UnionRN2

I did it. But my kids were older. Oldest in college. Youngest in high school. I worked a 36 hour weekend at the hospital and 20 hours a week teaching clinicals. The last semester I worked 36 hrs + 4 days teaching clinicals for two different colleges while working on my MSN. I would not ever advise trying that!

Water and electronics do not mix well. Just a suggestion. They will get tired of replacing them.

I can hear management/administration's argument now... something to the tune of "If you didn't get a break there must be something wrong with your organization. If you can't get organized then you will be written up and fired." And all those nurses on your floor who don't get break and lunch... they won't stand behind you. They will keep their head low and keep taking the abuse. And management knows this. As someone else said, document, document, document. And let me know where I can contribute to this class action suit.

I keep it for sentimental reasons. I worked very hard for it. It was a very important goal in my career. I was just as important as an LPN on the health care team as I am today with my MSN. And I proudly display it beside my RN license.

This is one of the core measures. If the any one of the standards are not met then payment is not made. We have one person responsible whose only job is to check all of our charts just to make sure all the standards are met so payment will be received.

I'm not sure of the name of the program. And I'm not sure why it takes pharmacy so long to turn around the meds. We were instructed by nurse manager and supervisors to stop calling because phone calls only compound the problem and makes the wait longer. I did call to try and get an antibiotic after 24 hours for an endocarditis pt and my name was collected (not sure of the reason... write up?) because nurses were not to call. Also asked the IS people walking around to help if it was possible to filter out the cancelled orders. It is... but they still appear. IS does not know why but they would get back to me. (But not one did.)

Recently started using eMAR. It had been a few weeks now. Nurses have encountered all kinds of problems. Some problems listed below: 1. Font size too small to read. (My guess is a size 8 font. We have been told it is too difficult to change the font size and to just deal with it.) 2. The medication box is cluttered with too much information so it is difficult to read the dose, route, and how often to give. Also, the generic and trade name are repeated multiple times within the box. The box may or may not contain all the information you need to administer the med (route, dose, etc.) 3. Once orders are scanned to pharmacy it can take 12-24 hours for the meds to be entered by pharmacy. So pts have to go without meds. Occasionally we encounter a med we can "over-ride" in the drug pyxix. So if this happens and you give the drug on June 17 at 10 am and the drug is not entered until June 18 at 1600, the earliest you can chart that you gave it is June 18 at 1600. You cannot put in the acutal times meds were given. If you give a med and have the weekend off and the patient leaves, it appears you did not give a med because you were not there to sign it as given. 4. Yellow boxes are supposed to indicate when a nurse is to give a med. Because of the tiny font size and clutter many nurses are relying on the yellow box. Many med errors have been made because this function does not always indicate when meds are to be given. 5. With paper MARs we countered an average of 15 incorrect enteries by pharmacy on a given day in ONE unit only. On paper we could indicate to the following nurse that it was an incorrect entry or discontinued and we did not have to worry about it being given. With the eMAR the incorrect med can only be removed by pharmacy and that can take up to 24 hours for it to happen. Med errors have happened. 6. Discontinued meds do not "fall off", but instead appear with a line through each word to "cross" it off. This just does not seem right. (Additionally, it makes for too many eMAR pages if the patient is in for any length of time.) 7. If a daily med is given, and the dr comes and DECREASES the dose, it may appear 12 hours later on the eMAR and indicate it is to be given per a yellow box. In reality, the dose is not due until the next day. Example: Drug X 40 mg IVP every day is ordered and first shift nurse gives it. DR comes in and changes it to Drug X 30 mg IVP every day. Pharmacy enters it at 8 pm and it appears on eMAR with a dose to be given at 9 pm. The pt receives a total of 70 mg, when they should have only recieved 40 mg today and 30 mg tomorrow. 8. One med pass takes about 15 minutes longer than it used to. Combine that with call lights, interruptions from drs and families.... and it is not a pretty picture. I don't know how the nurses with 7 patients are able to cope! Two patients in ICU takes at least 30 minutes on a good day! 9. ICU nurses are not being able to access drips like nitroglycerine, cardene, levophed, etc. All nurses complaining they are unable to access antibiotics and prescribed drugs. Is your eMAR experience similar? Did our hospital buy the cheapest program out there and it is not working? We have been writing up incident reports left and right. Meds are being charted in the narrative charting to CYA. Complaints are falling on deaf ears. Pts are suffering. Pts are complaining (can't access pain meds either). Don't you think it would have been prudent to test the eMAR in one area first and work the bugs out? Our pts are NOT safer !!!! Suggestions, please!

