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Hello: I am a relatively experienced nurse, and got a job at a new hospital in the new city I’m in. I had a patient on a heparin gtt, and per protocol, I stopped the gtt for one hour and restarted at a lower rate during the night. Just the usual. I was extremely busy with my two patients (ICU) who were more than anything for the busy- ness was that one needed a lot of attention, and the other had pretty constant coughing fits on the vent. I put a lot of time and attention into both, and also realized an overall picture for the center patient was that she was having cardiac issues (that had previously not been looked at) and I was trying to figure it out (big picture). Anyway, I gave report to a float nurse that had a float pool preceptee. I had thought I did a good job that night, and did a lot of “cleaning up” as I do, from the previous day (I work nights), and generally being thorough. I am not the type to sit and chat- I’m running between the two rooms, getting my baths done, labs, PRN’s, meds, tubing, etc. Then I got an email from the manager wanting to talk to me because someone had filled out a “psvr” (safety report). apparently I had not charted the stop time and start time for that hour of stop and start of the heparin. At my previous job- we didn’t specifically chart “stop”. We just charted the rage change when it was restarted and would write a note about stopping it per protocol for an hour. She also wrote that I didn’t chart the 50cc for a piggyback. I just remember being insanely busy with the two patients- the one that needed attention, the other with constant coughing fits— in addition to everything else, and that I had actually left that might thinking I’d done a really good job. I don’t usually ever go to management about someone else unless it’s pretty serious. If it’s something more minor, I usually would try to talk to them first before going to management. I did fill out a psvr recently for the entire ICU not having a syringe of d50, which is an emergency drug, and the pharmacy refusing to send one for an hour while they insisted one was on the unit (so I spent a whole hour searching the five fridges two- three times. Anyway that’s an example of where I’d complain. anyway now when I see this nurse (infrequent because she is float pool), I get very nervous because it’s like any tiny omission or mistake will be written up. This morning she came with another preceptee, and I was nervous and I guess I got snarky due to that and told her that I’d better be in my toes because I know she will write psvr’ s anything missed. She said “well heparin stopped should be charted the time it was stopped” and I said “if I complained about everything then I’d be writing things up constantly”. I asked her name because I wanted to be aware of who she is in the future (she usually has a preceptee chart everything so I didn’t know). I don’t know why that bothered me so much or why it feels so threatening. I probably shouldn’t have said anything, but I also wanted to express to her that wow - like I seriously would be writing everyone up all the time if people expect perfection. I did not not chart it due to laziness- she could have shot me an email? I want to stay away from toxicity… anyway- I’m asking for feedback about this? Thanks

Just wanted feedback regarding a situation that still hurts and confuses me. My nurse manager 'shared' with me one morning that the two clinical care specialists (RNs) on our floor were talking negative about me. She didn't explain exactly what they said. I don't really have any contact with them, save for my orientation on days, because I work nights. Nurse manager shrugged, and said 'I don't get it', and that was the end of that. Was I supposed to be glad she shared this with me? Now when I think of them, or see them in the morning (rare), I feel very uncomfortable. And it hurts, as they do not even know me.

Is it a boundary violation to buy something from a patient's family member, e.g. Mary Kay, Avon, etc?

What do you think of the need for sleep in a stable patient? Does your neuro surge team/resident on call come and fully awaken an A&O stable patient in the middle of the night to do a neuro check (i.e. lights fully on, fully awakening the patient and talking to him/her as though it were 2 pm, not 3 am, asking them how they are doing, ect). What is the norm at your facility?

surgeon mostly absent, otherwise covered by moonlighter who covers whole hospital at night.

PICC was pulled at 4 pm. Mom was upset no one was starting PIV. The one PIV started (@ ~11 pm) had pain/phlebitis right away. Mom was also upset at discovering tournequet accidentally left on for over an hour before discovered (hidden by gown). Patient's nurse told mom no one was avail to start PIV until a.m., so patient did not get abx from 12:00 noon until the next morning at ~09:00.

real life. Must add, pt is a hard stick.

specifically?

Pt lost PICC due to thrombosis at 4 pm. New PIV placed 11 pm, infiltrated right away. Pt has been on q 4 hour IV abx. So far missed 4, 8 and now midnight doses. Mom of this patient very angry no IV access established, and charge nurse decided mom is 'abusive' and that this could wait till morning. What is wrong with this scenario?

Thanks for the replies. Wondering why a coworker would ask me about this, especially 'not in private'....made for awkwardness.

In a spur of the moment thing, I applied for an open position on another unit online, then decided not to take it. A week or so later, a co-worker asked me about it, at the desk in front of multiple staff. I had told no one about this. She said she heard about it from someone on the other unit "I forgot who", she said. I didn't want anyone to know, especially since I decided not to pursue it. I was put on the spot, and told her no, I am not sure what you are talking about--- I didn't feel it was hers or anyone elses business, unless I decided to share this. I did tell another trusted co-worker about this incident, and he said I should have been truthful, and I agree, I felt funny about that, but really did not want to get into it, or explain anything. The only people that would have known about my application would have been HR, and the new unit's management. What went on here?

actually, the complainer was another new staff, who had previously been an na on a different unit, she is a relatively new grad. my orientee looked at the md like he was from the mon, not me, and commented to me that she didnt see what his problem was. i made her shift as comfortable as it possibly could have been for her.

Thanks for the replies. I never thought about hearsay, but you are right, it is...She was not privy to the phone call, nor the 2nd, more sincere, apology, which she wasnt around for. And she didnt bother to ask me about it, like 'what happened?'...Yes the reaction from the supervisor makes me wonder what little esteem she has for me, and should I bother working for a unit that holds me so low.... And you are right, I dont actually know what the report to her was from this coworker, but she did say that it was this coworker who made the complai t, couched under 'concern'. I do know I dont want to precept again, so as to avoid any further 'indiscretions'. Thanks for the compliment on my assertiveness. I am a pretty sincere person, and really do try to be kind to people(which may be why this rude md needed to think about it and call me back, lol). I really do give my heart and soul while at work, and after that, i feel i dont deserve to be treated poorly. i dont gossip, and i try to focus on doing the best job i can while i am there, and being supportive of coworkers, a team player....and no, i am far from perfect , i try my best at work, and i know others arent perfect, and try their best, and i try to be tolerant, and hope others are tolerant of me...ect Also, at this stage in my life, i donthave time for anything else.

Are you sure the nurses were glaring at you? Make time whe you know that particular nurse is on, and go and talk with her about it. It will help you process this situation, which sounds like its upsetting for you. I am sure you will feel better once you can talk to her.

sometimes you need to go through steps to get an accurate picture of a situation. For some reason, the thermometer you had wasnt reading accurately, perhaps. you took the temps, and did what they requested. i know parents can be very high stress if their child is sick. Eventually they got their answer. To be honest, the only thing I can see is what you did, retaking the temp, and because the parents were visibly upset at the warmth of the baby, perhaps getting the nurse...but other than that, you did nothing wrong. I am a nurse, and my son has had surgery, and believe me, i was a nervous wreck, i would have rather it be me than my child...so sometimes you have to look at the stress family members have and learn not to take it personally, but to empathize.