singleprego

I have ADD and I find that Chronic Hemodialysis is great for that. The chaotic environment of my clinic is great for my ever moving mind.

I will be going to my FA this Wed and telling her that I am not willing to have a particular PCT working under my license. I am not sure how it is going to go, but I am going to stand my ground. This tech has some mental issues, like passive aggressive and others. She knows how to be a tech, but she thinks she is the nurse and argues with my decisions. I listen to her opinion but my decision is final. The final straw for me, and this has happened in the past with her, is that on the vitals line she charts something like "bp low, saline given, RN notified". SHE DOESNT NOTIFY ME- EVER!! I have a problem with her charting that I was notified. It makes me liable for a situation I am unfamiliar with! She also goes behind me and changes my settings after I specifically gave directions. Other pcts say she changes their stuff too! HAS ANYONE REFUSED TO HAVE A TECH WORK UNDER YOUR LICENSE? [Management sucks and frankly, this is the most stressful job I have ever had. My clinic is SO busy. Of my 14 hr day I can sit when i potty or take a break. I am always on high alert for an emergency, play waitress often, handle situations techs can handle and do my and their jobs. It confuses me how a tech cannot run two pts off at the same time- but I can. (we have phoenix machines that stop the rinse back automatically).... Repeat every 4 hrs. ]

I am a RN working at a chronic facility. The FA spoke with me concerning a decision I made a few months ago. Some background on the clinic for you- Most of the nurses have been working there a very long time, maybe 10+ yrs and havent been working anywhere else during. The FA is not a nurse but a very intelligent business man. The mentality of all the teammates is "each man for himself"!...very unfortunate. Here is the decision, I would like your opinions nurses.... I took care of a pt that ended up septic after a c-section landed her with renal failure. After being in the hospital and on a vent for about a month she recovered enough to go home and came to us at our facility. During the admission assessment process she mentioned that she was breastfeeding. I was later instructed to administer her PPD. Just as I was about to stick her I wondered if the medication enters the breast milk and could cause harm to her newborn. So I stopped and went and asked the C.C. if she knew. She said that she didnt know, so at that point I began checking med guides- which there wasnt one there, online information, we paged the MD-who never returned the call, called a pharmacist- whom wasnt sure either. Well, the C.C. and the charge nurse thought that my judgement to withhold the med until I was clear about its pharmacokinetics, thought I was being over reactive. Things were said to me like "Its sub-q (intradermal, i know), how would that enter the blood steam"? "Why are you making a big deal, just give the medication"! I finally rec'd clarification from her ID MD and the med was administered. Recently when the FA talked with me in his office, he stated that I am to do what the charge nurse says and to not give them a hard time. If she said to give it, then you should have given it. I was floored by that! I explained how I would be liable if harm had come to that newborn and how the company would be as well. He said that the charge nurse would be liable. If I am not mistaken, I should never give a medication I dont know about. It is my job as a RN to protect the pt and I feel the FA should have applauded that fact that my thinking had not become institutionalized. However, I am offended that the FA didnt stick up for me. There has been other incidents like spiking the bath with CA without a recent lab value. I have been told to falsify documentation reguarding the new heparin infusion policy. Is this all a common practice in dialysis facilities? Thanks for reading, I know it was long.

If the pt was AOX3 I would transfer the call to the pt. I did get a call from the CDC or something asking for information on a pt. To make a long story short, I had the house supervisor give the information. For one, I never heard of them calling the floor to ask questions, two - how do I know its really the CDC? The supervisor took the call ....

That would be tough for me. I suppose if I were first on the scene of a MVA and a shirt were torn and I saw a big "DO NOT RESCUSITATE" written on his/her chest, I would only honor it if it had the word "PLEASE," before it.....

Wow, I have one week to submit an application to the nursing program for RN to MSN, to be a NP. I went to a web page that has a practice exam.... Tell me, will I get enough education to pass this exam? It was so difficult. Ive been a nurse for only 6 years..... I wonder if I could pass the NCLEX again lol. Im quite intimidated. Thanks for reading.

I know this is an ER thread but as a previous medsurg nurse ( I would get the pts from the ER) I always loved the crack head regular that would come in complaining of abdominal pain.... I would suggest to them that maybe they should have spend a few bucks on food during their last 3 day binge.....

A comment after reading errosmith's thread. I treat my patients with respect. I feel that if it wasnt for my patients being there, I wouldnt be there. I am here to work for them. In fact, Ive began mentioning to the pts that if they would like to do any educational inservices, or create a day like "bingo", to please do so. I love education and support anyone wanting to bring "fun" to the clinic. I know that just because these pts are on dialysis doesnt mean that they shouldnt feel important. Not saying an giving an inservice makes ppl feel important, but it may be something someone has always wanted to do... like being on a committee. I tell them that "this is your clinic too". I think its ok for a pt to educate another pt... as long as their information is factual, of course. I agree it must be difficult to be told what to do all the time. I have a different approach with some, I teach them why, not just tell them to do so. Well, I want to read more threads..... Thanks all for reading.

I got an email from my FA a few wks back stating that "Dr. Smith" wants me to give pt X vanco. The FA got a wound culture result off the fax machine on a day that we weren't open. He called and notified the MD and took the order.... He is a MSW, not RN. I let him know that I couldnt take that order... he was quite mad, but oh well.

Hi, new here, but Ive been through hprp and I have gotten jobs and I am working now. Yes it was difficult, but fortunately when I was able to return to work I contacted the place I worked through the agency at. The manager of the floor liked my previous work and gladly hired me that same day.... and I was 9mos pregnant! The staff groaned about having to pass my narcs, but it was either that or work short. That was at a hospital. Some hospitals are "recovery" friendly, and some live in a box. I do work in dialysis now, but that was by choice. I LOVE dialysis. Other suggestions for work include insurance companies and in mental health areas. Dont give up. If a particular manager doesnt want to hire you because of being in "recovery", do you really want to work for that manager anyway? I interview the facility/manager to see if they are a good fit for me and my sobriety. Also try going to caduceus meetings. Some medical professional there have been in recovery a long time. They can give you advise.