trustmee

Hi Snoopy, Hope your fully recovered from the Flu. To feel such a high level of guilt indicates that you know how your team cope with staff shortages/agency cover. You have most likely been in that position yourself. But would you have expected a person to turn up when they weren't able to? No, I expect not.....so don't be so hard on yourself! I've taken loads of calls from workmates phoning in sick. Although it's a 'downer' having to figure out how to cover the shift (knowing that I may have to stay on or cover more than one ward etc) I always try to empathise with the person on the other end. Managers usually know who the 'lead swingers' are but even then it doesn't entitle them to make scathing, hurtful remarks! I'd be the first one to send someone home from shift if they were showing up with an illness. Far better they rest up than spread it to the rest of the staff and clients. Take care.

Here in the UK most nurses I know only joined the union to get indemnity insurance cover in case they mess up and get sued! I have been a union activist prior to nursing and feel that without trained negotiators our pay and conditions would not be at the level they are. That said, I feel we have a long way to go!

Some of these responses are very amusing, yet scary! As for the nurse v nurse abuse, yes I have witnessed and been the butt of many types of 'verbal' abuse and harrassment. Confrontation has been the best approach. But, it's always worth trying supportive confrontation, rather than an aggressive judgemental front. Often the out bursts or 'niggles' are the result of ongoing probs and once touched upon it allows staff to reflect and resolves issues. It's not just our clients we have to build trusting relationships with!

I work on an organic admission ward and Wanderers are encouraged to wander within a safe environment under supervision. The level of observation for the person is increased if there are considered to be any additional risks that would result in harm to the person or others as a result of the wandering. Our People are supplied with Hip protecting pants if they are assessed as unsteady on thier feet and at risk of falling and fracturing thier hips. In addition confusion locks are on some doors (exit doors in particular) as well as alarmed doors on some exit doors (although this is only switched on if there is a risk of a person overcoming a coded lock. The code for these doors are on a wall nearby each door as we have a locked door policy if the doors are 'locked'. This policy is in place so that people are not detained against thier will. To maintain a safe environment kitchens, bathrooms and store cupbords are kept locked and staff are on hand to observe patients (except when short staffed, then this procedure is not adhered to). Use of restraint is unheard of and would be seen as cruelty. sometimes in exceptional circumstances protective head gear has been used when people have been repeatedly walking into walls, doors etc.. Close or special observation is best as the nursing staff can then develop better relationships with the client and it also give them a chance to try diversional therapies, laying tables, folding washing, anything physical but not too demanding mentally (or threatening). This also aids more accurate assessment of the persons mood, behaviour and needs. When the restlessnes causes physical exhaustion to the person involved short term medication such as clonazepam has been prescribed, but the staff will need extra vigilance when observing as this can result in increased unsteadiness when walking. I hope this is of some help to you

Based on recent experience, I've nursed a wide variety of 'functionally' and 'organically' ill patients to a positive level of recovery following disturbed/unmanagable behaviour. When placement back into the community becomes an issue I am then faced with 'backward' looking Social workers who focus on the person's previous behaviour stating that they are difficult to place! If the person can move on, why can't a social worker??? I know they 'die by their decisions', but even within my 'limited scope of practice' I can make a balanced decision on the evidence presented!