nursing_problem

I agree with you mam. If only they know how much we do our best not to commit any mistake to our patients.

actually i brought the kid in our nursery to Ask for assistance. However, they went outrageous when they learned that the kid will be the only one to go inside and.without them. So i brought the kid back to er and inserted it myself. I actually believe tht sometimes having relatives who have attitude like that brings negative vibes. It may cause stress and pressure making you fail.more

hi guys. just want to ask how do you deal with relatives who demands nurses to make sure they can insert or start iv just once esp. in pediatric patients. we all know that we dont like failing an iv to any ptient but their are times that we have bad luck on starting one. The relatives kept on telling me that i dont know how or im not good at inserting an iv for failing once.i tried again and i succeeded. It bothered me how they yelled at me infront of other and told that i dont know how to insert an iv.

in the letter she stressed out that i committed breach on ptients confidentiality.. i dont know what she was really trying to point out.. whether the patiemt is hearing her Bp or other people in the er have also heard.it. she also told i was arrogant. well for me, during.that situation, the best thing to was just to ignore her and not say anything because it may juat aggraviate or worsen her issue.

Update: she already sent an email of her complaints to our chief nurse.. But our chief hasn't talked to me yet.. I hope she'll understand my actions the way you guys do..

to make it short, its about a relative who was complaining why i said the bp of the patient to my colleagues esp. our resident doctor louD as well as when she asked me what is the bp. she didnt inform hat she doesn't want the patient to hear the vital signs for it may cause stress to the patient. that is a big deal for her and threatened that she will file a formal complaint to my superiors.

Thanks.:)

thanks guys.. i feel enlightened from your comments.. i talked to our chief nurse this morning.. and she said that i shouldn't mind what that relative have said.. she just admit.her relatives.in our.hospital for treatment and just to find something to complain about. with your comments as well, i feel i can really feel i can defend my actions to that woman. i just thought if we nvr communicated the bp of pt to our resident doctor we will not be able to givw het patient proper treatment at once. another question..based from ur experience, does stress really make your bp that high?

And by the way, we are used in telling the doctor the VS of patients in a voice where everybody esp. The other er nurses are able to hear.

Definitely I'm not from US.. The patient was not really feeling well to give us any information so her sister,which is the closest relative, makes decisions for her. Upon arrival, the relative didn't inform us that she didn't want the patient to hear her BP. I understood that she doesn't want to cause any stress to her patient. It was only when she approached me and asked for the BP again that she informed me of what she wants. But she's already angry with us.

t just happened this morning. A formal complaint will be filed maybe tomorrow or days to come. I haven't spoke to my the hospital administrator or medical director yet and they haven't reprimanded me.. YET. As I spoke to my chief nurse and head nurse the way I look at it, they understood the situation I'm into. I've already handled ptients whose relative requested not to tell the BP to the patient. And as requested, I tell the relatives the latest VS and if ever the patient asks I just say its quite high or low but we will give medications for it and rechecked it again.A

Thinking of the situation makes me nervous more and think I really did something wrong like not apologizing and answering back. But my point was to explain since she asked if that's how we do it in ER. What makes me nervous more is they're going to write a formal complaint letter to the superiors of our hospital. I always thought the pateint/ relative will always be right in situations like this since plainly speaking, they are customers. I already have spoken with our ER head nurse and chief nurse.

The patient was wheeled in ER via stretcher. Normally we get the data of the patient and her vital signs. After obtaining data, our resident doctor did his history taking. While doing it in the bedside of the patient, I told him the BP of his patient was 200/100. While transferring the data of the patient in an admitting chart, a relative went to me and asked for the BP of the patient. I told her in my usual voice that the patients BP is 200/100. She began to complain I'm a bit vulgar in saying the patients vital signs. She told me it may cause stress to her patient and cause elevated BP. So I told her ok, kowing inside me next time we will not divulge it in front of the patient. However, she get my name and have it written in a piece of paper. Unfortunately, one of my colleagues did not know the precaution that relative gave regarding the BP. Upon rechecking he told our resident doctor the lateat BP which was 190/110 which make the relative angrier. She told us is that the way we do it in ER? What if our Bp is high and hearing it doesn't it make it more elevated.. I told her that's the way we do it and communicate with the resident doctors in er and the nurse who rechecked it didn't know her precaution. After awhile, a co staff in the hospital told me, the relative told her If I was her daughter she would spank me. Is that how the nurses are in our hospital and we don't have etiquette. At the same time, she also told my co- ER staff that they will make certain actions regarding what I did in ER. She also told my colleague that I didn't apologize and answered back to her.I'm quite nervous of the possible things that may happen. Our chief nurse knows that relative for her manners. During previous hospitalization, our chief nurse started intravenous infusion to the granddaughter of the said relative. Since being a grandmother who doesn't want her relative getting hurt , she demands for the sharp shooter. One of the er nurse told her that our chief nurse is the sharp shooter in our hospital. She said to our chief nurse "so what if you're the chief nurse?"What do you think of my situation? My friends and I can't help but be sad because we were just doing our job. If certain precautions were told from the moment they brought in that patient, we will do it the way they want. But apparently, the relative just informed me after the second time I told the BP of her patient.

