Davey Do

Putting principles before personalities is not usually an easy thing to do because emotions get involved, but if we endeavor to be individuals of integrity, we must be true to ourselves. We only have to sleep with ourselves and it's up to us who we let into our kitchens, our heads. A mantra I use at times such as these is " My happiness does not depend on what others do or say or what goes on around me. My happiness is the result of being at peace with myself". If we act as a person of integrity, adhering to our principles, values, and beliefs, then we can be at peace with myself. Logical actions out shadow emotional reactions. May you get peace, CNAlove, because you did the RIGHT thing.

"Is it worth going back to formally report over a month later?" Your thanks is appreciated CNAlove. Being an ardent hard core chronicler, I jot down notes on an array of situations and subjects, so if something is on my mind a lot, it gets written down. This not only keeps track of things, but is also is a cathartic therapy. In a situation such as yours, the incident could be objectively documented in a report with actions taken, e.g. going to administration, and the results thereof. Submitting the report is your call, but just being in possession of it could prove to be a prudent measure, if called upon to relate the happenings. Of course, any identifying patient information is not used in personal documentation and a memory-jogging entry, e.g. date and diagnosis, can be used in its stead. Good luck to you.

Wow. A medication error not leading to harm and needing a lawyer? Had me or my colleagues required a lawyer for an innocuous med error which was appropriately reported and dealt with, we could have kept them in business to the point they wouldn't need to chase ambulances. Med errors happen, need to be reported and rectified, and we need to learn from our mistakes, but in my 40-year career, I never needed to seek the services of a lawyer.

Objectively documenting words and behaviors and submitting these reports to the chain of command is a prudent action. Once the internal chain of command is exhausted, we can then go to outside bulldog resources, such as the department of labor. Case in point: I was belittled and bullied by an older nurse with less seniority early in my career. I followed the chain of command, reporting the incidents to my supervisor and when the situation was not resolved, went to the DON. I was put on the hot seat and resigned my position. An adjudicator for the office of employment security ruled in my favor, citing unfair working conditions and I was awarded benefits. In the ensuing decades of my career, this sort of situation, from abuse from the higher ups to insubordination occurred from time to time. If the situations were tolerable with no gross ramifications experienced, I merely objectively reported and submitted my report following the chain of command. Sometimes the offenders were reprimanded, sometimes not. One truth was found in a quote by Edgar Cayce: "No one can get someone into more trouble than they can get themselves into". It all comes out in the wash.

Having worked in both staff and administrative nursing, I have experienced similar situations which entailed objectively reporting patient abuse to supervisors to bringing down the ax on an employee. As nurses, we need to adhere to policies, procedures, laws and moral codes in order to be individuals of integrity. In a nutshell, we always need to put principles before personalities. We are a nurse first, and everything else is merely accoutrement.

Had a similar situation at the last medical center where I was employed in psych. A tech had left the patient roster in the day room they were using to jot down VS which was found by a patient's relative. In those days, room numbers and both the first and last names of the patients were on the list. The tech was reprimanded with a verbal warning and the roster, from that point forward, listed the first name and last initial only. Your reporting to the DON was a prudent move, Maria, reporting the lost list after a search without result, which may motivate administrative officials to change the paperwork and procedure, in order to avoid a similar circumstance in the future. It would seem a worse-case scenario here could be a possible HIPAA violation. Now, I use the word "possible" because, if no further ramifications result if and when the list was found, it's not an actual violation. It merely has the potential for a violation, and if never found, it's merely dust in the wind. Maybe to ease your mind a bit more, Maria, a patient accidentally dropped a benzodiazepine tablet which I was in the process of administering to them in the dayroom. I searched for that pill exhaustively and never located it. In 40 years of administering meds, I was unable to find a lost pill only twice, the other time was a Seroquel in the unit's pantry. I reported the situation, wrote up incident reports, and received no negative ramifications, and hopefully it will be the same for you. Good luck!

