OrthoNutter

We have a similar thing going on for a couple of hours during the day shifts at my hospital, provided by the Red Cross. They're all volunteers, they don't get a dime for doing it but they all love the interaction so all we are free to get on with doing things which, to us are far more important, even if the patient may not agree. And because I'm not getting paged by the patients every 2 seconds to do flower arranging, toenail painting, application of makeup or providing cups of tea not only for the patient but every relative as well, I find it a lot easier to fulfill the customer service aspect of my job (ie smile and nod politely in all the appropriate places and mind my p's and q's). I only wish that they were on staff 6-10pm!

I went to ICU straight out from graduating. Spent the first six months of my nursing career bewildered, confused and utterly lost. I was supposed to have a 6-8wk introductory period as well but they were short-staffed and to management, a body was a body so we got thrown in the thick of it. My time management skills, which were used to a 6-8pt load went right out the window in my time there (I'm sorry if this offends ICU nurses, but it is a lot easier to for me to co-ordinate care for 1-2 very very sick pts than for 6-8 less sick pts). ICU terrified me but I'm proud to say I survived my stint there and still go back occasionally, when staffing needs necessitate it. I'm MUCH happier where I am now though (ortho, in case you hadn't gotten that).

In a perfect world, I would agree with you. I'm one of those lucky people who can work whatever shift and still do my job. I don't need to sleep on nights....sometimes at 4am my brain gets a little fogged but I find the best thing to do is go outside in the freezing cold without a jacket. That usually wakes me up. But I digress....lucky me, I work for the state. They give us NO choice when it comes to shifts. You either work all three on a rotating roster or you shift your keister to the private sector, which incidentally pays less. Money is important to a lot of people, so even though it may not suit their body clocks to be working all sorts of shifts, they do it for the differential and the public sector award pay rate. I continue to work public because I couldn't live on a part-time wage if I worked in the private sector. I'm just lucky that I can cope with the constant "back and forth" nature of a rotating roster.

You evidently haven't worked with some of the acute medical patients that I have. One pt I recall was on 80u Actrapid TDS with 120u of Protophane at night. Sounds insanely high, but that's what was required to keep this patient's glucose levels in the "optimum" range. No it's not a "regular" dose as you put it, but for some people, it's normal for them. Yes we should all be smart enough to know what is normal etc but mistakes do happen and I personally would rather cover my own backside than lose my license over a med error that could easily have been avoided. I respect your abilities and all that (as I do all of my colleagues until they prove themselves incompetent), but I'll have to agree to disagree with you here. It's not THAT stupid an idea.

The only meds we do not double check are oral meds, excluding the anti-coagulants and steroids. They too, must be double checked. Anything IV, IM or S/C MUST be double checked, regardless of whether it is a narcotic or not. Personally, I don't mind. The number of times on night duty where my mind is not completely at work, another pair of eyes has saved a patient as well as my license. It is so easy to make a mistake, so why not exercise a little caution when it takes so little time to do?

How does that work?? I'm starting to feel very technologically deprived here in Australia. We don't even have Pyxis! lol

When do you get time to do that? I have trouble fitting everything I have to do in the hours that are in each day as it is, let alone writing to someone every time they posted something that annoyed me. :chuckle

I apologise to all those who cringe at my typos and elipses....haha...I love knowing that what I do has a name. I have to say when I visit this board it's generally before night duty or after an evening shift. My brain is usually putty by then...I make typos, sometimes I even make (God forbid) grammatical errors and I put my punctuation in the wrong place from time to time. Sometimes my brain is thinking so fast....and I know you people who have a hot temper like myself will identify with this....that my fingers just can't keep up. But I really could not give a rats. I can advocate for my patient...I can interpret handwriting FAR worse than my typing at the speed of lightning...I can communicate with all the doctors of non-English speaking backgrounds in order to get the best care possible for my patients. My professionalism, or perceived lack thereof, does not come across in how well/poorly I communicate on a BB....it comes across in the way I deal with people at work and how well I do my job. And in the end, isn't that what really matters?

