Davey Do

This is from A week back, patient Perry Penguin, who was on a 1:1 status fell on the geriatric psych unit while I was charge. I questioned the tech assigned to watch Perry as to what had happened, assessed Perry, and found no apparent no injury. I contacted the NP and got an order to reduce one of Perry's BP meds. I contacted the wife and she informed me that two physicians had suggested the fine tremors I had noted while performing an accucheck could be benign tremors or Parkinson's. I contacted Dr. Banjo, the psychiatrist who had put Perry on a 1:1, and he wanted to be sure staff was following a strict 1:1 protocol. I informed the tech who was with Perry what Dr. Banjo had said. I contacted the house supervisor, Jason Hiney RN, informed him, and requested the Final Fall Form that the house sup and nurse need to complete together be generated. I documented the situation in Perry's nurses notes and completed an incident report. This weekend, my supervisor, Roofelmo, approached me and said the Final Fall Form had not been completed. She had read my nurses note and had asked Jason about it and, according to Roofelmo, he denied that I requested the completion of the form. I feel like kicking Jason in his Hiney.

Jason Hiney RN was a relatively new nurse when he was hired at Wrongway Regional Medical Center (WRMC) to work MN weekend option primarily on the adult male psych unit some ten years ago. Jason was in his late 20's, had about a year experience in LTC, and I quickly perceived him to be very intelligent, charming, and one of the funniest people I've ever met. Jason and I were coworkers/friends, which means that I have no personal relationship with any of my coworkers outside of work, but at work our relationship goes outside of a totally professional one. With Jason and me, for example, he has helped me with some computer and automotive problems and I have helped him with a lock problem and loaned him a little bit of money. Nothing terribly involved, just stuff a couple of chums would do for each other. Jason quit WRMC a few years ago to work in home health and to be able to spend more quality time with his family. He remained per diem, working a shift here and there. Shortly after Jason left WRMC full time, the institution gave phenomenal raises to its nurses based on other facilities' pay rates and I can tell you, my raise was outstanding! Jason attempted to get hired back to his old weekend option position in order to cash in on the pay raises, but was informed that the weekend option program had ended for the freshly hired nurses. In other words, those of us who were in the weekend option program before would continue, but newly hired or rehired nurses would be scheduled to work every other weekend. So Jason continued to work in home health, stopped picking up per diem shifts, did not continue his mandatory training at WRMC, and was eventually terminated all together. WRMC's psych division utilized the medical side's house supervisors for several years on the weekend and MN shifts and they were generally worthless. So WRMC psych division began hiring nurses, both within the facility and from the outside, for their own house supervisors. Jason applied for one of these positions as psych division house supervisor and was hired. A week back, patient Perry Penguin, who was on a 1:1 status fell on the geriatric psych unit while I was charge. I questioned the tech assigned to watch Perry as to what had happened, assessed Perry, and found no apparent no injury. I contacted the NP and got an order to reduce one of Perry's BP meds. I contacted the wife and she informed me that two physicians had suggested the fine tremors I had noted while performing an accucheck could be benign tremors or Parkinson's. I contacted Dr. Banjo, the psychiatrist who had put Perry on a 1:1, and he wanted to be sure staff was following a strict 1:1 protocol. I informed the tech who was with Perry what Dr. Banjo had said. I contacted the house supervisor, Jason, informed him, and requested the Final Fall Form that the house sup and nurse need to complete together be generated. I documented the situation in Perry's nurses notes and completed an incident report. This weekend, my supervisor, Roofelmo, approached me and said the Final Fall Form had not been completed. She had read my nurses note and had asked Jason about it and, according to Roofelmo, he denied that I requested the completion of the form. I feel like kicking Jason in his Hiney.

Ruby Jane, from the School Nurses Forum, requested a comic of Tina Turner on a hamster wheel singing her version of "Proud Mary". God, I love being inspired!

In honor of Mr. Lincoln's 210th birthday, I thought I'd link you up to a good read about a great nurse and one of our greatest Presidents: https://quod.lib.umich.edu/j/jala/2629860.0031.204/--one-of-the-best-women-i-ever-knew-abraham-lincoln?rgn=main;view=fulltext

Working three twelve hour MN shifts on the weekend at Wrongway Regional Medical Center make it go by like a whirlwind. It seems the entire weekend is spent getting ready for work, working, winding down from work and then repeating the cycle. I'm not complaining, because when I'm into the work mode, I'm into the work mode. The same with being into the off mode. During the weekend work mode, I'll make quick notes and sketches in my pocket journal for later use on my own website and/or here on allnurses. Since I can't get into involved art during the weekends when nursing things happen, I've decided to make a try at weekly reader. Here's the first edition: He was a 58 year old ex CNA dementia patient who was admitted on the Saturday MN shift for aggression at the nursing home. Also aggressive in ER, it took Haldol 5, Ativan 2 , Benadryl 50 mg IM and 4 point restraints to control his behavior. I thought he was a cute little guy and in my journal entry I drew him as an unsteady Perry the Penguin. The next day he kicked Dr. Banjo, had a fall on MNs while on 1:1, and vomited.

No, Davey Do did not reply to Davey Do's topic in Davey Do's Comics's Comics!

A fitting, edited allnurses comic for the Groundhog Day Phobia thread !

Saturday was my 62nd birthday. (Insert Happy Belated Birthday, Davey Do! here) Thank you. Being born on Groundhog Day and working as a Psych Nurse got me to thinking about the Groundhog being frightened by his shadow.

Welcome to allnurses as a full fledge member, Qzrn!

