BigBub1000

There are some different approaches. 1. quit 2. keep track of everything everyone says and does; not a bad idea but you will soon become worn out. There's 1 of you and how many of them? 3. make a police report because they have defamed you, maybe slandered you, and have at least disturbed the peace by threatening your safety, maybe this is even assault or battery or something worse. Get with a lawyer to figure all of this out. 4. Make friends with them. Here's a thought: next time they say Americans are lazy, reply with something like "Things must have been very difficult for you in _____ to make you leave home and come here where you must work with all lazy people." Or something like that. "You must be very homesick without any family here." Or if you see one of them eating something homemade from their homeland, tell her it looks good, smells delicious, ask for a little taste. Try to get to know about them as individuals. Married? Spouse back home or here? Kids? Their siblings and parents? You'll think of things on your own. Do this 1 on 1. You will maybe be able to begin to be able to chip away at their pain and envy and frustration and be seen as someone who cares about him or her as a person. Invite them to church with you or out for a coke after work. 5. Hold a meeting - either just 1 of them at a time or all of you together. You will have to figure out the best way if you take this approach. Do not expect management to fix your problems, even though that would be ideal. you will have to do it yourself, based on my own experience. Tell them that you know they know you are only 1 person and that you can't' be everywhere at once. Tell them you need them to function as a team. They are at work to care for the patients, you know, all the stuff you need them to remember and do. Remind them that they are not to leave the floor as a group but must go when assigned, in the number that can safely be covered in their absence. If that's one at a time, then that's 1 at a time. Take on the weakest one first, the one who seems most willing to be a good worker. Or take on the biggest, worst offender first. You will have to judge. It is really, really hard to be a good charge nurse when you have a good team and next to impossible when you work with angry, bitter, unhappy people who lump you into a pre-judged mold. Honestly, why work with Americans if they hate Americans so much and have such a poor opinion of Americans? Because they have to survive and support their families back home. Were they recruited by a religious group or why are they here in America? Things won't change overnight and you will likely never be best friends, but maybe you can at least get them to work when they are at work and stop threatening you and ignoring residents' needs. Of course, you could anonymously report all of them to the people in your state who take complaints of neglect and abuse. The c/o can always have come from families and alert residents, not from you. Try the friendly route first. It's hard, I know. Best wishes.

Should a C Section baby have the eye Rx? Should an NSVD baby whose mom is free of infection have it? What did we do before Vit K? I've never worked OB but I think there's a little too much "medicine" involved - when the L&D is healthy and uneventful. If an emergency comes up, all bets are off. Lifesaving first, apologies later.

I'm not sure you should put such specific information on here. But it sounds like the shot was ok. Next time, you have to aspirate. On IM's, you have to make sure you're not in a blood vessel. Your teacher is wrong. Just do it, don't say anything or question it or discuss it, just say, after the fact, if you are queried about it," Oh, sorry, I'm just used to aspirating on an IM. By the way, if you don't aspirate, how do you know you're not in a blood vessel?" And make her explain why she is deviating from standard practice and probably from hospital P&P. Do as you were taught and what you know is right. As for her pain being excessive - everyone is different. I think you were right to believe her. How is the site now? How is she?

I don't put much stock in these tests. You must get to know yourself and decide what type of work to undertake. Nursing requires intelligence, physical strength, dexterity with your hands, and a genuine love of people. You must be strongheaded and kind. You must be very savvy in a business sense way. you should speak with nurses personally, try to spend time in the presence of nurses, and look into the many and quite varied roles nurses fill. Some work with children, others with old people, some work in hospitals, some in patients' homes or in jails, on cruise ships, teaching in nursing schools, in surgery, in flu shot clinics, and in schools (grade school thru university settings). Some do research, so do sales of pharmaceuticals, and on and on. Do research and check it out. Best wishes.

