mstere

This actually happened to me. Now, looking back on it I realize there should have been more that I could have done. The ANA states my commitment is to the patient. I am not sure what the laws are in regard to this. Also, i was not aware of what power I had convince a physician to do something he was already unwilling to do. Maybe, I could have asked a manager, or someone in ethics at the time. In retrospect, I feel there is always something a nurse can do to help the patient and advocate. Just want to know what your opinion is on how you may have handled. Thanks.

Just want to know what your opinion is on this... A patient is admitted, states he is an illegal alien, has no insurance. The physician declines to call in a consult for this patient's health issue. The social worker tells the patient in frustration that he needs to learn English. The nurse has a legal, moral, and ethical duty to the organization and to the patient. What would you do?

Can someone tell me how long a nurse has to change documentation? In meditech. For example. I was told that I documented in falsification. Which I can say was NOT intended. I was NOT given an opportunity to make changes and...it did not harm a patient. Think I will lose my job.

Our unit director has asked to send in ideas of what we can buy on our unit that costs over $3000.00. Its great we have the opportunity to send in ideas. Our unit has all the general med-surg equipment including blood pressure equipment, scales, bariatric lift, wound care supplies. I thought of maybe SP02 monitors. What does your unit have that you have found to be very useful in your practice? Thanks. Mstere, RN

I just have a question for anyone out there who understands safe harbor. I live in Texas and I am a new nurse. I am learning about safe harbor right now and need some clarification. If, for example, I believe in good faith that I cannot accept an assignment one day at work because I feel my patients will be placed at risk for unjustifiable harm & then I request safe harbor. But, later the nursing management staff discusses a new assignment with me and I accept/agree with the new assignment. At this point, do I still have to go through with the process of Safe Harbor and the peer review committee? Thank you.

The nursing process..Well first of all you have to know the nursing process. A - Assess (what is the situation?) D - Diagnose (what is the problem?) P - Plan (how to fix the problem) I - Implement (putting plan into action) E - Evaluate (did the plan work?) All together equaling ADPIE... Ever heard if SOAPIE? It is how we chart. We need to record the following. S=Subjective:record what the patient tells you(relevant to complaint including negatives). O=Objective:record observations,scene,MOI,(relevant to current complaint). A=Assessment:clinical impression(relative to chief complaint) P=Plan:record pre-hospital care,initialization of treatments(Tx). I=Implement:What action you take based on your findings. E=Evaluations(s):asses and document response(s) to Tx. Everything you do in nursing is about making sure you are doing everything possible to care for your patients in a safe, prudent manner. You have to know what your goals are then make sure your interventions are working. If not you have to reassess and modify your plan. Its all about assessing and reassessing.

I started on a Med-Surg floor straight out of nursing school in June 2009. Since I have been there I have been very disgusted with the way morale is. People go around bickering all day about how hard it is. I started out with a fresh attitude feeling happy and ready for team work. When I mentioned it to others they simply laughed at me or said snide comments like just watch your back around here. I was shocked. I noticed little by little I was falling into the same behavior pattern. I started to complain too about having 6 patients to care for and one PCT down our hall of 12 patients. I ask for help from my co-workers for example, to pull up a patient in bed and they say NO. I call the charge nurse for help and she says she has patients of her own to care for. That is just one example.. I feel alone out there. Each time upper management calls you to the office it is to reprimand you. I was taken in to the office this week because someone told the managers that I was being negative. I am sure I was at some point. No, it does not make it right. But, I am disgusted with the way everyone is on the defense all the time. I am miserable and never really told the upper management. I do not get help from other nurses or charge when I have serious clinical questions a lot of the time and I am usually doing most of the patient care tech work. I do not mind working hard like wiping butts, doing bed baths and emptying foleys but when I go up to a co-worker and the first thing that comes out of their mouth is WHAT DID I DO Wrong...? That is sad. I finally was asked DO I REALLY WANT TO WORK THERE? By the manager..I said YES but not like this. The manager asked me to write a paper that tells her what I would change to make it a better work environment there. What are some ideas you have that really makes nurses happy where you work? I have an idea..What if they encouraged team work more, encouraged doctors to buy the nurses fresh fruit, bagels? what about putting a TV in the break room..we do not have that.. OR simply put a bulletin board up with notes from patients that thank us for good work. OR if they would not take us into the "OFFICE" just to spank us like they do. I think it is coming from up top why everyone is sad and miserable. I got a nice card from a patient when I first started working there. The manager did not even say GOOD JOB or anything. She did not mention it to the director. NO one cared that I did a good job. I am not appreciated is how I feel. I also feel like people are genuinely afraid to say anything. I love patient care and all my patients have great things to say about me all the time but co-workers tend to bite on each other all day. SEND ME your ideas so I can share with them too.. THANKS!!

I am a new nurse. I started about 7 months ago. I also feel your pain. I look up meds and diseases in a book that I bought called Med Surg for Dummies. That is exactly how I feel sometimes but I know I am smart and care so much about my patients. I want them to be safe. I work in an environment where my co-workers are so very scared to even have conversations with you because they are afraid someone is ready to backstab you or tell management about any comment of how unhappy we are there. It is like walking on eggshells everyday. The only time management comes to you is when something is wrong. I never get a pat on the back. I work so hard running around all day like a marathon almost. I feel so exhausted, dehydrated, and sick by the end of the shift I wonder what I could be doing wrong or if it is just that there is so much to do all at once. I do hear from experienced nurses that it gets easier. Not sure about that. I saw a nurse that has been there 20 years break down in tears because a patient was yelling at her and she had 6 patients that day. It gets too hard for us out there and we see no relief in sight. I was asked by management to tell them what I thought would improve my work environment.. I was wondering if I should have a director's job if that is the case. I am not sure how they could ask me that.

We must remember to care for the patient with a holistic approach. Family plays a large part of the patient's life in many cultures and we need to remember the patient's family has the right to advocate for them and be there with them. If the family gets in the way or is annoying you just simply ask them to step out of the room for a few minutes while you take care of your business. I dont think there should be a limit unless its in the ICU. But, we should be reminded that healing works well in a low stimuli environment in a lot of cases so we need to learn how to manage according to the patient's needs as well. Its a complex situation but just remember do not be rude. I have seen it a few times and feel it is not needed.