Engagement survey time again. Past experience tells me what a huge waste of my time this is. Fill out the survey, a third party bundles the results, and wonderful changes will be made in the organization! The "business" of the hospital does not care about nurses and they do not care about what the nurses need to do their jobs well. They do not care if patients are taken care of... just fill out the paperwork for accrediting and reimbursement purposes. Participation and results are supposed to be anonymous. Since nothing is ever done with these and no change is ever made I decided not to fill it out this year. To date I have received five phone calls, the promise of a plaster egg with a coupon for a small prize, the threat that I am ruining the chances of pizza for my co-workers, and the promise to be put in for a gift certificate for 100 dollars or a membership with the hospital's gym. First of all, I have morals and standards and cannot be bought. And secondly, how do they know I have not filled out an anonymous survey? Its very simple. Nurses WANT respect. Nurses NEED the supplies and people to do their jobs. Period. Yes, I tell my manager that all the time. Yes, I have put it in past engagement surveys. But no matter how many times you put that on a survey, managment doesn't understand the information. These are foreign concepts apparently that are not within their realm of thinking. So why do they bother with engagement surveys? Is it a source of amusement? Do they need these results to keep Joint Commission or CMS happy? Does my boss's bonus depend on it? What is the deal? Any thoughts?

We are switching over to eMARS with WOWs (workstation on wheels). Policy is to take the workstation in the room to give meds. Then wheel it to the next room. Problem: We get a a lot of patients from a local nursing home that come in with MRSA, VRE, C-diff, and baumanii. I can see this stuff spreading from patient to patient with this policy. What is the policy in your facility?

I do not trust the hospital I work in. It is not because the staff doesn't try. It's just the bean counters have made it so supplies run out, equipment breaks down, and there just aren't enough people to do what has to be done. We know what corners we have to cut to try and make it through a shift. We file grievance after grievance over the unsafe staffing. It doesn't help. I keep copies of the grievances/complaints. Someone will die as a result and I want to make sure when I get called into court I can say I told the management over and over that someone would die as a result of their bonuses for cutting. I don't want my family getting this type of care.

1. what is your degree in? bachelor of science in nursing (bsn); will have master of science in nursing (msn) in august 2. what state do you live in? michigan 3. what is your job title? staff nurse (in hospital); clinical instructor (at a local college) 4. how much do you make an hour? staff nurse: $33.14 (after 27 years of experience); clinical instructor: $27.50 5. how much do you make a year? staff nurse: approximately $55,000/yr; clinical instructor: approximately $11,000/year (per my 2010 w-2s) 6. what do you like about your job? staff nurse: helping very sick patients get better; clinical instructor: watching nursing students make the connection between books and real people 7. what don't you like about your job? staff nurse: the disrespect from administrators who know nothing about what nursing entails and from some patients and family members who are verbally and sometimes physically abusive. clinical instructor: the low pay. students who are unprepared.

Sorry Milwaukee nurses and patients. Our GAIN is your LOSS. This CEO is headed your way. Look out for major changes.... and not for the good of nursing or patient care! If you have supplies you need to take care of patients.... say goodbye. If for you thought you worked short before.... get ready for it to get much worse. Get ready for major layoffs, tell your health insurance goodbye, need that prescription.... good luck!, got a pension plan.... so sorry, but it will be gone shortly. Get ready for one of the most ridiculous code of conducts... which basicially allows for patient/family abuse of nursing staff like you have never seen or heard of before. Prepare for the outsourcing of jobs to other entities under the major umbrella of the organization this guy comes from (Goodbye LPNs, CNAs, medical record people, Bio-medical techs). Oh, and don't expect forwarning... you will arrive at your job and work for a few hours and security and police will show up to take your badges and keys and see you off the property with a warning that if you come back on the property you will be arrested. If you have flexibility in your schedules, like 12 hours, weekends only, etc... say goodbye. Welcome to 8 hour shifts and every other weekend and you can never get a "set" schedule to plan anything. Expect to get written up for those little things like coding a patient (you didn't get pre-approved overtime for that code... shame on you). Expect to model your organization like the airlines... because they have the best safety record. (Forget the fact that the services they provide are terrible.) Expect your morale to plunge to a level you didn't know existed, and then some more. Expect to be told on a daily basis how horrible and terrible nurses and your nursing care is. Expect to shut up, smile, and take it! Keep this in mind... like all CEOs he will be a short timer... he will wreck havoc, and go home with a smile. http://www.mlive.com/business/mid-michigan/index.ssf/2011/01/search_to_begin_for_genesys_he.html

The same thing happens to me when I use or someone near me uses hand sanitizer too! And it isn't any better in nursing education if you are at a clinical site where the students use it. (Because I work part time as a nurse educator in addition to my staff nurse position.) BTW, I know 4 nurses at our hospital with the same problem. One has become so sensitive that she was off on several leaves. Her pulmonologist put her off for a year, she came back and within a few minutes was back in ER. She was off again for a year and came in to visit a severly ill family member and ended up back in ER. Her pulmonologist says she can never work as a nurse again. Makes you wonder about our repeated exposures to some of these things.

PERRLA is the best money I ever spent!!!!!!!! Go to the site and take the tutorial. You will be amazed!!!

Downside: 1. dues 2. politics 3. seniority rules which are unfair to the lower senior people Upside: 1. Better staff/patient ratios 2. Higher wages 3. better benefits 4. administration can't just make stupid and arbitrary rules that jeopardize patient care and safety 5. defined pension plans 6. NLRB rules Of course I am a strong union supporter!