ObamaRN08

No I am in Indiana, nothing is mandatory. we will sometimes get nurses that come from places with 1:6,7,8 pts and when we tell them we only ever get 3 or 4 they nearly keel over, when we tell them we have an admission discharge nurse they say I think i died and went to heaven! lol

I work for a magnet hospital, and it is no where near as bad as what you all have written. Our ratio is 1:3 in our stepdown, and 1:4 in med-surg, however is is not uncommon to only have 3 on medical. We have rapid pt turnover, we may discharge 2 and get 2 admits, but we have an admission discharge nurse everyday but sunday and she does all the teaching too. Its a 32 bed unit. We were recently having a staff shortage and when staff complained that they were getting 5 pts to 1 RN they hired travelers to help out until our orientees were all trained. We have patient care assistants each one takes 8 pts. and we have 2 unit secretaries during the day and 1 at night. We also have a unit tech that fills our carts with supplies everyday and helps strip the rooms after discharge. I love my facility. they listen and try very hard to keep us happy. they know that happy nurses make for happy patients. we share in leadership, the staff interviews applicants, We have a say in nearly all unit decisions. We have problems as every workplace does, but nothing major... Granted it is a For-profit hospital, and I think that probably makes all the difference in the world. When nurses on my floor complain, I can't help but ask them if they realize how spoiled we are. We have got it much better than I think they realize. I wish all of you could have the same experience. I love my job and I enjoy being there. Not every hospital is horrible to their nurses. Some places spoil them!!!

I completely agree, how many times have you seen a coworker doing the "dance" because they can't find time to use the bathroom?! or found yourself 9 hours in without having had a single minute to catch your breath or have a drink of water? We have started to shout "Remember Maslow!!!" at each other to remind ourselves that its okay to go to the bathroom before you check off that order or whatever. how can you focus on your patient if all you can think about is having to pee so bad you can't stand still!

OMG... The nurses where I work are sooooo spoiled. our max Med/surg assignment is 4 pts to 1 RN PCU max is 3:1. Plus we have CNAs. So if my unit is full (14 PCU and 18 Medical beds) we get 11 RNs (if we are fully staffed) and 4 CNAs and we have an admissions and discharge nurse!. I am often charge nurse and have to work out assignments. My nurses will absolutely throw a fit if They have to walk to the other end of the hall. but then they throw a fit if their assignment is to heavy but is next to each other. There is absolutely no way to keep everyone happy when it comes to assignments. thankfully they only complain the first few minutes of the shift. I can't imagine tryng to keep track of 8 patients. It sounds dangerous to me.

The drug in question was calcium chloride. and the root analysis went well and they didn't point fingers so that was good. I made the suggestion that it no longer be an option to treat these infiltrates or not treat them. that we treat every one of them every time. everyone agreed that there needs to be a policy and procedure in place for these types of situations, and I believe they are working on one now. so at least something good came out of this and on the way out of the meeting my boss said he was proud of me. SOOOO....I guess Ill stick around a little longer...but i might update my resume!

I am so sick of my facility expecting me to be a nurse doing total care of critical patients AND expecting me to be a doctor. I did not go to medical school. I went to NURSING school. yeah sure I need to question crazy orders and get orders for crazy things that happen. I am okay with that. That is my job. I am NOT okay being held resposible for a MD's decisions. I had an IV infiltrate.. okay my job to deal with this. fine. I call pharmacy and ask if this drug needs any kind of extra attention ( an antidote or what-not) Pharmacy says well, there could be some damage but it is not likely and is not common practice to treat. I didn't go to medical school so I call the person who did and is responsibe for making these types of desicions. Pt IV infiltrated, such andsuch drug was running pharmacy said this and this, area is swollen but pt states is not painful at all , didn't even know it was infiltrated, ice pack applied per pharmacy suggstion. MD in to see pt...no new orders. will continue to monitor. 2nd Iv site infitrate area slightly swollen, pt states area is not painful ice pack applied. Md notified. No new orders.will continue to monitor. end of shift and I go home. 2 wks later. call from upper management for root cause analysis. pt infiltrate site got necrotic and had to be debrided. then a wound vac. where do I stand here? Did I not do what I was supposed to? I notified the doc and called pharmcy about it. I caught it from assessing the site properly. but for some reason I feel responsible. Pt has now passed after a surgery on the legs, an unrelated incident I HOPE. Manager says it was not related. I stil feel responsible though. IV infiltrates happen. you can check it and maybe even the moment you leave the room the patient moves wrong and its 2 hours before you get back in there. It sucks but I am not negliegent in this as we assess patency Q2. WHY do I feel responsible. Why do I feel like the worst nurse in the world like I should somehow magically aquire the judgement skills of a medical dr in 1 year of nursing. like I shoud have insisted the MD do something differently based on some knowledge of pharmacology and pathophysiology one aquires in medical school. Yes I know that I need to know quite a bit, but come on! If I knew everything why do we even need doctors??????? Okay. Its out now and I feel better. Thanks for reading the VENT!

Perfect Circle, orestes, "give me one more medicated peaceful moment" Another by Perfect circle, The Nurse Who Loved Me "she's got everything I need, some pills in a little cup, Im takin her home with me, all dressed in white, shes got everythng i need, I can see it in her eyes, she acts just like a nurse...with all the other guys" love that one! Tom petty, I won"t back down" I love this thread!

"When you have a party, do you clean before bed or in the morning?" Umm..that would depend on how much I had to drink.