The wet pants client above could be said like this - 1115 Client incontinent, slacks wet; she refuses changing now and is combative when writer attempted to remove wet pants; will try again shortly; You've stated the problem, the attempt to correct, why you were unable to correct it, and what you plan to do about it; No one cares if they were blue or brown or all the rigamarole involved; 1145 client allowed perineal washing & clean slacks were put on now; skin intact, no redness/lesions; resting in her chair now, calm; Keep it brief and factual. 1004 paged Dr. Jones at 909-0444 re: VS 188/144 98-18-96.9-80%; placed on 02 2l/nc, sitting up in bed, c/o hard to breathe if not upright; diaphoretic; A&Ox3, denies CP, headache, any other pain or discomfort; dtr Susan says "Please get Dr. Jones now."; Dr. Jones was overhead paged at 1003 and his office was called at 1003 phone # 909-0444, office manager "Ellen, RN" made aware of client's VS, dyspnea, and dtr's request that Dr. Jones come now to see patient, she agrees to continue paging Dr. Jones until she reaches him and will send him to client stat, upon reaching him; 1007 Charge Nurse with patient; 198/150 99-24-80%; Rapid Response Team called at 1006 and arriving now; See? brief, factual, emotionless; dtr was not screaming or demanding or terrified to within an inch of her life, she only said to please get Mom's doc now. You are not cursing the invisible, unreachable doc, you stated what you had done to get him. When you couldn't get him, you got the Charge Nurse and the RRT; You've got it under control. You are scared, nervous, frustrated, worried about your other patients who are being neglected while you handle this problem, you need to pee, you are starving, your own child is home sick, and your gal who picks up your son at school has canceled and you haven't had time to make alternative arrangements yet. But that should not be and is not reflected in the chart. The fact that your other coworker refused to help you while she polished her nails is left out. And I agree with the maxim of the less said the better in so many cases.

So are you working for free? Who reprimanded you? You need to be courageous, MW. I know it's hard, but no one can do this for you.

You need to tell people that you will get to their requests when you are able but that you have a patient who is deteriorating and must take care of him or her first. Be apologetic but firm. Say it then leave and go take care of the drain circler. You might actually need to leave if Admin gives you any mess about handling emergencies and taking care of patients in lieu of waitressing or being a concierge. You might want to run this latest dictum by your union if you have one, your Senator, someone in authority. Your facility is truly gone mad. Do you and the other nurses have the courage to tell your bosses the realities that you have shared here? Have you tried to get them to spend a few hours with you and see how insane this policy is? Are you sure you understand it?

Certainly some patients can take on the responsibility you suggest. But many cannot. They wouldn't know where to begin. Some people are too sick or might be too disabled or might be illiterate with regard to medical issues, lots of reasons why we can't expect the patient to do as you suggest. For those patients who are able, I vote for this wholeheartedly. Blind and uninformed reliance on others is called paternalism and it is still widely practiced. Right or wrong, it is alive and well. Doctor comes from the Latin word for teacher.

I guess lack of ecchymosis might be proof of no shots. Do anticoag shots always have to bruise? Maybe some nurses have found a way to give these shots without bruising the patient. Don't know, just wondering. Does anyone know? Why did both nurses get fired? I could see the one who was not really giving the shots being fired. But why the other one? Yes, I agree that some offenses are intolerable but I know just what the OP is saying. So very many people seem so suspicious of others, so jealous. They seem to resent their own lot in life and are just so glad when someone else messes up and gets punished. If we could eliminate jealousy, we would have less backbiting. It's better to try to educate and counsel, better to develop the staff, rather than punish the staff. If someone seems incompetent, that person should be educated and given another chance, if the incompetence did not result in harm. We all could be deemed incompetent in some ways, I imagine. We all are wrong or lacking skill or information at some times. Working together is necessary for patient safety, for job satisfaction. Teamwork. I get discouraged when I see someone trying to destroy another person, or trying to clawtheir way to the top by stepping on coworkers. I dislike it when workers spend their time buttering up the boss instead of doing their work. I recall a supervisor I once had who wanted a promotion. He didn't do his work, dumped it on me, spent lots of hours shmoozing with the boss, got the boss to write a recommendation in which it was stated that he belonged to a particular church and to a fraternal organization. It was hypocritical and off point. Who cares if you go to church or are a "brother" if you are not doing your work? Plus, he was "fraternizing" with 2 women on the job - while married. Wrong, wrong, wrong. He got his promotion, I got disillusioned and angry - but wiser. Some people are very unhappy in their personal lives and they bring it to work and make the workplace unpleasant. While we should try to care about and help our coworkers, the job is the job. I wish people would leave home at home. Hard to do, though, when your heart is breaking or you are ill or watching your loved one mess up. So, we have to be more compassionate, more gentle with each other. Let's try to be slower to condemn and let's not jump to conclusions. Let's use true scientific standards to determine fact.

