jvman

People, let's get back to the, "inflammatory question" please... All answers will need some sort of parameters to be personal and professional. Conditionally the answer is YES you can (avoid) even refuse to actively treat EBOLA or any other contagion.... That being said, it's dependent on many factors, ie) are you trained, equipped, is this your "usual area of specialty, are there others better versed, knowledgeable and prepared??? THINK of this scenario, you work in general medical and have been in ICU 10 years ago, you are floated to the ICU, should you be the first to enter that room? I think not as you have been away from that environment and would better serve in a more supportive role, ie) a more medical or surgical Patient that's about to be sent to the floor, telemetry patients although still critical but your interventions will be "more" in league with your current practice... another aspect to the current dilemma is that this is so new... if your not trained and the environment AREN'T up to the current standard set by CDC, I'd gladly refuse, stating I was not the safest practitioner, not trained for this, If you know your "SCOPE OF PRACTICE, you CAN LEGALLY refuse an assignment... it your RIGHT and DUTY to practice within your SCOPE of PRACTICE. This is a charged question for one to "self examine" and take the route of ethics, legality and safety for you, the client and the environment. If I breech Isolation, reverse Isolation and contaminate others, myself and the hospital, family the community.. well then, have I complied with, "least do no harm???"

>It's a great day when your co-worker says they appreciate your sharing knowledge, because you are non-judgmental and supportive! >It's an even better day when your PSYCH patient connects the dots and states, I just have to stay on my medications and think before I speak/ act and or meltdown!"

Miss, I'd suggest you go seek and find a daytime, office job, that's closed on the W/E so you can practice your faith, religion as you choose, and don't go into a job, and get hired and then "exclaim: I have religious choices that interfere with this schedule... I'm gonna jump on the fact you didn't explain this "Restriction" before being hired the second time, so I'm further going to say.... try getting work at 61, after being out on disability, and think of discrimination, as they won't hire you because you ar too old... get real, there are jobs that fit your CHOICES, and there are jobs that don't, so go where you FIT. Lastly, try living in Florida a right to work state, and "you want to claim discrimination???" be honest and seek what fits for you, not the other way around. As a single male, I've bee discrininated, always get the wacko patients, the non-compliant ones, and scheduled Holidays, so everyone else could be at home for Christmas with the babies and small children, suck it up and accept this isn't discrimination if you had been honest before the job was offered....

Is this thread still active, I'd like to know how so many of your are doing still today..... I'm 30 years a Nurse and so very proud and humbled at the same time for all the opportunities I've had to teach, heal and give to my patients and co-workers... but it's time for me to have some help and support too... So many thanks to all for your openess and sharing.... I'm only learning / confronting my own PTSD and trying to understand and change the panic attacks, still trying to recognize the triggers and the depression I feel as I return to isolation and avoidance.... today I started buspar, just started, so I haven't any changes, good or bad to report, but I have hope things can change, and am open to taking an antidrpressant and meet for therapy... I'd love to stay working, but doubt that I'll be able..... It's been empowering to hear of others transition and even recovery or at least their ability to return to higher function and productivity.... agaon thanks for the links and information given here on this post...

Hey-Hey, still have mine after 30 years, my school had a capping ceremony. While the ladies got caps, the guys (all 4 of us) got a pin, says our name and RN BSN I am still as proud and happy now as the day I got it. Like others thru the years there have been times I wore it on my ID badge or a lab or my Whites, now it's all scrubs, and not as visible, and in my current post, can be used inappropriately for patient selfcutting, or injury to others. It still is a keepsake and if / when I am teaching, I'm certain I'll be again wearing it daily....

