Manatee111

Thanks for input. The waiting for beds is quite frustrating. Sometimes the wait is so long 5+ hours with NO bathroom. Some people really struggle with bedpans. Do you allow patient out of the carts? This is my first ever PACU job. It's like a whole new world of nursing obstacles.

I'm interested in the amount of time scheduled surgical patients wait in the recovery room for rooms to become available in community hospitals near major cities. 1 hour? 3 hours? 5 hours? How long is the longest you've ever held a patient in the recovery room waiting for a bed? How long do extended stay patients occur in the PACU? And finally, is there a patient washroom in your PACU?

I'm concerned that even though there might be a few very large O.R. scrubs they go quick. Tomorrow is my first unofficial day at a new job even before orientation so things moved quick. Really just a day to shadow. It occurred to me that scrubs were going to be an issue after left the hospital at 5PM today. I had mentioned it to the director, but never the manager so tonight I ran out and bought blue scrubs. It is the color they wear, but it's not their scrubs ( I get that.) So my question: Just wear the blue scrubs I bought or maybe email the manager and explain th situation even though that will be incredibly embarrassing. Any other suggestions?

Recently, I was asked if it is individual states that govern nurses or if there was a national organization that governance over those individual states and I didn't know. So I put this question out to the knowledgable nurses here.

I work on a very busy telemetry unit. Most of our patients are hospitalized for a few days or they are made GMF. For the last 10 days we have had an extremely demanding and rude patient on out unit. He has been very inappropriate with our staff. He has made comments about nurses hair and breast. He is refusing male nurses and requested that we wash his testicles. Not an entire bed bath, but specifically his testicles. Today he called me a fat ass and remunded me he was the patient after I would not give him more Klonipin than the MD ordered. He is a 48 year old bed bound nursing home patient who the docs have started on Ritalin due to his manipulative behavior. So here is my question: is it okay that I suggested that my manager should discuss with him that his actions toward the staff have been inappropriate and that his lack of respect are intolerable. The staff is starting to avoid him now. As wrong as it is; it is human nature. So he calls the nurses station from his bedside phone.

I have been accused by a nurse of bullying, but that same nurse has accused others as well. However I haven't been caught sleeping at at the nurses station by co-worker. I don't receive long distance calls on the hospitals phone. I don't listen to loud music and sing at the nurses station at 3AM. I don't sit and do my husbands home work while I'm on shift. I don't go into a patients room (confused or not) with my cell phone at my ear. I have however discussed this with other co-workers and there is a huge level of frustration among our nurse about the situation and I'm sure it ones across when we deal with her, but I guess we kind of have a don't tell policy amongst each other and no one really says anything about her to management. Let me tell you though, I'm getting close.

The PCT has worked on our unit for several years and on our sister unit before that. Her know how is not in question.

A couple weeks back I was caring for a very high maintenance patient with a new colostomy. I had taken care of the patient three nights in a row. On the third night when the patient was more stable physically I asked our PCT to empty the patient's colostomy before the end of her shift at 11PM. She refused. She stated that it was not within her scope of practice. I let her know that other PCTs empty them and she rebutted that if it came off she couldn't put it back on. Because ultimately I am responsible, I emptied the costostomy. At our monthly night nurse unit meeting I asked if it was outside the scope if practice for PCT's. I was told it wasn't and it was taken down in our meeting minutes so it could be clarified later. The notes are then turned into our manager. I don't think any names were used, but I'm sure if the senerio was mentioned infront of the PCT she would recognize the situation as the one shared between us. Friday my manager called me on the phone and asked me about the situation. She said, "Deana (name changed) says you won't change patients or empty colostomies because it makes you vomit." Admittedly poop is my weakness. Some people are grossed out by sputum or vomit. I went to school who was grossed out by eye drops. Poop is hard for me. Ocassionly, I do dry heave. I try to do everything I can to be discreet about it, I even carry a small bottle of body spray in my pocket for super Code Brown situations however it does happen that I dry heave. I have never, however, vomited because of it and I most certainly don't clean up my patients to avoid it! Many times this PCT has helped me clean patients in the 3 years I've been at this position. I'm really bothered by this. I would like to confront the PCT in the presence of our manager just do the record can be set straight. I don't know if it will just start all this to snowball. Should I just leave it alone. Or should I schedule a meeting. I'm concern about here accusation and feel I must do something.