You weren't out of line but I think it must be unusual for an NP to do bedside care. When doctors occasionally lend a hand with bedside care, it is appreciated yet somehow embarrassing.

Phobe comes from phobic, doesn't it? And that means "fear". Fear of homosexuality and homosexuals. I agree that one is not necessarily afraid of these simply if one is heterosexual or is not in favor of same sex marriage or issues like that, which are very important to all of us (straight or gay). I know it's out of fashion to be conservative or old-style but true tolerance works both ways - or it should, anyway. I know it is best to try to de-fuse hot situations, but it isn't always possible. Being a nurse doesn't make all nurses have the same basic personality or guarantee sensitivity, good judgment, and common sense. Even someone who is normally a great nurse can have an off day, too.

If the parole is still pending, please attend it. And take the prosecutor with you. The sister of Sharon Tate has managed to help keep the Manson clan locked up all these many years and I think it's due, at least in part, to her always going to the parole hearings. The Manson family was, of course, all over the news and their crimes were so awful and involved an actress that there was no hope at all of the killers being paroled for the first 20 years at a minimum. But as time has gone on, I think people, myself included I am sorry to say, have begun to think that maybe they've served long enough and should be paroled. I think 1 of the girls was paroled and 1 has recently died. But there is Manson himself, Tex Watson, and there are a couple more girls. I hope Ms. Tate's sister doesn't quit attending the parole hearings. (I don't think these people should be paroled, I don't think they could survive on the outside after being locked up so very, very long. But I did find myself thinking that maybe it was time.) To the OP: wow, that is a really touching story. Adam was such a special little guy. How fortunate that he had you as his sis. I'm really sorry that something so horrible ended his life but I'm glad you had those years together. I wish you every success in school and in your chosen profession.

What freaked me out was when doctor was asked to give some cough med to a patient who was coughing his brains out all night and no one had bothered to get him an order. Doctor's reply was "He's a whiner. Let him cough." I thought Huh? You don't like the guy so you're going to let him suffer? I felt like calling Protective Services but then saw doctor start writing for Robitussin after all. Should have been codeine but I have seen where the OTC suppressant works just as well.

no fair calling in extra aides.

If a resident wanted his liqs mixed in juice, did you refuse to do so? Glad you got another position but what will you do if a resident there wants his liqs mixed and you disagree with doing that? As for cough syrup being ineffective if mixed with/followed by liquid, I've never seen this happen. It mixes, after all with gastric acid, doesn't it?

Promise to leave your service dog, your scooter, your crutches, your other service dog, and your need to pee q2 hours and eat at least q6 hours at home. Promise to wear the glasses on a string around your neck. ***???????

do you maybe you want to join the military? i think the best place to get your question answered is where you work, their main personnel office. or check with other states' prison systems. there is probably a legal matter or two involved, also, such as regarding safety or something like that. as an officer, you might be expected to handle disciplinary and safety issues, just as the co's do. do you want to switch to being a co if you prefer that type of work to nursing? i hope you can work out your differences with the troublesome couple of officers. it could make things unsafe for you if you are not getting along with them. hey, good luck.