Similar situation experienced here, once upon a time.... I'd been successful in many areas of Nursing, and at the top had worked one year ER, one year ICU (specialty Neuro post op) Had to go out on Disability... post chemo, radiation, chronic fatigue (i'll spare you all the details and heartache) 13 years later, I was ready, willing and NOT able to return, EVEN after I re-licensed, thru KAPLAN prep for NCLEX, sat and passed that, but then to find a job was nearly impossible... eventually after 9 months found a rehab (drug, ETOH and detox facility, and I'm back active, but still unable to even get an INTERVIEW for a real MS or CLINICAL based position... not even get a return call much less an interview... Locally there is a refresher course, that re-certs you for IV, shows you some new(er) equipment, but mostly takes your money, but I can't fathom, getting this accomplished, while working F/T and the cost isn't as EZ, and there still isn't any GURANTEE that this will get you in the door and hired, it's a gamble I'm not willing to take.. So, I continue on working in PSYCH, and Chemical Dependance... rehab... I enjoy the C/D and rehab, not long term and it's dynamic, you DO make a difference and every communication is a learning tool for the client... but the Psych is LONG TERM, not dynamic, not much learning, not much improvement, more of housing, basic needs and too much threat of voilance and physical harm and stress toward staff. I'd love to have the chance to return to ER or ICU and care for patients that could benefit by my ability to assess, and act via approved standing orders and to heal and return patients to their homes, family and productive lives... Now with F/T Charge and a year of House Supervision (in C/D Rehab) Why can't the Hospitals realize, taking on someone like myself, I'd only need a limited re-orienting and limited precepting to then have me pretty much up full steam, as my priortizing, teaching, delegating and all other skills are still intact / already well honed along with communication... just amazed at how they aren't willing to retain (not retrain) experienced nurses... Another option but it's expensive is to get my MS for teaching, and that would add years to my work life, but I'm not sure it's financially feasable, as that'll cost about 20.000, and I wouldn't earn that much more over the next many years, teach doesn't pay as much as specialty units... Well, I don't have any other advice , or answers.... and will likely have to retire, at 62...

Just a few words to help you digest your "mis-deed and pt. (well intentioned) advocacy", since you were "placed" in a supporting role by someone you didn't know, or not know well, and didn't have prior COMMUNICATION, with or know firsthand about his communication or lack of with the patient... You really didn't know, if that practitioner had not already communicated with the patient on what he would be doing, what to expect, feel, ect... besides, Any Thoracentisis patient I ever had, it was NOT their first time ( or last, either ) they KNOW what is going on, your role is to hold them, keep them still so the proceedure will be as safe as possible.. You would have been best advised to just be the supporting role and encourage the pt mid-way, with, " you are doing fine, or squeeze my hand / fingers, if it's hurting too much", let me know if you are feeling weak, or faint" ect, ect... So, let this be a learning tool for you, PATIENT TEACHING IS (when possible) BEFORE, not during the proceedure; what is going to happen, how it may feel, what behavior you expect from them, and what they may even hear, smell, ect... Now, should you be thrown out of class, school... NO, that's alot of overkill and just plain power tripping and people being way too ugly. Keep on learning, and be the great, wonderful Nurse that is your future. Careing comes from the heart and interest of promoting safe goal directed results. The blow by blow descriptions of a proceedure usually can only add drama and highten an already anxiety laden situation, rendering it possibly unsafe. Share all of your knowlwdge with your Patients while at the bedside prior to and after the proceedures. Your patients will love being informed and be less bothersome because they will know you KNOW your role and that you care and that you will include them in their pre-post proceedureral care.

BRAVO to all my fellow Nurses... it's particularily relavent to my own lifespan in Nursing, now 30 years as a (Male) in Nursing, as an RN, BSN I have been twice a patient, fighting Cancer and having had some major surgery, (lets say down below)... I worked, Neuro rehab, Ortho, Gen Med-Surg, ICU and now Psych... So, with some humility and tons of admiration, I say thank you to the many Nurses that assisted me with hygiene needs and proper disease and infection protection, while in their care, and they did it preserving my dignity, respect, and careing and again thanks for helping me when I could not do it for myself... it's that Compassion, Commitment to care, and concern for anothers' comfort, dignity and need to NOT feel like they are a burdon, problem or "unwanted task", that helped me to focus my energies on getting well and maintain a POSITIVE outlook on my hospitalization confinements and recovery. I ultamately had to leave Nursing on Disability for almost 10 years, and, 4 years ago my condition improved, Chronic Fatigue lifted and I, studied for 3 months and sat for NCLEX and re-licensed for my RN ( I had let it expire, thinking I'd never be able to return)... I'm now in the Psych realm of Nursing, 1 job is longterm chronic and Forensic. the other is Drug Detox, and Rehab, and all patients have hygiene needs and also have alot of incontinence issues, the 3-4 MHT's you have cannot keep up with them all, so as floor Nurses, Charge, medications, or otherwise, you'll have to step up and do what is needed and I'd hope it would be done with grace, humility and genuine care, if not than Nursing just might not be the correct fit for your profession and economic future. The patients that WILL get a careing and compassionate Nurse will be better off and appreciate that you were wise to change to another field that doesn't require you to be as giving and kind... Just put yourself in the others shoes, er bed, and think how you'd feel being the patient! I can state witout doubt, One day, you will look back on your OP and realize that to be a Great Nurse, you have to be "selfless" when it come to rendering patient care. sorry for the long post guys, but I had to say thanks for the great posts, and wanted to help to make the OP see what real Nurses are made of... Jeff

