IndySkies

There was a fairly long quote, paragraphs in length by a nurse that I think her last name was Metheny or Mathany about how to communicate with others nurses along the line of I will only approach you in a caring professional manner and I would only discuss any problems I may have with you with a third party to determine how to approach you. I've tried several searches with no luck.

First, some background, I used to lurk on this site, years ago, posted later, mostly topics about how management treated nurses, jokes, and psycho babble. Came back back years after that, just to look how professional nurses felt about the pandemic. I can kind of understand reluctance to take the vaccine, except, that ‘normal’ flues are Co-Vid type of viruses, (This does not equate Co-Vid as just the ‘flu’), which gave them a template to speed research and production. I understand skepticism in regards to our government, it’s been lying to me personally, since LBJ. But, Co-Vid is real. I don’t care if came from eating bats, or was a lab leak. it’s here, it’s real and it’s here to stay. I remarked on someone else’s topic about I’m glad it’s not Bubonic plague, etc., because I cannot believe how our fellow Americans believe that having to commit to relative minor inconveniences as wearing a mask is an attack on their freedom. Our ancestors, ‘The Greatest Generation’ lived through the depression, and World War II, created the society that we enjoyed, (at least for awhile), experienced quarantines much more deadly, restrictive, that what we are experiencing, (ours is more widespread, cause it’s more aerosol in origin). I responded to another topic, or maybe the same one, where is desire to find real info about Co-Vid cause they didn’t trust official sources, (they also expressed skepticism about masks). I wrote that the Kansas City Star, ( a newspaper, remember them?), did a survey of Kansas. (You can only find redder states in the Deep South, or maybe sporifice Western populated states). Every county that had mandatory mask implementation, incidences of Co-Vid went down, ever county that did not, COVID increased. His response, was to ask for citations, (guess he never heard of the internet). This response tells me he just wanted confirmation of his pre-conceived conclusions, and not the truth. Now all over MSN, and Yahoo news sites, and other, the largest study, can’t remember the country, found the same thing. Of course, skeptics won’t believe. Heres my thoughts, don’t take the jab, it’s your choice, (but capitalism is realistic, especially insurance, it’s not going to pay for your hospitalization if you’re not vaccinated, just you wait and see). If masks are ineffective, (and they are not to prevent you from getting it, but to prevent you from spreading it, mostly). Why do we wear them in surgery? Or why during invasive procedures, or accessing Dialysis catheters, or obtaining blood cultures. I am tired of wearing masks, ( and the isolation procedures you have to go through, numerous times a day)I I am tired of COVID+ patients complaining that they didn’t sign up for this. Non compliant with Vasotherm cannulas, pull off Bi-pap masks, refuse proning , refuse Intubation until WOB becomes too much, think Medications should work immediately, and why can’t they get what Trump got. Wearing a mask is not a sign of weakness, that you are afraid of getting the virus. You may be the virile strong person that the virus has little effect. You wear it so your fellow man, (which could be your parents, grandparents), from getting it. Don’t get the jab, it’s your choice. Your organization fires you because of this, it’s their choice. They’ll be be hurting ‘cause your such a good nurse, and you’ll discover most organizations ‘hate’ their nurses, you look like a cost to them, not a benefit. Nursing shortages have always been there, there are numerous schools cranking out AD RNs right and left. (Why do think BSNs have never became the entry level for Registered Nurses?). It pays better, and has a better rep than teaching, and most hospitals don’t care if you only stay a couple of years, in fact they rather you didn’t cause cheaper ones are always coming down the line.

Survey Kansas City Star. You’re a dialysis nurse? Do you mask and glove when you access a Hickman? I know I did. Can’t remember if I did accessing fistulas, at least gloved. Do you draw blood cultures? Mask for those. Assist with Central Line Placement? Mask there. Why do they wear masks in Surgery? You say you’ve seen things that say the opposite? Wearing a Mask increases Co-vid chances?Why are the highest incidences of Co-Vid in maskless, anti-vac states.

Masks aren’t helpful? Better than nothing. Counties in the state of Kansas with Mask Mandates. Co-Vid cases go down. Counties that don’t have Mandates. Co-Vid cases go up. Don’t do the jab, your choice. Wear the mask for your fellow Americans who may have co-morbities that put them at risk, or you may pass it on to someone and they unknowingly pass it on, etc. But, I know you personal freedom is being impinged on. Caring about your fellow man, that’s so 1940’s.

