tiroka03

I would be afraid too. Afraid enough to contact a lawyer. I would also be afraid enough to contact the next up in line, and anyone else you can think of in management. Keep copies, and make sure you leave a paper trail. I would start documenting, and blowing every whistle you have. Don't wait. That nurse by ordering a drug for you, I believe was meant to silence you. Then she went to the drug store and picked up the drug? That is pretending to be you as well. I would go to that drug store and talk with management as well. If this or anything else goes to court, they will eventually find you as well. Make sure the drug store knows what happened as well. Write to your pastor, write to anyone, and keep copies. Don't hide, you didn't do anything wrong. Get yourself a long distance away from her, don't even get in close proximity to she if you can help it. Make sure people aren't thinking that you and her are friends. Don't let her craziness rub off on you.

I agree with noyesno, when an employer assigns too much work, too heavy a patient load, and then one employee works off the clock, their co-workers are then expected to do the same. Management will say, "They can do it in 8 hours time, - why can't you?"

sometimes the answers are confusing in those reference books. I applaud any attempt to find answers.

Working nights, I take over carts from two nurses. When I get to work, they are whining about their jobs so loudly, it drives me nuts. Then they take their sweet time giving report. So slow. It puts me behind from the get go. I don't want to make enemies, but as it is I have no time for breaks or lunch. There is just no spare time anywhere. These nurses will follow me and whine, I suppose they think I feel the same, (and I do), but I don't have time for this. I just need to get moving right from the start. How do you deal with people like this?

I total understand this comic

Sorry it took so long to get back, The smell is sweet, yet kind of metallic, and very powerful. It isn't body odor. I will have to go look at his meds and see if there is anything you all have mentioned. I learned a lot from your posts. I will get back to you all later. Thanks again for all the info. He dosen't have any plants in his room. He isn't able to get up and stack anything anywhere as he refuses to get out of bed. We had him in the hospital once, and cleaned out the room really well, but as soon as he came back, the smell came too. I would really like to help. I know people are put off by the smell, and that doesn't really help him socially.

We have a patient in a long term setting. The patient is very clean, edges on neuotic he is so clean and everything has it's proper place,and the labels are turned just so. No Mess, not fility. Yet he smells really weird. We keep the door closed, because if you open it, the smell wafts out and nearly takes you out. I was wondering if it could be due to a fungus. Have you ever seen this before, and is there help for this man?

Eat? Break? Wow are you sure your night shift workers? I only work 8 hours, but on the off chance I get a break, and if I remember to bring anything, it's a 10min quick protein type snack. I own my own fledging buisness and after work, stop at Starbucks or Panera and get a coffee and work on my computer for a couple of hours. Then go home and I am too wiped out to eat, just fall into bed. This is an every day occurance, and I rather enjoy myself. Excercise - No, I walk a lot, our apartment building is 1 mile square to walk around, and .5 mile to walk one lap inside the building. To get the mail and back is .5 mile, to take out the garbage is a couple of (inside) blocks. To get to the business center is .5mile, so I am not looking for extra excercise. I usually take about 2 hours a week studying new things to improve my nursing, and again it's usually on the computer, or trying to figure out ways to improve my time spent doing different nursing activities. Which is good, and management loves to keep piling stuff on us lazy night shift workers. When I think I squeezed every spare second out of my routine, I usually find another 5-10 min daily savings every week or so.

I have been to the ER twice this past year. Once with my son, whose b/p was sky high and was starting to mumble. Turns out he had pneumonia. But, I am glad I was there. Some staff was really good, but some were so sloppy and didn't seem any more oriented than my son was. The Doc listened to his lungs and said, oh they sound ok, well, just before I took him in, his lungs were full of crackles and he had egophony on the left side. The doc said he's fine, you can go. Resp was 36. I asked for a 02 sat, can you believe they didn't even do that? It was 84. They finally took an xray, to find what I had already figured out, pneumonia. My son asked me to go with him on a follow up appointment, and that doctor listened to his lungs and said, "oh, there are some sounds in there" when I asked what the sounds were, she looked at me like she was inspecting a bug, and said, I said sounds, you know noises. I told her I had listened as well, and how the egophony was decreasing, and the crackles on the left were less, and there was polyponic inspiratory and expiratory wheezes, and was that what you heard? She turned in a huff, and the next person we saw was there resp therapist. The second time, it was me in the ER for my leg. I had sharp pains and couldn't stand on it. It was interesting to see how I was treated, as I didn't volunteer my employment. But, after being left in a hall way for 2 hours after an xray, while the nurse talked to several friends on his cell phone, and was rough and rude, I kindly asked when we were returning to the ER. I had wanted to see what it was like to be on the other side. One the ride back, I commented it was really different being on the opposite side of the w/c. You would have though I poked him with a cattle prode. He suddenly came alive, and for the rest of the stay, I was his new best freind. On discharge, the Rn was reading a generic form, and kept giving me cast care instructions, and I keep reminding her, I have no cast. But, that didn't deter her, from continuing. I had to stiffle a laugh when she told me if my toes swelled and turned black and began to dislodge to call back. I figured she was a lost cause. Good thing I was a nurse, she was pretty convincing and some people probably go home and check their toes frequently. I hope I never end up in a hospital, as this was one of the better ones in the area. I would be afraid to go to sleep. I am an lpn for 20 years, and hope I learned some lessons from both of these experiences. What it feels like to be helpless, and to depend on someone who wishes you were gone, and feels you are old and useless, and thinks they can treat you poorly. I pray God will keep me from those attitudes toward my long term residents that I face every day.

