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RNTEX, I got out of a contract for a large teaching medical center when I confronted the director of nursing and HR with my serious concerns about patient safety. Actually, lack of safety. I simply told them that I wasn't going to put my license on the line. That I felt completely unsafe to perform my nursing duties, then I stated examples. Then I asked them if I needed to bring an attorney into this. They, surprisingly, didn't even blink, they found my contract and gave it back to me right then and there along with a letter stating that I was released from this contract. I left that same day and never looked back and they never asked for a dime. It was also within the orientation period. It's not worth your license, or losing a patient, or the extreme stress. Good luck to you. Gather your facts, take notes, a present all these.

Several years ago, preceptor pay was 50 cents/hr, plus for the first couple of days the load was lighter by one patient. By the end of orientation, the new person should be caring the full load with the preceptor watching, answering questions etc.

I'm just used to charge nurses making rounds with the doctors answering questions and making requests that the staff nurse wants for the patient buts is tied up with another patient. Also, having as much info ahead of time when having to make phone calls, making decisions as far as assignments when new pts come in, knowing which nurses already have the heaviest loads etc. How report is done can really make the difference from a shift running smoothly or sheer chaos!!

With reporting at the bedside, how does the charge nurse on a 34 bed unit know what the heck is going on...how can this be a timely and safe way to do report? We use to listen to a tape recorder that the previous shift would report on each pt. This way the charge could take notes on every patient and would know what was going on. Report took only about 15 to 20 minutes. This bedside reporting and trying to find each nurse for all your patients doesn't make any sense to me at all!!!

when I was manager of a med/surg floor, if I heard from my staff that this happened, I would be talking to my supervisor and stating clearly that if I have to go through the chain of command, then so do they. As manager of my floor, they should have approached me first and then it would have been my job to explain to them the facts or go to the night staff and explain things there. We had a horrible administration at the hospital where I was manager...thank god the CEO and CFO got canned and all the rest finally have left...it only took a decade for the board of directors to get things in hand. Hang in there, you know what the truth is!!!

newtress, your boyfriend sounds like my exhusband who was with me while I was going through nursing school. He became so threatened of my new knowledge and capabilities that he actually tried to burn some of my expensive school books. He even tried to hide my homework assignments and notes from me. I had to out think him and protect all my paperwork/books until I graduated. He never learned to treat me equally, nicely, lovingly or with respect. I left him less than 6 months after I graduated and have never looked back. Abusive men want to control their women by intimidation, ridicule, threats among other measures always at the womans' expense. Again, please take good care of yourself. When our self-esteem as women becomes beautifully strong, no man can ever abuse us because we would never allow it. Stay strong and beautiful!!!

In home health you can also refer your social worker to go in and do an assessment...I would first refer to social services and then back the call made into APS. Also, I would notify the primary care physician of the facts and document everything. I'm not sure how AA works, if they would come in and try an intervention if a call was made into them?! If both these adults being mentally challenged, do they have case workers? If they do, perhaps a call to the state agency case workers could help?! I had one case where the patient was passed out and I found a bottle of pills spilled by an empty bottle of booze. I called 911 and it was reported to the police as an attempted suicide based on the facts. The police came out with EMS, took report from me. Based on all these facts the client was taken into the hospital, a pysch consult and detox rehab were ordered for the patient. Of course when he sobered up, he refused and continued on his unhappy way and ended up going to ER again, being placed in long term care where he died two weeks later. It's nursings job to assess, assist, report, treat, educate and document. By the way, it's none of my business, however, your boyfriend sounds abusive to me, not treating you with the respect that you deserve. Please take good care of yourself, abuse nevers gets better, it only gets worse. Best wishes and have a blessed Easter.

I remember my clinical rotation through pysch. I was in the locked admissions ward. The ward was patroled by techs that really acted like bouncers, they would take a patient down to the floor if they acted out. I was told to NEVER go into a patients room, to stay in the main hallway where the bouncers could see me. Towards the end of this rotation the charge nurse gave us 4 students, several patients that they thought could go for a walk outside on the grounds. I was assigned a male pt. The charge wouldn't let us review any records and didn't give report. So, we started to take these pts for a walk. My pt started to walk a little faster and faster until he was fairly ahead of us, when another pt said "I wonder why they let that fellow out? He's on suicide precautions!" As soon as this was said, my pt started running fast. I ran after him, just to keep my eye on him. About 5 minutes of running after him and totally losing him, I looked up in a tree and saw a human body hanging in a tree. I mean this person hung himself and was dead!!! I knew it couldn't have been my pt, not enough time to do that. I ran back to the group and then to the ward and reported the body. Had to take the officials back to the body and report what happened with my missing pt. Got back late to the school bus and my instructors gave me a U for the day, not because my pt got away or finding a hung body, I got the U for being late for the bus...I wasn't real fond of most of my instructors...they didn't have a lot of compassion.

smilingblueyes, I completely agree with you. I'll let you all know how the interview goes. I feel forarmed now more completely to ask key questions and to request a much longer orientation period...along with other requests/question to cover patient safety and protect my own licensure. Thanks again for all the input...I will let you know how the interview goes and my decision by the end of April. Thanks again!!!

I worked GYN surgeries for 10 years. The worst case senarios I saw were retroperitoneal bleeding and PE's...so of course, watch for changes in vitals, coloring, abdominal girths, and any unusual anxiety, SOB. Remind them often to do their IS, TCDB and ambulation tid.

mitchsmom, excellent suggestions! I checked out STABLE and printed it out along with all these concerns/ideas. All this info is definitely validating my concerns...I'm excellent at med/surg, home health nursing...however OB is a horse of a different color...and God forbid if anything went bad for a mom or babe because I wasn't fully trained and competent in this specialty. So, thank you all again for your valuble help.

sugglibumkins and rninwch, thank you for your great suggestions. Part of the orientation would be at a larger hospital with a much busier OB dept. I do have concerns about the patient safety under these circumstances, so thanks again for your input!

The nursing school where I went started with 50 students and by graduation there were only 22 left. They dropped out for various reasons, not passing, financial problems, too much stress, family problems etc. We also had a high % of students passing the NCLEX. Nursing school is difficult, stressfull and totally worth it in the long run...all you students, hang in there, and study, study, study. Good luck!!!

Hello all OB nurses, I'm flying out for an interview for a rural OB position in 2 weeks. They deliver less than 80 babies a year and the high risk deliveries go to another town one hour away. Orientation will be 2 -3 months. I want to be sure to ask the key questions. I feel comfortable about the general hospital questions. I really want to focus on what to ask about OB care, staffing, safety measures. So, anything that you could suggest, ie; those questions that you wished you had asked before accepting your jobs. I have a med/surg, home health background, no OB. My most important priority is quality pt. care and safety. Also, we're negociating salary so any input there would be appreciated. Thank you in advance for you assistance with this.

Creature, it's so easy for doctors to try and ignore or intimidate patients/families. That's why it's so important to always be the patient advocate...Hopefully your phone call into the office will get an order for some labs...Good thought...in the mean time, make sure your grandma is well hydrated and possibly a good calcium/magnesium supplement may help with the cramps. Soak in a tub with 2 cups epsom salts. Also, if the office doesn't return your call in a timely manner, take her to an urgent care center so they can give a second opinion and do labs there. If she is on medicare it shouldn't cost too much. Best wishes!!