brashis2008

Hey all. I was just looking for some input on the agency nursefinders. Any opinions or experience working for this company? Im specifically looking for input on working in one town, not out of town/state. Thanks

This is'nt the same subject, but kind of along the same lines. We had a family that contacted the local air-lift support. No call was made to 911 or the hospital. Of course, when air support is called in (at least here), our EMS still goes out and brings the pt into the ER, then transfers to the take-off site. Is this common? The air-support team said it was no biggie and they dont mind being called out. They are always very professional and upstanding. I love those guys. :) It was just odd to me. Maybe its the area I work in and its something common, that just isnt common here, but it made for a huge mess on this one incident. Of course, we had to bring the pt in for assessment and then TRY to find an accepting doc for a VERY minor health issue. It scared the family because some of the symptoms seem to be a neurological issue being there was some change in mental status in an elderly pt, but it wound up being a common infection that was diagnosed within minutes and could have been treated right then and there. If I sound ignorant in this, forgive me. Like I said, maybe its the small rural area Im in and Im just not used to things like this. Just seems crazy that a family can make calls like this, including calling in the code team.

I went into nursing directly because of two certain nurses. A nurse practioner that took care of me during my first and second trimester of my first child, and the RN working when I had my child and the two days following. The nurse practioner treated me not just for my pregnancy. That women taught me more in a few months than I had from anyone else. I left her services with a healthy child, a healthier mind/body/spirit, and a self-esteem/confidence that I had never known before. I never ONCE, spoke of any other problems other than issues with my pregnancy, but she picked up on SOO much. I still dont know how she knew soo much about me just from my appointment times. An insightful angel. The LD RN, was just as much of an angel. I hate to say that the rest of the other staff was seriously lacking in different areas. This one though...you would have thought she was taking care of a scared little sister. I knew very little of the process and had very little support in my personal life. She took care of my needs before I even knew they existed. Not once, did she complain with my naive questions. Not once, did it seem that she was busy. I felt like I was her one and only patient when I had her. Being as sheltered and timid as I was, not once did I ever feel awkward or embarrassed during the times that I JUST KNEW, I was going to have a heart attack over. I decided I wanted to be like them. I wanted to be "that one particular nurse", that someone would never forget...with a smile. :)

This has been an issue from day one for me. I had difficulties, personally, pushing certain meds at certain intervals that just didnt seem right. I have refused the ones that I absolutely could not push morally. It was a mutual concern among the staff and was brought up with the chain of command and dealt with as best as possible. It is not as bad anymore, but the instances are still frequent. I'm a little relieved to read that there are others that view it like I do, at this point. If I feel objectively that the patient will be in danger if the med is given, I notify the doc and go from there. Usually a change in orders is the result, or I just dont give it. Someone else can, but I'm not going to, but thats only been twice that I have felt the need to make that decision. For the most part, chart what is subjective and the pain assessment. If its not going to harm them physically, then I give it. I'm not there to detox them. I find it very important though, to make sure you chart that 30 minute post-med administration note. I watch and listen to the patient, THEN I step in and ask them to re-rate their pain. I chart BOTH even if they contradict each other, and notify the doc. If you have a less than cooperative doc on the pts who are possibly seeking, then at least I have charted that certain behavior was noted along with pt statement and physician notified. I feel thats all we can do in that particular setting.

When I first read this thread, automatically I envisioned a VERY hairy chest, because I can't imagine why it would be an issue if there's a "normal" amount. Hence, my reply.

Oh...I would. (laughing to myself....I'd want the same expectations/notifications from others on matters like this myself ....not that I have that issue, but anyways...

T-shirt or shave the visable hair. Putting aside everything else, its just more professional and seen as "cleaner". I mean, I wouldn't want to see a female nurse's unshaved armpit hair as she's hanging my IV. That's just my "medical" opinion, but is not indicative of my personal preferences outside of the work place.

I haven't seen a list yet at work, but we've heard from a couple of supervisors of a few abbreviations that are not to be used anymore. The ones I have the most difficulty with are TID, BID, QD, DC, SQ. I don't understand how these in particular can be soo misinterpreted and honestly it makes for a ton more paperwork having to spell out everything. These supervisors heard of these new rules somewhere and are trying to get everyone to switch over, but few of us have. There are no incident reports in this area that I am aware of, so I don't see the sense in changing unless it becomes mandated on paper. These specific ones deal daily with Medicare. So, I don't know if its something they are observing and deciding for themselves, or what. I did not realize that there were different "ways?" to abbreviate. I assumed that everyone was taught the same lingo. I guess thats what assuming gets you in this field.

