talondora1

I quite understand your dilemma, however, let's re-group here and consider some things: CNAs are not nurses. They are not taught theory. They are just what they are taught to be, assistants. If you need a special blood sugar get it yourself. Organize your duties and trade a task with another nurse if you need to, but get it yourself. You know the signs and symptoms of hyper and hypo glycemia and you should be the one to assess that situation anyway. The CNAs need to get the vitals first!! Those vitals as you know, tell us alot and are needed as a baseline or comparison first thing. The CNAs may not recognize serious vital issues, either, but those are readings you get at the beginning of the shift. I often give praise and appreciation to the aides and take the time to explain the dangers of not doing something at a requested or ordered time in a way that does not make them feel stupid or threatened. You set yourself up to be embarrassed in front of a patient by asking the CNA a lab value right then and there. As a professional that question should have been asked in private and perhaps then the response you got might have been different. If things continue to be an issue. You both need to meet with the Nurse Mgr. Hope this helps. Experienced over 19 years

My daughter was misdiagnose with the same thing. She was only 14 at the time. I did some investigating and had a chat with a pediatric nuero/endoncrinologist of all things. (She is also diabetic). He informed me that many kids are misdiagnosed as parts of the brain at a young age aren't firing yet so it's premature to call a child bi-polar. Suffice to say my daughter gave up those meds some other idiot put her on and has done extremely well. The only thing she uses is her insulin, period. Honestly, sometimes I'd like to slap those people!!! :roll:roll

Well done, Kiddo! When I got my RN license in the mail, I opened it, and dropped to my knees! Praise the Lord!! WE made it! Now the fun begins......:welcome:

I disagree. The doctor is the one who was out of line. True we are suppose to be a team. Not all doctors feel that way. If she misunderstood, fine. She didn't. Any physician who says to a nurse, especially an inexperienced one, "then I am not going to talk to you," is asking for trouble. Personally, I'd report his conduct. Our hospital would never put up with that.

You are correct in quoting the physician. If this case ever ended up in a court of law, quotes are appropriate. You have a license to protect, and so does your facility. The doctor should have chosen his words better if he was so concerned. I have been instructed over my career by many nurses to quote the physician if I am concerned. I would have followed his instructions however placing the collar if he ordered it.

It could be that the Interviewer has certain criteria she has to follow with H.R to be compliant with the hiring process. I wouldn't worry. Sometimes facilities do things backwards....(grin)

I wouldn't say anything negative about anything regarding your previous job. Perhaps you could say that you needed a change and would like to expand your horizons, so to speak. This tells them that you are eager to learn and be flexible. Good luck!

Most hospitals don't comment on wage as many are governed by how many years of experience comes into play and Union rules regarding pay. Just a hint: Don't ask about pay right off the bat when you interview. It looks as though that's the only reason that you are there and it doesn't sit well with the interviewer. Don't ask about benefits until the second interview. Be prepared to have at least 2 interviews: The first with H.R. and the second with the floor manager. Secondly, you are right to be prepared. However, you shouldn't have to take a pre-test before clinicals. Your schooling should be enough to prepare you for that. NCLEX is helpful but that is to prep for state boards and you probably have enough on your plate. As far as a "specialty" goes, interview for the specialty that is being advertised, ie: med/surg, ortho/neuro, oncology, etc. You will be assigned a preceptor RN who will mentor you through Orientation and help you find your wings. If you aren't sure what specialty you want, be open to learn on any floor and your opportunities will be unlimited. You won't be an expert right away, even if you are a superior student. Grades won't tell you what kind of nurse you will be. Only experience will do that. Good luck!

Most facilities have a policy regarding this issue but it isn't always the same. Is your facility a Union facility? If it is, the Union has their own rules about this. Most facilities pay minimum wage and then if you are called in, your normal wage kicks in for the remainder of time you are at the facility. Check with your Sup.

