HvnSntRN

That's when you chart like hell on that patient.

When I worked in Mother-Baby Care, we were not permitted to leave a drowsy mother alone with her newborn in the bed with her. If we set her up to breastfeed, we had to go in and check on them after 30 minutes. We didn't allow them to co-bed, but the baby was in a cot near the bed. We had pot lights installed above each bed so the mother could see her baby's complexion and become more easily oriented to her surroundings if she woke up (or was woken up) during the night.

Thanks, everyone for the support, and I apologize for not responding to you sooner. Once I returned to work in March, Head Office decided to shut down the call center in my city about a month later. I had heard some rumblings and had prepared for the possibility of not having a job. I was actually excited about the way it all worked out.

Personally, I think as a new grad, with barely 6 months' experience, being put in charge without knowing how to properly use equipment, etc., is an untenable situation. It would never have happened in any environment where I've worked. No wonder you were stressed and on edge. That being said, reports of verbal abuse toward clients - either direct or indirect - will get you in hot water. Your education didn't end when you got your licence, so look into taking ContEd courses on topics such as how to deal with difficult patients/people or stress management. You will need to learn skills such as self-advocacy so you can stand up for yourself when you are confronted with situations where you are being expected to work beyond your skill level, without training or any kind of support system in place when you need a more experienced person to bounce ideas off of, or get pointers from. I agree with the comments recommending that you speak to a lawyer. If there is a state nursing association (not the BON, but a professional association) and you are a member, you may have some liability protection included in your fees. Check that out and call them.

"The View" is just one more example of how TV has gone and made stupid, ignorant people famous and obscenely wealthy.

I, for one, have the highest respect for lab technologists. I studied Medical Laboratory Technology right out of high school - it was the toughest program to be accepted to, and one of the toughest programs to succeed in. For reasons that I don't wish to get into here, I left the program at the mid-way point, and didn't go back to school for over a decade. When I finally decided to go resume my education, I went into Nursing. I actually was extremely fond of my histology course - I loved cutting, staining and reading my own slides. Biochemistry was another favorite, as was Organic Chemistry.

Part of the problem for front line RNs is that these callers have the right to remain anonymous and to have recordings of their calls suspended. This also helps to protect the company because of a lack of evidence. Were I to override a caller's request to remain anonymous, I could be held liable for a breach of the caller's privacy. It's sad that they call frequently enough that we recognize them by their voices alone. Each one has a particular 'script' or playbook. I've had calls from at least six individuals, each with a distinct voice and script. We are not allowed, in our charting, to state that these are "repeat" callers, even if we are sure that they are. Again, I feel this is a way the company can protect itself from liability. As someone who has a history of being sexually abused, certain callers are triggering me. I'm off work for now to get the medical support that I need. But I can't see me subjecting myself to this again. My mental health and well being is worth more than this.

I've been working teletriage at a call center for almost a year and I'm getting fed up with the volume of calls from repeat male callers who are looking for a toll-free way to talk about their "prolonged erection" with a captive audience who happens to be a registered nurse. The calls didn't seem to be as frequent over the summer, but they seem to be ramping up now that the weather is getting cold again. Some of these guys are calling multiple times a day (the record-holder had called over 40 times in 24 hours) and it's like they're reading from a script - it's the same complaint/fantasy over and over again for each of the callers. Our company has a harassment policy where we are expected to give 3 warnings if they use inappropriate language or are abusive (yelling, berating) and clearly the callers know the game - they use proper medical terminology rather than slang (most of the time). More than once I've heard very clearly the distinct sound of masturbation, while the caller's voice has the telltale indicators of approaching climax. They usually hang up before completing triage (once they've completed their other 'business'). They almost always ask to have the recording turned off and to remain anonymous - obviously they don't want to be caught or have any evidence against them - and we have to oblige these requests. These calls leave me feeling violated. I've brought it up with my manager, but the company is satisfied that its policy is all that's needed. I've asked to have statistics on how many of these types of calls (anonymous males, non recorded, "member symptoms") are processed in a typical month/year. Apparently we don't need to know how pervasive the problem is. My thinking is that the company gets paid for these calls regardless of the content or the effect on the nurses, and because they are not life threatening situations, they're safe and easy cash flow. I'm at a point where I dread that the next call is going to be one of "them". How do you all cope? Or is ours the only call center where this happens??

When I was asked about a farewell lunch in my "honour" I politely declined. I don't do well when I'm the centre of attention at the best of times, but mainly I didn't want to reward the bullies with an opportunity to pat themselves on the back for giving me a nice-ish send-off.

I left my NICU job a few months ago too. There were bullies and while the manager paid lip service to the policies intended to reign in the bullies, ultimately I realized that my health and mental well being were more important. I miss the direct patient and family contact but I don't miss the longer hours, the night shifts, the mean spirited people and the lack of support from management. I also don't miss the migraines, hot flashes, and stress related sequelae that had me at their mercy on a daily basis. I'm so much happier - I can't believe that I put up with that level of mental torture for 3 years.

