33-weeker

I am not looking for legal advice. I was hoping someone knew of a similar occurrence and could relate how it was handled. Anyhow, I did not work for 6 hours without accessing the computer. I worked for approx. 2 until I needed to give a med and discovered I couldn't get in. (I take very detailed report notes so I don't HAVE to access the computer a lot.) My coworker stepped in and helped me with the med, and my manager (who, thankfully, happened to be working late that night) helped me with the rest until staffing assignments could be shifted around and I could give report and leave. My director was aware I'd waited to renew. After being alerted by HR, she called me that Wed. morning to make sure I was doing it. I renewed shortly thereafter, and then I notified her it was done. There was no excuse for HR not to know.

I find it interesting how many people chose to scold me over this--people who know nothing about me or my life. My question was posed as more of a legal / policy issue. Because I AM responsible, I've never had to deal with this in all my 20+ years (nearly 15 of that with this employer). Yet mostly what I've gotten is berated and scolded. Sad. I'm typically a conscientious person who doesn't wait until the last minute to do things of this importance. I'm also a skilled nurse who has a good record with my employer and who is often put in charge. I'm rarely, and I mean RARELY, late or absent. The reason I waited was because of an unusually busy family life this summer and the fact I needed to do some continuing education first, so I wouldn't be lying to the BON when I checked 'yes' that I'd done my CEUs. Obviously, I won't wait this long again in the future. All I have to say is I'm glad I don't work for tyrant supervisors like some of you apparently do. Anyone who would formally reprimand or fire a nurse for renewing her license on time (according to the Board) and being on time an available to work her shifts is neither kind nor looking at the big picture. With the changes in healthcare and the difficulty staffing the units, you think they'd be a bit more understanding and willing to work with a valuable employee. A nurse I spoke with said that when this happened to someone she knew, the system paid her for the missed shifts because it was their error, not hers. THAT was the reason why I pressed the issue and brought the question to a forum. If you have any information of a legal or policy nature that can help me, please comment. If all you want to do is fuss at me, I'd rather you didn't. It's neither thoughtful nor helpful.

I was showing up as renewed right after I did it on a Wednesday morning. My shift did not start until Friday evening. I even notified my director once I'd renewed. There was no reason for me to be locked out of the system. I did my part before the deadline and with enough buisiness hours/days left that they should have been able to get it updated in the system.

For one, I didn't wait until the last minute. I renewed on the 30th of a 31-day month, and more than 48 hours before my next shift. I was unaware that HR was now outsourcing to a third party. As far as my manager not fixing it, HR is the only one with the authority to do so. And THAT, in my opionion, is the problem. They should give the OA the authority after hours and on weekends if the nurse can prove she's renewed.

The BON gives us until the last day of the expiration month to renew our license. I renewed my RN license on the morning of 30th and checked to make sure I was showing on the Board's site as renewed. I was. I printed out the receipt and notified my director. Two days later, I went to clock in for my 7p weekend night shift. The clock let me clock in. I went to the unit, took report (viewing computer chart data via the off-going nurse's log-in), and started caring for my patients. Later, when I finally had occasion to log-on, the computer wouldn't let me in. The IT folks said I was locked out because of an expired license and that the only one who had the authority to change it was HR. My clinical mgr. was as caught off guard as I. She'd already verified my renewal and, obviously, let me come to work. By the time she checked with the director and arranged for someone to take my assignment, and I gave report, it was after midnight. I'd worked roughly 6 hours. I was sent home for the weekend until HR could straighten things out. Apparently our HR uses a 'third party' to handle much of it's processes, this included. I told my director I wanted to be paid not only for the time I worked but also for the time I missed due to the error--someone else's error, not mine. Result: They are 'investigating it.' Has anyone else had this happen to them? What was the outcome? Are there any laws that govern this, or are we at the mercy of company policy?