i know i haven't experienced a lot yet and my comment won't weigh much. but reading your entry is an envy for me. You find your job like a routine already and how I wish I could be one in the future. Consider yourself lucky coz here in our country we have nurses who experience 10: 1 ratio because of problems in gov't fund. We have no choice but deal with it coz we need experience so we can apply to other countries for a greener pasture. Maybe God is just waiting for the right time to give you the position you've been applying for. Just pray..! :)

Just take what she told you as a challenge and accept it. Think of it as a drive for you to make a smart care plan for your patient. Just knowing that you did your best is already enough. In case she finds your work still not good enough, don't be disappointed. just listen to what she'll tell you and who knows it might help you in the future. AND don't ever follow her footstep of being unprofessional. you can give comments to your students/ colleagues in a more positive way. :)

Well, there are times I evaluate how I did for the day. Sometimes, its overwhelming to see that I admitted a patient by myself, didn't get nervous because I knew what I did, etc. BUT.. I must admit I sometimes get toxified when there is a patient to be revived and move a little faster like I"M running already to our ecart nearby. I just saddens me that people didn't notice a change in me over the 6 months I've been in the area. Do you believe that you have a tendency to do what you learned from your training when you're already a staff nurse?

I know mistake is not acceptable in our profession but the truth is we cannot avoid making one.For a newbie like me in our work, I feel like I'm the most stupid person ever landed in planet nursing whenever I make mistakes and write an IR. My mistakes are not grave but its pretty depressing. Knowing my mistakes can be avoidable by some but I still managed to commit it. Im working in ER. Some of my collegues says that I'm toxic whenever I move around the area or carry doctor's order. They tell me to relax. Whenever I relax and do things at a pace I think would be enough for them, someone will tell me to move faster because patients are piling up. I just dont know what to do already. Any tips can you give me to atleast do good in our everyday job and lessen mistakes?

thanks esme.:)

thanks.. but my problems is, my topic should be clinical performance but instead the criteria i used for is for clinical competency.. im asking for an advice if i should go for clinical competency instead but it has problems which i stated already or go for clinical performance.. im asking for help what criteria i can use to measure clinical performance of er nurses? does clinical performance mean nursing skills?

I got my research topic already.. its about emergency room nurses' clinical performance and time management.. i need help/ suggestions.. i constructed my proposed criteria for clinical performance and questionnaire and based it on 11 key areas of nursing responsibilities... i thought it can be used as a measurement for clinical performance.. however, when my professor checked my proposal she said i can retain my questionnaire but instead of clinical performance i should change my topic as "clinical competency".. she said another problem is study on core competencies is already common ... if i chose clinical competency, we will see if panelists will let me go through the study or not on our pre oral defense,.. since i still got time, im thinking of sticking to clinical performance.but im wondering what criteria i can use to measure it.... so what do u think i should go for?clinical competency or clinical performance? if clinical performance, any suggestions for the criteria? thanks.:)

i know ideally if care shoud be given to them, it should include the relatives as well-- it should have been me holding that nebulizer, stayed with her until she was in the dialysis, get meds for the patient and not the relatives,etc. and that is how things are being done in your country. But unfortunately, here in our country, we were not able to do those things always. Here, if you're on out patient basis, relatives will get the meds for them because they have to buy it unless they have health insurance with them. If you're an in patient, the nurse will get the meds for you provided that you have health insurance, you are in a private room even without health insurance or you have a letter from your doctor. We have 4 patients in the emergency room an only 2 nurses are on duty. we have nurses in the intensive care unit. If they dont have any pt. They should be staying at er. Unfortunately, they will go to icu once they see that there are no patients in the ER. In case we become toxic, we attend to patient's needs before we can call them to go down and help.

i believe there was an investigation. however, the result of it was not yet known for the doctor just submitted his report. Our chief nurse told me that the major problem i will face is why i wasn't able to join the patient in going to our dialysis dept.. Because the patient's condition may have been aggravated during those time and i wasn't there. Regarding the blood pressure, our doctor will be the one who will explain why he didn't ordered us to give any anti hpn drugs despite informing him.. the chief nurse also told me that all the blame was put on me by the relatives because i was the one always in their cubicle, im the one who they talked to them more than our doctor who attends other patients. Do u think i may face any liability and loss my license?

its ok. Since the patient is in an OPD basis, their relatives where the one to get the meds from our pharmacy. But if they are admitted, we''re the one who'll get it. anyway, the patient arrived 2:45 am.. since our dialysis dept is not 24 hours, we call dialysis nurse to go to the hospital for emergency dialysis. just imagine how many times we have to call them and wake them up to go to the hospital. Out of 4, only 1 responded. i called her at around 3:19 am (as registered in my phone).. the patient was transferred to the dialysis room at around 4:15-4:20.. i admit i didn't know that we can give her an anti HPN meds before dialysis. So I just rely to what our resident doctor will order us to give.

