kat911

When I work I always seem to be singing " If I only had a brain" from the wizard of Oz. Go figure, DUH!:nuke:

Which way to the elevators. New building/units.:imbar

Can you clear up exactly what your job is? In our hospital there are phlebotomists who were hired off the street, given some training on drawing blood and let loose on the patients, many of them have no skill. These are the ones the nursing staff deal with day after day. The lab Techs are the trained and educated personnel who actually run the specimens for Chemistry, Hematology, etc. There is a big difference between the two jobs. The Techs are rarely seen outside of lab and have very little to do with the nursing staff except to call critical values. They are an important part of the health care team. The phlebotomists, let me just say there is not much respect for them because of the lack of training and some of them just are not helpful. Here the nursing staff must draw the labs unless the draw occurs at a specific time when the lab tech makes rounds. It is aggravating and frustrating that the lab gets the draw fee but the nurses actually do the job. Not necessarily fair to the phlebotomists but the really good ones who stick around are well known to the floors and they have the respect of the nurses.

A degree in Health Care Admin is not a nursing degree, nor is it "the same as". She still must have either a diploma, an associate degree in Nursing or a Bachelors degree in nursing. Here anyone claiming to be a nurse, who isn't can be prosecuted. Do your laws or Nursing regulations allow for that? Sounds like she needs to be confronted and she needs to quit giving advice. Has the personnel office verified her degree/education, she could be lying about that too, worth investigating.

Sassyredhead-You cannot control what a "competent" patient will do or not do. Remember no matter how correct a physician order is the patient has a right to accept that order or reject it, do some of it or do it sometimes only. It is always the patients decision. We cannot force competent patients to behave or take meds they do not want. Doing so or attempting to do so can be considered Battery. It sounds like you are trying to do what the doc wants, reasonalbly, but you cannot force or IMHO "bully" the patient into following doctor orders (some nurses try). Keep discussing the reasons for the order with the patient and hope he/she will come around. Otherwise all you can do is document, document, document. If the candy was taken away from the patient in this case she could accuse the staff of theft. That doesn't mean you can't ask the family to remove the candy or not bring in anymore or ask the patient if you can put it someplace "safe" like RN/Writer suggested and then doling out the goodies in a more responsible manner. I know it's frustrating dealing with noncompliance patients but unfortuantely you can't save people from themselves.

:yeah: RN/Writer said so well and so clearly! I have to comment about nurses who try to take away the snacks of these types of patients, they feel justified in taking the offending food because it is not allowed. Usually nothing happens when a nurse does that, other than making the patient or family mad, but beware that is called theft. You cannot take something from a patient unless as I said earlier they are a danger to self or others. Excluding illegal substances which we turn over to the police. Another pet peeve of mine, I have to deal with the ticked off patient or family.

EMT's and EMT_P's are not allowed to give meds in our, that includes hanging IV fluids. In an ambulance the practice off of the medical director's license when doing meds or other invasive procedures. In the hospital they are part of Nursing service and thus supervised by nurses. When we first started using them in our ED there were major issues of new EMT's giving meds because the "doctor told them to". Took a lot of reeducation for them to learn they can't do it just because a doc said they could. Ours are trained and checked off on the tasks they are allowed to do, IV"s, NGT's, foley's etc.

You can't force a pateint to follow the diet oredered and you can't touch thier personal belongings unless they are trying to do something that would be harmful to others, trying to torch the curtains for instance. I think you'd be safe taking away the lighter! Human beings have frailties, they make mistakes and do things that are bad for them. All we can do is educated them and document responses. I am sometimes amaxed at the venom directed at noncompliant patients on this site. I wonder where is the compassion and understanding for a fellow human being. I am not perfect and I don't expect my patients or coworkers to be, either. I think some nurses and docs take it personally when a pateint is noncomplaint. It's not personal and it's not directed at anyone, it just is the way the patient wants to be, and they have that right. Please excuse my minirant. Had to get that off my chest.

I fyou don't want a big city there are a lot of possibilities for you. Along I-35 from Dallas to south of San Antonio there is a wide variety of towns and cities with hospitals. There are private hospitals in Waco, Teaching Hospital in Temple, Smaller private Hospitals in Round Rock, Georgetown, San Marcus and Hillsboro North of Waco. Lots of clinics as well. There are University's and Junior Colleges in or near all of these places and you will be within one or two hours of a big city. You can venture out into the country side if you want rural living. We have a wide variety of hospitals and a few choices in countryside. Prarie, rolling hills, small mountains, beaches, Piny Woods, swamps. Take your pick.

In our hospital we use mandatory OT only in weather emergencies, ice storms hit us usually once a year. Much of our staff live out of town. No one leave thier work station until the unit is staffed for the next shift. If enough don't make it in to work (we pick up staff in town) staff must stay to care for the patients. Usually we have people voulunteer to stay. Only other mandatory OT is when no RN shows up on a unit and we have no one to send to cover that unit and no one will come in to work. If off going RN leaves she will have to deal with abandonment issue/peer review. Th:stone is happens very rarely.

If I ran fast enough to get to a "target zone" I'd need that code team and probably a back board and Ccollar and a lot of strong good looking men to pick me up off the floor.

Several years ago a hospital I worked for did Mandt training. It was pretty good, especially the restraint holds. Don't know if it is still being taught.

Like others have said, fininsh up your first year then try some other areas. Find out what you do best and what you like most about Nursing. Then find your niche. I have worked many different areas over the years and have no regrets. I am getting ready to change jobs again. After 28 yrs still look forward to new opportunities. You don't have to have just one area you like, you may want to try different things over the years. There are so many opportunities for nurses and more will develop over the next 10-20 years. Think of the possiblilites!!

:yeahthat: I agree with Tazzi. Don't make a bad situation worse. There are so many things that affect staffing, there is no one issue that needs to be fixed. People calling in because it's payday or it's the weekend and they would rather not work, poor managers who can't keep staff, illnesses that run through a unit like the plague, poor salaries (in some places), poor treatment by hospitals, toxic enviornment (toxic people) and staff who don't pull together and help each other out. I am sure there are many more reasons for poor staffing, these are just a few off the top of my head.

I had trouble keeping my sugars down because of my work schedule, I am sometimes on all three thifst in a weeks time. I was put on Lantus and that helped tremendoulsy. My HgbA1C's are WNL. I alos take Avandia to make my body more receptive to the insulin. The lantus works great no matter what my schedule is or when I need to eat.