chimama

It is naive to think that a career ladder is a recruitment/retention tool.It is a stressor to the staff and a creation of ivory tower nurses who live in the land of NANDA.

So sorry for your error.Don't beat yourself up. I have to ask, because I have noticed a tendency to take things at face value lately, was the mis-communication information out of the ordinary? I have noticed lately that some nurses are not questioning factors about their patients the seem unusual, when doing so can prevent an error. For instance, the other day a nurse reported to me that a patient had ac/hs blood sugars, and had had two sugars greater than 250, but had no insulin coverage ordered. Immediately after report I checked tha chart because this struck me as very unusual and found that a transcription error had been made when the pt was admitted and the ss insulin had been missed from the hospital ( I am in an LTAC). I noticed on another pt that the sodium tablets on the mar were designated as prn...how odd. This had been there for days on a pt with SIADH and when I checked the order was 2gm tabs po tid. I just want to encourage nurses the check out what may seem odd, even if it has been checked and double checked. It may prevent an error such as this.

I worked several areas at this hospital and enjoyed them all except the CV unit. The doctors were EXTREMELY rude...and this was the opinion of the ER docs also.It is a beautiful hospital and the staff is very nice.I worked everywhere but the CV units...I refused to work there and I have never refused to work anywhere.Just depends on how you react to working with hateful physicians.

I have drawn buckets of blood in the past 30+ years! I am the one the Phleas come get when they can't get the blood.I am not overqualified, undertrained, or "bad" at drawing blood.

You poor thing! In the unit I work new grads are given about 6 months of orientation and I have precepted for as long a three months because the grad felt she needed it. I think your manager is taking a HUGE risk having someone so inexperienced, even if you are real good,alone on shifts. I think you have been done wrong and should try to find another job.

Why do we care so much about all this? If I am in an ER and a patient tells me he has a migraine and needs Demerol, he should get Demerol. If he says he wants Torodol, he should get Torodol. Why should I get my panties all in a wad about drug-seekers?If a hospital wants a three narcs in th ER policy then you're out that is OK too. I just don't get all the passion and prejudice this issue creates. I guess what I am trying to say is why should everyone be so suspicious of people with pain complaints?Why do they care so much about the validity of the pain? Just treat it.

I totally know what you mean there! I work NICU and I hate it when a parent says...usually during CPT on another baby..."Does that hurt the baby?" I so want to say "Yeah...we are into hurting babies. That's what we're all about" (you idiot!)

I just stopped at a horrible looking accident and there were TONS of people helping. They seemed to be doing the right thing...the girl wasn't actually injured in an acute was, ie bleeding, LOC,ect.I stayed for a few minutes till I saw all was under control then silently slipped back to my car and left. I will always stop, but will leave as soon as I can see that the situation is stable.

If patient advocacy is the issue then why don't we name names and places?Who was this doc? Where did this torture session take place?Does stating the truth with names and places violate some kind of forum rule?I have always wondered why don't we just say who did it and where instead of all these vague references.I would like to know who I need to protect my family from. The names of sexual predators are published...why not the names of patient abusers? :uhoh21:

They won't let us drink at work anymore!They take all the fun out of everything! :rotfl:

I have been DON in three LTC facilities. The only thing that is going to change the "culture" of where you work is for you to be able to pay your staff more and start over. That is not going to happen. LTC is a lose-lose situation.You will have no life as long as you are there and when the state comes in they will treat you like a criminal who only went into LTC to abuse and neglect the elderly. I advise people to never go to a Nursing Home. Go on welfare and keep your loved one at home.Do something, anything but a NH. And you should turn in your resignation today. You are in for a miserable time untill you do.

Don't think of the situation as a long drawn out death. Think of it as the rest of your patient's life.They are living right up untill the moment they die.You can establish a relationship and a trust with them so that you can assist them in acheiving their death in the manner they choose.And you can always reassure them that nothing is written in stone...they can always change their minds.No one knows how to die.We just help each other along the way.

I really don't need a pain scale. I know this is probably blaspheny but I just ask "Are you hurting" and assess my patient and give them pain medication if they hurt. Why do I need a scale? Am I not going to medicate them if I get a low number from a fresh post-op?Am I going to get someone having an MI less MSo4 if they say it is better but still hurts?Do I really need a crying little kid to point to a smiley/frowny face to know he/she needs something for pain? And how about my Spanish/Mong/and non-English speaking paitent?When I have an alert English-speaking patient and can give either a pill or an injection I ask"Do you want a pill or a shot?"Why do we make everything so complicated?

DZcarrie has all ready gone the the higher up people. A state reported complaint along the same lines will be obvious, and administration is always thinking along these lines. Certainly she should do all she can for the betterment of patient care. If the state can change things, then she should report it. She just needs to know that there can be serious repercussions. I don't mean to sound like I support non-action. It is just that here in TX the Dept. of Human Services rarely if ever actually effect an improvement. Knowing what the concern is would make it easier to brainstorm a solution.

I worked in a hospital that used Neurontin by the bucketfull and have been for many years skeptical. My mother has post-herpatic neuralgia from ocular shingles and thinks it helps "a little". I am still not sold on its effectivness and suspet a placebo effect.When I was doing geriatric nursing I had many patients who could not tolerate it.The jury is still out as far as I am concerned..