purple10

ugh I have a pt that the one family member always has something to say about something. nothing is ever good enough. the pt has osteomyelitis and has been to wound care and was discharged, and was also on 6+ weeks of vanco IV. Well wound care discharged the pt after they where satisfied with the skin growth over the wound. Well this particular family member went to almost all the wound care appts and bugged the crap out of the wound care MD and his nurses about every little thing to the point he was writing stupid orders just to make them happy. Well the pt has an order for gauze to be woven between the toes and to have double socks to "protect the toe". the day after the pt stopped the IV a blackened area developed on the toe near the wound the I notified the MD and the MD said that it was because of the osteomyelitis and gave no new orders but just to do the dressing from the wound care MD. this family member comes in today and starts ranting and raving about how the wound was bleeding "everywhere" in reality it was a very light smudge most likely caused by all the extra pressure and friction of double socks and gauze. This family member then proceeds to tell me that they think its not being done like its suppose to be and without saying it that its my fault. I have jumped through hoops with this family member and its never enough, if you don't like me fine but geez its not my fault your parent has an infection that will NEVER go away. ugh this person makes me want to tear my hair out! so to make her happy we are sending the pt back to wound care and making the dressing BID. I tried explaining what osteomyelitis is and what it does all I get is "I know I went to the wound care appts so I know everything that's going on", grrrr.... *bang head on desk* There was no explaining anything to this person everything I tried to say she would question and would keep saying the same thing over and over and over. Another nurse had to step in and stop the conversation (thank god), the family member was even talking about going to my unit manager (who is new and knows next to nothing about the pts on the unit) but then would say that they not here to get anyone in trouble but cant understand why it takes for when they (she) to come in for something to be done. I just want to look at this person sometimes and go well the POA seems to be happy with the way we are taking care of the pt, haven't heard any complaints from them and they are here more then you. Ok that's my rant, deep breath, and Smile. :)

Hahaha yeah I reread my post this morning and laughed at myself, I guess I cant spell when Im half asleep...I guess this is why Ill never work the night shift! Im not really worried about it, its just sounds weird thats all, just trying to get some understanding thats all.

I work in LTC and I dont think its a "warehouse" we dont stack ppl on a shelf and wait for their experation date to come to a close. We rehabilitate mind body and spirit, we become family. We bring life and meaning to some of the pts. We entertain, laugh, cry, share milestones, share stories, share pictures. They talk we listen every word counts even if its a moan, murmer or hiccup. We speak for the ones unable to speak we are shoulders to lean on when a pt passes. We celebrate with the family and pt when they return home. In the LTC (atleast for me) we take care of the pt first and paperwork second. Medicare may be a pain but its nothing a little (lol or a lot) of charting cant take care of.

THANK YOU FOR FIGHTING FOR YOUR PT!!!!!!!!! we need more like you

quit plain and simple, dont use them on your resume (tech. you dont have to list a place if you worked there less then 30 days). I for one will own up to crying at work, i hate crying at work cause then i feel stupid but ive seen other nurses who have been in this profession for years cry at work its ok. things will get easier, take it as a life lesson and now youll know what to ask in interviews about orientation among other things. good luck to you, keep us updated on how your doing :)

I wasnt there the last time i seen the pt was 3 days before transfer and they were their pleasantly confused self, but from the NN it was just the legs. this person also had a inplanted pacemaker and was on lasix/potassium if that helps any. I guess the family is blaming the facility md for not keeping the pt on profilactic (sp?) abt but the pt was on florastor without incident until transfer. I know a person can expire from untreated cdiff one of the ARNP looked at the labs and said it looks like CHF i dont know, i just dont want to get dragged into a legal something or other cause hosp md/fam/facility md dont click to hear all the story from the family things just dont make any sense

hahaha too funny!

a pt sent to the hosp for swollen legs and elevated temp expired two days after admit, prelim cause of death cdiff. pt was on florastor for history of cdiff. no loose stools noted until transfer to hosp, labs and doppler done before discharge BNP elevated 5.5x normal limits...but that points to CHF not cdiff. doppler negative. am I missing something? is that a comp of cdiff or an md talking out their butt?

we work in LTC, My new partner is ok outside of work, I understand she is still trying to learn all of her people and all of their quirks. My friend is a creature of habbit and it just may take longer for her to settle in. I have heard other people state they dont know how to take my new partner. We work on the same unit we dont "share" the pts but if need be we help each other like ' I'll do your dressing so you can get caught up on charting' sort of thing. Most days it isnt too bad but others eh well... Management was thinking 'fresh eyes see new things' yeah ok the most the nurses see is tunnel vision to get the meds passed to the pts they only know by name band to mar matching. some of the pts are so upset by the change in their routine that even they and their families have complained, but management has said whats done is done.

When I started working at my place of employment I was teamed up with an awsome nurse we got (and still do get) along great we had awesome teamwork got all side projects done, then the management got a great idea to flip a bunch of people around not the best move I'd have to say... Now I'm teamed up with another nurse who is well dead pan, cant take a joke, doesnt smile, mind is still stuck on the other unit, not on the unit for half of the night, families have complained about her, she has this way of talking where it sounds like shes telling you and being nasty about it when she really isnt.... I honestly dont know how to take her, shes ok outside of work but in work I cant stand being around her. Im nice try to help with things but nothing seems to work. and management doesnt want to move anyone back for 90 days... The other nurse and I dont click (you can tell she doesnt like the unit), and my friend who got moved is highly stressed out and is ready to have a breakdown. Everyone was moved about a month ago, plenty of time to adjust, but it just doesnt seem to be working. I use to love going to work but now I cringe and wish the weekend could be another day longer. What should I do? It seems that no amount of talking to management is working.

the continous rule changing which said new rule only lasts for a max of a week (so then whats the point?) and a effective way to know when threapy takes a pt off the floor (since they dont seem to feel the need of letting us know) and the MDs need to do rounds more often (LTC)

ooo got another one... everyday you complain about something new hold me in your room for 10-15 min so you can complain about everything and tell me how to do my job, no i will not give you a enema cause you havent pooped ten times today. no i cannot change the temp in the main hallway if your cold put a sweater on. this isnt the service you paid for well this isnt a hotel you need to keep trying to do things for yourself i am not you lady in waiting.

depends on the facility.

your humor becomes twisted and things you thought were gross before and like it never exsisted. some people become germaphobes. some people it stresses out and the need to start taking medications or increase medications or self medcate

'If you dont have anything nice to say, then say nothing at all' I think just about everyone heard that when we were growing up and many of us as adults and being nurses learn how to bite our tounges and with hold what we are really thinking If you could say anything to your boss, MDs, co-workers, or anybody else while at work what would you say? Mine would be (just a few of the many)... 1. you want to go back to get your RN? well honey you need to go back to get your LPN first! 2. if your the on-call MD tonight then why are you getting mad at me for paging you, its your job! and just for that Im going to page you a few more times. 3. Im the nurse your the therapist whay are you asking me what you should be doing?

usually what it is, is they are pointing out something to take a better look at next time it is to help you learn and if (IF) they say and word it in the right way it wont come off as they are trying to make you look stupid. not all nurses are out to eat the young, some really do want to help you do better, and mistakes happen ask any of us we have all made a mistake on something weither its paperwork or paging the wrong MD these things happen and if you get someone who says they have never made a mistake they are either lying or too oblivious to whatever mistake(s) they did do. And yes in time you will learn which battles to fight and what to drop. Youll be fine, lol dont worry about it.

you could always call and ask if they need further info. and if you didnt get the job ask what you could to do to improve.

have you ever had or still have the best nursing job ever? what in your opinion makes it the best?

