON may say. What are your policies in regards to documenting dietary orders?
  14. LatinGirl

    Music Therapy in Psych?

    Has anyone had music therapy as part of treatment offered in their psych units? I work at a peds residential facility and have noticed that the kids tend to act out more towards the end of the day when there aren't any structured activities planned. I am trying to come up with some ideas to present to administration that will provide some structured activity for the kids and will also benefit them. I would love to hear your thoughts on how music therapy may help these kids or if you have any other ideas that work in your units I am open to suggestions. Thanks in advance.
  15. LatinGirl

    How Do I Handle This?

    Yes I am sitting in the front and we all have handouts on what will be discussed, my problem is when I am being asked to participate and am asked questions. Also I did not disclose during the interview that I am hearing impaired...didn't hide it either since I was wearing both my hearing aids, but wonder if they will have an issue with it now.
  16. LatinGirl

    How Do I Handle This?

    I started a new job...in orientation at the moment. Anyway because of my hearing impairment I am having a hard time understanding the speakers in orientation due to echoing in the classroom. Has anyone else had a problem with this? How do you handle it? I did tell a couple of the speakers that I was having difficulty, they just talked louder which seemed to make it worse. Any suggestions?
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