I couldn't agree with you more. I turned in my 2 weeks' notice on Monday morning. I've spent the last 3½ years in a Level 2 Enhanced Nursery after more than 12 years in Mother-Baby Care. I started my career a bit later than most - I graduated nursing school when I was 34 - and because I was raising my family, didn't want to work full-time until about 5 years ago. Just over a year after going FT, I was affected by redeployment/corporate restructuring and my job on Mother-Baby was made redundant so that RNs could be replaced by RPNs. While I love what I do working with families and their babies, the transition has been incredibly stressful: I've developed health problems that I didn't have 4 years ago, including hypertension, diabetes and anxiety, not to mention the additional stress of entering menopause and experiencing debilitating hot flashes triggered by working in a very warm (26°C) environment. I've had to be on medical leave twice since last summer. Clearly, my body is telling me that the job is not a good fit for me. I've fought it tooth and nail, trying to make it work, trying harder, but I'm frustrated, stressed out and approaching burn-out. I have 4½ years before I can take early retirement, but I know I can't torture myself in the hospital environment for that long without serious consequences. In the new year I'll be starting in a hands-off (TeleHealth) position, it's something that allows me to work with my strengths, and affords me opportunities to grow, that I didn't have as a staff RN. I'm excited to be working shorter shifts, fewer nights and weekends - I can actually make plans and have a life! - I know I'll be able to extend my career by at least 5 - 10 years or more by making this move, without having to start collecting my pension early. I can actually work at getting healthier again, instead of being drop-dead exhausted when I get home from work. Like you said, some people thrive in their nursing careers in their 50s - I'm just not one of them. I knew the end was near when I had my 50th birthday in the summer and started knowing exactly how many years, months and days it was until I could officially retire from the hospital.

If I can't get Workers' Comp for my sore feet, what makes you think you can?

I transferred to a Level II nursery last summer, after working for over 12 years on Mother-Baby. It's taken lots of attempts over several months, but finally was able to do a successful IV blood draw the other day. I assist and observe whenever I get the chance with skilled co-workers - on some of our premies even they aren't able to get a decent specimen, so I don't take it personally when I've had unsuccessful attempts. My main issue is that I know my skill level is novice, and I feel like I'm torturing the baby if I can't get it on my first attempt, especially if I already know that they are a "difficult poke". I've never seen anyone use the transilluminator for venous access, I may have to try that while I'm working on my skill level. Thanks for that suggestion!

My postpartum position was eliminated due to cutbacks and hiring LVNs. In hindsight, moving to the NICU was the best decision for me. Previously, it was routine to have 4 couplets, a couple of discharges and admissions daily, but once the LVNs came in with their narrower scope of practice (stable/predictable patients only) sometimes the RNs would have to switch-a-roo their assignments if an LVN's admission wasn't stable or a patient became unstable - all the "heavy" and complicated patients were assigned to the RNs. It was so stressful that there were days I'd drive home crying because I felt like I couldn't keep up with the demands, and I have over a decades' worth of experience. Staffing is a joke... our call-ins were low priority compared to the ER and ICU, so often we worked short, and absolutely no wiggle room for overtime or a lull in the census; as soon as we had shuffled out the discharges, usually someone was sent home without regard for what was happening down the hall. I am loving the NICU. Three babies, tops. No chance of LVNs coming in. No taking report in a war-zone surrounded by other nurses, students, residents and docs coming in to rip charts away from you. I go home on time more often than not. I feel like I've done my job at the end of my shift, and not missed anything. If you're looking for a change... look at the NICU... it's a bit of a learning curve from postpartum, but it's been great for my morale.

Don't eat junk food on nights. Your body requires the best nutrition possible - lots of fruit and veggies, yogurt, nuts and seeds, hard cooked eggs, etc. - we need to compensate for the physical challenges of tampering with our circadian rhythms. Also, the drive home includes a LARGE glass of ice water. If I have to pee, I can't fall asleep.

It sounds as though you may have been too busy with your education to document the negativity around you. If you can prove that you were singled out (hard to do without the documentation to back it up) and were the victim of "mobbing" (bullying in the workplace by co-workers and management), then you may have some grounds to file a counter-claim. "Constantly being written up for small mistakes" sounds as though someone had an axe to grind against you, and enlisted the aid of others in documenting the small mistakes. Let's face it - honest mistakes happen to everyone. I wonder if one of your colleagues was the ringleader in this process; someone who may have been jealous of your efforts to advance your career, and wanted to "put you in your place". You should have the right to view all the complaints and incident reports in your file. They would have to be anonymized (dontcha love how complainants are protected by the system and aren't required to look you in the eye while they stab you in the back?) and you should have had a fair opportunity to respond to the allegations against you. Get an attorney. This sort of thing stays on your professional record. Nobody should be allowed to slander you, and if you don't dispute it, it may end up "appearing" that you agreed with the charges against you.