Isn't new management fun? Love being on night shift, because you aren't there to defend yourself. Eventually they will get to know you. But, I agree with you it is pretty daunting to have new management, and not to have met them. They can form all kinds of weird ideas.

dear spikey I do give the pills, however in this case, she wasn't even awake. But, don't play moral police with me either

There are some people I care for that like the feeling of being high, and they admit it. It isn't my call, but the doctors who prescribe. If they know the magic words, I give pills. Drug seekers do take up a lot of time, so I feel it's better to get it over with and give them their high. However, there are times a patient can have all the outward signs of a drug seeker and have actual pain. Is it my job to deciede, or the doctors. I don't really want to drug a person silly, what is it you do? The other day I worked hard to wake a pt for a scheduled med. Instantly and still slurring her words from sleep, she rattled off a list of drugs she expected me to fetch for her. I waited to see if she would fall back asleep, but she was instantly awake and mad for the 10 min. wait.

Good idea, I think I will try it next time I cath a larger women. Might save them a lot of tugging and leg propping. Thanks

I am sorry for your loss. But, I do know from experience you will be a better nurse as a result. You will probably have a soft spot in your heart for people who remind you of you dad. I know anytime someone reminds me of someone I love, I can't help but think of their feelings. It makes you a better nurse.

My daughter has seizures, the ones that you might stare for a moment, usually unnoticed by me, because they are so brief. But, she tells me during the time just before it happens, and during it, see will see and hear things that she knows are not there.

It is not fair to give a new nurse 2 to 3 days training, and hand them over the floor. But, that is how it is, fair or not. I am in the position to train a new people, as you will be too. I try to give them everything they need, and have a lot written down for them. But, unless you as a new trainee take home the things I give you, and unless you consider what you saw on the floor, you will be at a disadvantage. My advise is to study and organize you thoughts after every day of training, take a couple of hours each night and consider all you saw and all you did. Then on your first day, don't be surprized if you feel overwhelmed, so do a lot of the seasoned nurses you will be working with. I would be surpirzed if you didn't go home and cry. But try to realize it will get easier. But you have to think about your work day every night, and try to find ways to get faster. It is a shame there isn't more training, because you need it. You will find time to listen to lungs and bowels and assess things, but you have to do it when you see it, not decieded to come back later and do it, because later will never come. Develop your own method to remember what you found, so you can chart and report on it. Or, call the doctor if need be. I carry around a blank grid with everyones room number on it, and I have 60 residents to one nurse. I write in the grid people on antibotics and on incident, and then write in things I find during my rounds. Then I have a reference for charting and reporting. Then later after my shift, I white out abotics and incidents that are finished, and keep the ones, I need to check on tomorrow. It keeps me organized and I dont have to wonder if I missed something.

I agree with the above posters. However, I would add two things. First is to pick the thing that is most probmatic to you, go home and think about it. Research it on your computer, or on this site. The first year or so, you are still in "school" mode, keep up your research. The second thing I would suggest is to keep a small note pad or address book and write in it the answers to things that slow you down. Put in there all peritant phone numbers and expalin to yourself all difficult procedures. Nurse Betty's(like me) still have to do this kind of stuff ourselves. It is easy to think the old timers, like me, have got everything down by rote. However, procedures and machines change every other day. Fax numbers change faster than that. We have the added aches and pulled muscles you younger ones don't necessarily have. I look at you new nurses, and wish I was younger, more fit, and had your energy. I wish I had the lastest training out there. I have to make due with what I have. That is why I am constistanly retraining myself, looking up new labs and diagnosis and machines. I listen to medical podcasts on my way to work. I work as an LPN, in long term, on night shift, but I take my job seriously, as you also need to do. Here is a goal, try to shave off 15sec to 1 min off a particular procedure. From then on you will save that time every time you do it. The next day find a way to shave off another 15sec to 1 min. This saved time will add up, and soon you will be surprized at how fast and efficent you have become. One minute saved every time you do a gt tube will effect you in 5 or 10 mins a day, depending how many gtubes you do. The next day find a way to do lung sounds saving 30 seconds. The next day try to talk less and give meds faster. By the end of the week you will probably have saved 10 mins. After a couple of weeks of this you will have saved approx an hour each day. After twenty years, (like us old Betty's) it seems like we don't even work hard, but we do.

