chillchick

I work on a community based research project and the majority of my job involves visiting clients in their homes. However, since it's research, scheduling is a bit more difficult thanut would otherwise be - that is, some weeks i have to run around like a crazy person and other weeks I have very little to do. Anyway- about a month ago two clients complained about me. In one case I rescheduled an appt last minute because I had double booked myself- something that occasionally happens during busy weeks - and he was upset about it. In another case I did not show up for an appt- this has NEVER happened before and I am shocked/mortified that I messed up so badly, but what happened is the appt didn't save in our database and since I don't commit appts to memory (as that would be nearly impossible) I missed it. I was extremely busy and thus that added to the problem, but luckily my supervisor was understanding and knew how busy things had been. After that I met with my supervisor to develop an action plan and all was well. Until yesterday when my car wouldn't start AND my cell was dead. Can you believe my luck? Ugh. But I have an old car and the reality is that sometimes it is unreliable. Anyway I was lucky to use a woman's phone to get help, and eventually charged my phone and called my client. I ended up meeting with the client about 90 minutes late, and didn't call her until about an hour after our appt was set to begin. Now, I am terrified that she is going to call my boss and I'm going to lose my job. I am nauseous and didn't sleep at all last night. I called the client today to apologize again but had to leave a voicemail. I am hoping and praying that she will not complain but I am fairly sure she will. What do I do? I feel like I'm just waiting for the other shoe to drop and waiting to be fired.

I work on a community based research project and the majority of my job involves visiting clients in their homes. However, since it's research, scheduling is a bit more difficult thanut would otherwise be - that is, some weeks i have to run around like a crazy person and other weeks I have very little to do. Anyway- about a month ago two clients complained about me. In one case I rescheduled an appt last minute because I had double booked myself- something that occasionally happens during busy weeks - and he was upset about it. In another case I did not show up for an appt- this has NEVER happened before and I am shocked/mortified that I messed up so badly, but what happened is the appt didn't save in our database and since I don't commit appts to memory (as that would be nearly impossible) I missed it. I was extremely busy and thus that added to the problem, but luckily my supervisor was understanding and knew how busy things had been. After that I met with my supervisor to develop an action plan and all was well. Until yesterday when my car wouldn't start AND my cell was dead. Can you believe my luck? Ugh. But I have an old car and the reality is that sometimes it is unreliable. Anyway I was lucky to use a woman's phone to get help, and eventually charged my phone and called my client. I ended up meeting with the client about 90 minutes late, and didn't call her until about an hour after our appt was set to begin. Now, I am terrified that she is going to call my boss and I'm going to lose my job. I am nauseous and didn't sleep at all last night. I called the client today to apologize again but had to leave a voicemail. I am hoping and praying that she will not complain but I am fairly sure she will. What do I do? I feel like I'm just waiting for the other shoe to drop and waiting to be fired.

Wow!! You guys were right! License was up today!!! I actually can't believe it!!! *happy dances*

I took it in June with no preparation at all (underestimated it, ugh) and failed at I think 230 questions. Was near passing standard. Got a LOT of questions about medication and a lot of exhibitions, some meds, some anatomy, few calculations. This time I studied for maybe 2 hours and I got 165 questions and then it shut off. I got the last two wrong and most of the questions seemed (to me) to have been easier than last time. A lot of priority questions, some meds, some calcs, and a fair amount of nutrition. Oh and TONS of infection control. Could I have done WORSE than last time?? Also, how accurate is the "Pearson Vue trick"?? I just tried it and it seems to indicate I passed but I am extremely skeptical... Thoughts appreciated!! Xo

i don't take it to mean oral intake at all - because regardless of mode of intake, it is going to affect fluid volume in the body, right? i interpret things incorrectly a lot though, haha, so i always ask. it may annoy people, but patient safety/best practice is most important. thanks for posting this though, it's an interesting point.xo

So glad I have you all to set me straight. Thanks for the replies. It probably should not bother me so much, especially since I am generally lacking sleep/looking awful and they're probably just trying to make me feel better! Thanks for your input, ladies and gents. xo

So before I say this, let me say that I realise I may be being uptight, at least that is what my boyfriend said, but I want to get your opinions. :) A lot of my patients are older people and the older men always need to make "sweet" or "cute" little remarks like "of course I'll take a walk with a pretty girl asking me," etc. I know they're just trying to be nice but I don't think it is appropriate. My male colleagues never get these kind of comments and it makes me uncomfortable when patients seem to forget my qualifications, education, and JOB and make these types of comments. Of course, I'm not going to tell a critically ill person to keep these remarks to himself, but it just bothers the hell out of me! (Clearly!) Although the consensus seems to be that I should chill out about it, I'm wondering if anyone else gets bothered by this, because I think if those I know had to deal with it they wouldn't think it so "sweet." What do you think? xo

I would personally think the more significant issue were your failure to document giving a med... if someone else gave that med, depending upon what it were, there could be some seriously adverse effects upon the patient's condition! If it were me, I would not say I was fired, I would say I left... I don't know if you *have* to say you were fired? If anything, I would say it "wasn't a right fit" or something to that effect. However, I probably would not include this job on my resume if at all possible (e.g., if you have other relevant experience). Good luck with the new job! xo

That is a bummer. What happened? I know how you feel because I am a very nervous test taker... once someone told me that I needed to learn how to deal with it bc in patient care we have high stress situations. However, I cannot really think of time when I felt nervous whilst actually with a patient! So, I understand the "freezing" and I would think they would too, especially if its four points, and especially if you passed your clinical... don't you need to use the same skills in clinical to pass? I hope this worked out for you! Sending positive vibes. xo

If you have the grades for it, a lot of private schools can be very financially appealing. I know a ton of grad students paying barely anything... private schools have more resources (i.e., $$$) for students with demonstrated financial need. Of course, as with the others, you have to be an excellent candidate for matriculation. :) Best of luck! xo

I used to be a barista! Got me hooked on coffee and coffee snobbery! xo

To be honest, a lot of it probably depends on the program. If you're in one of the best programs, you're going to need to stay on your toes more than if you were in a different program. All nursing educations were not created equal, that is something that is very clear in the hospital (as well as who the more studious nurses were). That said, Cs get degrees. xo edit - I forgot, though, it pays to get As!