Wouldn't the specialist get paid for coming to the bedside? Not only would he speak with the family but he would also examine the patient. And that exam is certainly billable. Yes?

if you were doing her work, you were complicit. i do understand you got tired of waking her up, but being an enabler was not the solution. was she suspended for a week or what? at least she stopped sleeping otj. for everyone else and for op: do you see what shape our profession is in? someone who is sleeping through q 15 minute neuro checks is allowed to keep doing it? by the don, no less! op, you did a good thing by going to the adon if you already know that your don is so "accommodating". we shall see the outcome. if you get no satisfaction, you have a tough (but simple, not easy but simple) choice to make. that would be to complain about her to higher-up's, to cms, to jcaho, to the owner of the facility if it's a nursing home or long-term facility. remember this: your license is on the line if her sleeping causes serious problem(s). that is, if a patient suffers harm as a result of her being "missing in action", and if it becomes known that you knew she was sleeping but did nothing about it, you could suffer repercussions for "ineffective supervision". i'm not a lawyer, but that's my view. picture yourself at a deposition, facing the lawyer of an injured patient. let's say the patient fell trying to get to the toilet because no aide came to help her within 30 minutes and she just couldn't hold it any more. she broke her hip and banged up her hands, knees, other bony parts, and face. the picture someone took on their cell phone or videocamera shows her looking horribly bruised. you, as the supervisor, must explain that you saw aide smith asleep but you did not wake her, since she does this every night. you were afraid to go to management, since they knew she routinely did this but repeatedly took no action against her, despite multiple complaints about this sleeping beauty. there might be some mercy for you because of the hx of management's improper behavior, but you could conceivably find yourself being adjudged co-complicit in causing the patient's injuries. you could truthfully say that you were busy with your own work and it is not your job to police your aides, if you have to follow them around, how can you do your own work, they are supposed to come to work to care for patients, not snooze at unauthorized times, and the like. but you might find it difficult or impossible to get yourself totally absolved of all responsibility. something you might want to do is hold a meeting, having people sign in and keeping a copy of the minutes and sign-in sheet for your personal file as well as giving a copy to the don, adon, and hr or whoever. at the meeting, discuss this issue and read the policy on it into the minutes, and state that you are unable to do anything other than wake a sleeper and report that person, as well as send the person home for a 2nd offense. be totally up front, totally honest. cite your own liability for doing anything less. have everyone sign for a copy of the relevant policies that you hand them. this is business, not personal. holding such a meeting should help protect you in case of any trouble. hold it at certain intervals, maybe q 3 months. or make new staff sign for a copy of the policies about sleeping, dress code, tardiness, breaks, whatever other issues you want to include. it should only take a few minutes. i know it's hard. we are not policemen, we are nurses. our hearts are not in law enforcement but in ethical treatment of hurting humanity. and some of us have a hard time seeing how a little snooze could be so dangerous or how anyone could sleep, knowing that patients are needing care but are being ignored. but that's the reality. don't take my word, talk to some malpractice attorneys or view malpractive insurance websites. there are stories like this by the gross. let's compare it to the situation of the white house party crashers. you know the guard who let them in is history. but what about those who were supposed to teach him his job and supervise him? do you think they might also be shown the door? believe me, someone is going to go over his hr file and whaterver other files are kept with a fine tooth comb. was he oriented to all procedures? did he get all required inservices? any hx of screw-ups like this? was corrective action or discipline taken? and so forth. his immediate supervisor and maybe someone even higher up could well be fired along with him over this extremely serious and embarrassing mess. thank goodness the first family was not harmed. imagine if they had been. the whole blasted ss would be fired! as it is, they created a serious embarrassment and a serious breach of security. the rest of the world is laughing and tongue-wagging, i'd imagine. just like when people have broken in to buckingham palace or something like that. horrendous security lapses. you know someone had to have been fired. while not in quite the same league, nurses are held responsible to effectively supervise our subordinates. and no matter how much we hear about teamwork, a good lawyer will likely point out that the licensed charge nurse or team leader nurse was ultimately responsible for the functioning of her team members. just my thoughts, i could be totally off base. maybe nothing would fall on you, as "stuff" does roll downhill, so they say. but you did right to report this to management and to wake up the aide. next time, wake her directly and send her home, i think. have your boss there as a witness. or maybe you should inform your direct report supervisor of the situation and that you want to send her home. get your boss to put in writing anything to the contrary, anything that is a lesser stance or that allows or condones this serious misbehavior. for those who feel empathy for her, as she might have terrible sleep-preventing personal situations - do not think me heartless. but, as much as you might empathize and sympathize and understand, are you still willing to go out on a limb for her? do you think the licensing rn board is going to applaud you for being kind instead of getting this dangerous worker out of the reach of harming helpless patients? we hold lives in our hands, even if indirectly. we must be only about their safety. forget empathy for workers, forget being afraid to correct and discipline. go over the heads of whoever is standing in your way, whoever is a threat to your livelihood and ethical integrity. you might find yourself as the don, whether you want it or not!