Re: Dangerous nursesQuoting Mamason above, "because of the ridiculous stupidity that goes on between the night shift and day shift. Don't want to be a part ot that mess anymore" Ok, you'd think the "third shift didn't do it" or the stepchild excuse was bad enouff! Now with 12 hour shifts, we're directly able to trace where the bubble burst, or the work was dropped due to negligence, sloppiness and outright lazy nurses... I try to do my best every shift with every patient, we are all human and can either miss something (hopefully nothing major!?!) or just run behind because of things out of our control, if you (we) all give others a work ethos to respect, then we can understand when someone has a bad shift... The problem is: employers now only prize the employee that's out the door on time... no matter the consequence to the other staff and the patients wellbeing... We have ourselves to blame, we specialize and have higher credentials, yet often someone slides under the radar and learns to skip the basics, initial assessments at first contact, and then it's down-hill thereafter... how can you compare a patients decline or degraded status, if "you" didn't go see and get an initial "eyefull and assessment right after report??? Also, Danger lurks in the approaching 40% of (continually relapsing) impared nurses in the workforce, (I'm speaking to the Chem-Rehab-Psych arena) far too often, we have had colleagues that we excused their borrowing meds, missing treatments, and skipping protocol and NOTbeing nice, respectful and part of the team, danger also lurks in spiteful and bias thinking between LPN's and RN's and techs that think they are nurses... Lastly, tighter attention by management to job descriptions and accountability to assignments is lost when management makes us all worrk with higher acuity, greater numbers of patients, under trained and streesed out staff. the last example is my number one complaint. Employers are now driven ONLY by the $$$ and not by quality care... sure they say it, but quality care is out the window when you look at the staffing sheet, and you are chronically down by 2 or more nurses, YES, I said chronically despite med errors, accidents, falls and omitted treatments, late IV site changes, dressing change omissions, patients hygiene needs neglected.. Just be sure to clock out on time is the mantra, where once it used to be give our best, and go the extra mile because the patients deserve it! Somewhere over the last 15 years it's all changed and seldom for the better. There is NO shortage of nurses, it's a shortage of nurses that will keep working in dangerous situations, for far too little pay fand employers that don't care or value your service... just my soapbox 2 cents, thanks, I feel better now, ;-) OMGosh, I hope you feel better also, when really reading, line breaks aren't needed, if one only skims, they can mis-read and lose the point. play nice now... ;-)

Quoting Mamason above, "because of the ridiculous stupidity that goes on between the night shift and day shift. Don't want to be a part ot that mess anymore" Ok, you'd think the "third shift didn't do it" or the stepchild excuse was bad enouff! Now with 12 hour shifts, we're directly able to trace where the bubble burst, or the work was dropped due to negligence, sloppiness and outright lazy nurses. I try to do my best every shift with every patient, we are all human and can either miss something (hopefully nothing major!?!) or just run behind because of things out of our control, if you (we) all give others a work ethos to respect, then we can understand when someone has a bad shift... the problem is: employers now only prize the employee that's out the door on time... no matter the consequence to the other staff and the patients wellbeing... We have ourselves to blame, we specialize and have higher credentials, yet often someone slides under the radar and learns to skip the basics, initial assessments at first contact, and then it's down-hill thereafter... how can you compare a patients decline or degraded status, if "you" didn't go see and get an initial "eyefull and assessment right after report??? Alsp, Danger lurks in the approaching 40% of (continually relapsing) impared nurses in the workforce, (I'm speaking to the Chem-Rehab-Psych arena) far too often, we have had colleagues that we excused their borrowing meds, missing treatments, and skipping protocol and NOTbeing nice, respectful and part of the team, danger also lurks in spiteful and bias thinking between LPN's and RN's and techs that think they are nurses. Lastly, tighter attention by management to job descriptions and accountability to assignments is lost when management makes us all worrk with higher acuity, greater numbers of patients, under trained and streesed out staff. the last example is my number one complaint. Employers are now driven ONLY by the $$$ and not by quality care... sure they say it, but quality care is out the window when you look at the staffing sheet, and you are chronically down by 2 or more nurses, YES, I said chronically despite med errors, accidents, falls and omitted treatments, late IV site changes, dressing change omissions, patients hygiene needs neglected.. Just be sure to clock out on time is the mantra, where once it used to be give our best, and go the extra mile because the patients deserve it! Somewhere over the last 15 years it's all changed and seldom for the better. There is NO shortage of nurses, it's a shortage of nurses that will keep working in dangerous situations, for far too little pay fand employers that don't care or value your service... just my soapbox 2 cents, thanks, I feel better now, ;-)

