bossfrog

Back in mid-December to mid-January I had what I thought was a strange cold. I had a cough that was productive with an expectorant but only minimal nasal drainage or congestion. It would get better for a few days, then come back bad again for 4 or 5 days. It cycled like this 3 or 4 times. I had some deep congestion in my chest where I could hear and feel some wheezes while exhaling after a deep breath. After about 4 weeks it was finally gone. I haven't had a single day where I felt under the weather since, but I've been curious if that could have been coronavirus. So I went to Labcorp and got myself tested for antibodies last week. I got the results yesterday and I was POSITIVE for the antibodies. So here I sit with confirmation that either I had it back in January, or I had it later and was asymptomatic. Either way, I am negative for the virus itself now. So I'm wondering if anyone else has had the antibody test and if so were you unexpectedly positive?

I wouldn't listen to Mayor Bill. He's the genius who was telling everyone to go to concerts and theaters and parades and festivals on March 13.

I'm not worried about ever reapplying there and I'm frankly not worried about what she might say about me. My work history prior to her is rock solid. The bottom line is that I feel my license is in undue jeopardy under current conditions and that is my reason for leaving immediately. Any employer worth their salt will understand that. In fact, I do already have another job lined up. My references have already been called and background check started today. But I think I will do as you suggest and just keep the letter generic and brief.

Hi, I am giving my resignation to my current employer this evening which is to be effective immediately. I cannot give them 2 weeks notice due to concerns about protecting my license. I work in dementia care assisted living and due to some shady actions by the owner, we have been losing staff at a high rate. Particularly she decided to cut staffing to a dangerously low level given the acuity of our residents. Out of 21 employees, including cooks and housekeeping, she is looking at losing at least 13 of us by the end of next week. The mass exodus started last week with my supervisor, who was great to work for and it has been a domino effect since then. The owner has been moving cooks and housekeeping staff into the CNA role to help with ADLs. We have 3 or 4 who are a strict 2-assist and these girls, while doing their best, simply aren't appropriately trained or licensed. My question is this: What I am understanding is that if any of them handle a resident incorrectly or do something negligent that results in an injury, then it is me and my license who will be blamed and scrutinized if anything legal came about. Is this correct? Because this is my primary reason for justifying immediate resignation, though I could easily name several other reasons, like not paying owed holiday pay and overtime.

Yep. You're right. I mean, yes, the doc's name always goes on the order form in the morning, but that's NOT the way it's to be done. Just to clarify, in case it hasn't been to this point, I personally NEVER do this. When a referral comes to me I do not accept them until I can talk to the doc. If I can't get him on the phone, the patient sits tight until I finally do get hold of him. That's actually part of the flack I got. They said I let a patient sit in the ER somewhere for 6 hours without giving them an answer. And I told them that's how long it took to get the doc on the phone. I mean, in the end, what are they going to do? Oh, right... they gave that decision to a CNA.

Elkpark: Your first paragraph above is exactly right. When patients come overnight, the admission orders (PRNs, vitals, labs, home meds, etc.) aren't gotten until morning. That itself isn't generally a problem and isn't uncommon. The problem is that there are no PRE-admission orders, which is where the order to admit or deny a referral is usually issued at almost every other hospital. That needs be be gotten directly from doc before giving the green light to transport the patient. That order is on the same form as the rest of the admit orders. So there is no order written for a patient to even be on the unit until those orders are gotten around 0530, according to how administration wants it done. It IS going to bite them in the ass someday. What kind of brought this to a head was a new process apparently started last night. The unit secretary put a referral on my desk and said, "You have a 15 year old girl coming soon." I asked, "Did you go ahead and call Doc or what?" She said, "No, I approved it." I just looked at her and said "Are you kidding me? I didn't even look over the labs or anything to verify her medical condition." [she's NOT a nurse, BTW. She's a CNA.] She told me that administration was getting tired of some of us nurses refusing to bring in patients over night(without calling doc), so they approved for her to make the decision. I guess if they're going to do that then I'm going to wake up Doc anyway and get the order before the patient arrives. I won't have a patient on my unit without orders! Then if he denies the patient for whatever reason, our unit secretary can call the ambulance service and tell them to turn around. I told the secretary she has no legal right to make that decision. She said it was a change in their policy. I told her the law trumps policy and she's just too dumb apparently to get that. I was just beside myself and that's when I made the original post on here. I'm pissed because I like everything else about my job. And the problem isn't the doc. It's the pressure his wife (the owner) puts on administrators (who are all business people, not medical people) when he gets woken up. But because administrators want to push the limits of what is legal, I might have to quit. As for being a "mom and pop" hospital, no. They're the largest privately owned, free-standing psych hospital in Indiana. So there is no ERP to write admitting orders here. It must be the psychiatrist. I feel like this crap needs to be reported somewhere but I don't even know where, or even if I should. I don't want to hurt my staff that I work with.