Heh heh heh heh! The advice may have been interpreted as an attack on one's life stance, Emergent. We often believe that if we repeat the same ol' spiel to just about every patient to which we provide service, the word will get around. For example, "Your threats of bringing a lawsuit against me will change nothing". Or: "No you can't have a fan or phone in your room". One patient replied, "I'm not coming back here (to the psych unit). I responded, "And tell your friends!"

Of course inspection, care and cleaning of the insertion site can and needs to be done regularly, Deb, which I am relatively sure you know, along with any professional interventions should a problem arise. In a quick search by putting in a few pertinent words in the search engine, such as "free rides for medical patients to the hospital", yielded some viable results, in response to your "live 45 minutes away... no vehicle". Here's one: 10 Free Transportation Programs for Seniors: Your Guide [2026] – Savings Grove Good luck, Deb, and the best to your mother in law!

Emergent's advice is seconded. This nurse is a bully and needs to be called out directly and objectively on their behavior. Objectively and directly calling someone out needs to be based on facts and "I statements" need to be made. For example, "Do NOT physically push me out of the way or give me orders. I am not a subordinate in this situation and I will not be pushed out of the way or in any other way be disrespected!" Now, I had time to come up with this response, yet in formulating it, stuck to those basic rules institutionalized within my behavior, which are based in facts and I statements. Facts: A staff member put their hands on me. A peer (with less seniority) gave me an order. I felt disrespected and if I feel that way, it is a fact. Back in '92 or '93, while working in a small rural hospital, I was the nurse recording the intervention during a code. I was the newbie nurse at this facility and a seasoned nurse with a reputation for being difficult with which to get along with had given me a hard time from the get-go. This nurse would give out VS in a muffled tone for which I could not hear. I said loudly and clearly, "I can't hear you, so you need to speak up!" The nurse reacted appropriately. That nurse, much later on, accused me of harassing her, and I was fired for arguing with her. During this altercation, I followed the factual format, believed I had handled the situation well, which was recounted at the Employment Security adjudication process, and won the case. Some years later, I received a telephone call from the Dept. of Public Health, who was investigating njmerous charges brought on that facility, by that nurse, who had, by then, been terminated. One nurse charge involved a particular code (with which I was involved) needed to be investigated, and listed me as one who would verify the charges, in effect, be on that nurse's side. I told the Public Health investigator that this nurse was not involved in that particular code, not being scheduled that shift. I also said that I had no idea why I was noted as someone who would verify their complaint when they were the root cause of my termination. I sensed the investigator saw the reality of the situation- that these were bogus charges- although said nothing specific to that effect. Edgar Cayce said, "You can't get anybody in more trouble than they can get themselves into", and this is one of many which proved that premise in my nursing career. So, if we remain objective and factual in practicing the principles of our professional integrity, we will allow others, however eventual, to hang themselves.

All Healthcare facilities are to generate, and have passed by a board of administrative professionals, a Policy & Procedure manual. For each direct care procedure, guidelines are provided in outlining the process and which professional can perform, or is responsible for, that particular procedure.

I cannot say for sure, but I've known scads of nurses, including myself, and other health care professionals who have been through counseling and therapy and never got a second glance. Lots of professionals I've worked with have even been prescribed psychotropics like antidepressants and anti-anxieties, and some were controlled substances like benzodiazepines. As long as they had a 'script, even drug testing was not a problem. In my experience, professionals who sought mental health services were viewed as prudent, where as the coworkers who were bat crap crazy and did not address their problems received a lot of exasperated sighs and eye rolls. Good luck to you, onele!

@Lynker advice is seconded as I was invited to, and moved back in with my parents during the LPN program in order to save on expenses, moving out when I got my first nursing position. And, like Lynker, I often studied at the local library.

