busy-bee

They have yet to bring this up again with me. I think they understand that by bringing this up after I have told them I am uncomfortable with their request would not be in their best interest. The person they terminated was terminated unfairly when the facility knew this situation and they are at fault for allowing it to go on for years without doing the right thing from the first incident. I wish I could just tell you all what it is cuz it would put a different light on it. And the person terminated was a victim as well of their denial. Not only once, but many of times. I feel very sorry for this person, it is not fair this has happened. They say only unemployment is what this person could get but I disagree. When I turned this in verbally it was to say "look this is happening", "you need to be honest" but they instead said "this person is the cause of it all" "terminate"! I wish I had some balls, I feel terrble.

This is a non union facilitly. I have done nothing wrong and I am not quiting my job just because they think they can force me into doing something I told them I do not wish to do. If I write what I know, the heads will roll and they should know this. They said "don't be elaberate with your statement". I am not writing anything to help the facility dig themselves out of hot water...nope....not me.

I have been requested by the facility I work at to write a statement that I verbally reported. When I verbally reported the situation, to my knowledge no action was taken. Several days later, after a series of events...they terminate this person. Now they want me to put my verbal report in writing. When I verbally reported what I had seen, the DON stated to me many reasons why my verbal report was basically not credible. I do believe this will go to court...and I do not wish to put anything in writing for many reasons. I know this is very vague...but I need to be very vague. This situation has been going on for several years at this facility, and many staff have been affected by this. The facility is trying to blame this one individual for the final outcome of their denial of the situation and not taking the appropriate measures years ago. If I put anything on paper in will be the truth, the WHOLE TRUTH. This will be very bad for the company. I explained I am very uncomfortable....but got the dagger look. What should I do, I have been told my job is in jeopardy if I do not write this.

Maybe I should know this..but I don't...and I can't find any literature on this. If a patient has a triple lumen feeding tube...first g-tube...second J tube...and I think third is BAL...Which site is used for the feeding. I have always been told the J tube, due to this type of tubing is used when a patient has difficulty with gastro feeding. And the G-tube used for the medication and the BAL is to left alone. NO MD order present...which should be...but none. And not my patient but overheard the other nurses talking about which one to used...and they all told the nurse in charge of the patient to use the G-Tube. I disagreed stating what i did above....but more importantly said to call the MD to get an order. I guess she decided to use G-tube. So.....does anyone have correct answer other than the real one which is to get an order. Patient has been in facility for over two weeks and it seems funny to me no one has clarified this.

No sure what the final outcome of the patient. The rapid response doctor did not write an order to send him to ICU, why I am really not sure. This was the second rapid response that was called on him within 12 hours so one would of thought the plan would of been ICU. I asked the supervisor what the plan was, and she said she just did not know. I have only been in the hospital setting for a short period of time so all this was very new to me.

Had an elderly pt with A flutter with RVR. History of two MI's, one a year ago or so. PT respiratory rate like that of cheyne stoking and rapid response called on him several times without change in condition. Blood pressure bottoming out, desating, pt anxious trying to get out of bed so he could breath. We wanted pt to be transferred to ICU but it never happened. Pt is a full code and the pit in my stomach was terrible. I was having chest pain from worrying myself to death and from running myself ragid. I had seven pts all primary care. When I asked if he could be transferred to ICU the supervisor stated he was not a candidate, even though that is where he was transfered from. I felt so useless.

"I'll help" but the help never comes

Thanks for your replies, it is frustrating due to the the time that is wasted prior to getting permission to notify. They say you can't put what the doc actually says if he is rude for that is called negative charting. I would never call unless it was important and always have everything in front of me prepared for the doc. I think the system is broke if you have to spend time tippy toeing around people who are suppose to be professionals. The next time I call for a BP that is sky high and I have nothing to admn and the doc yells at me and gives me no orders I will just call a RRT and then he can deal with it later.

I work night weekends on a med-surg unit. I have been there for about 7 months. When I first started, the LPN's prior to calling the doc, had to discuss the reason for wanting to call the doc to the RN/PCC or the Supervisor and they would decide if if the nurse could. Then after three months, we were informed that only the PCC was allowed to call the doc. Now it's the LPN runs it by the PCC, she decides whether LPN calls or she calls. And every since I have worked there, I have been informed of how this Dr. is going to "chew your butt out when you call him so be ready". Not for something you have done wrong, this is just for calling him. Hell before I even call the doc, I am so damn stressed out it is unreal. First for having to run everything by the PCC....then wait to see if she/he gives me permission...or if she decides she'll do it or will I...and then wait to get my butt chewed. Understanding the PCC must know at all times what is going on with the patients. And then if I am told not to call....where am I protected as a nurse. And if I get to call and the doc yells at me and gives me no new orders except DON'T CALL ME....then what? All the other places I have worked....I just called....I didn't have to jump threw all these hoops. I would really love to chart "{Dr. informed of change of condition and no new orders except he states "don't call me again!"}

Thank you all...tonight I had a great night, I hope for many of these.

I have been a nurse for seven years, all in LTC. I recently took a LPN position on a med surg unit. It is pretty overwhelming. The patients are fine, it's the computer I am having problems with. It just takes me so dang long.......all the other nursing are done with their assessments before I even get done with my first assessment. I am so use to looking at paper MAR's, that the medication administration list on the computer confuses the heck out of me. I am so cautious not to make any med errors which takes me a great deal of time administrating meds. I just want to make sure I do things correctly/accurately. And the reports are taped and the nurses go so fast...and sometimes you can't even understand what they say. I am being really hard on myself and thinking about going back to LTC, but I want this experience. I know I can do this if given time to get in the nich of things. Need some encouragement.

Write each and every occurence up. I know taking time to do this is aggrivating as all h*ll, but you need to do it. Just write it quick, simple, and to the point..hand it to the CNA and be done with it. No long discussions, or going over what is written....it is written and she can read. If you give her a verbal...write...progressive disciplinary action on each occurence. That should take care of it...and if she continues...then move to the next step....even if it is the next day...and give her a written warning...writing...progressive disciplinary action on each occurence...after a few of thes progessive actions she will either quit, be fired, or get her head out of her...ya know.

I have just accepted employment at our local hospital. I have been a nurse for seven years all in which I have spent in nursing homes/rehabs. I am feeling a bit anxious and hoping I have made the correct decision. I feel I am a good nurse, but my skills are poor related to nursing home experiences doesn't give many opportunities to start IV and there are many procedures I am not familiar with. I feel this is the best thing I can do for my career. I will be working 6p to 6a weekend op on the med surg unit. Has anyone had this transition and if so will you share your experience with me? The pay is good too, which I was shocked.

DX MRSA in urine...tx macrodantin....no cath placed....is this common? At all the other facilities I have worked, we always placed a cath. No a private room either, and both patients use the same toilet?

Today my intent was to put altered nutritional status as the nursing diagnosis related to a patients low albumin level. Suggestion was to put...."low albumin" as the care plan since this was the problem. Low albumin is not an approved nursing diagnosis. In this facility every order, there is a care plan, that is for labs draws, xrays, everything...not one order should not have a care plan. I am a bit confused. This is a nursing home, and all the other places I have worked upper management took care of the careplans. I don't object to doing them....just need a bit of help. I thought altered nurtritional status....was much more appropriate than low albumin....what do you think...or do you have better nursing diagnosis. The order I received was "full dietary evaluation related to low albumin level". Help....how about nutrition, imbalance. :bowingpur