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drmorton2b has 2 years experience and specializes in Sub-Acute/Psychiatric/Detox.

drmorton2b's Latest Activity

  1. drmorton2b

    Horizontal Violence/Gossip Vent

    As a male nurse I always thought I was immune to this. I am starting to feel it and become a gossiper myself. My goal is to stop this habit I am developing. Especially since I am now at a new facility and as always I am constantly reassessing my own nursing practice. I know people aren't perfect.. But when a few nurses are totally missing pages of forms and not signing it ticks me off because Information I need it totally missing. Because my job encompasses updating things (Kardexs, etc.). And I'm not writing a med or treatment without seeing the order. I don't care if you said you called the Doctor.. I need to see it in writing. This problem is starting to go away thankfully. Unless its standard admission or protocol order (example Epipen or Tylenol).. I need the written order... No writing it in the MAR or in your Nurses Note or verbally telling me doesn't count. Because if its not written so the doctor can sign it if something goes wrong every nurse who gave that med or treatment will get blamed for that error. You better believe in a higher power too if you don't have a written order and you do a med or treatment and the patient has a reaction to the treatment. Since you never wrote out the order. The Doctor who is much more likely to get sued and have a long drawn out medical malpractice trial will quickly deny he or she gave such order. I've been on 2 medical malpractice juries. One case took TEN years to go to trial! The Nurse will always be the first kicked out the door if it came down to a Doctor being fired and you being fired. They will always chose you. I no longer can get mad at these nurses anymore and bash their practice openly anymore..this leads to gossip (its so hard not to sometimes..) I have to figure a way to say no comment. I know I can't hire a spokesperson to be with me 24/7. Horizontal Violence exists in Nursing big time. I can see why they have done studies on this. A lot may have to do with the fact that its a bunch of women (sorry but its true go to any Scrub Store and looks in the mens section). and men of various cultures and backgrounds who deal and view with things differently under stressful circumstances that can be literally life or death. Also in some cases Doctors. Doctors sometimes get Doctor Rage when things aren't working out with their patient. I have never seen it happen but read about it and its similar to road rage. Its in some of the Suzanne Gordon books. I have done better at keeping my private affairs private. But I am sick and tired of this... I do my job the best I can for 8 hours and I go home. I don't care if I get a compliment or not. I don't care if you don't like working with me. I saved the same nurses who put me down behind my back quite a few times while they were asleep (I work nights always have and always will). Yellowing out a Med Order that if it was given would have probably ended your career. Or calling the insurance company waiting for hours for them to call back because you either forgot or were to busy fiddling around online and mismanaging your time. If I didn't get that auth we wouldn't have gotten paid losing the company $$$ and NO COMPANY likes when they lose $$ because someone didn't do a simple task to prevent this. I order all of your supplies. Filing your paperwork in the right chart. Find allergies you miss that are life threatening. I make your job easier. On top of this I do the same Nursing Duties you do. I come to work to work. They don't pay me to gossip or sit online all night. Just because I work 11-7 doesn't make me any less of a nurse. This is the solution to the problem I have been having with gossip. I try to ignore it and as long as it doesn't involve danger to my patients or lose of my job or my license I try not to care: -My goal is to provide the safest nursing care I can provide reasonably in 8 hours while protecting my nursing license at all costs. -To NOT gossip I need to stop. It isn't who is screwing who kind of gossip it mostly involves me bashing other nurses poor practices and it needs to stop. But I need to stop unless it involves a pertinent patient care issues (example Nurse A didn't get or do this then fine so I will tell Nurse A when they come back in the AM or try to rectify the problem on my own or with the oncoming 7-3 shift). Other then that I don't care how I was treated by another nurse. I need to learn ways to SHUT IT DOWN and prevent it from happening and snowballing. On a scale of Low-High I rate this a medium threat. I'm going to start going no comment mode and start saying so and so isn't here and it didn't happen on our time. I am just amazed at the lack of oversight and horizontal violence that occurs in Nursing. Its like I don't really care. No one can be trusted... Its like I'm a police officer at times and I have to worry if a suspect is going to try to do me harm (to my reputation). -Remember the 3 rules. 1. Does it affect patient safety? 2. Is my license on the line? 3. Is my job on the line/discliplinary action going to happen? If I answer no to all 3 questions then there is no reason to discuss it. Unless that other nurse did something that will affect patient safety on my time/into next shift I don't care. Lets talk about anything else except other people, politics, religion and sex. -I need to learn that I am no longer in administration/planning position like I was in my past job. I need to do my 8 hours tie up any lose ends before I leave and go home. I wasn't hired to be Miss America (or Mr.) and be everyone's friend. I will treat you with respect but I am tired of these games. I'm no longer sending out the Calvary to defend anyone via gossip except myself. Its always misconstrued and I'm tired of it all. So I need a Patriot Missile way to avoid gossiping a way to detect it coming towards me and redirect it and make it inert. Also go into no comment mode when it involves an issue that doesn't involve me. I don't really care that so and so nurse got eves instead of days. I have often wondered how Military Nurses handle things and I bet there is gossip. But they have a core mission saving lives of service members. Plain and simple. Plus pride people lack pride in their job with the exception of one older nurse no one has pride at my place. I never really cared that certain people don't like working with me. If you don't like working with me then well tough. I really don't care. My goal is to avoid drama and do goal # 1. I know I will always take flak as a Nurse or in any job. That being said there is no other job on earth I'd rather do. If I think of all the little things I have done for my patients just the last week alone that have produced positive results it far outweighs the gossip which I need to avoid. It needs to become a habit like exercising or meditation.
  2. drmorton2b

