stressednurse

Wow, guess I am lucky where I work. I did work agency for a while though and was put in uncomfortable situations as far as staffing in the past. The state of PA requires a minimum hours of care per patient in a 24 hour period (HPPD). This is calculated daily and kept on record. A sub-acute unit requires more hours of care than a LTC or dementia unit. Personal care requires the least amount of care hours. I admire you for sticking up for what you believe is a bad or unsafe situation for the patients. When I worked in ICU I used to write incident reports for unsafe staffing situations explaining the patient acuity and how I gave the best care possible under these situations but ultimate care was not possible. These reports went to the DON, unit manager and administrator along with the head intensivist. I did that once where I work now and it was accepted without repercussions. If a facility dosen't have staff, then they need to look at why. Once again, I stand in your corner as a patient advocate.

My first nursing job was 7on/7off, I worked 6 hours Monday-Friday, 12 on Sat and Sun. Then had 7 off, got paid for 40 and had full time benefits that was in 1992, I have suggested simular scheduling where I work. We have just started a weekend program for nurses and nurse aids. They work 12 hours every Saturday and Sunday and 8 hours on Monday or Friday, get paid for 40 hours and get full time benefits. Right now full time and part time get double time for extra shifts worked on weekends which includes from 3pm on Friday until 7am Monday. One of the benefits of a regular schedule like these is you know far ahead of time when you have time off.

I cant seem to access this site with the mothers statement. Please offer a link. Thank you.

OK add LTC to this pain management dilemma. 105# 72yo wears 175mcg Demerol patches changed Q48hr. Takes PRN perc q4hr and klonopin TID. Usually seen dozing in her wheelchair, when awake she is on the call light for more meds. The narcotic use has been going on for about 30 years with her. History is fractured hips and ribs and an arm at multiple times and now spinal compression fractures. She has pain I am sure somewhere under everything else but is either complaining or unconscious and after so many years of the narcotics would probably die during detox so why do it? When awake is paranoid and gonna sue everyone for not doing what she wants now. Oh yeh she is also anal fixated because of irritable bowel and demands questran as a preventive. (I have found her in the bathroom for 3+ hours digging herself out.) Can we fix her....NO, can we make her comfortable, PROBABLY NOT...can we deal with her...As nurses with the right approach YES. She put herself there, we are not responsible for her being the oldest living drug addict and we can make her last few years kinda comfortable. How did I deal with this? The doc made most of her PRNs regular scheduled meds so we as nurses don't have to decide if she really needs it or not.

Yes I double glove for suppositories and suctioning and usually dressing changes. If the procedure takes more than 5 minutes I usually reglove. In my opinion everyone has everything imagined and things we don't know about. Gloves are cheap.

Paramedic for 4 years while I went to nursing school. 1 year in med/surg then ICU/CCU in a 12 bed unit that did fresh open hearts (this facility also did sex change operations and I got pulled to that area occasionally). After 2 years of that I went to ICU/neuro and was on a specialty flight team for 6 years. This team was doctor assisted and was one of 3 teams in the USA that would transport patients on ECMO LVAD and RVAD. (cardiac bypass and left and right ventricular devices). I traveled as a nurse for almost a year and worked in a level I trauma center for 6 months then off to an Open Heart center for 2 months and back to the specialty flight team (I was surprised they took me back after resigning to travel) Total burnout placed me supervising in a large(325 beds) LTC facility with a sub-acute unit. I am still there after 4 years and now I think I am ready to go back to hospital nursing for a year so I can travel again. Other little things were Nurse aid for about a year after high school in 1975 while I was establishing a horseshoeing business. And working as a unit clerk in a busy suburban ER friday and saturday nights while I was going to medic school. Next step is to make sure my 14 yo daughter has an education (two adult kids already) then I am off to explore the world.

Good luck with passing boards. When you do and a nurse aid says that a patient cannot have a BM and has passed very small balls of BM multiple times....please intervene and give the patient something to assist with this before that patient starts to dig themselves out. When a patient has urgency to void and little or no urine each try...please intervene and call a doc for testing for UTI or voiding problems. Oh yeh and please give some feedback to the really wonderful nurse aids that reported the problems to you so they know what the problem was and what will be done (no you are not violating HIPPA laws telling another care giver what they need to know to give the best care possible to the patient) I work LTC in a sub acute unit as an RN and I also supervise at the same facility. If your nurse on your shift does nothing then let the next shift nurse know what is going on.

My orientation to ICU/CCU after almost a year of Med-surg was under the direction of the nastiest nurse (Bonnie) ever put in control of newbies to ICU. I quietly listened to her demeaning comments and not allowing me to do much of anything as "I wasn't ready for that yet". After my first two weeks in the ICU the manager called me to her office to ask how things were going and if I still wanted to be an ICU nurse. My response was, I have survived 2 weeks of "Bonnie", do I pass and can I stay? I was given a new preceptor and worked another 6 years of ICU including 4 of flight nursing on a critical care team. After getting to know staff better, everyone seemed to think Bonnie was just plain lazy but her nasty disposition kept most from even saying anything to her. (The alligator nurse....snaps for the hell of it.) Plus she had been there since dirt so had some kinda special connection in that manner with the also dinosaur administration. It seems everyone knows what the 'bad staff' is doing or not doing but most don't know how to end it, alter it or just get away from it....management too. It seems administration is scared of hiring more than yes people for supervisory positions. Management is in a tough spot too with the dreaded "nursing shortage"... working with a license and showing up for work most of the time is acceptable in a lot of places. Oh yeh and when I became nursing supervisor for a large facility, "Bonnie" became an agency nurse that frequented my facility and I treated her with more diginty than she treated me. She began her old behavior of not interacting with other staff...just being nasty and we decided to not use her as a nurse after that but that wasn't my call. My 2 cents, maybe not the advice you wanted, but it is a recollection of how I handled a simular situation. Good luck.

Yes I work in a facility that has really good communication between docs and nurses and respiratory staff and the nurse aids too. But cover your eyes as I work in a Specialty Care Center, yes what most people call a nursing home. Far from my first job, and not where I thought I would be 10 years ago.

I was a paramedic prior to becoming a nurse. I also worked as a flight nurse and have my Pre-hospital RN certification. I stop if it looks like no one knows what to do or if it looks like someone is doing something unsafe. Otherwise I leave it up to the professionals. Unfortunately the local police know my training and so do the local EMS services so occasionally they will pull me aside and ask for my assistance (hold c-spine, help lift, start this IV for me while I intubate please) I do feel an obligation to help if I can though and that includes showing people how to use the self check out at the grocery store, how to change a flat tire, help put large items on the roof of the car at Home Depot etc. I am a friendly outgoing person and that must show because people often come up to me in public and ask for assistance. I don't fear being sued for being nice, I fear the loneliness of those who live in fear and uncertainty.

I went to nursing school so I could support my kids when I divorced my ex-husband. That kept me going, working another job and pregnant with the third child during first year of school. My marriage wasn't going anywhere and after 3 years of trying counseling I figured it would never work. I had some really awesome friends that I studied with and some really cool friends who were already nurses. I was a paramedic prior to nursing school so I had some nurses who volunteered as medics to chat with. Becoming a nurse was going to make my life better....and it has. Nursing is a changing field, medicine changes and so do the patient problems. I have been a nurse for 12 years and I still love it most of the time.

Where I work we would need a designated person to make all those calls to the authorities. Patients and family members seem to think that abusing the nursing staff will help to heal the patients.

They reach us from their world, those that understand that are so awesome.

Maybe a Veterinarian, but not a people doc.

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