Jesus commanded believers in the Bible before He went up to Heaven and told them "Go to all the world" and share the message of forgiveness and love, eternal life. It is an act of obedience she is doing to God, regardless of denomination. She has a burden for lost souls. Meeting the spiritual needs of a patient is not only ethical, but in the holistic approach it is required. Meeting the need. When she stands before her Maker one day she wants to know that she made the effort. I can't tell you over the years of working post op and ICU, Hospice and the like how much this means to patients and families. Many feel helpless to even ask a question let alone find a nurse who is willing to pray with them. Often the floodgates open and though the loved one may be dying, the healing of the soul begins.... I am sure if she is being led by the Lord, she is sensitive to how she approaches those who are dying. She may be their last chance to hear of the message. A Chaplain can't be everywhere at once. What is unethical, would be if she stood there as Judge and Jury, which I doubt is the case. Personally I wish that more nurses as she is met those needs. God will be her judge, not us. You asked a great question! God bless you.

Contact your state nursing board to be sure.

Stop eating our young!!!! She will see wisdom in time. It isn't fair to stand on your soapbox and ream her out when she is still finding her place. Knock it off.

It sounds like you have really thought this through for quite a while. If you are able to privately share your concerns in a respectful yet direct way with your manager, it may help. If you feel that you must leave your facility, do so. Give a proper notice and when you give reference to your new employer don't say anything negative about your manager. I too had manager issues at my old facility. I know how difficult it can be to the point where you start losing sleep at night. You are much too young in your Nursing career to get this burned out this quick on a floor. It's also inappropriate for a manager to discuss "placement" with you in front of others. A good manager isn't everyones friend, nor should she always believe family. One can still maintain professionalism and tact without resorting to manipulation and bad politics. Do what your heart tells you to do, Honey. And Godspeed.

In our hospital we make a practice of letting the Charge nurse know not to assign patients with too many issues all at once to a nurse. Example: Divide up the load more evenly when possible. Perhaps you could suggest this?

The inner "bladder" of the cuff is designed to inflate a certain way. It needs to be placed correctly for accuracy. Many times the readings aren't accurate due to incorrect placing. The same holds true for a manual cuff. However, I too am one who believes in good old fashioned technique and equipment. If they weren't so darn dangerous to use and not so slow, I'd still opt for the mercury thermometer. (grin)

Sounds like the Night nurses need to sit down and have a Pow-Wow with her. Do it as a group, it's more effective.

It's always a big deal when a narcotic comes up missing. It reflects on the whole floor as the count is off and no one is suppose to leave until it is resolved. It becomes a trust issue that can affect everyone who works there, placing undue stress on your peers. It is good that you came forward to straighten it out. I doubt that you will make that mistake again.

I have always done them twice on my evening shift, as in our part of the world they are done around 0800, or with an am bath, 1600, and hs. Check with your floor policy as facilities times may vary. If all else fails, have the Dr. specifically state in the orders. You are right about not doing them at night when we promote sleep.

While one can get alot of great experience in Med/Surg, I must disagree with the advice of going there first. The O.R. environment is nothing like Med/Surg. The need for O.R. nurses is great. Both fields have merit, but you should go where you want to be. You won't regret going where you feel led. You can always switch later. Do what is right for you, not what someone tries to talk you into.

No, you are not crazy. Most hospitals will link you up with a preceptor for a couple of weeks. There is nothing wrong with making a change now and then. It helps prevent burn-out. In my 17 years I have been a combat medic, a Home Care RN, Hospice, Group HOme Medical Coordinator and Med/Surg. I am now learning Critical Care. Do what your heart and training tell you to do. You will be utilized, rest assured, and more valuable as an employee with added experience.

It's hard at first when you are doing clinicals. You are still feeling your way around a floor that is known to be chaotic by nature let alone being "new" in the field. It is true that we are all responsible to reinforce teaching. Many times these patients are nervous and not able to process the learning that they need. Never assume that someone else has gone over the use of PCAs with them and that they understand it. As far as Morphine not working for him, that should have been addressed Pre-Op. The blame is shared, not owned by one. You did the best you could under the circumstances. Next time it will come easier for you and you'll know how to help him.