Glad it’s not Ebola, Small Pox, Polio, Bubonic Plague, You don’t want take the vaccine, OK, (I’ll grant you that ‘freedom’ although I think you’re an idiot). There have been ‘some’ adverse reactions, always will be. 40,000-45,000 deaths reported is a lie. Wear a mask. “But, it inconveniences me, what about ‘Freedumb’ Kansas City Star did a survey of all the counties of Kansas (also known as Brownbackistan, cause the former Governor was jealous of the infrastructure and populace benefits support of the southern states. Wanted it to be come the Mississippi/Alabama of the Great Plains, Midwest) Counties with a mask mandate, the incidences of Co-Vid went down. Counties without a mandate the incidences went up. 7th grade Science. Organizations have the authority, ability, and concern to keep their employees, and clients safe. Don’t want to follow your organizations directives? Fine, get another job, there has always been Nursing shortage. Just because it’s worst now, it’ll pass, and you won’t be missed

Whoops..I made a mistake it's the diameter on the plunger, not the exit port of the syringe that makes the difference

I like your response to the question and the trouble shooting suggestions you mention. However, not to get to pedantic about it, I think you mean the smaller the diameter the greater the pressure, that is why a 3cc syringe will flush sometimes when a 6cc or 12cc will not. This is not that intuitive but it has to do with the fact that fluid doesn't like to be compressed and you are using the same pressure, (i.e., your thumb, hand pressure), on the plunger over a smaller diameter, (the opening of a 3cc syring as apposed to a larger one).

Floor Nursing is the 'Boot-Camp', 'Trial by Fire', (LTC is the 'Hell-Hole), that other specialities could only wish they had the fortitude, skills, and intelligence, to be able to master, much less survive. I have always said that the standard uniform of the typical Med-Surg nurse should include a red-headed wig, since they are treated like a 'red-headed step-child by most facilities. (Oh...by the way...I'm an ICU nurse).

When ya wanta be cancelled yer not....When ya don't wanna be yer are...:flmngmd:

NO HARM! NO FOUL!

These problems seem to me to be the result of weak managers. You need to vent professionally in staf meetings, (I know, they are never scheduled at a time that is convient for you). Or need to vent to the manager, again and again

I've worked in rural EDs that have paramedics/emts on staff, working along side with RNs, taking assignments, etc., no problems here

When I was first a nurse, (in the mid to late 70s), the Evening shift was the shift that the 'newbies' and the young nurses had, (i.e., those in their 20s). It was okay if you were a partier, you could hit the bars and/or parties after work, go home and sleep it off before you had to go to work the next afternoon. But forget about ever seeing your family in the evening in any meaningful way. Later when I became an ADON at a LTC facility I found that the hardest shift(s) to cover is the Friday evening shift. There are other advantages to an 8 hour evening shift, only one meal to deal with, hs care and pre-op baths, ect. Usually less exams, med passes, and procedures, but I would never go back to five days a week 3-11 shifts. A 12 hour shift usually allows for more actual patient interactions in a somewhat less intense, gotta get tasks and paper work done type of situations. More days off is a big plus. (It has got to be advantageous to the 'suits' also, or they would never have offered it, or allow it to continue). The fact of being tired after 12 rather that 8 hours I think is a negative I guess, but I remember being much more tired and stressed out about how I am going to get all my work, (and paperwork), done in 8 hours that seemed to be a day-to-day thing, five days a week "once more into the breech my friends, and fill the wall with our British dead", than I usually feel after a 12 hour shift. The complaint about not being able to eat or 'go to the bathroom' for 12 hours as opposed to 8, well...that is a lack of self-assertion and allowing yourself to be a martyr than a real objection to 12 hour shifts But, there will never be an abolishment of the 12 hour shifts. Too many 'working stiffs' like it..Too many employers see the advantages for it for it to ever to be done away with.

Even if you like everything other thing about the unit you work except this behavior of your manager it is better to leave now rather than later. The problem is if she has some problem with you and you never can be sure what it is, how you can correct it, or even confront it, suddenly you're reputation in that hospital is ruined, or you're out of a job, or even worse, and it's what the ? just happened. Worse case senario is your career is ruined and you never really knew what was going on.

