BizzieRN

I would like to thank all of you for your input. I guess the doctor is going to have to get used to getting phone calls in the middle of the night. I just wish she would be more professional on the phone at 0300. Working in research is sometimes not as cut and dry as working the hospital. We obtain a medication list from the coordinators for each subject, and that is what the subjects have to take. No changes and no deviations from that medication list. But then when they are admitted to our inpatient research unit, we find out that our subjects change their medication regimen in a way the see fit for certain situations (i.e. Taking humalog after eating when they have a low prepranial BS, or only taking 1/2 of a B/P medication at HS for a low B/P during the day. It is up to the subject to take their medications as they would normally take them at home. Now with this new rule, the subjects can't really do that. The subjects' autonomy is gone. There will need to be better med hx's taken by the coordinators to avoid late night calls to them too. I have learned a valuable lesson from all this. Poor Doctor will be getting a lot more calls than she likes. I feel sorry for her and her family, esspecially considering she has 11 month old baby at home :stone, but she will be getting exactly what she wants.

recently my work promoted an associate rn to nurse manager. i am a bsn nurse and very angry with this decision. not only did i never get offered the position, but the adn has been an rn for less than 5 months. there are also two other nurse's that are bsns (there are only three bsn nurses in my facility) and never offered the position. what a slap in the face i'm considering putting in my resignation over this. all the bsn nurses are charge nurses and we have discussed among the three of us about "looking for better opportunities" what's the point of having a bsn if i can't grow after being with this company for over a year?

I am a night charge nurse that works in diabetic research. Two nights ago I was given shift report about a subject with a low blood sugar. Well come to find out the evening nurse had allowed the subject to administered 35 units of Humalog with a BS of 108, post dinner. At the time for HS snack the subject was down to 56 and symptomatic. Administered the snack right away, and continued to monitor his BS Q15mins until symptoms subsided. The subject continued to be on a roller coaster with his BS's and finally at HS he was 52 and I suggested to the nurse assigned that he should obtained fingersticks at his discretion and administer OJ and crackers before bed. Then came the big question....should I administer the 30 units of Lantus? I advised no. The subject was obviously unstable and I wanted to avoid any more dips in his BS. We should wait until morning and see what the doctors would like to do with his regimen of insulin. So the nurse held the Lantus, and agreed to report to the day nurses to notify the doctors in the morning. 0200 the subject was back up to 78,asymptomatic. The next morning the day nurse failed to notify the doctor, and the doctor found out the hard way about the Lantus being held the night before. The doctor had a hissy fit! And these are the new rules that came from the Doctor's hissy fit... Now if a nurse is going to hold any medication....we have to obtain a doctor's order. Now if the subject wants to administer any more or less insulin than what is written in their medication history....we must obtain an order. Nurse's discretion is somewhat of a gray area, but it falls under the oath of patient safety. I know in a hospital setting I held insulin all the time for low BS, also B/P meds, without an order. I'm just wondering if I used my nursing discretion correctly? I know Lantus peaks in 6 hours (and good thing the subject didn't get lantus, b/c he was down in the 40's in the AM), but I am monitoring subject safety. And I thought that was the safest thing to do within my scope of practice for that particular study. The doctors do not want to be notified in the middle of the night unless the subject is symptomatic, or if it's an emergency. But its such a catch 22 sometimes! The doctors get mad b/c my night nurses don't call them, but whenever we call we get rude answers and attitudes. Plus the questioning of why it couldn't wait until morning. Sometimes I feel like I never make the right decision, and my nursing discretion sucks.... These new rules about obtaining an order for holding medications are irrational. Do nurses need to have the hands held so much or am I feeling belittled? Anyways, thx for letting me vent.

I work for a rapidly growing research company and I am the only RN on nights. About two months ago I requested leave a month in advance, for two days off. One week before my leave was due I get a letter from my nurse manager saying she couldnt grant my leave. Reason behind it was because no other RN was willing to take up my shift for those days. Okay so I missed out on precious time with my fiance, who is a marine stationed far away from me. He was only in town for a week, and I only requested two days off. That was strike one.... Strike two! I put in two days of leave about two weeks ago (kind of short notice, I know) for a spur of the moment family event for this upcoming weekend May 17-19. Surprise! Last night I got a note from my manager stating my leave was denied! My family is extremely upset, seeing as I will not be at a remembrance for my older brother who passed away. Seeing as I have a wedding coming up, a honeymoon, and all that goes with that, I am quite worried about getting leave for these things. Day shift and evening shift RNs have NO problem getting their leave approved. My questions to you all are: Do any other night shift nurses have problems with getting the leave they request? What do you think I should do? Isn't it a nurse manager's job to help out when needed? So doesn't that included giving your primary night shift nurse a break and maybe take her shift for two nights???? Let me know what you think. I am a valuable employee to this company, and I really don't want to quit over something as stupid and childish, like not getting my way with my leave. But I have missed out on two very important events already this year

I work five nights a week at the moment. I have to be honest it is tough at first. I would rather do four ten hour shifts, so I have the extra day to recover. I hope they are giving you one day off during the weekdays. I have found that having that one day can make a big difference for things you can only do during regular buisness hours, ie doctor's appointments, errands, ect.. It takes a special breed of nurse's to work nights. Just remember to take care of yourself, so you can give the best care you can to your patients. Sometimes that can be hard on nights, because you are working against everything your body is used to.

Just an update for all you who viewed and commented on my post. I went ahead and wrote a professional letter to my floor supervisor and all the managers below his rank. Starting tommorrow there will be two meetings. One at 1400 and one at 2030! I have to come into work an hour and a half early, but at least I am getting 8 hours of sustained sleep. Thank you too all of you who posted comments. You all gave me the strength and encouragement to write that letter and hand it to them. With all the research I've done, maybe I'll write a professional journal article on night nurses and the issues management fails to comprehend.

I have offered to buy a tape recorder, a video recorder, and send one night shift representative to these meetings, but they are still mandatory. I guess I will try a professional letter next. My managers put on our evals how many meetings we missed. To be honest these meetings last 20 minutes and can be put into an email. I am to the point of calling the State Board of Nursing and seeing if they some sort of law/regulation protecting night shift workers against things like this. If there isn't there should be. We have people'e lives in our hands and if we only get 4 hours of sleep, because of a mandatory staff meeting, a serious error can be made. Pilots and truck drivers have laws about sleep, why not nurse's? Maybe there is one, I just have not found it in my research.

I have recently started working for a rapidly growing research company. I am the only full time RN on the night shift, and usually the only nurse for the facility on those nights. I have about 25 patients in house every night. In addition to my full time night schedule I am required to attended mandatory staff meetings at 2pm approximately every two weeks. This cuts into my sleeping time, and I am usually scheduled to come back that same night as the meetings to carry out another night shift. I do not feel comfortable working under my nursing license after those staff meetings. After several conversations with my managers about this issue, they still haven't changed the policy, or made special arrangements for me and my support staff. I am seeking some help on laws and regulations that I can bring some serious attention about this matter. If anyone knows of any resources I can use, I would be greatly appreciative. Also if anyone has some extra guideance on what else I could do besides quit. Sometimes I feel because I work night shift my demands are ignored. Do any other night shift nurse's get that impression? Thanks