HelloAgain

antepartum\postpartum 1:6 ante&post pt.without complication hello! antepartum is a complication the other guideline was 1:3 antepartum with complications but stable? what do these mean exactly? is there an awhonn book or site that can spell it out or offer some kind of print out?

Hello I do not think people are being too sensitive I have seen this particular person in full form and while she has made attempts to my face as well as behind my back I am not intimidated by her, I can clearly see that she ALWAYS has an alterior motive and I do not trust her or respect her. I do see her in action with others and if I am their I try to change the course of the conversation and offer the people in the room support and encouragement without actually saying anything honestly though if I am in the room she doesn't say much any more unless it is really passive aggressive - and she is good at that at this point I don't feel like i need to leave i do feel bad for the others that i have watched fall victim over the years

I would like to think we wouldn't put up with it but gee whiz it has been a long road there is somone else who isn't quite as offensive but equally rude and during one HR counseling I heard that she said "shouldn't 17 years matter for something" I was thinking yeah it should- you should be an example - an excellent role model - and taking the new nurses and anyone having trouble under your "wing" I wish I had heard her say that because I would have responded with those words! it would not have mattered to her I am sure Thanks for your response

A severe flaw is occuring when a nurse continues to behave badly to new nurses and old nurses constintly going behind other nurses backs to "report" something always instigateing trouble for someone and walking around like the own the unit WHY do health organizations that want a genuine change in culture put up with this type of bully? there have been enough complaints over the past 15years to fill a cabinet yet nobody has created an official paper trail for fear of retaliation:o even though she has been caught more than once in a lie or manipulation obviously this type of person does not represent any of the standards of conduct with their behavior The hospital has encouraged (strongly) in the past that the individual go to classes but the behavior is still there some say "she is getting better though" is it enough? this person has a license to terrorize and put on a great front for administrators there are people that avoid working with her because their day will be miserable if they work with her and their are persons who have stayed on night shift 5 years past their "turn" because they don't want to deal with her I have also just learned today that this person will be the new Co-chair in the hospital shared gov. ARE YOU KIDDING ME! this is the person you want representing your nurses and hospital! negative-instigative-arrogant-judgemental (i know that is what I am doing) :down:a serious flaw in the system!

A severe flaw is occuring when a nurse continues to behave badly to new nurses and old nurses constintly going behind other nurses back to "report" something always instigateing trouble for someone and walking around like the own the unit WHY do health organizations that want a genuine change in culture put up with this type of bully? there have been enough complaints over the past 15years to fill a cabinet yet nobody had created an official paper trail for fear of retaliation:o obviously this type of person does not represent any of the standards of conduct with their behavior The hospital has encouraged (strongly) in the past that the individual go to classes but the behavior is still there some say "she is getting better though" is it enough? this person has a license to terrorize and put on a great front for administrators there are people that avoid working with her because their day will be miserable if they work with her and their are persons who have stayed on night shift 5 years past their "turn" because they don't want to deal with her I have also just learned today that this person will be the new Co-chair in the hospital shared gov. ARE YOU KIDDING ME! this is the person you want representing your nurses and hospital! negative-instigative-arrogant-judgemental (i know that is what I am doing) :down:a serious flaw in the system!

hello all i have always assumed (no one ever told me) that my presence with the physician during a vag exam was to assist him but mostly as an advocate for the patient. i was recently told that my presence was really to protect the physician and if they didn't want me there that was the physicians loss and putting himself with no "coverage" that feels weird to me, i do not currently work with anyone i have any suspicions about them being inappropriate, their is one who insists on covering the patient comp. making only a tunnel for his hand.. i just assume he is trying his best to make the situation as private for her as possible.. however i usually hold up a bit of the sheet to observe as well and i think it annoys him... i have felt this was my "duty" to the patient. i guess i feel like the patient may be reassured by my gestures that all is well and that i am making sure the doc isn't being inappropriate... what do you all do? is their a law or rule? is it ok not to be present? if you are present should you visualize what you can see of the exam?