We are specifically instructed *not* to use names in incident reports... of course, we also don't file them for things like tasks left undone (unless, of course, they cause the patient to become unstable).

Haha oh I just wanted to clarify - I did not write down her address or phone number or anything like that, guys! That would be downright creepy! She and I were the same age and as stated previously she was in bad shape (physically and emotionally) so I spoke to her for a long time and we talked about her job. I was going to call her work place to see if she wanted to speak to me or whatever - I remember that because it's a restaurant I really like - I'm still not going to do that as I recognize that this could be taken the wrong way - just wanted to clarify that I'm not a total whack job! xo

With IV Potassium I would ALWAYS be thinking about the patient's current labs and monitoring VS and cardiopulmonary status due to the risk of arrhythmia. Also input and output because if it changes greatly from the previous day this could affect internal K+ levels, again creating a very bad situation! Irregular heart rate, WOB, SOB, change in skin color, changes in levels of consciousness are some things I would be looking for. Sorry if that is stating the obvious but you really have to be focused on those things when it comes to potassium! That is correct regarding the insulin but try to be precise and not draw up too much. Correct w/nitro and of course do not touch it! Also label when placed, initials, etc. As far as who is responsible - what do you mean? Legally? Institutionally? I feel that one of nurse's primary responsibilities is being astute enough to monitor any and all changes in a patient's condition. Thus, I think a good nurse should be able to recognize an adverse reaction quite early and take measures to counteract it - thereby mitigating the issue quite a bit. Also it depends on the reason for the reaction - is it contraindicated for your patients, incompatible with one of their other meds, not the appropriate route of administraiton for your patient? Those things determine if it is your fault so it is always important to cross check orders before administering meds.

Haha thanks guys - you're so right - I knew I wouldn't do it. It's just sad because I know she isn't going to find the resources she needs. Bah, c'est la vie, right? xo

Do you have a routine when giving meds? I check the "5 Rs" - right medication, right patient, right route, right time, right dose... it is a good way to just double check and it becomes an instinctive part of giving meds.

I would stay focused on where you are working... like women's health meds are totally different than med/surg meds which are usually different than ped meds. If you let me know where you are working I'll tell you which ones I see most in that area... but as the others said, it is best to know those most prescribed according to a resource since I think specific drugs vary somewhat between facilities (ergo, it's essential to know classes of drugs and their physiologic effects...i.e., pharmacologic mechanism of action!)

3-4/1 (Some of you guys are blowing my mind!)

How long did this occur before you left? What I mean is: Did it look like a skull fracture or was it a skull fracture? Esp. if there were decels, they may have gotten rather "rough" in trying to get the baby out which can cause some seriously nasty-looking marks/protrusions/etc. on the baby. Just curious what kind of diagnostic studies they did bc I had an infant whose shoulder they thought was broken (and it certainly looked like it was) that healed in less than a week in the NICU. If it is an actual skull fracture, supposing no complications, I would imagine it would be largely dependent on the location but in any case it should still be okay since their heads are "designed for" trauma to a certain extent. I hope all goes well. xo

I don't know what lamaze really is but I think my colleague teaches childbirth education, because it isn't just about methods for coping with actual childbirth, it also includes "what to expect when you go home," "what to expect when you're admitted to the labor floor," etc. I think it is a really great thing for families because they are then already educated on pain management options, timelines, what effacement/dilation mean, etc. Sorry I can not offer more help - hopefully someone else shall! xo

Thanks guys... I appreciate your advice. I am actually going to consult with some of my mentors though because I think different people have different ideas about where the boundaries lie in nursing. I most likely will not do anything, especially since I am young and don't want this type of scandal... however, she very badly needs some support and a benefit wouldn't even really be me - it would be the community I am familiar with that often does things like this. I would only be contacting her to see if it were okay/something she would be interested in... and the answer may very well be no. Thanks again for the great advice. It's just hard because I know the resources I have access to could make a tremendous difference for her. And she needs all the help she can get, you know? But, you're right, professional is professional and personal is personal and we should try to keep them separate. Thanks again xo

Hi, I am new here! :) I joined because I want to ask if something would be appropriate that I don't necessarily want to discuss with my colleagues. Although I'm not homosexual, for various reasons, I've been active in the LGBT community in my area for a number of years. I began because my best friend is gay, and he opened my eyes to the issues they face, and I became passionate about working to deal with them. Anyway, a while ago, I had a patient who was the victim of a gay bashing. She was in VERY bad shape. She was very angry and was yelling at many of the nurses. However, she was wonderful with me and I felt she just wanted someone to understand that she had a right to be upset (none of the other nurses knew the story behind her injury.) Long story short, she was discharged and I'm still thinking about her. I know her name and where she works and I was thinking of contacting her to see if she had any interest in a benefit or something dedicated to her. I feel she is not well-off socioeconomically and probably is facing large medical expenses. And what's more, I didn't know such horrific things happened so close to my home, and I know others would be as outraged and upset as I am... But, is it unprofessional or overstepping boundaries to contact her about this? I didn't speak to her about it whilst in the nursing role, but would it be a HIPA violation simply to contact her? We have good rapport and I doubt she'd mind, but I still feel like this is probably a no-no, despite my strong belief that it would be a good thing on all sides. Advice please? xo