No, this is not normal. In fact, Flylik, this situation sounds like patient neglect/abuse and reporting it would have been an appropriately prudent action. I've tried to understand such behavior from nurses and have come up with a few possibilities: -Apathy -Fear of the patient or the intervention -Laziness -A power struggle -A convoluted sense of righteousness I'm with Sour Lemon- If they have the med ordered, it's time, they want it (or in this case truly need it), GIVE THE PATIENT THE **** PAIN MED! Sheesh!

No, carls, you are not being a brat and this is not "normal". From what I read, psych is for you and it sounds like you work under administrators who are not only uncaring, but are narrow-minded bureaucratic bullies who utilize an intimidation supervision technique. You have a couple of options: You could shake the dust of this inpatient psych unit off your shoes and attempt to find employment where your caring talents will be appreciated and supported or you can fight the machine. Having done both in my career, I can tell you both options have their benefits and pitfalls. When I worked at Anomaly State Hospital (ASH) in '91 and '92, I chose to leave. I fought the machine at Wrongway Regional Medical Center (WRMC) and have been there 16 years. To fight the machine requires dedication to objective documentation, informing those responsible in following the chain of command, and a willingness to go to outside entities if wrongful practices are not rectified from within the institution. Even though I did leave ASH, I did pursue having the wrongful charges of patient neglect/abuse dropped and expunged from my record with the help of the Illinois Nurses Association. I was also monetarily reimbursed, 1 1/2 years later, for lost work time due to a suspension. At WRMC, when patient safety/care was being compromised and I believed that I was being harassed, I followed the objective documentation/reporting thing and have had no problem with administration in years. In whatever you decide, carls, I wish you the very best!

Some go there after they die, Leadkrm. That is, if their body's still warm.

Thank you, Emergent for that rippling status report! Doncha think it needs to come with some sort of disclaimer?

I am truly sorry you experienced trauma, PHC-nurse and have the insight to see that one of the ways in which you deal with your anxiety is through cleaning. A behavior is counterproductive only when it profoundly affects our abilities to function in a so-called normal manner. For example, if you refused to take your children to school because you hadn't disinfected your car, there might be a cause for concern. As long as you have your priorities reasonably intact, do what makes you feel safer or more secure. We all have our foibles and idiosyncrasies. We really only need assistance dealing with them when our quirks profoundly affect our health, relationships, or work. If our lives are profoundly affected, then we need to seek professional assistance. Good luck and the best to you, PHC-nurse!

Wrongway Regional Medical Center, Psych Division.

Congratulations,jrbl. The very best to you! It's good to know when to hang up your stethoscope. I'm not quite there yet:

Please list your name, specialty, and how long you've been a nurse! Davey Do, psych, 36 years. What lead you to the nursing field? The Fates. Want to see a picture of them? What specialties have you worked in? Psych, Community Mental Health, Home Health, Chemical Dependency Tx, Administration, ER, OR, Med Surge. Satisfying aspects of nursing? Nursing is a very interesting and diverse field, I have always found employment, I feel like a contributing member of society, and the money is good. Dissatisfying aspects of nursing? Bureaucratic pencil-necked Geeks in control of policy & procedures. What is something that is generally misunderstood about the nursing profession? I've tried to come up with what I believe would be something truly generally misunderstood and could come up with nothing. Most memorable patient experience? There are so many patient experiences that stand out that choosing a "most memorable" one would be next to impossible. So I'll just link you to the most memorable patient experience this past weekend:

The OldDude has had a lot of deep, meaningful conversations with a lot of allnurses members:

For those of you just joining our program, I need to inform you that the OldDude and I are identical twins that were separated as infants and brought back together due to William Wright's study, and subsequent book, Born That Way on predisposed genetic personality templates. It was either that or Farawyn suggested that the OldDude visit the Jacob Rockstar Thread and we met thataway. Like the Incas and Aztecs, I get those two mixed up. I have quite a few OldDude comics and since the vast majority were lost to the digital winds when allnurses upgraded, I thought, "What the hey..." I've noticed that the OldDude has a new avatar since the upgrade. He used a generic avatar of Indiana Jones because, to quote him as closely as I can recall, "I look a lot like Indiana Jones. Well, I look a little like Indiana Jones. Okay, I don't look anything like Indiana Jones, I just like Indiana Jones". This was the OldDude's previous avatar: The OldDude's new avatar is a picture of Indiana Jones with a serious look on his face, concentrating, trying to make an important calculation and decision: So, here's to you, OldDude! This is Davey Do posting in Davey Do's Comics some OldDude comics!

The OldDude and I have had many intimately philosophical discussions and he has given me a lot of support. Here's an example:

I'm sure the Old Dude is busy making tough decisions! I'm sorry. The devil made me do that. Congratulations, Catitude, on a job well done- I doff my proverbial hat to you!

You're dealing with someone who has all he earmarks of a personality disorder, jb92. TriciaJ said it- do your job and ignore her when anything is outside of the realms of her business. Nothing you do will change her behavior for very long. Stay focused and consistent. Another bad thing about personality disorders is that even medicinal therapy doesn't help. Jednurse- I just thought PSW stood for some kind of social worker. A lot of social workers seem to be know-it-alls. Oops! I didn't say that!

Since you know that I love you, Emergent, I believe you will not take it as a personal affront should I argue your premise. Just about all medicines works as either catalysts or inhibitors. For example, analgesics, anti-psychotics, anti-hypertensives, and the list goes on, block certain synaptic clefts or inhibit a chemical in the body's production or absorption. Other medications increase the body's natural state, like amphetamines, etc. What if essential oils stimulate or inhibit a body's natural process? Would essential oils be any more of a placebo than an SSRI which theoretically keep the serotonin levels high in the brain's synaptic clefts lessening the symptoms of depression? I believe essential oils have their place in the treatment and cure of some ailments.