RN819

nurseI56.... as far as the assistant working under the doctor's supervision, I thought that would entail the doctor being in the office and consulted about prescribing medications? It is being done without the doc knowing. I do know that I need a job. I am in such turmoil as to what to do. Thanks all for your input!

Thanks. That's a good idea. I have thought about it and plan to talk to the Dr. first. Will post back with an update.

I've recently started working in a MD office. The Dr. is out of town and a patient called requesting an antibiotic. The office manager helps take calls, googled a bit and without talking to the Dr. called in a script. She says, "I know what the Dr. is going to order". She has operated as his assistant doing patient care at times when the Dr. was without a nurse. Talk about practicing medicine without a license!! I was shocked! Problem is, I think the Dr. may be OK with it. I definitely want to talk to the Dr. about it. Might not even matter if I tell the Doc. If he doesn't do anything about it I will definitely leave and report it to the appropriate agencies. He would then know that I was the one who reported him and I'm afraid will destroy my nursing career by bad mouthing me. I'm thinking I should bail and leave the job to protect my nursing license. I'm concerned I could go down with the office with this kind of thing going on there. It is my understanding that I am mandated to report this type of thing to the state. There have been some other questionable things occur as well. I've heard her on the phone with patients clearly advising them out of her scope of practice. She doesn't even have a scope of practice. She is working under supervision of MD. I have a license to protect. What a mess! Thoughts and recommendations please!! MUCH APPRECIATED!

I don't want to give up that easy!! I love bedside nursing, just trying to figure out the secrets to doing it. All of this advice from everyone is EXTRA HELPFUL!! Thanks!!

I guess every nurse just works within their own comfort level as far as integrity goes?? I'm not trying to be Ms. Perfect, I just feel so guilty if I were to make up something just to get the job done.

"My preceptor taught me to try not to be so wordy in my charting" When the requirement is that a note is made on every shift, it seems like charting starts to be the same for every patient. Such as....... "Patient denies pain, no distress noted. Call light in reach, bed in low position." Is that ok as long as that is true for the patient? I feel like my charting for each patient has to be more unique.

IRL?? In real life?? Is that what that means?

"And know that when you do your assessment, and document accordingly, you might find that nurses behind you are going to copy yours word for word....." This angers me sooo much! These nurses who copy look like they are great while I appear slow and crappy. When in reality, I am doing right by the patient and could lose my job because I am not fast enough. It just burns me up to see nurses giggling and goofing around at the nurses station, I become like the outcast because I am not there "socializing" with them. I feel inadequate, but I definitely am not. Any words of wisdom to deal with this situation??

From reading another post about cutting corners, it seems that all nurses do cut corners. So my dilemma is trying to figure out where I can safely do so. I am by the book kind of nurse and I'm finding out that is impossible to do. I'm afraid if I cut corners, there will be consequences where I may not notice that cutting this or that corner is a bad idea. Any suggestions on determining where to cut them safely?

I have been a nurse for about 3 years. I have about 9 months as a floor nurse and the rest of the time I worked in a doctors office. I have always felt slow from my first job out of nursing school. I am now back orienting to work on the floor again. I see my preceptor documenting assessments that she simply did not even do. It seems like that is the only way you can "get everything done". I refuse to false chart. I assess my patients, I cannot just chart something to be charting it. Nothing is like we learned in nursing school. Nurses will say, "that is nursing school, this is the real world." Why don't we do things with accuracy and thoroughness as we did in nursing school? That is good patient care. Seems like real world is just working with no integrity just to be the fastest and make it appear that you did everything. Any tips for how to survive? I'm still orienting on the floor, but not sure how I will make it when I am on my own. The thing that really angers me is that I am doing a good job and doing right by the patients. However I appear to be a crappy nurse because I am not as fast as everyone else.

This is the hardest thing!! In nursing school, we are taught the "Gold Standard of Nursing". After 7 months on a telemetry floor with a patient ratio of 5 or 6 to 1 nurse, I learned that there is no way we can do everything the way we learned in school. I fee like I am giving suboptimal care if I cut corners or otherwise not give my best to my patients. I cannot cut corners and sleep at night. I do a thorough assessment on my patients, because I WILL NOT false chart. I was the slowest nurse on the floor, and it makes me look bad! As a somewhat new nurse, how an I keep my job, maintain my integrity and give patients the care they deserve???

I've been told by instructors that your resume is a marketing tool and to only put down the pertinent jobs to the position you are applying for. That is usually essential if one is to keep their resume to one page anyway. (Except for those "spring chickens" who don't have 20+ work experience. My instructors told me that on the application one should list all of the jobs they have had for the requested time frame. Just passing on info I have learned along the way. I am not an expert in this area myself. Good Luck

Thanks CaliBoy and Marshall1!!

I am applying for a contract job at the VA through an agency. I will be starting the VetPro process this week. As far as past employment goes, I am not sure if I should put down a couple jobs I had that only lasted about a month. I figured out those jobs were not a good fit for me so I left them. I am not sure if those employers have any ill will towards me or not. I feel like those jobs don't really matter, since I wasn't there very long and didn't gain any experience and was not even out of orientation at one of them. I don't want to throw myself under the bus by putting them down, but at the same time, I don't want it to look like I am hiding anything by not putting them down. I'm pretty sure the VA/government share info and probably know everywhere that I have worked since I was 16 anyway. Any advice?

Madwife2002 - Thanks so much for the encouragement and tips! Hearts Open Wide - Thanks for that reminder. We are all replaceable and some of us could be considered irreplaceable at the same time. Irreplaceable because some of us place a higher priority on providing good care than others do. I realize that "Momma said there will be days like this" and then there are better days. (Yesterday wasn't too bad.) I know that no management can guarantee staff happiness in any career. Happiness is a choice we make. Providing good care makes me happy! Again thanks for that perspective. In this economy I KNOW i am lucky to have a job at all!