phoebebrat

Opinions please. My husband is having increased hypertension. Taking metoprolol succinate 50mg and amlodipine 5mg. Diastolic has been staying 94-104. His primary (VA) instructed to him to add a dose of amlodipine at night too. This was ineffective. He called the office back to update the Dr. The drs nurse called back and said the Dr said to keep doing what you are doing. In other words keep doing what isn't working. My husband has also been symptomatic. He called the office again today to let the Dr know that his bp is still up and he was having symptoms. He asked for a Med change or increase. The drs new order, DC metoprolol, continue the amlodipine and he was adding HCTZ 25 mg qd. I was furious. Can anyone find the sense in that order? From everything I've learned my husbands bp will be even more elevated. I called back and told the office nurse that my husband won't be making that change. Is there something about amlodipine with HCTZ I don't know?!

I’m interested in private duty nursing but don’t know where to begin. What kind of insurance would I need? How would I function without working under a Dr?

Kbrn2002, All my concerns seemed to fall on deaf ears. I talked to the don about being alone and something happening with a resident. I was told to leave the resident and go call for help. When I said that a nurse doesn’t leave a patient that has fallen, or has chest pain, or can’t breathe, she said….get ready for this, it’s a brain cell killer…… the response was “Well where are they going to go? They are already on the floor!” I’m dead serious. That is what she said. I knew for sure then I was fighting a losing battle.

They are definitely a needy group. There were aides from another unit that were supposed to help me multiple times but they always refused. They were even instructed by management to help. Based on the number of smoke breaks they always take I know they had time to help. I hated to leave the residents but I figure as long as a nurse is willing to work like that the unsafe conditions would continue. No thank you!

They are putting patients lives at risk. These people aren’t in the hospital because they are healthy. Things can and do go wrong, vitals can change, pain levels can change, you may notice something with a patient that just seems “ off.” You are doing the right thing and doing what you are getting paid for. The nurses that aren’t checking vs and doing assessments are falsifying documentation and not taking care of their patients. They wouldn’t even realize if their patient started to show a sign of decline. I wouldn’t want their work ethic and I definitely wouldn’t want to be their patient!

Thank you for all the replies. I did decide to quit the job.

Overtime is only paid on certain calendar days because of the way the pay periods are set.

I would like opinions on this situation. Due to staffing issues it has become normal for me to be without an aide between 10p-6a. I work on a skilled unit with 18 residents. I think this is very unsafe and unacceptable. I have complained to management about my safety concerns but don’t really feel heard. How would you all handle this situation?

I too am in the same situation. I have never been comfortable with change. I usually fight against it instead of trying to go with the flow, which only causes me more problems. I currently work in LTC and hate it. I'm not learning anything, and feel I am losing what I have learned. I worked in med/surg for two years before the LTC and I was terminated. I want to go back to med/surg but really fear getting fired again. My self-esteem has really suffered, I didn't have much in the first place. I miss actually feeling like I know something, and actually helping/seeing a pt. get better. I also really dread that interview question of.....why did you leave your last job?, or have you ever been terminated? The LTC I work at now fires nurses constantly. I would think they would be happy to have them on staff. They don't seem to care about the bind they put nursing in with being short staffed and what about the residents? Lack of nursing affects them too. Good luck whatever you decided and let us know! Phoebe

My experience has been that the oldies eat the newbies. (I'm 45 btw, but a new nurse), Why can't we all just get along?!

I'm still so depressed. It's been 7 mo. since I lost my med/surg job and I still can't seem to move forward. I have a job now in LTC, been there for 5 mo. I strongly dislike it. I don't feel like a real nurse at this LTC job. (please nobody flame me, that is just how I feel) Also the facility I work for doesn't even have a policy and procedure manual to follow. I'm scared to do something wrong, which is what happened at my last job. A big part of me wants to go back to med/surg but what little bit of self confidence I had is gone. I had one interview at a hospital before I accepted this LTC job, and the interviewer only seemed to focus on my failure at the previous job. I thought I was doing the right thing by being honest during that interview. Any ideas to help my problem?

You didn't say why you feel your job is on the line.

I think the shortage is in certain areas of nursing. When I worked med/surg I averaged low census one day per pay period. Now I am working LTC (and hating very minute of it) and there is a terrible nurse shortage on the floor. There is a reason for that.

Would I be correct to guess you are working in a LTC? When I worked in the hospital my orientation as a new nurse was 3mo. In LTC it was 2wks and I was with a different nurse each time. A couple of times I was even with a QMA. There is so much that they did not teach me, esp. the paper work. I think orientation in LTC really sucks!

I have worked in a LTC for one month now. I almost always leave on time, although I don't know how. I always wonder what I forgot. I work nights though and it seems that the day nurses have so much more to do. There is one day nurse, who has been there for many years, and the earliest I have ever seen her leave after her shift is after one hour over. She is usually there for another 2-4hrs over her shift, and NO I'm not kidding. It sounds like you are doing fine! Give yourself a break. Phoebe

Probably, but I'm not going to. I think I just need someone to talk to that understands and can help me see this whole situation in a different light. The people that I have available to talk to either aren't nurses or have never lost a job that meant a lot to them.

