Lakeshore18

Recently our Nurse Manager informed the nursing staff that we were now to conduct our shift report using certain "scripted" parameters. Basically, we are to wake patients up, conduct shift report at the bedside, include he patient in the process by giving him/her the opportunity to ask questions and add to the information we pass on to the oncoming shift, check all patient orders on the computer and then conduct a brief"physical exam" of the patient with the oncoming nurse. There are certain scripted things we are to say as well. For example the nurse going off shift is supposed to say: "Good morning, Mr. Jones. I will be leaving shortly to go home to my family. This is Sally and she will be your nurse for the next shift. I have known Sally for 4 years and she is a fabulous nurse with excellent clinical skills. I feel confident I will be leaving you in good hands wth Sally as your nurse!" After this, we are to continue on with the above outlined report, conduct the mini physical exam, check the orders in the computer and give the patient the opportunity to give feedback during our report. Generally we each have 5-6 patients on our very busy cardiac monitoring unit and our shift report is 30 minutes long!! My colleagues and I are at a loss to figure out how we will accomplish all of this in 30 minutes! I am all for including the patient and allowing them to give feedback, but I fear shift report will now take so long we won't be able to get all our work done! And what about visiting hours? Shift report takes place right in the middle of them at 7pm. Now there will be visitors for both patients adding their comments as well. In addition, I am uncomfortable giving my opinion about the skills and expertise of the oncoming nursing staff. We are expected to stick to the script and give positive reinforcement about the capabilities of the next nurse coming on shift. What if he/she isn't a very good nurse or has poor clinical skills? Am I supposed to lie to the patient? And if I do, won't I be undermining my own credibility? Does anyone else think this is a little over the top?

Many moons ago I worked in a large teaching hospital. We all dreaded July 1 when the new crop of very green interns made their appearance. Second week of July, new intern writes orders for his new admission and remembers hearing his resident tell him to write prn orders for anything that could possibly come up so the night nurses won't call and wake him up. He was totally shocked and annoyed when I called him cause his patient wanted a sleeping pill. "Check my orders..... I already wrote for something to help him sleep" he says in his most annoyed voice." Yes, you did" I tell him "but are you sure you really meant to order MOM 300 cc po QHS prn sleep, cause if I gave that, sleeping would be the last thing the patient would be doing!!" Not to mention this is not the correct dose for this med! Of course he didn't believe me, the lowly nurse, and had to check with his resident before changing the order! Lol

In New York State, as if 12/28/16, when the NYS Health Commissioner declared influenza to be "prevalent" in the state, we have no choice. You either get the vaccine or wear the mask in areas where patients are typically present. I always get the vaccine, so I have no problem with it, but I notice many colleagues wearing the mask this year. One of the ID docs I know ALWAYS wears a mask in the ED, regardless of the time of year! I don't 100% agree with the mandate for wearing the mask if you haven't been vaccinated, but that's the rule so we all have to abide by it or find another line of work.

I never lend my bright orange stethoscope, which is ALWAYS looped around my neck, to anyone I do not personally know! And when I do, I usually look them straight in the eye and say with a smile, "if you don't come back in 5 minutes with this, I will hunt you down like a dog!" Usually they laugh, but they always come back with it! And I would NEVER allow anyone to just take it off my neck and breeze out of the room with it. That's just rude.

I hate it when adults use cutesy or baby terms for bodily functions as in "Could you please give my mother the bedpan because she needs to go "cocky." I kid you not....a grown woman, who was at least 40 years old, came to the nurses station and uttered that statement! And she said it with a straight face! My colleague and I were laughing our heads off as we went into the room. As far as difficult to pronounce words go, paroxysmal atrial fibrillation, atelectasis, empyema and exacerbation are a few that some nurses on my floor have trouble pronouncing. And I could probably retire by now if I had a dollar for every patient who asked me for some Ty-nol instead of Tylenol. That drives me nuts!

After reading OP's account of this incident, two things struck me. First, I'm surprised that OP even heard anything after MD told her that she shouldn't even "speak" while he was in the room! Really?? 1950 called and they are looking for their lost doctor. I would have been doubled over with laughter after that remark and I'm sure I would have missed most of his rant. Second, what the heck was the charge nurse doing while all this was going down? According to OP, charge nurse witnessed the entire incident. In my opinion, most of this could probably have been avoided if the charge nurse would have taken CHARGE of the situation! Perhaps something like, "Dr. Snowflake, I see you are a little upset over something that happened in your patient's room with Nurse Nancy. Why don't we all step into my office (or the back room or any other more private venue) so we can discuss it without interrupting patient care?" That might have taken the wind out of his sails or at the very least, taken them away from the eyes and ears of the other staff, patients and visitors in the area. Bottom line.... MD was wrong in what he did, but OP should not have yelled back at him or pointed her finger at him. While she was attempting to stand up for herself, she displayed the same poor behavior the physician did. Both displayed unprofessional behavior and each owes the other an apology. And maybe the charge nurse should attend some conflict resolution seminars because she missed an opportunity here to head this off at the pass.

Take a bit more time to hit your stride, Flustered. I am an RN with 30+ years of nursing experience, including 15 on a very busy telemetry med-surg unit. There are days when I feel exactly as you do! We are caring for sicker, more complex patients on these units every day. It will take you much more than 3 months to feel comfortable on such a unit since you are coming from a job where you utilize such different skills. Additionally, I hope whoever supervises the nursing preceptors in your hospital gives you an opportunity to critique their performance as well. They need to know that your preceptor wasn't the best one for this job. Hospitals spend a lot of money training new nurses and if your experience is typical for this particular preceptor, new nurses to your unit will be leaving in droves! Good luck to you!