Happiness08

At this point, I want to paint a better picture of the facility where I work. Management does really care about the patients there. As I stated at the beginning of my post, I am happy working the 3-11 shift as a staff RN. The root of the problem was a vacant position for supervisor on the 11-7 shift. Supposedly that position has just been filled. Although I am a new graduate, I do have some training in management and have a Masters degree in Public Administration. This is a second career for me so you can figure out that I am not the typical new graduate. I was told the thinking related to mandating me was that the 11-7 staff has been working there so long and have so much experience that they would be able to assist in an emergency. In other words, management had confidence in the "team". I was also told that the current situation in the facility was considered and that no problems were anticipated as no residents were in crisis status or situations. My concern was that some situation might develop and that ultimately I would be held accountable. Hopefully, the new person will start soon. My suggestion to management was to provide me with training and some orientation in the event that I might be called upon to "fill in" again. I thank you for all your replies. As a result, I did feel encouraged to submit a letter of concern addressing the issues and expect a good outcome. In the event that I am wrong and should be placed in this situation again without orientation or training, I now have the rationale to use to refuse to accept the assignment. Thank you all for your input.

I typed up a letter of concern addressing the issues. Why do you say "leave now"? I wiiling to learn from your experience.

as a new graduate, i am happy in my current position in ltc as a staff rn on the 3-11 shift. however, i have been mandated to work as shift supervisor on the 11-7 shift x2 when the 3-11 supervisor left to go home and the on call management personnel did not come in. on both occasions i had worked the 3-11 shifts beforehand. therefore, mandating required me to be up more than 24 hours by the completion of the 11-7 shift. i never was oriented or trained to this position nor do i feel that i have the practical experience to handle any extreme emergency that may develop without some training. i was told by the 3-11 supervisor who was going home that if i left it would be considered job abandonment. there was another nurse on duty on the 3-11 shift who has worked as supervisor. she, for some reason, was allowed the option to choose to go home. i have the sense that the requirement was only the rn that follows my name. this was spoken out loud to me by an incoming lpn who supposedly repeated what a supervisor had said. at some point, with proper training and orientation, i might consider such a position. at this time, however, i have concerns. what can i do to handle this situation in the future as a pattern seems to be developing?

as a new graduate, i am happy in my current position in ltc as a staff rn on the 3-11 shift. however, i have been mandated to work as shift supervisor on the 11-7 shift x2 when the 3-11 supervisor left to go home and the on call management personnel did not come in. on both occasions i had worked the 3-11 shifts beforehand. therefore, mandating required me to be up more than 24 hours by the completion of the 11-7 shift. i never was oriented or trained to this position nor do i feel that i have the practical experience to handle any extreme emergency that may develop without some training. i was told by the 3-11 supervisor who was going home that if i left it would be considered job abandonment. there was another nurse on duty on the 3-11 shift who has worked as supervisor. she, for some reason, was allowed the option to choose to go home. i have the sense that the requirement was only the rn that follows my name. this was spoken out loud to me by an incoming lpn who supposedly repeated what a supervisor had said. at some point, with proper training and orientation, i might consider such a position. at this time, however, i have concerns. what can i do to handle this situation in the future as a pattern seems to be developing?

What would you think if the daily practice was to bolus but not use a coughalator afterwards?

Thank you for the rapid response. My concern is that it seems this practice might be used almost daily with NO SUCTIONING following the bolus. The pt is then left to clear the airway himself. I knew it was no longer recommended before suctioning so I was thinking without suctioning it would be even more harmful as the coughing might dislodge feeding tubes beside the possibility of the patient not being able to clear the airway himself. Is NS ever recommended as a bolus to a trach without suctioning is really the question I am asking.

has anyone ever heard of bolusing a trach with NS but not suctioning afterwards? it seem to me that this is more harmful than benefical.

i am a new graduate rn seeking my first nursing position. i have much life experience, worked in social services for over 8 years, and have a master's in public administration. i was surprised to be interviewed for a staff development position. the reason i was told i was being interviewed for the job was my previous education and work experience. my thinking is that it is a wonderful opportunity; yet, i have no real hands on patient care experience except for nursing schools clinical. i am wondering how this might affect me in the future should this job not work out. i would appreciate any advice or feedback.