Call back. Do not let this chance slip away. Good luck. I hope you get the job you want and where you will be happiest. Even if you have to take the one that has the least desirable weekend situation for now, just take it and get your foot in the door. It's hard to find work now, so don't be too picky. And don't be afraid. Faintheartedness and timidity are not virtues just now. Don't be too pushy either. Well, you know how to do it. Hey, good luck!

I have worked with people who seemed to just hate me but I could never figure out why. I think it was because I had had to enforce some policies with our aides and these aides were friends with the ones who began to show animosity toward me. But I could not abide sleeping on the job, disappearing from the ward, or maltreatment of the patients. Wasn't going to happen as long as Big Bub was OTJ. I never want to have to tell a jury why I did not effectively supervise my aides. Oh, I wanted us to be friends, Mr. and Ms. Jury Person. Do you think that would fly? Should Bub have to let patients be wet or dirty for extended periods because of aides' smoke breaks? Not in this lifetime? Should Bub have to do his own work and theirs, too? No. :angryfire Well, the aides didn't like having to sign out and back in for breaks or report to me when they were leaving and returning. Too bad. I didn't give a rat's hind end if they liked me or not about my practices on the matters I've mentioned. Sure, it's better to have peace at work but my license comes first. But that's pretty amazing that they gave you a bonus and didn't fight your unemployment applicaton. Well, hopefully you are in a better situation now. As for the OP, I applaud your willingness to approach her openly, gently. I hope she responds favorably and opens up to you about what is wrong. I hope you guys can work things out. If not, maybe give her a little time and try again? I've done this and not gotten too far but maybe you'll have better luck. The people I approached in the past didn't seem to know what to do with my open, honest approach. They were embarrassed. They also saw, I think, how cruel and unfair they were being and didn't like realizing that they were wrong about me. Just because I was the quiet type didn't mean I was stupid or incapable. They had to admit I was actually a darn decent nurse. Well, good luck. Just try to realize that it might be more a matter of personality than anything else. Miscommunication. Misunderstanding. Maybe you remind her of someone who hurt her in the past. Maybe she's jealous of you?

I agree with the others. You need to figure out, by talking to the Dean, the top people at your school, exactly what the reasons are for booting you out of the program. The lovenox issue isn't nearly enough, IMHO. Do not take this lying down. You've spent too much time, effort, money, blood, sweat, and tears to get kicked out for something so trivial. And I'm not saying that giving a med other than the way the manufacturer says is best is something trivial. Meds are super important. Super. But the way you have described things is leaving me with my head spinning, as I just don't think it's serious enough to get someone kicked out. How is your attendance? Tardiness? Turning in papers late or with lots of errors in spelling, punctuation, grammar, etc.? Have there been complaints about you from peers, other teachers, patients, doctors, etc.? Anyway, fight it with all your might. And good luck.