been there

Safety in hospitals ???? Since when ?? I've "been there" both as a patient and as a nurse.....after I discharged from my patient status I quit and went into Home Health and loved it. Recently a hospital ,where my husband had been a been a patient, was given the Nursing Excellence Award. They've got to be kidding me. My husband had an ASD closure. For the newbies who are not familiar with this procedure...a catheter is placed in the femoral vein to work its way up into the heart.....a device was placed in the opening between the atriums because it was too large for regular surgery. This procedure requires specific nursing observation and specific teaching to be given to the patient on what to report after discharge. Well....the bed on the recovery floor was broken and bent in semi-prone position. The RN on the floor turned him on his side to put a pillow under his back less than half an hour post-op!!! I had to go "potty" and wasn't there. A while later the nurse came in, didn't wash her hands, took his BP and left. For some reason I peeked under the sheet and saw a blood-soaked dressing. I ran to the door, couldn't see the nurse, used the call button ro report it, go no response then went to the door and called out to the nursing station that we had a femoral bleed. When the other nurse came in the first thing she told me was I was not supposed to be touching the dressing....I had been applying pressure, of course. Her next comment was "Why didn't you use the call button? " Naturally I called the surgeon. Before he had been brought to the room I was curious about his orders that were on a clipboard the nurse had left in the room. Naturally, the different diagnoses I saw were not his, looked further and noted they were for all the patients on the floor !!! His "patient teaching" order was "cessation of smoking"...!!!!! He's a non-smoker !!!! And was never given any teaching........... Techs came in, without washing their hands, couldn't work the machines to do vitals....no one who entered the room washed their hands......so I had to be vigilant and awake for 72 hours before he discharged to ensure his safety. When we passed the nursing station on our way out I informed the charge nurse that she had done a pathetic job of patient care and of oversight....that turning this type of patient on his side less than half an hour after being in his bed is forbidden, that cessation of smoking for a non-smoker does not help when the patient needs to be taught to watch for swelling, pain and redness at the site and to call the MD immediately then go to an ER....and to not bend over or lift anything heavier than a dinner plate.....Oh, and there were several cardiac surgeons writing in their charts at the station. I also wrote all of this down on the form sent us for an evaluation....and did receive a phone call from the DON to whom I gave names of everyone involved, dates, and times. But still, they received the Excellence in Nursing Award !!! I'm not the only nurse who has had a family member in a hospital and we well know to stay there till they leave to go home. Cost cutting is the prime reason for cutting down on RNs and using more free "learning" Techs from schools to replace valuable and experienced LPNs. This hospital didn't have enough pillows for all the beds on the unit....or enough sheets or blankets. I loved hospital work but when cutting the budget became prime I left.....to protect my nursing license. If RNs would notify their State Board with specifics (dates, times, names and occurences and the fact that they went to the Charge Nurse with these instances) they will get the backing of the Board if anything happens....and with enough pressure from the Board changes might be made. I do know one male nurse who quit after he was told he had to stay 3 straight shifts in the ICU because there was no one else to replace him. He was turned into the Board for patient abandonment a couple of weeks later but he had already gone to the Board first ....and had also given them a copy of his paycheck and timesheet !!!

Got in trouble big time once. MD ordered a change in the flow rate of a regular IV, which I did, and documented, and told the on-coming shift about. I went home and was called about three hours later. When I got there I was in big trouble with the MD. The med had not been delivered as ordered, was too slow. I was blamed but I informed him I had changed the rate to his order, documented it, informed the on-coming shift. I was sent home. Later that night, it was learned from the patient that a visitor, who was a nurse, had slowed the IV telling him it was going in too fast and would irritate his veins. My reprimand was removed from my records but I never was given an apology from the MD, who was the one the patient told what happened. The lesson I learned was to have the on-coming nurse for that patient check the flow rate with me and document it before I left the floor.

Certainly not Baton Rouge. After Katrina and Rita a couple of us RNs answered the call for RNs at two local hospitals. Both stated they were accepting only "displaced RNs" (those from the New Orleans area displaced by the hurricanes). Two or three weeks later we learned both had shipped nurses in from their sister hospitals from other states. A lot of displaced nurses are still displaced and the locals are sitting on their thumbs. Charity in New Orleans is closing and is currently laying off hundreds of nurses.

