RNNITEOWL

No, You did not fail her. The DR. could have written a DNR. The pt already had her wishes written out and the majority of the children agreed. The one child who refused to follow her mother's wishes obviously was guilt ridden about something. But why do we encourage living wills if they're not followed and honored? I've been in your position before and you provided her with compassion,love and dignity with the only means that you could. And I believe She knew. God Bless You!!

Might want to check into Travel Nursing also...would give you a foot in the door and an oppurtunity to "try it out" to see if you like it.

Regarding beds/baths:If you have N.A. for both AM/PM-odds done 1 shift/evens the other and the N.A. has to sign the flowsheet, marking whether it was done or not..if not, pt refused,family will do etc. then the primary nurse is to be made aware & co-sign. And yes a checklist,expectation list, whatever you choose to call it, is a great idea. That in itself will requre some accountability. And yes, there are lazy CNA's just as there are lazy nurses...So, let them know you appreciate and respect them..be willing to work with them. If your problem continues then your nurse manager should definetly address the situation with them.

WOW...Peds nurse/pt ratio has ALWAYS been less than the adult med/surg. I can tell you THAT's TOO MANY. Our ratio on avg is 5 (Extreme circumstances maybe 6) It has been my exp that the smaller hosp will pile it on you...I worked in one for years & didn't know it could be better. Good luck!!

One should never do ANYTHING just because someone said so: You can question your DON & make her aware of the P&P..i.e. I just wanted clarification. The DON doesn't have the authority or the right to "make her own policies" and if you're in court I tend to believe a written policy is going to carry more weight. Turn it around: what if the policy said assess q 30min x 4 hrs & your DON said "oh you can assess every 1 hr for 4 hrs" what do you do then? No question you follow P&P because that's what it's there for. Bottom line: speak with your DON, question her reasoning and have her be very specific on what she wants documented...if she insists on every 30 min..so do it this time..but follow up with her boss. Because if this happens again to another pt, who does have a severe rxn, & it were to go to court, and the DON didn't consistently follow P&P, then there could be problems

I'm a JCJC graduate and the program is tough,grueling and I never want to repeat it again! With that being said, I believe that it made ME a stronger nurse, a better nurse. Their program is known to be one of the toughest and @ did have one of the highest ratios of nurses passing NCLEX. But in all honesty, you will get out of the program what you put into the program. So weigh your pros and cons: travel time/distance..accessibility...people you know...community. You have to go into any program with confidence and determination!!! And I can't not say this...The Lord brought me to and through the program... Rely on HIM....Good Luck:nurse: