ChaosRN777

this is part of the reason why it is such a big ordeal, errors. And it is part of the reason why there should be a pharmacist on. however I learned to not trust any one person with medications. I received Prochlormozine 10mg amps for a single dose of 50mg of thorazine, when i realized that it would take 5 amps to give the dose, i called. the answer i got back was "aaaahhhh what's the big deal?" so i always double check and double check that last double as well. But i beleive that it is truly outside our scope of practice to be doing this.

I can only address New York State requirements, and my facilities interpetation of them. Doctor must be present for a restraint. They have to document time called & time arrived ("actual time of restraint" and "Ordered time of restraint"). in my facility they have gone as far as saying no 4 point restraints without prior authorization. Those authorizations are few and far between. We use LS, locked seclusion. The policy is that it can not happen unless the nursing supervisor is there with the psychiatrist. In the real world that is not always an option, given that we have 15 wards spread out over 5 buildings, and maybe four or five acres within a fenced "compound". A seclusion is only allowed for one hour with a FTFE by the psychiatrist & can be extended for a second hour, Must end and if there is no other option, the "whole process starts fresh with a new event packet". (my opinion of this process follows: )

if you are lucky, she is the exception that proves the rule. and although I would make no generalizations, she sounds like an aberation. i'm glad you were not discouraged or driven out. best luck in remaining school & career :balloons:

one can hope that this second set of eyes at least doesn't come in with the mindset of these students don't know anything. And s/he will be professional about her observation and evaluation. Be prepared to hear nothing from the instructors or administration, as it would not be professionally appropriate to report to "subordinates". hope it works out. )O~

Flight Nurse 2b- I hope you kep us up to date on any actions you take and the results of those actions, if you can

I too was a non-traditional nursing student, a little older than most of my peers, male, and 4 years EMT & level two EMT instructor. That being said, i had an instructor who tried to find fault with almost everything i did. After I graduated, she had an student placed on the unit I was the charge nurse for (about three years later). In front of one of my nurses, two unit aides, and her student she passed the comment: "of all the students i have had this is one i never thought should have finished the program". I can tell you I was embarassed first, but i calmly replied, "as usual you continue to make errors in judgement, based on ignorance, i'm glad to see you have not changed" my point ? sometimes the universe gives us a second shot if you wait for it! Vashtee .... wait for it! don't take a swing in the dirt! Good luck )O~

Actually it would be a JACHO standard that would be violated. Then you could look into the state standards, for New York it would be OMH - Office of mental health. They have "taken away" our use of observation rooms, except for use as a restraint (locked seclusion). We cannot use it as a bedroom nor can we use it as an observation room for someone who we might want to keep a closer eye on, say, over night only. then there is CQC .... their number should be on any patient rights packet. )O~ PS- doesn't that sort of violate pt privacy and dignity too?

the police may not be as responsive as one might hope, but the store may have security footage either of the event it self or the "group" walking in the parking lot to the van, from there they might get a plate number. I agree with everyone who says report it, it is patient abuse, besides being illegal this is most likely NOT a new behavior for her! )O~

We have a pharmacist who stays until 6pm, and a Pyxsis type cabinet, and a schedule of who is "up next" (which usually falls to the closest one, becuse several live in the next state), most of my units have "stat drawers" for common meds that could be ordered in an emerging situation. My population is intermediate to long term chronic psychiatric adults (320 to 360 census). It is only problematic when the medical attendings stay late and write orders after 5pm.

what this really all comes down to is, those who are directing the profession, i beleive, fall into one of several sub groups: those who haven't done actual patient care since glass syringes those who haven't done actual pt care since school those who didn't like actual pt care and "got out" those who shouldn't even be in medical care those who have been "stuck with a bad experience" or those who have done nothing but paper/policy work and lastly those who prove the peter principal i beleive that surveys are not effective in doing anything except IDing issues that should be dealt with "locally" rather than creating sweeping regulations, because one size does NOT fit all. Scripting is just an example of that