I'm sure things have changed since I graduated in '91, but the way I got into a specialty area right out of school was going through an 'acute care women's health residency' that consisted of classroom and clinical rotations through areas like L&D, PP, Nursery I & II, Antepartum, Gyn, etc... Those of us who passed (there were some tests, but I don't think anyone failed) interviewed for the places we wanted to work and were hired into the various areas with a 2-year committment in exchange for the program. Except for taking a 10 mo. break doing Gyn (to get the shift I needed), I've worked in nursery ever since.

I'd like to add to this, as a neonatal nurse of 20 years, that thinking of PP patients as 'healthy' is painting them all with the same brush, and potentially dangerous. Yes. It's true. Most of them are young and healthy, but even those can turn into an ICU case at any time. New moms frequently faint, so they are an even a bigger fall risk that first time to the bathroom than the elderly. They can bleed out faster than you can say 'post partum hemorrhage.' They can have seizures, too, that compromise both them and baby. Not only that, many have chronic health issues like diabetes that must be monitored an cared for. Maybe choosing PP/FBC does limit your career options, but--just like newborn nursery--if you think it's all fun and games and easy, healthy patients, think again.

You know, I can see how that would irritate you hearing it so much, but look at it from the patient's perspective and consider OB care these days... Everything is so technical and specific- a test for this, a monitor for that. Heck, the patients are actually given a due 'date' and not a range of due 'weeks' (more accurate), and the doctor treats the due date like it's the holy grail and not the often-wrong, educated guess it actually is. Then, when labor starts, they come in and are hooked up to every machine known to man. Their contractions are monitored and their labor progress scrutinized -and often modulated with (unnecessary, dangerous) drugs (and I've seen experienced nurses control the time of delivery fairly well using that, too). I mean, the labor team acts as if they know every little detail about everything else. Is it any wonder the patients expect us to be able to predict the time of birth?!

I don't see that as such an odd question, unless they're truly wanting a specific time. Families get called to the bedside all the time because 'she's taken a turn for the worse and it probably won't be much longer'. I see it as asking 'hours? ...days?'. Not such an odd question.

Maybe I'm strange, but I don't mind 'labels' as long as the diagnosis is accurate. (I think the 'don't label my child' thing has become a cliche concept that people parrot without really thinking it through.) I see the label as a comfort, because it helps me focus on what I need to do to fix it or at least treat it. I was actually relieved when my first child was diagnosed, because it meant I wasn't a bad parent. Her delays did have an organic cause. [My parents had fussed at me for not reading to her enough (she wouldn't sit still for it) and my dad thought her delayed speech was because I let her watch Teletubbies.] My parents are educated people, but parents always seem to look for blame with their kids, because they continue to see us as 'kids' and not responsible adults. Anyhow... I've never hidden from my kids that they are dx with autism, but I also don't treat them like they are damaged or retarded or (pick your adjective). I love them and treat them like the smart, capable kids they are, and --while I try and plan for the possibilities of them having trouble or needing help later in life-- I try not to assume they can't do something or assume they won't achieve things in the future. I've done that easier with autistic child number two after watching the radical changes in number one and knowing I shouldn't judge their future abilities/functioning level by the present. I truly feel how we treat them is far more important than the effect labels have. That is what determines how they view themselves, not some diagnosis printed in some file. And I don't know about things there, but here, they must have a label to get certain services. It is the diagnosing that qualifies them for the modifications and therapies they need. So I say, bring it on. Call them 'purple polkadotted' if you have too, just help them and get them what they need. Regarding their dx, I don't say things in front of their friends (I leave that up to them), but I do mention it to other parents when appropriate. And I try to say things that give them a positive attitude in the process, too. "You know, we're real proud of [daughter]. It's hard to believe she didn't have any functional language at the age of three. She's come a long way since then." That comment is usually met with raised eyebrows, a look of pleasant surprise and an agreeing nod. The symptoms I saw were: extreme stranger phobia from about 4 months in the first child, then words without true communication followed by increasingly odd and aloof behavior and poor eye contact by a year and a half. The second child was better about trying to communicate; he just didn't have the words. But after a while, as the first one came slowly back out of her shell, he progressively became more 'Rainman-ish'. Though there are similarities, they each manifest their autism (PDD NOS, to be specific) differently. Hope this helps.

