BmichelleRN

Thanks...it is through her medical records that I noticed some indiscrepancies. My access is limited because I am home health RN. Just seemed odd that she has spots on her liver, kidney and pancreas and no chemo, no hysterectomy. There is the additional concern that because she is bipolar and on medicaid that she is not being given standard of care. I really appreciate your responses. Just goes to prove what phenomenal people nurses are that you took time to respond. Thanks!!! BTW, I am strongly encouraging her to seek second opinion, just in case.

Can I ask why? If it is a necessity, I think your chances are good. However, you really would benefit from two years of full time med/surg experience. It really is an invaluable training field. Having said that, some people hate med/surg and I totally get that :) but if you just hang in there, it really does help to round you out as a nurse. You receive invaluable education on medications, procedures, pt education, documentation, etc. I wish you the best of luck!

Hey all..I am a med/surg nurse with no experience in oncology. I have a pt with bipolar disorder who is claiming to have stage 3 ovarian cancer as well as stage 2 uterine cancer. Pt states she has spots on her liver, kidney, and pancreas. Pt claims to be receiving radiation treatment four days a week for an hour at a time for two weeks two days. No hysterectomy, no surgical or chemo intervention . Does this sound like standard of care? I can not find any literature that supports NOT removing ovary/uterus, NOT giving chemotherapy . Thoughts?

I am really starting to question whether I should be a nurse or not. Long story short got my license in 03 worked two years in med/surg had to move and stayed out of the field for a year working for my husband, returned for 2 years,resource, did a little of everything and as a homehealth director. Decided i am a med/surg nurse and I want to work a flex schedule, after being told by another employer :cry:I was not working out, not enough experience with IVs basically. So I am working with a crushed self esteem at the moment...Last night I am on my third full day of orientation on a med surg floor. I have three patients, one gets d/c'd within the first couple hours, the doctor doesn't write to DC just tells the pt he is dc'd. Needless to say the pt is antsy, wants to go, I have to wait for the order and then put it into the database along with his dozen meds and all that info, takes me about an hour in between things. I think he was okay, not perturbed when he left,then my next pt has to go to get a stress test...more and more unfamiliar paperwork, rushing his few meds and off he goes, during this time my charge, who should be orienting me to their process is bogged down due to understaffing, so if i have a question I am on my own and was. Then the charge shows up and wants me to take an admission right before I am told my stress guy is going to another facility for a cath. No, I do not know their procedure here. The secretary does tell me to call report to the other facility and to fill out this and that. In the meantime, they have put my new pt in his bed and never notified me. So I am running like a crazy person without a clue and my new guy has a fever 104, I medicate immediately, stop what I'm doing, and do it. Tear off his blankets, his condition is known for these fever spikes.The supp. brings his temp down within 30 minutes, I check 101. barely over febrile 100.4. So okay good,back to my other responsibilities like verifying new orders, getting them started then at 6p the news comes, he is at 104.6 now. I again tell my charge and I also tell the supervisor. I give him a supp. thinking it has been 4 hrs, when the computer prompts "too early" I can not get out of the program (can not find a soul to help me). I go ahead and give it 15 minutes early and call the doctor at the advice of the supervisor as I am a little worried and in my own 12 hr work coma. Dr calls order after vitals are given of tacypneic, tachycardic, >103 T and temp spike and decrease. Nurse sup seems to think the info I gave is not enough?? He seemed disoriented ,yes, he had a high fever and I saw it dissipate when it came down. We put a fan on him and give him new med. His temp drops down a degree and he is more conversational, in better spirits, even his wife agrees, A&Ox3.My shift is over and I am waiting for report off so I go check his temp again it is still north of 103 after 30 minutes. Bottom line, I feel like a failure, never had a guy go bad so fast and I am home today praying he is okay. Hopefully they sent him to the unit as night nurse asked why that was not done when I gave her report. Any hoo, I missed a med and didn't know until I was closing out, good times, good times, so I went back and gave it late...It is a routine med so I wasn't too sick about it. So I am freaking out, about my lack of critical thinking, I should have called the Dr with the first spike but it was in my head that he (said dr) was just in the room with the family and warned them of this so I didn't get concerned and the temp responded so well to the suppository tylenol. I don't know if I am meant to be a nurse....I have never not given a med on time, let alone missed one. Oh, and my cath pt should have gotten a PNA shot prior to departure, didn't show up on my MAR and it does not alert on the computer, old system, pt unmedicated, another first!! Also, maybe I was too laid back about the temp the first time. What do you all think and have you had these days from hades. And should I go to my supervisor? Let her know about my errors in judgement or med giving....Or the fact that I am in orientation and do actually need someone to guide me somewhat.