Thanks Davey. But what are those appropriate outside agencies? And the write-up really just pissed me off more than anything. My DON said if I'm not comfortable bringing in a pt without talking to doc, that's fine. But the administrative people are the ones insisting we do this. They say the doctor's wife (she owns the hospital) complains when the doctor doesn't get enough sleep. So administration doesn't want him called. Either way, I'm sticking to my guns.

Perhaps you, too, should step away from your high horse and get some perspective. Quit pretending you know everything. A great number of teens - particularly younger teens, get on the transgender train for various reasons. One that I see most often is that they will often admit during therapy sessions that they "became" transgender because they have been picked on and bullied and they see being transgender as being part of a protected class. They have found that if they say they want to be a boy, or vice-versa, then there is a group of peers who will jump to their defense if anyone tries to pick on them. Some even claim to be transgender because it actually caused them to feel popular. This isn't my opinion. This is directly from the mouths of the kids themselves. Less than 1/3 of the kids in psych hospitals who say they are transgender truly want to change sexes. Some are simply homosexual and they have the idea that if they are a girl who likes girls, then she must actually be a boy. And political correctness is only pushing it on them. Please note, I have not said there are no true transgender individuals. But there are not as may as it may appear on the surface. Many are just confused or misguided.

I have been a psych nurse for 6 years and did some traveling for a while. At my current job in Indiana (which is a permanent job, not travel), they have a practice that I'm not comfortable with and I can't seem to find anything definitive to confirm what I believe to be true even though I'm fairly certain I'm right. What they do here is on night shift, when a referral comes through, they expect the nurses to make the decision whether or not to admit a patient. If the criteria is clear (such as psychosis or suicide attempts) then they want us to get consents and give the referring agency the go-ahead to send the patient without calling the doc. None of the 5 psychiatric facilities prior to this one ever did this. Even when the criteria was clear, they ALWAYS called the doc for the decision to admit. Now the understanding here is that if it's a clear case, the doc will sign off on the admit orders. But the question I have is what if a patient gets admitted that the doc says he wouldn't have accepted? You can guess who would get the blame. I have refused to do this, with the support of some peers and the scorn of others. RNs do NOT have admitting privileges to my knowledge and there can be no such thing as a standing order to admit non-specified patients. One of the unit secretaries actually wrote me up for refusing to make a unilateral decision on a patient! Am I way off base here? Is this common practice and this is simply the first time I've run across it? Most importantly, is it even legal? Should I report the write-up to the Nursing Board? Hell, should I report the hospital itself and start looking for a different place to work?

Essentially what this is is management pressing us to fudge the data for them to help the unit meet Core Measures metrics on smoking cessation and I've decided along with a couple others not to do it. If they want to threaten discipline, we'll have a conversation about that.

Okay, I work on a psych unit. So I come into work tonight and we have a new "read and sign" instructing us to always put "yes" when our assessment form asks if the patient is interested in smoking cessation, smoking counseling, FDA approved smoking drugs and outpatient smoking cessation programs. The fact of the matter is that 80% of the time the patient is NOT interested in those things. The "read and sign" tells us to think of it as documenting that we are offering those things, but that is not the verbiage on the form. I am inclined to refuse to document this way and if they want to raise Cain about it, then I think I'll tell them that I will consult the Board of Nursing for advice on the matter. I have already sent my unit manager an email outlining my concerns. What should I do if they tell me to do it anyway?

I'm a psych nurse. Last night when attempting to do a reassessment on a borderline patient, she flipped me off and walked away. So I charted the following: "When this RN attempted to initiate a conversation for reassessment, the pt displayed the dorsal aspect of the second digit of her right hand in an erect fashion and walked away, refusing to speak."

Yep. That's pretty much where I'm at. Except you have a few more months of experience on me. You should be able to claim a year's experience in peds and qualify for about any peds job soon enough.

Yeah, we're definitely going back to WI anyway when we get our tax return. (Unless somewhere around here hires me in the next 3 months or so.) We lived in Green Bay for 8 years and we've been away for 6 years and miss it dearly. Between Green Bay, Fox cities, Manitowoc, Sheboygan and everywhere in between, there are tons of facilities which could be potential employers.

Yeah, my supervisor told me the same things. When the mom removed me from her case, my supervisor said I did nothing wrong and said, "Welcome to home health care." I explained to the mom that it is not within my legal scope of practice to modify prescriptions. I can withhold them, if tests indicate so, (like holding on the digoxin when the patient's heart rate is 52) but not modify them. Told her if I gave more than prescribed and a problem developed, I could lose my license (to which she replied, "This is my son... I don't give a damn about your license.") I even suggested to her than since Miralax is an OTC drug, she was free give her son more than the prescribed amount, but I could not, even with her permission.