I disagree with the statement that the pedi is the best resource for getting autism diagnosed. In my experience, most are rather clueless when it comes to pinning down specifics like that. I am the mother of two kids with autism spectrum disorders (now ages 10.5 and 13) and I have been a nursery/NICU nurse for 20 years. I'll tell you about my experience and you can do with the info what you like. FWIW- I do think it is possible for a child to have global damage/impairment and also have autism . I babysat a girl like that once. (She had a rough time and low apgars at birth. My kids did not.) In Texas, a group called ECI (early childhood intervention) will come into your home and evaluate your child for delays. Although they won't diagnose, they will offer services/therapy and or suggestions as appropriate for your child according to their findings. Check your state's services. There is probably something like this available. Then, (in TX) when the child turns three, the school district takes over and you can request an evaluation. My kids got in under 'language delay/impairment' and were later evaluated by the school's team for autism, once the staff had time to see them in action and secure permission for the necessary testing. I was satisfied with their evals and did not seek an outside diagnoses, although I could have for $$$. (At that time, ECI and the school services were free. Last I heard, ECI now charges fees on a sliding scale.) I encourage you to see what's out there and make use of the services available to you. I personally never involved my children's doctor until after the diagnosis was made, then sought one who tested them for heavy metals and prescribed oral chelation (which I think helped). She also gave us medical waivers for vaccines (we don't vaccinate -- and don't slam me over that -- it is with much research beforehand and with our doctor's blessing.). I also involved a child psychiatrist to prescribe the ADHD and other related medications one of them needs. Anyhow, get involved in groups around you of other parents who've dealt with autism. They can be a fountain of information and support for you. And when it comes to stuff like this, NEVER take your pedi's advice as the last word or only word on the subject. They are smart and they care, but they are rarely that specialized. Seek a multitude of wise counselors, and all the parents dealing with similar things you can find. Good luck.

You know, on one level, I agree with you, and I realize this is an OB post. But I was in the hospital with my 6 yo son for 10 days - 4 in the PICU and 6 on the floor - a 45 minute drive from home, and that's NOT in rush hour traffic. I was the only one and best one to stay with my child, because he was critically ill and I am a nurse. I got to go home twice for a few hours during that time. My son has autism, and had shut down (verbally) due to the hospitalization, so I couldn't leave his bedside for long at a time. I was so thankful that they had a washer and dryer for us to use. I was so thankful that they had a snack and coffee area that even had danishes put there for breakfast - for the families. When he was in the PICU, there was even a fridge that people could donate homemade food for families to use ad lib and heat up. I might have missed a few meals if it wasn't for that. I had ridden in the ambulance from the outlying hospital in to the big med center and I didn't GET a chance to go home and pack for an extended hospitalization. Heck. I didn't even have my car. What started out as an ER visit for a 'stomach bug' turned into something we didn't expect. I don't like patients who give me grief and act like they are entitled to have the red carpet rolled out for them-- especially the 'career' public assistance variety, but everyone's situation is different and we nurses need to keep that in mind.

When I have a 'breast only, no pacifier' baby, I DON'T keep it if it is crying. I take it right back out if reasonable measures (diapering, swaddling, burping, holding for a few minutes, etc.) don't settle the child. I will take a little more time with the babe if mom HAS been nursing frequently and is really getting tired, but I don't just let the baby cry for hours on end. Sorry. Either you can feed it or you can ask me to feed it, but one way or another, it's gettin' fed.

:lol2::lol2::lol2:

RE: Why do they even bother coming to the hospital... The parents in question didn't plan to come to our facility. She precip'd before they could get to the FS birthing center. My side comments on homebirth and vaccines were made simply to elaborate on the point that I believe in parental right to choose and to encourage people not to 'go off' on such parents as these in the OP. I never meant to start a debate on those issues. Sorry. Bottom line - is giving the eye ointment with parents refusing, in a state where it is law, an act of battery?