The port, and only the port. Unless, I just replaced the bag first.

I used to think everyone thought like me. So, I treated them with the same respect I thought I deserved. At some point, I realized you give them back the same respect they give you. So, if they are treating you in a harsh disrespectful way, that is the language they understand. I am not saying be disrepectful, but be more frank and harsh back. Let their attitude dicate yours. Don't feel bad when you are harsh and frank to some one would displays that attitude toward you, it is the only thing they truely will understand. You can work at relationship building at a later time.

I have been in that situation more than once. However, it's easy to forget about the CNA's position. They do get to know the prn meds. They haven't had the training we have gotten in school. They also are the people who deal with the patient more closely than us. She may be a gruff person avocating the best she can. I have had to tell more than one CNA the reasons I will not give the med they want given. If I can tell that it is a CNA trying to get out of working, and just wants to sit around doing nothing. You know let the meds babysit the patient, while the CNA reads a book or hides out. I save a special surprize for them, I initiate q 1 hour vitals until the "patients" situtation resolves. It is amazing how fast that will solve the problem. I have been also known to add q 15min checks if the CNA is really working it for all they have. Most realize I do want the pertiant data they see, and I will support them. But, when it gets to be every other pt needs a prn, I am forced to pull the same methods back to them.

The residents behavior needs to be charted and tracked, a psych eval done, and interventions placed

I have some insight to add. My daughter is handicapped and recieves medicare. I haven't been able to find a doctor who will see her. Well, thats not true, if you include ones who shouldn't even be allowed to place a bandaide. Last year my dtr was hurt at school, fx her foot. You have no idea the inferior doctors you will find. I was shocked and very dismayed at the level of doctors that would see her. It was awful. We did resolve it, finally, but to go to the ER because you can't find compentent care elsewhere I believe is warrented. I also work longterm care. I have 60 patients. If a resident becomes a 1:1 nurse care project, and it means I am not able to attend to the needs of my other residents, I call the doctor for help. Now, most assurdly there is no return call, but if I get an order to send someone out, you will not hear me complaining. I have no backup, so if I have to choose between a trach suctioning and keeping Mr. Crazypants from injuring his roomate, I have little choice. Sometimes the hospitals dump on nursing homes as well. I suppose that comes as a surprise to some ER people. We get people who are unstable and need a higher level of care than we can supply given to us under false pretenses. The EMT's drop them off drugged out of their minds, and when it wears off, we have a nut and no orders to control them. In reality, it is the system. Everyone is getting a bad attitude. There are just levels of care that each of us can handle. You in the ER get slammed with people who may not need to be there, and we get slammed with people who are above what we can properly care for. Neither case should be happening. Blame it on the politians. To make matters worse, I was in the ER a couple of days ago. It was really late, everything was closed, and my leg gave out from under me, I couldn't stand on it. I didn'tn want narcs, just to make sure I didn't fx it. I was in the ER waiting room for 4 hours, and I understood I wasn't a priority. Last year I brought my son in hardly able to breath with pneumonia and they pushed right in, in front of other people. His need was urgent. Mine the other night was not. I expected the urgent to go in front of me. However, as I looked out over the room, I saw a sea of people that were walking, talking, eating, laughing, and it wasn't possible to guesse what was wrong with them. I have to admit I was shocked. I had come in asking for the lower level part of the ER, and was refused, as I was too SICK. I felt really bad about being there at all, but that I couldn't even bear wt on my leg. Most of these people with the exception of maybe one or two weren't even sick enough to go to their doctor the next day. I needed to take care of my leg in order to get back to work on a timely basis, these people were either looking for drugs, or to get a little company. As a nurse I could understand your viewpoint. However, my discharge was from a nurse who gave me cast care instuctions. I had no cast. When I told her that, she continued to tell me how to take care of my cast. When I asked her to show me, my cast, she said, oh you don'thave a cast. Then continued to tell me to call if the cast became to tight. I understood this was a little nutso, and I let her continue, as there was no stopping her. She told me to come back in if my toes turned grey and started to shrivel up. Good night. I did get good care, but my discharge instructions could have been given better by one of my CNA's. So there are problems on both ends. There aren't any good answers are there?

I have had to struggle with this same issue. The latest word from my boss is to put what you have to in order to push a lab through, but then document onthe 24 hour report and ask for the code specialist to correct it. I am not comfortable with this either.

Don't forget to document on their behaviors. They may need a psych eval. I also write it in the 24 hour report, because repeated behaviors need to not only be documented, but followed up on by the doctor.

Many times what works for me, is to pullup a chair or to put a hand on their shoulder. I listen and validate their opions. I take the time at the begining of the problem to get them to know I will do what I can. This many times stops them from continual problems. I will let them know what my plan of action is, and how and when to expect it. I tell them I am a nurse, not a doctor and can't make the doctor write an order. I check in on them occasionally and give them updates or check on them. This seems to take a lot of wind out of their complaining sails.