    Sympathy strike...would you do it??

    My union sucks because it is not a nursing union. Sure it's better then nothing. They get a a 2% raise then the union raises it's dues by 6.5%... and then non nursing disciplines totally tie up the bargaining. Some union is better then non. I am glad we can't strike... I can't live off of $50 a week.
  3. drmorton2b

    Is Becoming A NP Worth It?

    $125 an hour for a contract Psych NP here in New England. I will be an NP someday, as long as I have a steady nursing job to plan $ wise. I think nursing wages will go down slowly for the average floor nurse. We won't notice the pay cuts because they will come in the form of no raises and heavier workloads. Also I am tired of people confusing me the LPN as a NP, just like people think that because I am male I must be the doctor.
  4. Overbedding as it was called 20 years ago in my area we lost 4 acute care hospitals including city hospital which Ironically I work at now but not as a acute care nurse nor does city hospital in my city exist as it did. New industries will pop up. It's just foolish the dems are lawyering up. Provider Cuts are the same as benefecary cuts. Then again sick people need care. More utilization of sub acute/ home care and IN HOUSE treatment of medical conditions that most people would go to a walk in clinic are needed.
  5. drmorton2b

    Job Market in Boston?

    Bad idea the Boston job market is horrible.. I would stay where you are..
  6. Well as I see it we have the Democrats who want to raise taxes and do not touch social security or medicaid/medicare. We have the republicans who do not want to raise taxes at all. Its one big mess... I honestly don't think it will end that badly. Its still not going to be a pretty rosy picture for the providers though. Let the political machines work.. This is my last post on this matter. I am going to sit back and "record" this game and wait until it comes out in the newspaper who won. Its causing me too much anxiety. Its always the worse case scenario for me. We all as nurses unless we are Instructors, work with cash only clients any legislating related to healthcare costs and funding directly affects us first and other ancillary workers in facilities. This NYT article sums it up nicely: http://www.nytimes.com/2011/07/05/us/05deficit.html?_r=2&seid=auto&smid=tw-nytimes&pagewanted=all
  7. I think either way we are looking at more medicare and medicaid cuts to providers. The question is how severe the cuts will be. We are barely making it now and more and more cuts. No nurse is immune. I am going to go hide in a cocoon for a while. This deal still has a long way to go. not only does a deal need to be reached... it still has to pass the house and senate. This whole process will take awhile. I have researched this subject to death and none of the results Are consoling. Folks, all I can advise is to take things one day at a time, one shift at a time and pray if that's your choice that things work out. The dems say they won't support any medicaid or Medicare cuts. however I get the impression that only applies to beneficiaries. They maybe in favor of cutting payments to providers (us). I personally don't think the cuts will be as severe as we think.
  8. Looks like the day is finally coming... The day we all feared.. In all honesty I am too scared to write any more besides the fact that some how it will all work out.
  9. drmorton2b

    First day on your own?