I really really feel for you. I would definitely seek an advocate, someone who can guide you through this process. I do not see how your license could be revoked but I would still dot all my i's and cross all my t's. To me it seems the med error bears most of the blame (hold lovenox!!). When you come through this, you'll be an even better nurse! Thanks for sharing, it reminds me to be even more vigilant!! And document document document. Let us know and best of luck.

I have run into quite a few nurses who have taken time off to care for family or deal with personal matters. It has not effected their ability to get a job, I don't think it will yours either. Best of luck!! :nuke:

PS definitely follow the advice of instructors like the above poster mentioned.

I think that is truly a personal choice...Obviously, it seems smarter to wait until you both have good paychecks coming in. I know several nurses who have had children in school (one girl had her 6th and came back one week later to finish clinicals and nurses in their first year as a nurse and all are fine. Maybe make a pro/con list, consider the above, your age, etc. A baby is truly a blessing... GOOD LUCK.

I just want to add that many citizens in UH, especially in Canada and England, travel all the way to the US and PAY for healthcare here. That to me is a big red flag.... and even if wages go up, everyone's costs will increase in the form of taxes: in the end I think we'll have worse healthcare system at a much bigger cost to all of us. Look at any government run program and you will get the truth....

That's rough but sounds like you did a great job...and the next time, cause there will be a next time, it'll be a little teeny bit easier. OH and I remember those shifts well. You just keep on movin on...

The answer would be YES...BTW, most hospitals require a follow up to determine pain med effectiveness...some require you to ask the patient their current pain level on a scale of 1-10 within an hour of medicating. If your hospital does not, I would do it as my own personal nursing practice. And document their response. Finally, it irks me that this patient wouldn't call out for pain med if he/she were in pain. Most patients are skilled at using that call button. IMHO sleeping in a hospital should be solid evidence that this patient was very likely not in pain "all night". LOL

You absolutely did the right thing. The guilt is hard to deal with...but you have to be honest with yourself or the guilt will continue to lie to you. If you don't report cause you like the person or respect the person then do you only report those you don't like?? You know, that is guilt, irrational. Then there is the possibility of jeopardizing your own license if you didn't report and she's found dead on the floor from an overdose. Or how about the patient who is in pain and can't get dosed and must suffer because they are Q 4h and someone said they had the dose 15 mins ago. Don't beat yourself up. Maybe this will be her rock bottom and she will get her life back to where I am sure she desires it to be!! And good for you for doing the right thing for everyone. My past instructor calls that a RN: REAL NURSE!

I think my biggest concern when reading your post is what kind of nurses are they?? And please don't let them be my caretaker should I end up in your facility!! I agree with the idea of the neutral statement...but if you were saying that about me and I was the NM, I would approach you and ask you what I could do to help the floor run more smoothly...Why can't people, especially in healthcare, work together, is it not stressful enough?? (having just been stabbed in the back, while they smiled to my face, I'm a little sensitive) And I know, people are going to say that everyone is different but what happened to serving people instead of being self serving. I have had both experiences and I will say staffing is much better on units that work together...what better motivation to reach out rather than to strike out. And shame on those nurses who confronted you!!! I personally do not care their motivation, they could have approached you like professionals, like intelligent ?? adults.

I don't know what employment opportunities are like where you reside but if there seem to be other opportunities out there, IMHO, you should keep looking. The last two times I had gut reactions that made me feel that way, they were on the money and I would have rather stayed unemployed a little longer than to be in the horrible situations I found myself in. Also, I think it indicates the way you will be treated, as the facility seems to lack concern for its own residents. Just a note of encouragement: I have interviewed in two different states for RN positions and have gotten every job I interviewed for...Just make sure your cover letter and resume are well done, you want to stand out!! That will help get you in the door. best of luck!!!

One thing I commonly had to do with potassium infusions to stop/prevent pain issues was to slow the rate. I never had a complaint once I did that. Of course, the doc had to agree... A little ice near the infusion site also helped for the more sensitive people. I let them know that it is not something to be alarmed about, that slowing the rate was almost 100% effective. Sometimes I never made it to a rate decrease because with their anxiety decreased they often didn't mention it again and I would come back from calling the doc to find them denying any further pain.