I didn't do this but they say revenge can be wonderful. A rather hard and strictly business nursing instructor of mine in nursing school chastized me for not being able to catherize an extremely large woman with cellulitis in both legs. Two other students had to assist because this woman was LARGE and the site I needed was well hidden under multiple belly folds, not to mention the pain caused by handling her legs. My instructor marched in and called me incompetent, etc, etc. and said she would show me "one more time". She got on the bed, kneeled between the patient's legs and shoved them aside. Then she promptly contaminated two insertion sets. The third was the kicker. Each time she tried to "insert" the lady would yelp out "Whooo". The doctor came to the door and asked the instructor what in the he.. was she doing!. The patient told him she didn't know but she sure got a charge out of it. Seemed as if the site she was poking wasn't exactly where the catheter was to go!!!!!!!!!!!!! I know this is gross but ....AAAAAAAAAh sweet revenge!!!! Oh, I got an "A" for that clinical!!!

Please don't think your question is trivial due to what we have suffered here. I'm a Baton Rougean, we suffered damage, those parishes above us have had no food, water, power for days without help and they have to come to whatever source of gas they can find for generators and the world knows nothing about them. We have many many evacuees here and know many NO people. We suffer for them. BUT, you don't need to disregard your needs. You have a future to work for also. Check with Southeastern Univ, School of Nursing in Hammond to see if they can help.....985-549-2000. God help all of those in need right now and help us all to give of ourselves to them and each other with supportive actions and comments.

Narcotics are not a good mix with patient care. The RN is responsible for anything you do under the influence of the medication and could well lose her license. I agree with another post, if you require Vicodin for pain you should not be working or driving.

I had to take a speech class and give oral presentations. As a BSN I often have to speak in front of groups (MDs, nurses, MSWs, family members, etc). I see no difference between the groups of RNs but there have been rumors around here for years that a BSN earns 2,000 / year more but has to take a whole lot more bull and stress. I have been faced with the problem of having RNs as my boss who did not have a BSN and they had reactions to this that, in some circles, would be called childish. I just look at all nurses, LPNs, ADNs, whatever, as nurses and I don't care about the letters behind the names unless it is something that an RN must do by law. I wouldn't recommend going to school for a BSN because and RN is an RN is an RN.

I was lucky. I got into nursing school the first time I tried. We entered by GPA and there were only 25 slots. However, what about the nursing shortage when there are a lot of us who have only been retired a couple of years and need to go back to work.... rarely have I heard anyone say they were accepted. It is said that it would cost too much to train us!!! Don't hospitals still do a 3 month training for new nurses???????

Some facilities may not appreciate the art work but not all of them. I know of nurses with warts, freckles, leg braces and one who has a butterfly on the top of her breast that is easily seen. The best liked nurse in one hospital is an old retired Navy man. Now this guy has some stuff on him and he tells tales about how and where he had each one done. The patients love it. Maybe a recruiter or personnel interviewer, who cannot comment on it, would be "diverted" if you said "I'm sure you notice my tattoos. This one I had done in California at a little shop next door to an orthodontist......." Be straight forward about it and put the other guy at ease. I see many nurses, male and female, with tattoos and it is becoming more common place. I would love to have a tiny butterfly on my ankle but I'm fast approaching Medicare and it would be a waste on me!!!!! Go ahead and make the jump into nursing.

I also question how the patient received the Toprol without a script. Of course dizziness is an early side effect and goes away when the med is stopped. BUT how did he also get Tegretol if it was not on the med list? The dialysis unit usually has an MD who decides which meds his patient needs....so.....who wrote the script???? A lawsuit may not occur from this but you do need to write down every conversation you had with everyone during the sequence of events just in case. No one can fault you for being honest with the dialysis unit, the family, your DON and the MD. You took immediate action when you learned of the problem and no one can question that. We have all make med errors and have learned from our mistakes so don't beat yourself up over it. Just learn from it and keep on being the responsible person you are. ( and c..y..a..)!!

