AMBOO

Hi! I agree with your post but as you can see the reaction you get when you call "chain of command" at my hospital you are in trouble either way, so you learn to live without someone to back you up and unfortunatley my floor supervisor is finding out what her great management skills are doing... we have 1 staff nurse left...three new RN's came to our floor and NONE returned!!!! As for leaving the patient without pain meds for extended period of time...I would rather know what little airway wasn't comprimised remain patent than risk giving another rx and risk another rxn. As you saw in my post she has multiple allergies and hx of vent, tachs...etc Also, when there is no MD calling back I can't give anything till a order is given, but that was just my nursing judgement and there were multiple issues.

I really need to vent ...my floor is going thru Major staff turnover and also trying to convert to a stepdown unit (by the way only 2 RN'S are ACLS cert.) the big dog management has been secretly asking what the prob is to floor staff and riding our floor supervisors to stay at the desk (there are 2 and one has to be avail-Always now) which is killing them b/c both of them come to work, clock in, and leave to take kids to school, lunch, airport, etc...whole other story...anyway, to say the least they are stressed b/c they know they are being watched "from above". So, yesterday I had a pt that from am report was told she is ESRD, Diaylsis pt M-W-F, IDDM, etc...allergic to 36!!! diff rx...and has been put on a vent/trach'd 2x's d/t these severe rxn's..well she is currently on PCA MS 1-6-30-4 lockout during the night she swelled up , SOB, tachy, etc...DR (primary)was called and said to consult pain mgmt DR....no order given to d/c PCA so I go and check w/RN what is left "9" pt tells me how horrible she feels and hits button again about hour later now her skin is light purple on neck, face, etc I give Benadryl...and hold onto epi..page DR at 1300-no call back page again 1325-no call back 1350 call office and speak with nurse "haven't heard from all day" my ? who is covering ? Pt calls house superv tells her I won't give her PCA RX...at end of shift call me up to write me up for having negative attitude with pt!!!! I tell her whole story above and she tries paging dr.. duh no call back either...so she says I can't just take her pca away(I just shut it off) with a rxn like that and no DR CALLING BACK WHAT SHOULD OF i DONE????? I cya big time and left report with floor sup..and I really don't want to go back I am sick of this one way street...I am debating wether to go in tommorow...husband says "quit" but what do ya'll think? :imbar

I personally use the Nuk nipples and send every baby out with both kinds and let the parents pick but that is just my prefrence b/c they look and feel softer than the generic hard straight nipples. Also, we had a baby with cleft lip/palate and he didn't do good with the long nipples and did really great with the Nuk......everybody does their own weird habits and this is mine!!!!: