scrubs12

Thank you, this is basically what my manager said re immediate use compounding- adding epi to BSS or 3L saline bags. About clear as mud when the BRN says no RN shall compound drugs but the updated 797 implies we can (???) and of course all the managers and surgeons want us to compound for them.

This is an old post but would like some clarification. If RNs are not allowed to compound meds why would it be OK for OR RNs to still mixing "certain things things that the OR staff has always mixed"? I work in the OR and was "trained" to mix local medications, add abx to irrigation, epi to BSS and just am now realizing that is NOT allowed. Had a recent conversation w/DA who was unaware... I plan to refuse to compound any meds from now on.

thanks for the comments. the dangerous co worker is a RN. some surgeons have written him up but still get stuck with him and gave up, only a couple of surgeons (directors) have him banned from their rooms and have been successful. our ADA actually has to help him on a regular basis- ADA prepping, foley insertion, trouble shooting as he watches. ADA documents it, has meetings with the DA and HR but he is still here! management's rationale is b/c this dangerous RN's incompetence hasn't resulted in a patient being harmed! ***! that is b/c we ( the rest of the staff) step in to prevent it. there is no way anyone of us will just stand there and watch a patient get harmed, hence no patient harmed, hence- he is still here according the mtg! have no respect for mtg after they said this. once, a scrub actually had to break scrub to telephone for help b/c the dangerous RN just froze when surgery suddenly went bad, the surgeons were asking for other trays asap, blood to be ordered, etc and he can only process one. thing. at. a. time. and. it. must. be. repeated..... ticking time bomb. another RN was sent to "help" while he just stood in the corner being useless. regarding documenting conversations with management- how do i do this? usually, we write the dangerous rn up and give it to mtg but they never get back to us unless we specifically ask, but they never give an answer, a plan, their progress... nothing. do i make my own personal documentation to turn into the DON- ie. spoke with xxx DA regarding complaint filed on dangerous RN. no answer given..... i would appreciate some pointers here:) thanks.

i work in a large unionized hospital in the OR dept in the evening shift. we have a co worker who we (nurses, scrub techs, surgeons) believe to be a dangerous nurse. he is unable to provide safe patient care without constant intervention. no one feels safe working with him in the OR setting because he is: paranoid, has tunnel vision, unable to multitask, freezes- literally freezes, lies- incapable of admitting any mistakes, cannot prioritize, unable to function at a basic novice scrub/circulator nurse level in the OR without calling the charge nurse for help repeatedly during a single case, fails to anticipate and act quickly when circumstances change- ie laparascopic to open... he has been in the OR for over 10 years, this is his second career- sued his first career employer for $$$ and was paid to be trained in this career. he has been on/off of workers comp multiple times for extended periods of time for questionable injuries ( he has his own doctor), accused co workers of threatening him, for discrimination.... we ( even surgeons) have individually written him up multiple times, we have spoken with our DA's multiple times ( they are scared of him and/or don't care), nothing is done and we suffer- emotionally and physically. morale is extremely low, we fight each other about our "rotation" with him. its so difficult to describe what environment is like- you are forced to do his job as well as your own for the patient's safety all the while feeling paranoid that he is setting you up for another workman's comp claim or lawsuit- said he was choked when getting gowned up, ran and stuck his foot under an empty gurney and claimed injured toe, brushed against a coworker holding surgical equipment and claimed that person hit him with said surgical equipment ( didn't notice there was a witness).... we've even discussed getting a petition refusing to work with him for our patient's safety and our personal safety/license. we've discussed obtaining a lawyer because our supervisors are aware of the situation but unwilling to do anything. suggestions other than getting another job?

i recently took over in a laparoscopic assisted mini laparotomy case. colon was brought out via mini laparotomy opening to create the stoma. only laparoscopic instruments were used inside the patient. no other instruments were placed inside the pt. instruments were not counted. i've received conflicting opinions from fellow nurses, some say instruments need to be counted for any and all laparotomy cases, including mini laparotomy. others say instruments do not need to be counted b/c it was a laparoscopic case and the bowel was brought out, nothing went inside the patient from the mini laparotomy opening. should surgical instruments of been counted for the mini laparotomy case?

hi all, i have burning questions about getting RELIEF! please let me know what is the practice in your hospital! End of shift relief: the last 30 minutes end of shift in the OR. i work in a unionized hospital in los angeles. we have staggered shifts but the majority is 700-1530 and 0700-1930. this question is not addressed in the union book. we are expected to be dressed (in scrubs), clocked in and ready by 0700. relief nurses are expected to to be the room by 1500 or 1900. there is a 30 minute overlap for what i believed was used to get report and for the outgoing RN to change. a fellow nurse complained b/c she did not get a pm break. i grieved it to management but they came back saying that she was relieved at 1510 and so had time to get her last break before the end of her shift! Lunch relief: how many hours do you have to wait to get lunch relief? sometimes we've waited more than 6 hours to get a 30 minute meal break for an 8 hours shift. again, union book does not address timing of the meal break. california labor law is vague about it. Inservice relief: inservice is 1xwk at 0700- am staff and 1400- pm staff (1500 start). surgery starts at 0800 for inservice days. relief rns ( 0900 and 1100 start) often times do not get a chance to go to inservice b/c they are still giving afternoon breaks to the am staff. this is a known issue but management isn't doing anything to make changes for relief rns to attend inservice. what is the relief practice in your hospital?

