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UpdogRN's Latest Activity

  1. UpdogRN

    Recertification question

    Hello out there. I was wondering if I could get your input on a recertification issue I'm having. I am clear on when a patient clearly requires continued care you naturally will recert the pt. However, has anyone else sometimes found that although you are the nurse assessing the pt and know what their status is, you are still gently pressured to keep the patient? I would never discharge a patient that still required home care services, but I have one or two that I feel have met the goals of their treatment plan and could be discharged. I love educating my patients, but in these cases I really feel that it would be redundant and unnecessary.
  2. UpdogRN

    Safe PT to Nurse ratio, what is yours?

    Ongoing issue when individual hospitals can dictate their idea of "safe" staffing ratios. I work in Behavioral Health and while the patients may not customarily have acute medical issues as on a cardiac or med surg floor, many are detoxing off drugs and/or in psychological crisis. I have worked with 35 or more patients and 2 nurses....not cute at all.
  3. UpdogRN

    Alternative nursing positions

    I am seriously considering a job change, and I wanted to ask about the types of positions that are available. I am an RN since 2003, and I'm already ready to leave the hospital as well as my home health care position (I work per diem at both). While I enjoy many aspects of the job, I am finding it more and more difficult to work within the constraints of the actual healthcare system, as related to staffing, burnout, unrealistic expectations, the usual things that nurses face. I would like to do a job that I can see a positive benefit from the people I'm caring for, instead of feeling like a rancher with a cattle prod moving patients in and out of the hospital like a factory, or teaching and teaching and assessing and assessing and finding that my efforts many times seem futile and don't even matter. I have my BSN and would like to remain in patient care as much as I can, but I am thinking a change in environment from the traditional systems may be beneficial. Any thoughts or suggestions would be greatly appreciated :)
  4. UpdogRN

    Interrupting a Nurse Makes Medication Errors More Likely

    Unfortunately these things usually are tolerated by the nursing staff who will vent to each other about how flawed the system in place is, but do not bring it up to administration for fear of retribution or loss of employment. I did email my DON this morning and respectfully voiced my concerns, with examples of actual situations that occurred on the shift that are potentially dangerous and that she should know about. I know as nurses that administrators can understand the concerns, but it is different when you are removed from the actual day to day issues that staff nurses encounter daily. Then there are the constraints that are placed on them by their bosses that, at the end of the day, dictate the action or inaction that takes place regarding the issues. I would rather effectively communicate my concerns, knowing they are documented, because otherwise it is typical to be negatively labeled as a "complainer" or not a "team player." The concern is for the patients, who are the reason we are there doing the job in the first place. I am not looking for any specific response, and most likely I won't get one, not expecting to anyway. But at least I expressed my concerns to someone who is in a position to acknowledge them.
  5. UpdogRN

    Interrupting a Nurse Makes Medication Errors More Likely

    Agree 100%! Staffing is the main factor in the difference between the expectations of management and what is actually possible for nursing staff to accomplish. 30 or more patients, 2 nurses that arrive at 7p for evening shift, and hs meds need to be passed by 9? All this after count, shift report, and about 100 interruptions in between? And a threatening memo from administration regarding patient complaints that meds are not getting out on time and failure to do so will result in disciplinary action. The patients absolutely should receive their meds in a timely manner, I would never dispute that. We hit the ground running to get them out on time but it's a challenge, and it's clearly not a good idea to rush through a med pass....so something's gotta give here.

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