I hear ya....when they float me to OB....not being a midwife....all I do is make beds and answer phones....they won't even let me do the vitals because they always have to go back and do a foetal heart rate as well so according to them, it's a waste of time me doing the others. So I sit back and collect my RN paycheck for doing the work of an AIN/ward clerk.

Again, I have to ask....how does this happen and people not realise? I'm assuming that these syringes are like the pre-filled Clexane (enoxaparin) ones we have here...but even so, the syringe is enclosed in packaging so people would know if it had been tampered with. I'm assuming that the same precautions would be done with pre-filled narcs or how would you know that you were giving what originally came in the package? We don't have any narcs in pre-filled syringes in my state. We have to physically go to the DD cupboard and sign the ampoules out, break the suckers and draw the stuff up. It's not all that time-consuming that I would see a need for pre-fills. All our narcs are checked by two nurses and we count each time the cupboard is opened. Maybe we're just more strict in our practice here....but this is just not an issue where I work.

How do you do that with a glass ampoule???

Considering some of the people I work with, I don't think it requires much intelligence at all. In fact, I'm beginning to doubt that you even need common sense either. :roll Forgive me folks, a large number of my colleagues are excellent to work with and could probably beat me in the brains department any day but sometimes I have to wonder where management finds them! Seriously though, I don't think you need to be an Einstein. Common sense will take you a lot further than Einstein intelligence any day in my book.

I never wear gloves when starting IVs or taking blood because I too, can't feel the veins properly, especially if they're a hard stick. My thought is that gloves are not going to protect me from a needlestick anyway...it's not like they're made of industrial strength steel. But for all other jobs, the gloves are always there. A pair always lives in my pocket "just in case".

Hell yeah....I think that theory is a whole heap of stinking, messy code brown.

I don't see what the big deal is here. Sheesh....part of the appeal of doing travel work or agency, per diem, casual pool whatever...part of that is because no one tells you what to do. I'll be switching to that next year myself and if I find anyone telling me "oh no you can't have every friday off because nobody on the FTE staff does", then they can just kiss my sweet (_|_) !!! lol I agree with sleepy...no fault here...except with management as per usual!

Maybe but would you want to put your bits in it??? I know what that stuff does to my mouth....lol

Our hospital policy is that an employee's full name must be displayed at all times on their tag. You don't like it? You don't work there....simple as that. That's what I was told after my manager pulled me up with a black sticker plastered across my surname. I've had ex-pts look me up in the phone book and call at all hours of the day or night. I've even had them camped on my front door when I get home and had to call the police to have them removed. Admittedly, these pts all seem to have psych issues and the general pt population probably couldn't give a rats about where I live or getting my phone number. But the nutcases are out there and one of these days....something will happen, if not to me then someone else. So now, I don't have my sticker on my badge, but it stays firmly tucked in my shirt pocket where nobody can see it unless I need to show it to them..

I fell pregnant unexpectantly two years ago....didn't have the $$$'s to leave work so I continued to work on a busy med-surg ward. I miscarried when I was 6wks pregnant because an elderly demented pt kicked me in the belly when I tried to help him up from the floor. In a way I'm glad that the pregnancy wasn't planned because I can tell myself that it wasn't meant to be. But if I had planned it....I'm not sure I could have gotten over it. Please be careful....look after you and bub...don't let management bully you into looking after pts that could compromise your safety. Hope all goes well for you!

Good luck ruffhouser! May the force be with you! :)