Taking the MAR into the room, opening each unit dose in front of the patient is a JACHO ( I may have the initials ou of order),rule I think

Here is the problem as I see it. Sometimes you cannot get blood for love nor money, for labs, IV start, etc. Now it could be against policy, (and ivory tower nursing ideals). To have a patient draw their own labs, start IVs. However, how you gonna get it done? I find 'doctor draws' to be somewhat of a joke. Occasionally some IV/Lab wizard can get blood outa a turnip, or a friendly CRNA might show up to do it...but sometimes, (most-of-times), its a little old ER/ICU/Floor nurse who's gotta do it. Any complication from a adverse lab/iv start is gonna fall on the poor little nurse whose watch the situation haapen to come up on. Just like failure to start IV/draw lab is gonna bite 'em. Of course in this law-suit happy world, it woul kind of be embarrasing to answer the judge why you let the patient start his own IV/lab draw. Another episode of 'water retaining wall' if you do 'water retainig wall if you don't.

i would never have a patient draw their own blood. it should be against hospital policy. Why? The only reason I can think of, (if it is done properly, aseptically, and carefully), is it might cause the patient to relive their addictions, and may be a stimulus to cause a relapse. I have seen, and done an arterial stick, when it has been impossible to draw labs, via a vein, sometimes what works trumps over what is textbook.

On Non-Q wave MIs, and NSTEMI MIs, (Non-STEMIs, or No ST Elevation MIs), the thought is that the infarction did not go all the way through the myocardial tissue, therefore the cardiac fuction is not, or very minimally impaired.

I don't know the culture of the hospital you work at but I wonder if you report him through proper channels if anything will be done. I doubt if you were the first nurse he slapped, and if you were, he probably did it because you were new and he could probably get away with it. The problem with a police report for assault is that it should of been done at the time of the incident for maximum effectiveness. Will your witness truly back you up, I mean not now, but later if there is truly an investigation. The one thing about hospitalists is that they are usually employees of the hospital, (at least where I work), which means they are not really revenue producers like the primary care physicians that admit the patients, which means there is usually a little more leverage the hosptial has over them, and they should be held to standard a little higher as regards to acceptable behavior. It all depends on how your hospital stands up for its nurses. Now to answer your question. YES!!! REPORT HIM!!! Go through proper channels but expect, and demand professional courtesy and response from management about your valid complaint. Require that you are kept informed about any findings and actions taken. Do not allow them to 'stonewall' you and say that is is an internal investigation and any responses will be kept confidentail, otherwise in actuality nothing will be done.

It Gets In The Way Of The Paperwork!!!:)

Just my 0.02$ worth...I would follow hollyvk's advice first and then if you feel like you have not had aedquate follow up with your management I would follow up with lindarn's advice. I had a situation similar to this and a gradual professional escalation of 'pressure' works best and does not make it seem like a vendetta or insubordination on your part, but does show that you are standing up for established procedures and policies, (and for yourself).

Early in my career I remember an Orthopedic attending that if he happened to be on the floor while we were totally lifting patients or log rolling patients would pitch in and have any and all residents and/or med students that were trolling behind him pitch in. These would be any patients wheter they were his or not.

One of the reasons I will not work LTC any more. Discipline of CNAs, (now, I met a lot of them...I when I worked nites @ a nursing home...I had some of the best), is usually non-existant unless it is some grevious, suit libel malpractice occurance. I had a CNA that stayed on the house phone for at lest 20 minutes...long distance no less...that when I told her politely to end her conversation..she cussed me out and left. It was near the end of the shift so I finished her work. Informed the DON/Administrator the next day, (it was the eve shift). The next day I worked, two days later, the CNA was back on the job like nothing happened. This is a typical result all too often.

I have read the post and all of the responses....and I must say I am appalled. I thought this web site was AllNurses.com.not SomeTimeNurses.com..or...NurseWhenIFeelLikeit.com...Don't cha know nursing is a 24/7/365 day gig...you must bend over and say "Yes Please, May I have another... You should hang around the nursing office on your days off...and on your off-shifts and ask is there anything I can do for you? Be like me, the only time I have ever asked for time off is to have surgery so I could get a port-a-cath for TPN feedings an Ostomy and supra-pubic catheter so I can work with as minimal breaks as possible. When I die I gonna have 'em mount me with arms out stretched in the classic 'Jesus Christ' pose so I can at least be an IV pole.:)

This is not a rare situtation at all. The nurse gets caught in the middle. I cannot believe people think its safe to bring infants on floors, much less an ICU. If the floor nurse says nothing you get reamed by the supervisor. If you try to enforce the rules, and the family member/patient complains, the supevisor will inevitability allow the infraction, then you end up with a 'smug' 'told you so' patient or visitor.