MvfRN

Would so appreciate your thoughts on this issue, pros & cons, how your company/unit handles it & the response by you & your coworkers. I currently work in an ICU in a small acute care hospital in which seniority is based on how long you have been with the company, not how long you’ve been in our ICU. We are currently in contract negotiations with our company and quite a few of our newer night shift nurses (~ less than 5 or 6 years as a nurse) want to change the policy from company seniority to ICU seniority for the purposes of applying for the few day shift positions that become available. We’ve had night nurses who lost out on a day position because someone from Tele, Cath Lab, or one of our sister hospitals transferred into our night ICU and they had more company seniority (they transferred because they wanted to advance their skills, not for the day position). Some things to note: We had a kind of mass exodus a few years ago, so we have a lot of newer nurses on the night shift. We are also talking about changing just ICU not the rest of the departments, We’ve had a good discussion on our bargaining facebook page, but I’m really interested in what other ICUs are doing, especially those who changed from one seniority to the other, or any other creative ways to manage this issue. Thank in advance to all of you who reply!

I do some psych nursing and have some suggestions. First, become knowledgable of all the resources in your area such as all the in-patient psych facilities, the county health dept services, and emergency rooms. Next learn where there are homeless shelters, and places that provide free services such as food and medicine. Most severe bipolars usually end up using these types of services. The best opportunity to help her will probably be the next time she contacts you when she's in one of her depressive states. When they're down, they then to better comprehend the havoc they've created in their life and their family's life. She will probably state, at some point, that she wishes she were dead or that she should kill herself. Those are common statements when they realize the mess their life is in. Once this type of statement is made, a 72 hr hold can be initiated. Sometimes, this is the true entry point into the psych health system for the patient. What you do is when she makes the statement and you know where she's at, call 911 and tell them she is either thinking of suicide or that she wants to kill herself. Also tell them about her bipolar and her out-of-control behavior. She should be placed on the hold and most likely to be taken to an ER to have a medical screen exam. Many psych facilities will require this of patients to be sure all medical causes have been ruled out (ie. structural or antomical brain defect). I know this sounds sneaky like you are setting her up. But, you would actually be doing what she needs. Don't worry that she will have a history as a psych patient. She has a psych illness and needs care. Also, your sister cannot, again cannot, control her behavior. It's like if you eat bad food and your stomach wants to throw it up - you're not going to be able to stop it from coming up. Uncontrolled behavior is inherent in the disease. There is hope though. Most bipolars can be successfully managed on medication and therapy to help them learn about their disease and it's triggers. However, their are some people who are refractory to medications, but I hope your sister is not one of them. I know you are incredibly frustrated the turmoil your sister has created. Try to turn your energies into helping her. Because, in helping her, you really are helping yourself. Prayers for you.

Haha I think what socks meant was that the physician was abrupt in his speech - thats probably what she meant.

Socks, What your son is doing is not normal and may not be related to the video games. If it is truly involuntary and it continues to occur you need to take him to the emergency room so they can do a CT scan. It is perferable to take him to ER when the symptoms are occurring or as soon as possible after. Some other signs to watch for: 1. During these episodes, can he respond to you by looking at you, turning his head towards you, or speaking? 2. Is he immediately aware of what is going on around him after an episode? 3. Does his vision become blurry or changed after an episode? 4. Does his speech become erratic or slurred after an episode? 5. Is he running a fever? 6. Any nausea or vomiting? 7. Is his balance and ability to walk normally intact afterwards? There are lots of other things to watch for. He could be having seizures, transient ischemic attack (mini strokes), tumor, arterio-venous malformation, etc. I know money is a concern for you, but the symptoms you described are serious enough to be considered an emergency. Please keep us informed on how he's doing because we care.

Its easier to get a job when you have a job. Do the best you can do for now. In the meantime, look for employment elsewhere. The current company you are working for does not value patient care and safety, otherwise it wouldn't be practicing nursing like this. Since you recognize and are concerned about these safety issues, it obvious that your beliefs and values regarding nursing do not align with this company. You will never be happy at this job - so get out as quick as you can.