Just a quick addendum: If you are already employed in an institution and requested a transfer to Mother-Baby or Obstetrics, perhaps this is an issue that the union (if you belong to one) would address on your behalf. Certainly with my employer, the competition process is dictated by union rules, and a position would be given to the individual with the seniority and credentials that meet the unit's needs the best.

I respect the fact that you are a competent professional. Your gender wouldn't be a problem for me. I would welcome gender diversity among my female-only Mother-Baby Unit colleagues. Would my nurse-manager hire you? I don't know. Having worked on a female-nurses-only unit for the past decade or so, I notice quite a lot of clique-ish politically (as in "office politics") motivated behaviour that I never noticed on units where I trained where male nurses were better represented in the staff pool. Maybe a gender bias lawsuit would wake people up to the fact that there are males who want to work in the OBS-GYN specialty, just as there are females who want to work in urology. The old biases don't work anymore. Patients here have to sign a release form accepting the fact that they will receive care by medical staff of either gender, and I don't see why that form cannot encompass nursing care too. The focus should be on the nurse's ability to provide professional nursing care, not whether the nurse has a member or a lady parts.

When we see a birth plan at the front of a chart, it's almost guaranteed that the delivery was by emergency c-section for maternal or fetal distress. These are the ones that need Code Pinks, etc. One of my colleagues created a spoof birth plan that included almost every ridiculous request we'd ever seen. She included things like "My partner wants to kiss the baby's head as it crowns" and "He'd also like to chew through the umbilical cord the way nature probably intended" and "we'd like to be in the jacuzzi so he can shave my perineum during labor for better photographs of the delivery". Of course, she finished with "But seriously, all we want is a healthy baby - whatever is needed to accomplish that is fine with us."

The unit where I work has three hallways extending from the nursing station, in about the shape of a "T". Just to be kind to one another it is normal practice to try to assign nurses to patients in the same corridor, but in no more than 2 corridors. One day I came on to see my assignment was at the extreme far ends of all three corridors. When I questioned the assignment (like any other of the nurses would upon seeing an assignment like that), the nurse in charge who had made up the assignment sneered at me and, in front of all our colleagues from both shifts, said she wasn't going to change it, because "you could use the exercise, anyway". I marched into the manager's office and told her what had just been said, and said that if the assignment was not changed immediately, I would be writing up the charge nurse for harassment and taking it up with Human Resources. I said that I do not come to work to "exercise", and that when and where I "exercise" is nobody's damn business. I am there to deliver patient care, just like any other nurse is supposed to be. The manager agreed with me, and someone got taken down a couple of pegs for a few months while other people got to be in charge.

The local Public Health Department hires RNs (with Bachelor's degrees as a minimum educational requirement) to go to the various hospitals with Mother-Baby Units in the region to perform the hearing screening. The pay rate is less than what unionized RNs in hospitals earn. The hours are part time. You are expected to have your own vehicle for travelling to the 4 sites across the city on a daily basis. Parents also have the option to make an appointment to have baby's hearing screening done at the Public Health office.

here's a video link that we use to show just this very thing! once staff members see the baby perking up and showing interest after taking just a few drops of ebm, it makes them all jump on the hand expression band wagon. http://newborns.stanford.edu/breastfeeding/handexpression.html

Here is a link to the Registered Nurses Association of Ontario (Canada) site's Best Practice Guidelines for Breastfeeding. click here The page also offers various PDFs for download, including an evaluation tool that may be helpful in developing your survey questions.

My institution has BFHI plaques up in staff-only areas, mainly because the institution will never be a baby-friendly one, thanks in part to the formula companies who donate product for patient use and perks to management for allowing them to do so. Infant formula is a very political issue, even though we may not be directly involved in the politics. We have a wide assortment of ethnic populations who combine breast and bottle feeding quite well. I had a huge argument with a former manager about how we respect the rights of these women to make a culturally based choice, but for some reason we don't seem to afford the same right to women from our own country. It seems to me that if you're caucasian, you better exclusively breast feed or you'll be "poisoning your baby with formula" is the prevailing attitude. My position is and always has been that the choice is with the parents (regardless of culture or race), and I am there to inform them of their options and then support that informed choice, whether it's exclusive breastfeeding, bottlefeeding or combination feeding. If the mom wants to exclusivey breastfeed, but for whatever reason cannot, we will start her pumping within 6 hours of delivery with a double electric pump. We encourage "power pumping" or "cluster pumping" rather than a q3h schedule as it simulates baby's clusterfeeding behaviour. EBM can be given by cup, fingerfeeding, feeding tube or bottle. Some of the late pretermers have so little energy to suck effectively for the period of time required for adequate milk transfer, so we make it easier for them by giving EBM or formula by cup or spoon.

I agree that it sounds as though you are in the midst of a burn out. Maybe it's time to explore new opportunities or just take a vacation. Are you looking after yourself? When was the last time you did something to pamper yourself... something like a pedicure to appreciate your hardworking feet?? or a massage to help lift all the work-related burdens from your shoulders?? Sometimes "not caring" is a symptom that you need some TLC yourself. You can't give what you haven't got! If the well is dry, it needs to be replenished!