Loribabble

UGH - I provide case management for peds and often need to contact parents... once had a CPS level medical neglect case and trying to reach mom. Called the dad, who was listed on file, nothing on file to state he wasn't to be in contact with child, etc. To say mom was LIVID at me for calling him is a huge understatement. Couldn't, wouldn't accept that unless we had court documents, we were calling him. (She didn't have any, she just wanted to keep child from him).

Hi, Let me just start by saying that our union rep is awesome - just would like to see if anyone else has any input for us since I am so new to all this union biz. Kind of a long story, but our administrator is a non-licensed person overseeing nurses in what has been determined at the state and federal level to be a nurse driven program. Previous admin have also been non-licensed but understood the purpose of the program and supported the nurses. To put it mildly, the nurses (and many others) have been at war for the last year with this administrator over her poor leadership and neglect of duty. She has been exposed and we have the support of her supervisor and the administration above her, our human resources, etc. Unfortunately, in our county, firing or demotion is next to impossible to happen... but, there is a MAJOR re-org planned for our department that would remove her from overseeing the licensed (75% of the department) and be relegated to only supervising 8 clerks. We have a meet and confer about the re-org planned in 2 weeks.... 90% of the department is 100% behind the re-org and super thrilled with it. Our administrator is kicking and screaming, refusing to acknowledge any culpability; trying to get our rep fired because she can't attack the nurses anymore.... etc. The 2 main players, the nurses and our administrator are in the same union but have different reps (it's been interesting.... ). I know our rep with help with preparing us, etc... just wondered if anyone else had any thoughts on what we can expect etc... Thanks!

I work as a nurse case manager for a state/federal mandated program that is supposed to be nurse driven; office is 45% nurses - other positions are to support the nursing team. 1 of 2 nursing supervisors announced her retirement last February with an effective date in May. Program Manager drug feet and position not posted until July... list of candidates was posted in September, we JUST started having interviews last Fri. Remaining nursing supervisor not on the panel, the only nurse on the panel is a new hire still on probation instead of one of the 14 experienced nurses in the building. The panel consists of our brand new to the program Medical Director ( During this time, we have rotated 5 nurses working out of class 4 weeks at a time and now that we have started interviews... 3 of those are working out of class for 2 weeks at a time... talk about chaos.

I work in a smaller office for an organization that is supposed to be nurse driven. Our 'celebration' was held today and I stayed home because I couldn't stomach the fakeness of it all. Our non-nursing admin has been nothing but hostile toward the nurses over the last 3 years and one day of ignoring that was more than I could take. Never been one for token gifts, a sincere "thank you" would be wonderful!

Thank you so much for your response ktwlpn... much appreciated. I will set something up and keep pushing.

Hi All... First let me say how much I admire and appreciate all you do to take of this special population! Thank you! I know the majority of nurses take great pride in the care they give and do a great job with the limited resources and support. Thank you! My father is currently in a SNF for a 1 month stay for IV antiobiotics / wound care only (home infusion co-pay was $1600/month on his $1200/month SSI... don't even get me started on that one!). Otherwise, he lives independently, still drives, still putters in the garage doing odd construction projects etc. I'm concerned about some of the things that have happened and would love your input as I have exhausted speaking with admin and his case manager. His PICC line came out 8-10 inches in his sleep for an unknown amount of time - not happy but not upset as these things happen - problem was NOC RN tried to push it back in... no hand washing, no gloves, no swabbing. My dad threw a fit as he was concerned about infection so the RN didn't succeed. It ended up being pulled and new one placed. An ARNP came in and took his dressing down, left it open and then left the building without telling anyone. This was confirmed with the staff. His hemovac hadn't put out for days. The day before it was scheduled to be pulled, there was so much output that it was no longer compressed. He repeatedly asked staff to assess it and got no where. He ended up draining it himself with my instruction, estimated the amount and re-compressed it to keep track of any further drainage. The staff do not do proper hand hygiene and when asked to do so, he gets push back. His antibiotic is a 24 hour infusion and there have been several unexplained instances where he didn't get it for over 8 hrs. He repeatedly informs them but there's no follow through. I have inquired but have had no response. Between being woken up at MN for vitals, 2 am for labs and 4 am for levothyroxine and the noise, it's difficult to sleep. We have both asked to have this changed and he was told by admin that he was being unreasonable. The DON was agreeable and supportive of giving him a chunk of time to sleep, was able to get his levo changed to 6 by the Dr and was put on the MAR but for some reason it keeps getting changed to administer at 4. We've inquired but haven't gotten any feedback. Things are in disrepair - dining tables are all wobbly, PT stairs not sturdy. When he first moved in the heater above his bed wouldn't turn off, the toilet bowl wasn't securely bolted to the floor and his bed didn't lock. My dad requested that they be repaired and nothing was done (his roommate had been requesting for the last 3 months!). My dad is a journeyman carpenter so he has some experience in this area. I tried and tried to call but kept getting put on hold >15 mins each time, was transferred as soon as they thought they knew what I wanted... only to be put on hold again. I was so frustrated that I ended up sending a fax with my concerns. This resulted in a phone call from Admin within the hour; but besides the glaring safety issues in his room, everything else has been lip service. I get no response to my questions from the case manager. The State came in last week - but the resident panel was by 'invite' only. One of the friends He's out in a week and we can ride that out but my heart breaks for those who don't have an advocate and/or unable to advocate for themselves. The stories he shares with me are painful. My dad is a nice guy, very appreciative and doesn't speak up unless it's a safety issue and is respectful about it. He raves at how wonderful the day nursing staff is but the night crew and admin are another story. Any thoughts from those that work in the trenches would be wonderful! Thank you!