    I like the idea of prioritizing the diabetics first. Maybe if possible mix that in with the patients on Digioxin and HTN meds also.. get their apical/vitals. Also have a list of the residents and room numbers and use that as your report sheet. Some places don't use report sheets if not develop your own. Make a blank one with the room numbers or just something to write the pt name. diabetic Yes/NO, etc. other notes. Prepouring meds is foolish unless you have 1 patient which wouldn't happen in any setting.
  10. drmorton2b

    Drooling secondary to Clozaril

    Very good post to the above poster.
  11. drmorton2b

    how to be invisible in nursing

    Don't say things like "I'm calling, HR, State, Compliance" or make a big deal about nothing..basically don't be sending the whole fire department to put out a non existent fire. Don't rat out anyone to upper management unless it can affect your license directly. Especially if you work 11-7.. you'll be stuck with the same person and it will be obvious who ratted you out. Sometimes bad things slip out. But when they do with me I keep it to a min. I may say so and so can't multitask and leave it at that. That is the worse I will say. I also have kept things more generic and I know who tells everyone everything at work so I don't tell them anything. I keep things simple the most I reveal about my personal life is that I have a girlfriend that is all I don't mention anything more then that. That way people leave me alone and stop trying to fix me up with their crazy friends. I'm under 30 and male. I think also its more of a women thing.. they tend to argue at times and the older nurses end up being like the mother trying to stop the fight...
  12. drmorton2b

    Skill level not high enough for acute care

    I think the OP met by LPNS being employed on the unit means that there is a lot more nursing support on this unit. This whole skill set is dependent on what one what the unit needs. I couldn't start an IV to save my life.. because I was never trained I work in psych sure I could take a $700 IV course. Sometimes its people not having common sense and putting patient safety first. Then again... each situation, unit, hospital and state is different. I find it funny that working in sub-acute or Long Term Acute Care (aka the dumping grounds of hospital ICU Patients) if your an RN doesn't count as med-surg hospital experience to some white coat nurses. It all depends.. whats funny is that the people deciding how much experience you need may have not worked the floor since Clinton was in Office. Some competency is needed though. This is why I wish I could take a seasoned older nurse with me everywhere I go if I worked in a hospital.. They have answers the the books don't have. Up here in the Northeast LPNs are gone out of most hospitals or "disarmed" meaning they can't do any nursing tasks like pass meds.
  13. I am curious how is 11-7 (I'm not saying it would be easy to do) at an LTC Facility. Long-Term Unit, no sub acute, no rehab. Plus if there is only 1 nurse on for the whole floor what do you do if someone codes? Yes there are 99 y/o patients who are a Full Code. I am trying like hell to remember how many nurses they had on over night at these places when I was in nursing school.
  14. drmorton2b

    Emergency Rooms in Boston

    Concerned about working at a unionized hospital? Do you have any idea how much unions have defended us nurses in MA. The issues with Tufts have been resolved look at the MNA Website. Also the job market is bad in the Boston area so I don't think one can be choosy. That being said congratulations on your new ER job. The only non unionized acute care hospital in Boston is MGH.
  15. drmorton2b

    Becker College

    Anna Maria is expensive.. the instructors aren't that good. Becker is Expensive also and the instructors will hold your hand.
  16. drmorton2b

    What are you best work tips?

    1. There is no easy job. 2. Focus on your current job.. until someone tells you to stop (you get laid off, etc.) or you find a new job. 3. Unless so and so tells you directly it is hearsay (example a Nurse said that another nurse from 1st shift said this about me). Basically unless someone tells you something to your face don't be getting angry and if the person does tell you something assess the situation. 1. Does it affect patient safety? 2. Could it cost you your job. 3. If the person is a non administrator then ignore them if you answer no to 1 and 2. 4. Be prepared to work.. if possible leave the cellphone in the car. If you have kids give them the #. 5. Don't trust anyone.. get documentation.. When giving a new med I like to see the order.