Hey Robi, First look up refresher courses on the net for your area, I believe there are a few in Florida, maybe middle of the state or in the north, I know of a Clinical refresher held in FtL, that's Broward County... and some state schools will hold refreshers, altho there are none local to me... IPE programe might require monitored survalence, that is the BON can and will require URINE and or blood tests any number of time a year to truely test if you are staying clean and sober once you are re-licensed, and you'll probably have to sit for LPN NCLEX once your fines are paid and your refresher course is completed.. now for today, are you still going to AA/NA, if not, I'd suggest you do, because there you'll meet and make contacts in all professions, including NURSING, and you'll meet administrators, RN's, LPN's and CNA's all that have been down the same road as you have... and they'll all have their own take on Impared Nurse Programs, ect... some will be good mentors, and others, maybe not as strong and honest, but that's for you to figure out... either way they'll stear you into rehab/ behavioral health leads and jobe that'll hire you once you are re-licensed, and you'll find if you are truely clean and sobe you can again work toward re-establishing you career and find the rewards of being a nurse again... I'm not certain but all states have IPE, Impaired Professionals / Nursing Programs, and I cold be wrong, but all are anywhere from 3-5 years long, any day week or month, you can be told to go test at the nearest lab, but then, I think you'll agree, testing is EZ if you really want to be a Nurse again- you'll remain clean and sober= therefore you'll again have your dream, and since you lost it once, you'll be a better stewart for yourself to preserve it... best of luck, Jeff

Thanks for giving all nurses that have given excelence over the years (28 years as an RN so far and counting) the best of care every day, every shift, for every patient.. Alot of schools don't teach caring and class, many newer grads don't have a clue and are only manipulated by employers to become machines, and that only makes the entire industry suffer with less staffing and bigger patient loads, until something happends and patients and nurses suffer injury!

thanks, Ma, I posted earlier, likewise out for more than 13 years, and so much has changed, and to realize getting acquainted with computer charting and barcoded meds, along with no preceptorship?? I've been declined even an interview at one of my hospitals; said "if you don't have recentclinical experience, within the last 3 years, don't ask for an interview!" what's a 57 yo 2 do, I still have some skills, maturity and the old give a care, that alot of schools can't teach nor holds in high esteem anymore... Jeff

Licensed in 1980, RN/BSN 14 years all specialties and mostly ER / CCU (neuro/surg), after being out on disability for 13 years, I've took my :yeah:NCLEX and returned, and found without CURRENT clinical practice, I had to take the only job I was offered- I'm in Psych / chemical rehab for geri's X1 year now, I'd like to find a way to re-cert for ER or ICU (neuro/surg) again, but there are NO, I repeat NO clinical refresher classes within 80 miles of my home, and commuting would be an option, but I'm told clinical applications are on seperate day from classroom, and may be on evenings and week-ends, I can't hold down a job and do both... and with only 3 area hospitals, that don't offer any refresher course, what's a guy able to do? on the Treasure coast, Florida... feeling so trapped

Hi again, thanks to all that replied, I PASSED, and have had an 8 month long successful job in Psych/Rehab, and just took a Per Diem post at a local jail, bill are getting paid on time, credit card getting down-soon a zero balance, just have to wait out this housing crash, and I'll move south back into Broward County, Fla. best to all NEW graduates, do your study, and practice questions- you'll be ok! Jeff V.