hmm good question, I feel the need to look this up and expand my knowledge

haha well I made it through, Im here wondering if Im going to catch any slack for last night...eh oh well today is another day:)

so last night was a disaster heres what happened... My unit partner called off (lol everytime she calls off or goes on vacation something happens) so I had a PRN nurse with me ok not that big of a deal. Then I get a unanounced admission during report (yippie skippie). A code was called on someone who was sleeping yay adreniline! Get through my first med pass and am working on the admission papers just as i get all the meds written out on of the aids comes up in the middle of dinner for the residents and askes if she can go home (with big ol **** grin on her face) I ask her why she says she doesnt feel good (still with a **** grin on her face) and im sitting there thinking and you havent even been on your assignment half the night cause your wandering around the other units. So i said to her 'so you want to go home cause you dont feel good but yet you have a big ol **** grin on your face?' her answer 'yeah' then I told her to go talk to the shift supervisor. after she left the floor to talk to the supervisor another aid came up and complined that the other aid (the one that wanted to go home) smelled like ETOH, just freaking wonderful! I call the supervisor and ask if she sent her home, she said yes and i explained what i was just informed of that aid told the supervisor that I said it was ok for her to go and that she reported off to the other aids and that the assignment was split up, well that was a huge lie! NONE of the other aids even knew she left! Well girlfriend got herself a write up and automatic termination for abandonment (i guess she was telling people it was her birthday)....well happy birthday heres your pink slip. then i go down to our med machine to see if my admits meds were ready and they were not so back to the floor to start my second med pass I get part of my hall done and the next thing i know an aid is flagging me down to come look at something, i walk in the room put on gloves walk around the curtain and blood everywhere! HOLY CRAP! in report i was told this person was having pink, PINK urine and a ua/c+s was ordered, um yeah ok. this person was soaked in bloody urine like gown underwear and pad (the pad can hold 1500cc) and not only was it bloody it was like jelly like someone dropped a jar of smuckers in this persons lap! I called the supervisor and she came we got this person cleaned up and she examined her, then i paged the md many many many times... NO answer! OMG freak out moment! then we call the DON they dont answer, then the ADMIN for the facility they say to call the medical director call the medical director they give me three orders 1. call primary md q2 hrs until reached then d/c 2. get better # for primary 3. send to hosp if poa agrees and if not do labs in am. Nothing like being ordered to blow up a pager. anyways POA denies transfer, will carry on with labs in am. then about 20 min after that the primay calls back and informs me that this person has a do not hospitalize order (thats nice cause it was the first thing i looked for and couldnt find) grr and i never did get a better number for him. ok finish my second med pass late try to complete the admission the pt refused to let me do a complete skin check, double grr. charted my butt off for two people. then i had my pt/inrs to do and clean up what the previous shift didnt finish and help my unit partner with an iv. I had no break no food no drink and forget about going pee i had to stay an hour and 20 min over and the next shift supervisor was nit picking stupid stuff that she could do her self and the nurse who took report from me would not help for anything i told her about my crazy night then she told me 'well you need to blah blah blah' i didnt care anymore i haad it she was barking stuff at me while i was was trying to chart and ended up writing what she was saying. oh and to top it off i a pleasently confused person who was up out their w/c trying to put people to bed and a new person who was trying to kick out the room mate cause they thought that their oldd room mate was going to move in there too. lol so that was my lovely night, my only question is whould you have written the order to call md q 2 hour and get a better number for them in the pt's chart or just take it as a verbal order for the nurse to do outside of the pt's chart? cause next shift supervisor wanted me to write a t.o. for it and i told her that, that would be stupid cause it throws the md under the bus and makes it look like we dont know what we are doing.

"dont worry if I fall the floor will catch me" ... yeah enough said:)

Well I head back from the admin. and they decided to promote from within, but Im in the running in for the next position. Its nice to know thats its not anything to do with me or my skills. Maybe next time

Well I had the interview, and I think I rocked it! just have to wait and see if I get the call back for the second interview. Fingers crossed XX

Interview on Monday! Yipee!