As a prior DON in skilled nursing facilities I agree this is criminal abuse. The DON is responsible for the condition of every resident and the actions, or inactions, of each nursing staff, and, each staff member is responsible for his or her actions/inactions. Please report this to the ombudsman. Also, it would be good to invest in a polaroid camera, take photos of each wound on admit and have witnesses sign and date each picture. Let the ombudsman see these , and she or he can report this to the nursing boards if necessary. I would make copies on a copy machine to keep and date/sign the copy. Also, why hasn't the survey noticed this??????? I realize that staffing is an issue ie: one CNA for 25 bedbounds is not unusual but skin condition IS A BIG ISSUE WITH LICENSING AGENCIES FOR NURSING HOMES. I don't think race is an issue because State funding and lack of family attention play a major role. Now...I have taken polaroids of residents who were wound-free when they were sent to the hospital and returned to us within the 10 day window with decubes. It became a habit to photograph butts and shoulders before transfer with the family present because one hospital was notorious for lack of minimal skin care. Your case is horrid and inexcusable and is definitely abuse. Your state Elderly Services department is another avenue you may want to take. They deal with abuse. God Bless You for getting angry.

I think this subject has been beaten to death. We all have the right to our own personal opinions. As nurses we all have been subjected to a lot of crap during our careers but we stick to it and do the best we can for our patients. That is why we are, as a group, "one of a kind".....the best kind there is. What about a nurse who has drained your knowledge for her own gain under the guize of a "friend" then stabs you in the back when she gets where she wants to be and disregards you when you need something?

Kevin I apologize for all of those who posted "cutsey" remarks. Most, I'm sure, are from very young persons who have never been exposed to the real world before nursing school. I feel male nurses look at the sexuality of the patient as 1) this is a female so I insert the catheter..... 2) this is a male so this time I insert the catheter a different way, etc,etc. I have worked with many males over the past 20 years and have only noted one to have a problem with his libido but he did contain it to the female CNAs who were willing. This guy was caught in the act and lost his license, the CNAs lost their certification. The others were professional and very very good at their profession. In some cases it was best to have a male nurse handle a difficult male patient. My salute to you guys and thank goodness you have begun to join us. As to the hairy chest issue.....a tee shirt would really be preferable but don't forget some females who lean over too far when doing vitals and expose themselves all the way to their waist!! Looks like some have forgotten this irritating problem with the way scrubs are made. Any comment from the staff about a hairy chest is tantamount to remarking about a nurse's protruding teeth.....it may unknowingly hurt the recipient. It did me and I'll never forget the nurse who said it. You guys are doing a great job.

I wouldn't chart what you suggest because it is not correct. What would happen if the administrator knew this patient and asked her if she refused and she said she didn't? Can we try to think from the patient's point of view? Why did she only want an RN? Did no one ask? Had something happened to her or someone she knows and she was apprehensive? Like someone else said, I don't know the whole story either but I think good patient care and concern would include a simple question. I don't mean to seem harsh and critical , after all, she may have been "one of those patients" we seem to get at times. I had one on orthopedics with 3 sisters in her room but she stayed on the call bell telling me she "would let me" get her purse from the closet, the next time I "could" get her hand lotion for her, etc,etc for several calls while I was trying to hang piggybacks on other patients. I "vented" to the supervisor but she was worthless as a tick. I finally kept my cool and explained that I had several other patients that required meds on time and I would appreciate if her 3 sisters would help me out. She didn't realize what she was doing and apologized. Even sent me a Thank You card to the floor!!! I still don't like the woman.

I started college for a BSN at 45 years old, married, 3 sons (Jr.High,2 in High School). It took me 5 years and we ate a lot of bologna sandwiches, all 3 sons were in college at the same time I was. We all made it. Your age has nothing to do with it. Just remember, if you didn't learn the metric system like I didn't when I went to regular school start learning it now!!! If you follow your heart you can get through anything.

Get other nurses together who are facing the same issues, including RNS. All of you document specifics as to who, what, when, where, etc. and send these to your boards. Call the Boards to follow up and document this. The Boards may not be aware of the situation but they definitely will make a formal decision that you can use to confront whomever is allowing this to happen.

You seem like a gutsy gal I would hire in a flash. You've been through the mill and still choose to stay in the nursing field. I agree with Thunderwolf, I don't use my title in the field or on the floor, I'm just a nurse who respects anyone who works WITH me, not UNDER me. Stick with it. Don't get frustrated about not passing a test. Sounds like you go in with stress and the feeling that you won't pass. Get help from nurses in boosting your weak areas. I tutored a CNA whom I encouraged to become an RN. She now puts up with grief that RNs get. Go for it, never lose sight of your goal. Go girl!!

For your legal protection it's always safest to put the name and title of the person who actually performed a technique on your patient on your chart documentation. Be direct, clear,and never vague, in charting. If a nursing assistant placed a foley is there documentation in his personnel file that he is qualified to do this? I wasn't aware that CNAs could do more than basic cath care. Maybe in your state? And now there is controversy about CNAs allowed to pass med? God help us and the patients.