So, tonight the patient of another nurse requested a pair of pajama pant because although he was told not to wear underwear to Cath. Lab, he did & they cut them off. He's a bigger guy and the only size pants we had was a large, but not large enough for him. While his hurse was off the floor picking up a transfer he starts making a stink about how's he's paying $1800.00 to be have this procedure and we don't even have a pair of pants to fit him! I checked every other unit on our floor & there weren't any. He then goes on to threaten that we just better wait till he gets that cutomer satifaction survey! Over a pair of pajama pants! This is getting ridiculous. 1st-Not even my patient, 2nd-Now patients are threatening us with bad surveys! This guys is a diabetic with a blood sugar of 194 tonight who just had a sheath placed & he's been drinking coffee and juice and eating snacks all night. Why do we even both if we are just gonna let them run all over us anyway. I'm so disheartened by the reality of nursing.

Recently, our hopsital made insurance adjustments which included employees having to certify that they were non-smokers or be charge $25.00 a week extra for health insurance. They have also begun to charge any employee that catch smoking on any hospital property $25.00 for every time they are caught. I'm not a smoker, but this is really taking things kinda far. I still see patients and family members smoking on benches inspite of them putting up additional signs and taking sown smoking hutts. Anyone else have this going on by them? I hear the next move similar to this is gonna be for the over-weight employees. I might have to find a new job then.

You are so right. I came in last night to the latest staffing grid change & as I protested I could feel the eyes from the staff on me. I come to find out that all day the staff was completely overwhelmed because the day RP is a total "yes man" & just kept taking more patients. They were glad someone finally said something, but now I'm afraid my big mouth will get me into hot water for bucking the system.

I have been working as an RN for 2 years still making the $24.05 I started at because we didn't get raises & the new grads coming in now asking me for help & guidance are making the same $24.05 I am.

July marked the beginning of the new fiscal year at the hospital I work & as always they are trying even harder to cut costs. For over a year now a "SHARE" program has been in effect where employees find ways to cut cost & are rewarded monitarily (i.e. standardizing after-hours snacks, using cheaper contrast media, eliminating sign-on bonuses, blah blah, blah). They have also changed the staffing grid AGAIN. We were using a 4:1 ratio on our unit & our customer service scores were improved, but now they want budget cuts (even if that mean sacfrificing customer service???) & they have made us go 6:1. The hospital I work at is in a poor community mostly populated by senior citizens or people receiving government aid. We see very few private insurance, but we see a ton of self-pay. This has to effect the bottom line & don't they know that? Anyone out there going through similar situations at their hospital & what steps are being taking to improve the budget?

Boy, are you ever preaching to the choir!

This is called "Accountability" now, dontcha know!

Shared governance is a joke. It doesn't really exist. They say we have it on our unit & we have our unit counsel meetings monthly & we give our input, but they still just do want they want to do & not what staff suggests.

No way they rest of the world gets it. This passed Father's Day I worked the Sat. into Sun. so getting to spend the day with my dad was gonna be difficult since he insisted on going to his summer place which is an hours drive from my house. He wanted us to be there before noon so he could let all the kids in at once & not have to keep coming to the gate. I told him that I couldn't get there that early because I had worked that night. He told me that sometimes you have to make sacrifises. ARE YOU KIDDING ME!!! Or my sister will call me & want me to stay up the whole day after I've worked 7P-7A to go to the zoo with her & my neice, but she's a night shift nurse too & she would NEVER do that, but thinks I should because I should want to spend time with my neice! Oh, please!