Well, for one, mednp73, I appreciate your recount of your son's plight and your energies in dealing with his situation, making prudent endeavors to seek appropriate treatment for him. In order to better understand the conditions of functional pain and MALS, I had to do a little research. Functional pain is akin to idiopathic etiology, which basically means the symptoms are there, the cause is just unknown. MALS seems to fit your son's symptoms and it makes me wonder why the testing, diagnosis and subsequent possible treatment wasn't pursued. Once again, your plan for the course of treatment is appropriate and admirable. Too often, we as medical professionals accept other professionals' diagnosis and base our assessments and outcomes on that perspective, when we need to start from ground zero. Several times in my career, had I accepted the off-going nurse's perspective, I would have not identified life-threatening conditions. Starting from ground zero, I performed basic assessments which led to the identification of conditions such as lithium toxicity, high ammonia levels, sepsis, and even a fractured femur. Following others' perspectives and labels without questioning is not always the best tact to take. The very best to you and your son, and, please, keep us apprised.

Gee, that's a tough one, Marlene. Having experience in several areas of nursing including HH and SNF, I found each had their benefits. Like you, I enjoyed the 1:1 of HH, and felt overwhelmed in SNF, so I chose to work the MN shift which was a slower pace and there was more time for each resident. However, the MN shift comes with limitations in one's personal life. As an LPN, I worked psych, surgery, and chemical dependency before I got my RN, and found assets and liabilities in each. The last 17 years of my career, I worked primarily in geriatric psych and found it very satisfying, utilizing skills from both my medical and psych experience. Geriatric patients typically have comorbid conditions which keeps our medical skills honed with meds, IVs, urinary catherization, tube feedings, dressing changes, etc. Good luck, Marlene!

My first LPN nursing instructor said, in 1983, "If you can do nothing more for your patient, be there for them" and this advice buoyed me on through my nursing career. You, Celestialbeing, were not only there for your patient, monitoring and intervening, but you also reviewed, critiqued, and requested feedback from your peers regarding the situation. There really isn't anymore that a prudent nurse could do. In 1979, having worked as an EMT in the Volunteer Emergency Corps on Search & Recovery, I was exposed to dealing with death early on. The totality of our job was to recover and respect the victim, and I found some satisfaction in that. As a new LPN student, I called a code on a patient, which went well, but the patient expired. Being actively involved in that code, I did everything possible, and was able to deal with it reasonably well. Later working in ER and OR, I experienced a fair share of patient deaths, up to my final position in Geriatric Psych. One truth I learned was that when it is their time, they go. An elderly lady who had a minor procedure in OR, with the nurses telling her how good she looked, passed away the next day. A coworker who I later told, "I saw your guts all over the table", recovered well and went on to get her RN while working as as Unit Secretary. I reiterate: When it's your time, you go. The very best to you, Celestialbeing

We have all done imprudent actions in our careers, Wasnt, and the best post action is to learn from our mistakes. The "forever tagged dumb" is motivated by fear of how we are viewed by others and it doesn't need to be that way. As "the best revenge is living well", the best way to overcome this negative feeling is to prove to yourself you can rise above this negativity and use it as a tool to improve yourself. Speaking of "stupid mistakes", I had a similar one in my fourth semester as an RN student when I mixed up roommate's meds. This came the day after I had identified and intervened in a potentially life-threatening condition of a patient. I received accolades from all, flew high in April, and was shot down in May. I was put on probation for the remainder of the semester, graduated with honors, and passed the state boards that Summer. It all came out in the wash for me, Wasnt, and I'm sure it will for you. Best to you.

"You can get no one into more trouble than they can get themselves into." -Edgar Cayce

In 1990, the RN state board examinations spanned two 8-hour testing sessions. The internet was still in its infancy, so trial booklet state board tests were utilized and three were obtained in preparation. I could not pass the tests, scoring in the 70 to 80 per centile, although I had worked as an EMT for 4 years and as an LPN for seven years and had successfully completed the RN program. It hit me: I was answering the test questions as a somewhat seasoned nurse in the real world and not ideologically. Once I saw that I was not giving the answers the testers WANTED, I changed my tact and began doing so, and began testing in the upper 90 per centile. Something to consider...

Interesting in that this "undocumented immigrant" could complete the nursing program yet could not complete the process in order to become a citizen.