Any non-patient care employment for a nurse requires prior patient care experience. I have never hired, nor worked with, an RN (in over 20 years) in any field who came straight out of school looking for such a position. These are usually managerial positions and those who are supervising "patient-experienced" personnel are setting themselves up for problems. The old saying "If you ain't done it then don't tell me how to do it" holds very true in any position. You may want to think of another field other than nursing if you don't want to wipe a dirty butt, put in a catheter, or just sit and hold a sick person's hand. I'm a non-patient care BSN but I still do patient care when I get the chance. Hands on nursing gives you a good feeling of being needed and of caring for another person that you cannot find in any other field. Take time to research what RNs actually do. You will have many long lonely hours, eat lots of bologna sandwiches, loose a LOT of sleep, and face serious instructors who do all they can do to make you accept criticisim like you have NEVER been faced with before you graduate as an RN. We are a special group of people because we care for people who need our caring and skills. Why would you want to be an RN and not do patient care? It's what we do!!!

Reminds me of the story about the teenagers parking in a lonely spot, the girl hears something, the boy didn't then when he drove her home and went to open her door he saw a hook (like Captain Hook's) caught in the door handle!!

I wear Fruit of the Loom nylon with elastic at the waist and legs. Never had a problem with riding up. They do show through in whites but I don't wear whites unless the top is long. May not be anyone's style. Just remember what momma said.....always make sure they don't have holes and are clean...just in case of an accident!!!!!!

I agree with you totally. I had loud hot pink and other colored tops with flowers, etc. that I wore in home health and the patients loved it. Even in the nursing home I suggested to my staff that they wear colored tops . The residents loved it but the owners didn't. There is, however, the nurse image. A hot topic currently in Nurse Week, November 15, 2004 issue is about the professionalism of nurses being better portrayed in "whites" so the patients can distinguish us from housekeepers, etc. Reminds me of the time I was in Wally World with a printed vest over my scrubs and a customer asked me where something was. She admitted she thought I was an employee! There is a lot of sense to both sides and I'm caught in the middle. At times I think colors work better, but I always want to recognized as a nurse.

Sounds to me like, since you were new, you didn't kiss where the sun don't shine as well as the ones who have stayed there, since you mentioned there was a high turn-over rate. Bravo. Now that you know the game do you want to play and stay ...or... leave? Time to go elsewhere. I would have been gone after the first eval, and, before I signed it and turned it in (regardless of Joint Commission) I would have made pertinent comments on the form to set things right first...then I would have made a copy for myself in case the original was "mis-laid". As my name "Been There" implies, I have been there.

If I had been your patient and had received the comments you made about being a "work subject ony to me"...."don't go into people's room because I want to....but because it is my job" I would be shocked at hearing this from a NURSE. I don't mean to offend you but I have been a patient several times and I was a bit leery of one nurse who made it clear that my need of a bedpan was " something an aide could do, that it takes up too much time for a nurse to do". The patient's further comments to your probably came from HIS being shocked and was a reflex. The nursing image of a caring professional is always "on" regardless of our personal feeling. To go further and tell him about your belly piercing, planning to get a nose ring (will your organization approve of you wearing this?), tattoos, etc. is more information than he needs and , were it me, I would not divulge ANY private information about myself. A nurse enters a patient's room to help the patient, to realize that "crap" or comments might come from the patient's fear of what is happening. Nursing involves receiving unwanted comments, realizing where the comments really come from, and working on alleviating this fear in the patient. Of course, I'm getting on in years and can remember when doctors made rude and ugly comments to nurses and "Code White" would be sent out over the intercom. For those who don't know what "Code White" means....when any nurse on the floor, or in the building, who is free at the time hears this code they all come to the scene and quietly stand around the poor nurse who is getting it with all barrels. This sent a message to the doctor that other nurses were hearing him and to "back off". Again, I don't mean to offend you but all nurses must remember to maintain the professionalism of nursing at all times. We can vent in the breakroom and/or to the Nurse Manager. I know I've gone into my manager's office, closed the door and thrown myself into a chair saying "I know we need patients to keep our jobs but I really want to strangle one right now". I had a friend who had a butterfly tattooed on her butt but over the years it has sort of drifted down to the netherlands so plan ahead for this before your next one!!