No bullying from physicians here... have had some wonderful experiences though. Had a nightmare 3 hour "Code Grey" (out of control pt) on my birthday no less! My pt was becoming more and more delusional and her roommate had borderline personality disorder... was NOT a good mix! My favorite doc actually came and sat with my patient to keep her distracted and safe while we worked on getting her a private room while I was also dealing with a rapid response with another of my pts. Once things returned to a state of calm... she went down to the cafeteria and bought me ice cream. It was such a crazy frazzled day and it meant so much to me that she made the time to be in the trenches with us. On the other hand.... when I was working overseas, my RN supervisor who was also from the US, was a true bully. Oh the stories I could tell about her! I was just one of a long list of those who were run off by her and the board that oversees her refuses to address it and thinks she is just the bees knees.

Laughter was what got me through many a rough days, especially working at a bush hospital overseas... my favorite black humour moment was in the States though. I can't remember what the patients diagnosis was but they came in for a procedure. He was non-responsive, total care, etc. Had a wonderful family, who took excellent care of him at home... were hard working folk who refused to rely on silly things like ambulances to transport him back and forth to appointments and such. Procedure was over and I went to offer to call transport for him and found that they already had him dressed, up in a wheel chair, strapped in to keep him upright, hands and legs propped into position, etc. As they were walking down the hallway, they realized they were going the wrong way and turned around... causing his body to slightly flop to the side and his head to bob. All I could think of was "Weekend at Bernies!"

I wasn't even in nursing school yet when I was at a conference with a group and an older lady in the group pulls me into her hotel room to show me the boil on her butt before I had a chance to even know what was going on.... needless to say, I avoided her at all cost after that!

If you are an employee you get a discount... esp for the noc shifts. The $20/day is if you pay what the visitors pay. I either paid $30 or $60/month for nocs full-time. (sorry about not knowing the exact... I'm per diem now and canceled it a couple of months ago).

We recently had 2 gals in the same room that had whining down to a fine art... called the room 'the vinyard'

Oh, I soooo wished that would work in my situation. There are only 2 of us for a 12 hours noc shift, so it is pretty close quarters and I tried that tatic only for her to get really defensive and say that she wasn't/doesn't complain and sometimes there is a reason to complain. This coming from someone who will call pharmacy 10 times for a missing routing colace and then complain about it for 2 hours. Memory like a steel trap that one... definately keeps a running tabs of "wrongs"! UGH!!!!

There are several... The closest is San Antonio Community Hosp... I worked there right out of nursing school (6 years ago) and really liked it... my step mom has worked there for over 20 years. Pomona Valley Kaiser Fontana Arrowhead (county) Loma Linda San Bernardino and a couple of other small ones that I haven't heard too many good things about. I can't tell you anything about pay/cost of living as I haven't lived there in quite a while... they are really building up the Cucamonga area though. Hope that helps :) Lori

I can't really help you since I haven't been in the area since the 2nd grade - but...OT I was born at Elmendorf in a broom closet (1969) - I was my mom's first and they didn't believe her when she said I was coming. The had run out of rooms and placed her in a broom closet thinking her labor was going to take another several hours. We lived in Palmer when I was in early elementary school... we lived right across the street from the old hospital. I remember sneeking to look in the windows... The place was sooo small - all the patient rooms were on the ground floor. Maybe that is where my interest in nursing started? I would love to go back and visit.... it was a great place to grow up. -Lori

I PM'd you... Lori

We just started allowing any family member to stay the night - doesn't matter what gender - and we have double rooms (one triple). According to our administration we are trying to catch up with other US hospitals in providing family centered care. We have been told that it is still up to the nurses discretion to decide what will be best for all involved (including roommate) - still working out the bugs but so far so good and Suesquatch... from what you have told me I would let you stay as long as the roommate was ok with it... definately seems like it would be a benefit for your husband to be there. We are also going to be giving report at the bedside with family/patient present... this is med/surg... I have no idea how that is going to work with our primary patient population... "42y/o male, in for cellulitis LLE, hx of ETOH, IVDA, admitted 4 days ago and found smoking crack in the BR yesterday." - I am sure that would go over really well.... :uhoh21: Lori

I had the privilege of being shown my friend's grandmother's BM diary. She has kept one for years - states the date, time, consistency, color, odd smell etc. Honestly thinks that the doctors want all that specific detail... and no - she does not have a hx of bowel/GI problems. :chair:

Hi - Glad to hear that there are so many other nurses interested in missions! I have gone on 4 short-term and am in the process of going full-time in Zimbabwe. Just waiting for my work permit and Zim nurisng license. There is already some great info here so I am just going to add my thoughts - please feel free to PM me if you have any other questions. (There are also some resources on my website...) I would strongly suggest getting at least 1 year of experience on the floor in the States before you leave to go overseas. This is the time where you are actually putting all those pieces together that you learned in nursing school. If you can, work in OB or OR... both of those areas are greatly needed. There are lots of opportunities to go short-term with just an associate's degree as a 'visitor' - meaning you are there on a tourist visa and will be practicing under the lisence of the local missionary nurse/MD. If you are going to go for any length of time... (in Zim you can only be on a visitors visa for 6 months) then you will need to apply for a work permit and nursing license in that country. Most governments will not grant you a license unless you have a BSN. There are a lot of teams that go and I can suggest some good groups. While teams are good - you do not get a real picture of what it is really like. If you really feel called to full-time then I would suggest interning at a mission hospital. The teams are great if you have never traveled overseas before and/or just stepping out - but going independently will give you are more realistic picture of what life on the field will be like... there are many hospitals that have programs... networking is the best way to find out about them... The Global Mission Health Conference that JRaphasRN mentioned is another great place to not only network but also learn more about medical missions in general, along with the nuts and bolts of being a medical missionary. There are 2 other great classes you can take... one is CHE - Community Health Evangelism and a Mission Medical Intensive. CHE is all about development work (not relief) which empowers the local people instead of creating a dependancy. The medical intensive is designed more for lay people but is designed for missionaries who are living in areas far from health care. Much of what you learn will be a repeat (how to give medications, NG tubes, IVs etc) but they also go over how to dx most common ailments, suturing, birth, etc. It basically gives you tools so that you can be safe on the field but there is some GREAT info for clinicians. Most missionaries need to raise thier own support and the amount should be enough to live on etc. Since I am currently in the process... I can say that it is definately a faith builder! Also.... to echo what another writer said... you have to be VERY grounded in your faith and calling to go - there is so much out there to pull you away from that, and so many distractions that it is often times very difficult to keep focused. Having a great support team to hold you in prayer and to help keep you focused when needed. Christ is definately my lifeline... but He has used my support team more times than I can count to keep me going when I am getting hit from all directions and unsure of which way is up. I have to run... but please feel free to PM me if you have any other questions... I will also be at the medical conference if anyone else is planning on going... In Him - Lori

We have a patient that comes in quite frequently who started taking collodial silver for UTIs years agao. He is literally battle ship grey - you could stand him next to the ship and he would blend right in. When he is asleep he looks like he has been dead for several years (he's really thin too). He is paranoid schiz and won't listen to any kind of reasoning so won't stop taking the stuff.... he puts the "textbook" case pictures to shame.

We give it PO all the time for our pts who need it pre-angio... but our pharmacy carries it in the pill form... NO SMELL!!!! We had one pt refuse the liquid stating that he had the 'pills' in the past - asked pharmacy about it and sure enough... it exists! They were a bit reluctant to admit it due to the cost... but they started providing it that way to our floor... I haven't given the nasty stuff in over a year...

Thanks... that's what I figured but wanted to get an 'experts' opionion/thoughts before I raised holy heck. I hadn't been in there for a while due to being out of town/work... I passed on the info to her daughter and hopefully something has been done. While I was there I did address it to the doc and it sounded like they were going to pull the line soon - that would be wonderful - one less port of possible infection! Thanks again!

Thanks... my friend went into DIC/TTP which resulted in renal failure and required temporary dialysis but hasn't needed it since Aug 17, and they hadn't changed the dressing since then and it was falling off. The nurse was being pretty unreceptive about my concerns (esp since the whole thing started with sepsis)... Hopefully the catheter is coming out soon anyway. :)

Hi... I was just wondering what the standard of care was re: the frequency of changing dialysis cath dressings... Thanks! Lori

I have only had a couple of run ins at the teaching hospital I work at, and they were quickly dealt with. When I was a new grad I worked at a community non-teaching hospital that had several docs with known God-like complexes. I made it my goal to break through and succeeded with all but one. It became a game to me... and actually all I really did was treat them like humans... said "good morning, dr ____" etc, offered my seat if I wasn't doing anything immediately important (always can find something else to do), didn't make excuses when I messed up, little things like that. It all was just basic common courtesy stuff - but I had them eating out of my hands. I could call the worst offender in the middle of the night and he would just say "what would you like Ms Lori" - other nurses always wanted me to call for them... I told them my "secret" but they didn't want to "kiss up" - didn't think I was - just treating them the way I would have liked to be treated. PS... I am not implying that any of you don't do this - just sharing what I have found that works for me... I also agree that there are times you have to be assertive and stand your ground - Thankfully the majority of the docs I work with are great. :)

I don't remember being asked to do anything different or that the administration did anything different than protect privacy... only that I was notified about it. I did take care of one of our hospital's medical attorneys - she was really nice and even wrote a glowing thank you letter to the administration naming the nurses that took care of her.