There's one ward that I get pooled to frequently....most of the staff are usually courteous and appreciative of my help. But there's one nurse who always acts like she has a broomstick shoved up you-know-where. I asked her how a patient was being mobilised....I had been on holidays for three weeks and it was my first day back on a ward that wasn't my own. Moreso, I wasn't familiar with the pt diagnoses that I was looking after. So here I was, no clue but trying to help out as best I could and she told me to ask the patient. I told her it was pretty obvious to me that the pt was confused so that would probably be a waste of time. She told me check the care plan. Told her the care plan hadn't been written up for a week so that's why I was asking somebody. She storms over to me and says "for F&*^s sake, can't you use your f*&^ing brain? Use a walker, wheelchair, like I give a f&^%ing s&^%" I just shoved the chart in her hands and told her she'd just upped her pt load by six because there was no way I was going to stick around and cop that kind of abuse from staff. I went back to my own ward and phoned the manager and told her I would never pool to that ward again if that nurse was on shift. For a change, the manager was sympathetic to my cause and told me that the other nurse was frequently hostile to poolers and agency staff. That twit, who is a charge nurse, shot herself in the foot because the managers refuse to supply her ward with agency or poolers now because of her attitude towards them. I just feel sorry for the regular staffers on shift with her because they are really nice people and deserve to have a decent pt load but unfortunately, they end up wearing the extra load most of the time.

You are kidding right???? We just have an obs sheet (or flow chart), nursing care plan (tick and flick kind of thing), med chart, fluid order chart, maybe a fluid balance if they still have IVT going, and an admission/history sheet. That is it....we're supposed to put in a manual handling sheet but because that's incorporated into the care plan, hardly any of us ever bother doing it. Why document something two, three, four times?? I guess our admin people are a little bit more understanding of unnecessary double-documentation.

Urgh...I will never date a doc again. I was living with one up until a year ago and he was sooo demanding, not to mention, we worked at the same hospital and he was always wanting to talk about cases at home. He didn't understand why I didn't want to relive every torturous moment of my shift at home. lol The other thing that bugged me was that he was allowed to do as many hours overtime as he liked but if I was a few hours late home or I hadn't cooked anything because I just got home myself, he'd storm out of the house and get takeaway. Never again would I date someone I work with....except the physios and resp techs....hehe...I could be swayed on them.

Shannon....when you've been there quite a bit longer than a year, tell me how much you love it then. I did medsurg for three years before escaping to Ortho....sadly things aren't much improved here either on our really busy days but fortunately those really busy days aren't every day. Still I've booked my ticket out....because things are only going to get worse.

I'm definitely going with the Star Trek theme....and hey...what about that thing in Lost in Space....completely automated medical treatment holographical model complete with defibrillator....there could be a robot that dispenses pills and takes care of the basic needs of the patients. Then we wouldn't need nurses or doctors at all....leaving us free to cruise the Carribean. If there was a problem, the robots could just page us using ESP...lol

When I was in my graduate year, I worked with a nurse in ICU who frequently turned up to work, not just drunk, but also high on pot and ecstasy. We reported her to management time and time again. They did nothing because they claimed there was insufficient proof that she was a habitual user, even after a positive tox screen came back on three separate occasions. I followed her after she did night shift and she'd been looking after a dementia patient who'd been brought in with hyponatremia and hypokalemia. She couldn't understand why her numbers weren't coming up, despite multiple flasks of IV fluids w/KCl. If anything, her numbers were dropping and she was starting to have runs of VT. When I was doing my bed check, I noticed that there was a lot of fluid in the floor and this nurse said the patient was constantly peeing all over the place and she wasn't going to clean her up one more time that shift. That to me was odd because the lady had a catheter and it seemed to be draining a reasonable amount of urine, although concentrated. When I turned the pt over to wash her up with another nurse, I found her IV line was not connected to her. The bed was absolutely saturated and there was no way it was pee. Now, I would be prepared to believe that the pt pulled her IVC out but the bung was in and very securely. Plus, the IV line never had its safety cap removed. When I raised this with the nurse, she said the pt must have taken off the IV line and replaced the safety cap. PUHLEEEZZE!!! I reported this to the unit manager pronto but again, they did nothing. They said that no one was hurt because of this girl's actions because the mistake was caught in time and that they were encouraging her to seek counselling for her problem. I asked whether the nursing board was going to suspend her while they investigated and they said that they hadn't even contacted the board about it. I phoned them in my lunch break and that nurse had her licence suspended indefinitely. I'm sure she knew who it was that tipped them off but I didn't care. She was a liability and I was sick of management covering for her. She got what she deserved. As far as I know, she still doesn't have a licence.