I've been staying with the hospital where im working for almost 2 years. I had my training in different areas in that hospital for 1 year and 4 months until last April of this year I was hired as an ER nurse. in other words, I am an er nurse for 5- 6 months. I admit I had minor medication errors like opening Ceftriaxone instead of Cefuroxime, i got a Flagyl instead of Metrogen for Metronidazole... but didn't caused any fatal to our patient.. But I made a mistake few weeks ago. A patient was brought to ER with difficulty of breathing and hypertension.. SHe was a patient with CKD and undergoes dialysis. It was my senior nurse and our resident doctor who first saw the patient because I was starting an IV line to another patient that time. The initial BP was 220/11mmHg ans I can see that patient has dyspneic presentation. She was hooked to O2 inhalation 5-6 lpm. The doctor ordered for nebulization. I was the one who asked he relatives to buy the needed meds and started it. But before starting, I checked here BP it was 230/110 and informed our ROD, yet he didn't gave any order of anti-HPN. Maybe because the relatives gave the patient Catapres before goingt o our hospital. The relatives also asked me its ok since patient has history of cardiomegaly. I told the query to our doctor. he said its ok so I proceeded. When I asked the patient to hold the neb kit, she wasn't able to do so I asked the relative to hold it for her and left to attend other patients. After contacting the attending physician of the patient, he ordered an emergency dialysis for the patient. I secured a consent from the relative. She told me that the patient still has difficulty breathing, I saw that her neb kit has still the med in it (actually its as if she didn't nebulized yet). I asked why isn't she nebulizing, the relative told me she was just resting but will continue later. I asked the patient to nebulize it may help her breathe easily. Then I checked here BP its 220/110. The relative asked me if there is no anti HPN meds. I told her I cannot just any anti HPN drug especiall she will undergo emergency dialysis. She asked me two times, and told her the same. After more than an hour our dialysis nurse called that machine is already ready. I checked her BP few minutes, it was 220/110 still and informed our ROD but no meds was ordered. I asked the client to move a little so our male attendant can assist here to the wheelchair with oxygen. I was about to go with the patient when I was asked by other patients regarding confinement,etc. Suddenly, our dialysis nurse called and asked our ROD to assess our patient. The doctor found the patient gasping and intubated and perform CPR. UNfortunately, the patient died. 2 days later, the relative voiced out her complaints and according to our chief nurse, the doctor is out of the picture and completely complaining of the nurse which is me. I submitted an incident report. The relative said that what I told her regarding the anti HPN meds and I was not able to accompany the patient to dialysis. My superior and I are aware that our ROD is informed regarding the BP of the patient. Worst is the patient is a also a relative of our lab technician. The doctor expressed that it was the congestion/ difficullty of breathing he was concerned first he must overlooked the BP. He thinks that if patient undergo dialysis she will relieved. Unfortunately, she wasn't able to be hooked in dialysis machine. OUr chief nurse had an emergency meeting with us. She eventually asked me if I can fo it in Er. I just tell her if I cant then I'll be back being a trainee. I told her I can. She told me I will be supervised by my seniors for the time being. I read forums here and it helped me a lot move on. or i was trying to move on. I prayed night and day. I heard the relatives just voiced out their complaints and our resident doctor was able to explain his course of action. I must say, whenever I encounter such patients, I stay with them once Im done with other work and I regularly asked their condition. I even try to establish rapport by talking to patient and their relatives. I know that I might get suspended for some days because of the incident and I'm ready. However, this morning the resident doctor called me that he was about to write a letter to our legal department because the relatives wrote one. The doctor told me he will be the one to explain regarding the BP however, there are other complaints which is not for him. I told him that I know the mistake I've done and wrote an incident report already. Which bothers me right now is, I heard the relatives told that I just left the patient to nebulize by herself without telling who will hold the neb kit (which I told you guys earlier, I did asked that relative to hold..). Im really back to being desperate, nervous that I might lose my job and standing on a witness stand. Even my picture was taken out from the organizational chart to present to the board because I;m new and board members dont know me yet. Sorry for this kind of post but an advice will really help me alot... thanks.