So now that our unit has gone from semi-private to private & I float 1-2 a week I would ask my managers the following: Why did you go & hire 2 new grads who can't float for a year when there is already too many nurses to staff the unit now?

I have been told by mult. people that after 2 years nurses are no longer considered "new grads".

Oh, how I wish I could get through an hour without having to be in there 5,6,7 times! LOL

How do you handle a patient who "abuses" the call light all night long? I had a patient the other night (for a 12 hour shift)who was mostly appropriate, but elderly with a lot of anxiety. She had 2.5 mg of Ativan in less than 6 hours, she was medicated twice for pain, her pillows fluffed, diaper changed, tissue within reach, curtain pulled so she could see the clock, TV on (because she gets paranoid in the dark), oxygen tubing adjusted, blankets pulled up & down, repostitioned 5X, etc... I personally answered the call light for her at least 40 times that night & that doesn't take into account how many times other nurses or our PCT answered the light. She would have been too much if it were 1:1. So seriously, how do you tell a patient to lay off the call light without ruining our customer service scores, of course!

On one paticularly horrible day on the job when I was at my wits ends thinking about this very type of thing my husband & I went to get our taxes done at a popular tax service. After finding out my occupation the lady preparing our taxes couldn't express enough how gratefulshe was for the job nurses do. Her mother had passed away a few months before. She died while on hospice after fighting breast cancer that had metastisized through various organs. She & I both were teary eyed... her for the loss of her mom & me because it was a stranger thanking me. I'd didn't knw her or her mom, but she just needed to express thanks to nurses as a whole for the job we do everyday. Nurses don't get recognized enough, not by our managers, not by our pers, certainly not by doctors & sometimes not even by our patients, but sometimes it is a random person who thanks us not for our individual action, but for our profession as a whole.

I started on my nursing career 2 years ago on a Cardiac Intervention unit. Most of our patients are chest pain, post-cath, new onset Afib, but within the last year there has been a transition and now we are caring for post interventions. Pt. 3-4 days post CABG, 1-2 days post carotids, 2-3 post fem-pop. When I started the ratio was 6:1. They've changed it to 5:1 with in the last 6 months, but sometimes even that gets to be too much. Many of the patients are very elderly and are confused or sundown. It gets very difficult to keep those patients safe. The other night I was caring for an 83 year old man who cam up to our unit with bilat. sheaths following an angiogram with intervention. Poor guy... If his ACT would've come down faster I could have pulled at 19:45, but his ACT was over 180 until 3AM! About an hour after I pulled the sheaths he became very comfused, was taking off his clothed, tele monitor & was trying to get up out of the bed. Thank God, no bleeding or hematoma!

The hospital I work for owns several other hospitals in other areas of the country & recently they sent out this memo stating how a survey taken states that our hospitals have been chosen by Gallup as one of 25 organizations worldwide to receive their “Great Workplace Award”. I have to laugh at that because less than a year ago we took a Q12 survey that showed that the majority of the nurses at our hospital are only mildly happy with there jobs. Our managers went as far as to have 1:1 meetings with the nursing staff before the next Q12 survey in order to see what could be done to change our answers before the next survey in order to circumvent our answers. Obviously, the "Great Workplace" doesn't include our hospital & I really think that the company that owns us should know the truth. I think that by speaking 1:1 to our manager instead of only taking the anonymous survey they will know who the negative Nellie's are& really the 1:1 is for that purpose only.

I've only been in nursing for 2 years, but I do already have my regrets. I thought I would feel empowered, but truly all I feel is small. The back-stabbing by other nurses makes me feel like I'm in Jr. High again. I work nights & my manager calls me at all hours (9AM-3PM is all hours for night shifters) for ridiculous things. "Did you sign-up for ACLS class, did you fill out this or that survey, did you do your NIH recert.) We never have a PCT who will do the job or we just don't have one at all. I haven't had a raise since I started & the new grads. being hired now make as much as me. I think if I could do it again I would have gone into health care, but as an U/S tech or a resp. tech.