kw11

Just wondered what everyone thought about this. The other night I worked I had an elderly patient whose main issue was blood loss and heart related issues. Her daughter accompanied her and when I was admitting her to the floor and going over what we were going to do (the dr. ordered catheter, etc) (daughter is POA), the daughter said "she just needs the units of blood, I don't want you to place catheter!". So I said "OK let me check with the dr. and see if he has any objection to that." (This was a hospitalist admit, and it was nighttime so the night shift hospitalist was the contact). I called him and he asked a few questions and said "no problem d/c the catheter order". At no time during the report from the ER was there mention of acute kidney issues so I thought everything that I was doing was ok. Then in the morning, the day shift hospitalist that wrote the order came in and started yelling at me at the nurses station during nurse report. It was very embarrassing. In short, she said "What sort of intelligence did you use to decide to not place a catheter on this pt?" I told her the story above and then she started yelling more saying "I can't believe that you would not do this order, you can't just rely on the night shift dr., they don't know what's going on with the patient. It was up to you to educate the pt about why it was necessary." I was so stunned I didn't even think to say until the dictation came up at 2 am and labs came up I didn't even know that this lady had kidney issues. But I did say, "the daughter was very upset about what occurred in the ER, so I didn't want to push the issue." The dr. then said "what do you think? Do you think this is Burger King, we don't just give the patients things their way, we have to be smart and explain to them why it's needed because they have no clue". Anyway, I get that I should have pushed the catheter issue more. But, after the yelling and after she left some of the other nurses were like "Gosh I'm sorry that happened to you, etc., I would have done the same thing." What I am wondering is if I should personally talk to this dr. about how I wish she had talked to me away from eyeryone else or if I should complain to my manager. what do you all think?

Just a quick question, I graduated 4 months ago, I have been working 4 months as a ltc nurse, since i was only working part time i kept looking elsewhere cause i thought i wanted more varied experience, now i have two choices and i really dont know which to take 1. work 3 12 hour nights at hospital, or 2. when i turned in notice to ltc was offered ft days as care manager(8-5, M-F). These are the two work choices, but i have other problems 1. i dont think i will do well on nights 2. my 10 year old son has aspergers and will not adjust to day care well, i have a 14 year old who can stay with him in the summer, but there is always before and after school. My husband says i am being selfish if i do the ltc cause it will disrupt the kids more with me gone business hours, but i know i might turn into a crazy person if i work nights:uhoh3:. Initially i really wanted the hospital for the skills and experience but is this really so important? Just wondered what others opinions would be, please let me know.

Both of yours sound like mine, I took it today also, I had 15-20 SATA, two sound ones, tons of pharm and endocrine. No OB or peds or psych or drug calc. I had 75 questions also and now Im freaking out wondering if I passed. Did PVT and got popup so hopefully I passed!! I'll keep my fingers crossed too, Im in Idaho so have to wait two business days.