I was frustrated yesterday and I think I misunderstood all of this. Everything but the rationalization is pretty common. It's the rationale that seems a bit absurd and not in our scope of practice, so I dont see how we could be forced to do so.

Oh yeah, it's more common than most think. I personally just try to look at it and decide if it's behavior that is attacking me personally unjustified or severely disruptive. If it is, go to your DON. Let the powers be of the chain of command approach this, if its this bad, then hopefully something will change for the better down the road, for all. Most of the time though, its not done that way or needs that type of attention. I dont believe in "sucking it up" all the time or trying to "earn" respect. I mean, you do to a certain point because its just the way it is. If its a "decent" physician who really is concerned with their pts wellfare, then in time they will come to see that you are on the same page in regards to the pts and are going to take care of not only your license, but his/hers as well. I have only had two instances where I felt the behavior needed to stop, but I didnt feel it was an admistrative issue. Remember this, yes they are our superiors and the working atmosphere is not always pleasant. No hearts on your sleeves in this field, BUT.....they are no more human than we are. Sometimes, pulling them to the side and having a quick "come to Jesus" chat is all that is needed to calm down the high-strung doc.:wink2: Especially if you let it known quickly with confidence and sincerity that you are NOT to be treated and will not accept being treated like a piece of trash. You are there to do your job which is take care of your pts and watch your doctor's back and that is something he/she SHOULD be grateful for. If that doesnt work....than a few consistant 3 am phonecalls about some possible NOW orders of M.O.M., or a customized bulls-eye target in the break room should help with some of the stress. :wink2: (j/k.....well kind of....)

I agree that it takes about a year to have the confidence in your skills and in tackling anything new. Telemetry IS complicated and its not something that is taught in detail through the program. Ive been an LVN for 5 years, and it wasn't until taking ACLS that I "got the picture". I mean, sure I know what NSR is and what is minorly "abnormal", but I wanted to know what is "WHOA....vitals and crash cart by the door now, just in case!" and of course to know if anything is medically induced/needed I think we all feel that once we actually startworking, that we only learned "basics" during school. It's true what they say, "you wont start learning until you start working". So, your not alone in this and its NOT uncommon. :) Hang in there. Its a never-ending learning process, and do NOT be satisfied with the occasional mandatory inservices/CEU's....educate yourself every chance you get. The internet is a great source. KEEP LEARNING any way you can. Good luck!

There's shortages everywhere hun. Maybe your applying for positions that are looking for a nurse with more experience? Maybe your applying for shifts that are not available or difficult to obtain while being a new grad? Like stated above though, it may be that they are hesitant to hire on until youve passed your boards. Keep trying and dont let them "forget" your face and enthusiasm. :) good luck

This is ridiculous. We, at my facility, are not implementing this, neither have any of us heard of this so far. It's not the nurses' responsibility to explain a physicians decision. We have the right and obligation to question orders if we feel it is in error, but to RATIONALIZE? RIDICULOUS. It's just extra work on us if our written justifications are plausible, but what about all the other times when the orders are in question with a particularly "difficult" physician? That's where this is going to get us in trouble. We all know that implementing and following through on this is going to lead to a ton of falsifying or basically lying.....to get an order that makes no or little sense, to pass. Question an order and chart the action/physician response. Anything above that is picking up responsibilities and legal burdens that are not ours. It may cause a stubborn physician to rethink an order, but there are just as many physicians out there that will NOT reconsider and just start to expect that their decisions will be justified. Its then left on the nurses, from medical records/admissions, to justify anything in question. If my facility started doing this and it became mandatory policy, I would not be staying.

Ok, first of all hello to all and Im new here. This was the first thread I read up on, but not completely. I am floored honestly, that you can have certifications in all the areas listed here? I have experience and have performed most of what is listed, for the past five years. You mean to tell me that I could actually have this experience put into a certificate or added to my license? Do you HAVE to take classes, or do inservices with experience count? Im honestly in shock at this, and a little peturbed. All of these things we are just expected to do here and I definately dont mind, but whoa. I work a small hospital in Texas and basically the only thing I have not done due to legal reasons, but I have watched and helped...... is the actual hanging of blood. We are basically an acute care/swingbed/end of life/ and trauma facility, but the LVNs do basically anything. I hope what Im reading is something I can make into a very positive thing in my income as Im looking to move to a larger town at the moment. So, I guess my question is......do I have to take actual classes to get these credits? thanks