I started a new job in LTC about one month ago after being terminated from my med/surg position. Some of you may remember my post about having the pt. who was allergic to Vanco and MD ordered it anyway, telling me to have epi on hand "in case of allergic reaction." Anyway, I just didn't feel like I was ready to put my tush back on the line in med/surg yet so I thought I would try LTC. I'm working at a very nice facility, nice work conditions, nice schedule, nice pay, and this is the first LTC that I had ever been in where the residents didn't smell bad. Some actually smell good! My problem is that I'm just not happy there. I'm still depressed over losing my previous job, and am always comparing this job to the old one. I feel like at the LTC all I'm doing is giving pills, doing accu-checks, insulins and vital signs. Am I missing something? I just don't feel like a nurse anymore. I feel like anyone could do what I am doing at this job. For those of you that work in LTC and love it, please don't flame me:(, I'm trying to make sense of this change I'm going through and really am trying to like the job. There are some things about this new job that I'm really uncomfortable with. It is under new management and somehow the policy and procedures have been lost:confused:. I asked to see that the first day I was on the floor and nobody could produce one. I was told that they are being rewritten. Another thing that scares me is all of the autonomy linked with this job. Autonomy was never a good thing where I worked before. I've seen so many nurses use the old....do it now, get the order later routine, and they say, "don't call the doc now, they will get really mad." I want no part of that after losing my last (and first and only) nursing job. I was a lot more stressed when I worked in med/surg but was happy with my job choice. I really felt like a nurse and felt like I was making a difference. I still fear getting fired again and would be scared to go back to med/surg now after what happened. Can anyone shed some light on my situation for me? I feel like I'm just not able to think clearly anymore about what I'm supposed to do with this career.

I just started in a LTC facility a month ago. I work in the rehab/skilled unit. I miss the hospital environment and was wondering if someone could tell me the difference between rehab hospitals and the rehab unit in a LTC? I've been thinking about seeking a job in a rehab hospital because this LTC just isn't what I had in mind when I went to nursing school. Any feedback would be greatly appreciated.

I would love to be an interior decorator. I just practice on my own home now.

ALWAYS make sure you get a COMPLETE order from the Dr. Remember pt name, drug, dosage, route, frequency. I lost my job over one of those items missing from an order. Don't let this happen to you, even though you might see the other nurses do it!! Also, I saw a co-worker get chewed out by the NM because when he was giving report on a previous shift, the CNA was in one of his pt's rooms cleaning the pt up and she hung the O2 cannula on the IV pole. He got blamed for the pt not having the O2 on even though he wasn't the one that done it. The next shift was kind enough (sarcasm) to write a variance on him.

I think you did the right thing and good for you:yeah: I would have done the same thing. It might not have been the correct action "legally" but I think it was right ethically. You have to live with yourself and would have felt bad if you didn't do anything and this guy went unresponsive. I wonder if it would have been all right to do something then? Oh, but I guess that is different. And seriously, I don't think the hospital would be liable if something went to court, I'll bet the nurse would be. Crap runs downhill. That is my experience anyway. I also think that checking VS is an assessment, not a treatment. Good for you for doing what you felt was right. You will come up against those kind of decisions many times. Good luck!

Thank you NewEngland RN for your question about working in LTC. I also have about 2 yrs. exp. in med/surg, am currently not working and I'm considering LTC. I can't answer your question but I am curious to see your responses. It's like you read my mind! :wink2: Good luck with your decision.

BTW, what is a redspoon patient?

I'm sorry to hear what you are going through. The only advice I can offer is maybe you should consider consulting with a legal nurse attorney. If it is just a consult I don't see how any future employers would know about that. Your consult should be kept confidential. I'm not sure what the problem is about you collecting the unemployment. Were you saying that the DON had a problem with it? Do they even know if a former employee goes after unemployment? It sounds like they were looking for something to catch you on. Maybe not, but appears that way, you might also feel that way. I lost my job more than a month ago over an order the dr. signed and then decided to complain about it, that it really wasn't an order. Another nurse got herself involved and I think she might be the reason I was let go. I know what you mean about the hurt, fear, disappointment, and all the other negative feelings that go along with a job going sour. About her reporting you to the board of nursing though, wow, that is really harsh and probably way out of line. You are going through so much with your family, divorce, now this, I just can't imagine. I don't know of any other advice to offer but I wish you luck and hope everything works out for you.

Thank you to Poochie for this post. I lost my job 33 days ago and am still crushed. I'm trying to talk myself into applying for jobs this week. I'm really nervous about it, I'm afraid that during every interview they will ask me why I left my last job, find out I was terminated and I will never get another nursing job. I never harmed a patient, probably helped more than anything but it is all policital BS. Sometimes I wonder if the DON just likes to take a nurse and make an example out of them with ocassional firings. I also hope that every superior that fires a somebody without GOOD reason gets to feel what it is like for themselves at some point. Especially considering all the rude, unprofessional comments they feel it is necessary to make during that horrible discussion. I feel for all of you that have been through this. RedZepplin, what you went through, unbelievable!!! I hope you heal completely from your terrible ordeal. Thanks to everyone for sharing their feelings. I was beginning to wonder why I was taking this situation unusually hard. I see that now I am probably reacting in a normal fashion. It is truly very difficult being a nurse.