i'm so mad and frustrated from the constant bs from tenet- california's evil hospital corporation. 2 years ago i was hired for a dou/telemetry floor- ekg and acls training and certification required. not long after, when all the talk about safe staffing ratios from title 22 came buzzing around, they (administration) started to say "well, its more of a med/surg floor" but yet we are still required to keep up our acls and about 30%+ on average are on tele. yet again, one of our regular night nurse got floated tonight to a stepdown unit while other "med/surg" rns on a different floor aren't allowed on step down yet they routinely remind us we are "med/surg". and the med/surg nurses that get floated to our unit get all the lightest load and we end up with the heaviest. everytime i ask- why do we need acls if we are "only" med/surg- i never get a definite answer. so let me ask all the nurses here, b/c i am a fairly new nurse, and so maybe i'm blowing this all out of proportion, but does your med/surg floors require acls??? what the heck does DOU/tele stand for? thanks for letting me vent. and yes, i'm looking for another hospital... sad, b/c my co-workers are the best. otherwise i'd of left long ago.

is there such a thing? i'm posting because lately, i've been having more bad days than good days. can anyone relate to this: i love (most) of my co-workers and patients- even some of the psychotic high maintenence ones but hate the hospital/management in regards to nurses??? all they seem to care about is customer satisfaction polls- but how can they expect so much although while cutting staff left and right? i had my doubts working in any tenet facility (based on this website and from others) but i took the plunge at usc university- cutting edge technology, great staff. but after being here only 2 years of trying to do more with less, fighting for but unsuccessful at unionizing and now, to find out they are trying to go for magnet status!!!! what a joke, i can't bear to go to work and see the suits anymore. my ideal hospital is: not another tenent facility. -upholds safe staff ratios (even though our governator sold us out) -nursing retention by pay scale and encouraging and providing training programs -has great benefits and pension- does this exist anymore? kaiser permanente is the only one that i know but i guess thats why its so darn hard to get a job there. any nurses that know of other hospitals in los angeles that is an ideal place to work- or am i dreaming? then thanks for letting me rant and dream

gomer, thanks for your positive support on usc! whew, i think i made the right decision. i'm so excited except the tenet owned thing- hope it won't make me miserable there. i haven't read anything negative/scary about usc being tenet owned and therefore a terrible place as some of the other tenet owned hospitals.... keeping fingers crossed. after.

colleen 10- no offer letter, but i did get a letter from the nurse educator/interviewer about the orientation schedule for the month gomer- i decided on usc- the university hospital, on the tele floor. the other hospital i wanted was a community hospital, in icu. both are about the same size-wise, not too big/small but totally different- community vs teaching/research and both seem to have very good orientations and i liked the managers. i think both could be ideal, felt safer with starting icu in a cummunity hosp setting, no trauma, known for cardiac but likewise on a tele floor in a teaching/research hospital. but the day shift, close affordable living- my very first own place! in the heart of the city made usc the best choice for me. ok, now my impression is that its a good choice. my only hesitation was that it's a tenet hospital and the stuff i've read about tenet in general has not been positive. that particular floor seems well staffed, well supplied, clean and modern. any opinions or experiences to share? thanks, after.

hello, and thanks for your replies. i will be sure to send the hospital a "thank you for your consideration" note. i felt in my gut my sister's suggestion to negotiate for more- benes, whatever- was not straight, even with a nursing shortage, as i'm new, it will be really a give/take situation on both sides. anyways, i'm so HAPPY :) about the day shift, no rotating to nights...i just about jumped up to hug the hr person and was nearly ready to sign anything at that point. what is this "offer" letter? it seems to come AFTER? the pre-employment physical? is that right? thanks again, luv this board- after.

i've interviewed for several new grad programs in los angeles and have received job offers from all. i gave a verbal agreement to the first, then decided later that another was better overall: day shift, shorter commute... i agreed to an appointment for pre employment physical with the first offer but now i want to withdraw from it all, in addition they never said what the pay was, which is especially important b/c the surrounding area has very expensive rentals, so when i followed up c a phone call- was told that person was out and would return next week. instead was asked if i rec'd an "offer"letter- salary should of been there. i didn't receive the offer letter, just a verbal offer: so does that mean i can withdraw from futher consideration without burning any bridges for the future? am i committed in any way because of the verbal acceptance to the verbal offer? i'm not sure how to handle this. in addition, my sister ( she is in business) said i should negotiate with the hospital i want to work with, even though i'm pretty happy with the benefits and all, even though i am applying for a new grad postion. i thought salaries are pretty straightforward as a staff nurse, but she insists EVERYTHING IS NEGOTIABLE. i could understand negoitating if working with an agency and if i had experience but.... any opinions/advice/experience? thanks, after

thanks for your replies, the 6-8 wks orientation includes both didactic and clinical instruction, it makes me a little nervous but it seems that ALL the los angeles hospitals are offering the same kind orientation time frame... everyone at work says there will be no problem finding a position as los angeles is so desparate for nurses and if one hospital's program sucks i will be able to easily fine another but i don't want to place my future patients at risk nor my license. any recommandations on particular hospitals in los angeles?

hi everyone, looking to transition into icu, but finding that new grad icu programs in los angeles (from several hospitals) offering orientation lasting around 6-8 wks. i have 15 mos home care rn experience that included 6 mos of orientation. icu programs with 6-8 wks- can that be safe? and its from hospitals like cedars sinai- a magnet hospital, usc and others.... what are your thoughts? any advice? thanks, after