Hello Trudy yes I could have brought the chart with me but still I don't know that I would be looking at it I was literally sitting with her on the bed.. one hand on her one hand on her IV bag making eye contact with her while she was sobbing about her loss. we do have a clerk but they just put the papers under the right tab and hand it to the nurse, I have already addressed this learning moment with that clerk yes I plan to discuss this with the phys. simply (non aggressive) Thank you

Thank You all for responding I now it is difficult without knowing the whold story The order in question was a DIC panel ordered at 830AM in the ER and I recieved the pt at 1030am, it should have been done at 830 however I do accept some accountability for that had I reviewed the chart/put it together I would have seen that it was not done and initiated it but again I never cracked the chart open until 45min after the pt was on my unit because i was sitting on the bed with her until her pressures and appearance looked better. I was asked what I might do differently and honestly I would do the same, hindsight is great so of course now i might ask someone to put my chart together or check her records and ER paperwork in case there was something missed in report, but really we never do that pt first chart later- i still stand by that I am not a new nurse I am an exp. RNC that has been there longer than this phys. I do agree this situation was not ideal I would have liked to go through her records to know more as well but the situation would not have been appropriate for me to review the chart 1st. also this MVA pt just exp a tremendous loss and I needed to be ginger with her I sat on the bed assessing/bolusing as well as discussing POC offering support to her and her husband and allowing her to express her emotions as needed. 40 min wasn't really that long for all of that, I felt like she was in need of immediate care/action however I did not feel she was in dire straits or I would have called the phys. and asked that they come immediatly but I knew they would be there soon my charting was all done after the fact-the whole chart I progressed a couple paraphraphs on the situation (1hour) I have gone over the situation and I would still be with the pt initially however this phys putting so much energy into reporting me (going to my director/chief of staff/and planning to discuss it at the phys mtg.), makes me feel guilty-know what I mean? also if the phys. really was interested in pt advocacy they should have come to me immediatly so we could be on the same page with her care, but because she waited it feels "slithery" like she is trying to get me in trouble I have never had a review of my chart like this - sigh- I have a feeling that even though it appears that I have the support of my coworkers and managment at this point, they will also want to pacify the phys and show that action was taken.

Hello! Not with Mec? I think I did hear a doc mention that the other day less of a risk of meconium aspiration if we "rinse it out" so why are we advised not to now? Thank You

Hello All ok so I recieved a pt who was hypotensive and a little tachy, I sat next to her on the bed assessing her and bolusing her until she was stable enough for me to leave the room. that time was about 35-40 min the physician walked into the nurses station just as I sat infront of the untouched chart and asked for the records, I gave the records and we proceeded to the room to see the pt. I did not know all of the hx or the labs of this pt because I had not cracked the chart open yet later as my pt was stable and I came to the desk to work on the chart my coworkers asked what was up with the doc because they came to the desk and said they didn't think their pt was managed correctly and what woule "they" do .. and that I (the nurse)should have been watching the pt more closely instead of sitting around talking, the physician also said a clear lie about an assessment. Had i seen the phys. I would have asked them to come to me directly if they feel their pt is not managed appropriatly and not to question my competence at the nurses station, however they went home The next day my manager and director called me into the office to tell me off the complaint and that the phys. went to the chief as well and we would do a timeline and chart review. I am told my superiors that I have their support, but I feel awful about it the main complaint is that I did not have the info to report (labs,records-history) and an order was not initiated that was ordered while the pt was in another dept 2hours prior to me... that is all true however I felt ( and still feel) that the pt needed me in with her not as the desk doing the chart. I feel like the phys. should have come to me directly not spoke with my colleagues in a defamation tone and I feel like they are trying to get me into trouble intentionly This is a phys. that is notorius for being very rude with new nurses/students/residents and so I really wasn't all that bothered at first but then when I heard all the effort and energy she is putting into it I feel betrayed... and to say I didn't watch her close is frustrating because the phys. wasn't even there and I was on the bed with the pt until just before the phys. arrived. so no I didn't have the info from her chart to tell the phys. and I did not know about orders in the chart because I never saw the chart! I also cant believe the phys is reporting a different assessment then what we both saw (at the same time) anyway I am told there won't be disciplinary action, but I have never had my competency questioned and an official review with all my superiors and chief phys. of my chart and actions.. any advice? ok