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zuzi

zuzi

trauma, ortho, burns, plastic surgery
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zuzi specializes in trauma, ortho, burns, plastic surgery.

A happy happy nurse in USA

zuzi's Latest Activity

  1. zuzi

    Nobody Likes A Tattle Tail

    Hey nice social phenomen..."tattle tailing" in nursing world, why and for what? Could you debate the subject a little???
  2. zuzi

    Treated like crap

    Nothing matter more than your hapiness! If you are happy you will find 1000000 jobs, because you will be yourself. If a PRESIDENT job make you unhappy, run away as fast you can...find your spot, don't let others to make you unhappy..YES!!! YOU ARE SOMEONE...you are YOU! Hugs hon, I am so sorry to fell like that... find another job!
  3. zuzi

    advice for a coworker

    Neither to try to talk! Is worthless whatever you will try! Corporate head of HR KNOWS better than you imagine what is happen there! Is a lost game, trying a direct confrontation with upper levels. Let the time to go....go out... at one moment you will help people that you care about....but remember... You care about people.... well, dear you ...you will be surprised how many of them will care about you.... For buddies, just keep Caliotter advice, stay strong, keep them closed, when the time will come to be able to help them. You think from bottom up, they think opposite....hugs!
  4. zuzi

    i hope i know when to hang up my stethoscope,

    My first world came is POOR YOU, supernurse. Hon your dreams are too too high , your expectancies giant. Give your self time. These oldies has their role...... may be they are not so speady, neither so mind bright, and may they hands are not so good than before.... but they are there for a reason EXPERIENCE. When a top level control will be in place you want one of them closed, when a "supersmart" young MD start to prove him self you will wanted the oldies with you.... Belive me hon are young nurses MUCH more ugly souls than oldies ones. People are people give nice one a chance. LIVE AND LET OTHERS TO LIVE! Don't mess up with oldies, they will not mess up with you.... Find your spot in life and let others to live their life....just be ....good!
  5. zuzi

    Defiant and Insubordinate

    It is a Mafia and you could not fight against! Be aware with the "open sweatheart kisses"... when they are nice with you ...kissing you on both cheacks, lol, listening to you , then you could ne sure that "la cappo" already let the tumb down for your head my dear! Is an ugly game, but it is how it is! Good luck and be strong if you want to fight, and mellow if you want to survive... i will give you some lemone.... just in case if you need to kiss somenthing ugly....lol .... be brave!
  6. zuzi

    Seeing the future

    Live your life in present hon, not in the past not dream high for future. Take each day steo by step and live, happy. Let all unhapiness behind and live....yesterday is not, tommorow could not be either, LIVE TODAY and smile !
  7. zuzi

    Defiant and Insubordinate

    "Fight to fight" in a nursing facility is not a good approach AT ALL! Special for patients. The employee will not fallow up the management decisions as soon as they will not belive in them and in the fairness of and much more to show them the door, is also not a good approach....until all other methods was used.... They MUST to know WHAT are the exepectancies at the work place and what will be happen if they will walk the line! If you and all of the management of facility need to have and make OPEN the policy related of this type of cases . If you don't have a strong documentation related what will be happen with ANYONE who will walk the line...........the same and the same will be happen again and again and on big dimensions all the times. You will run in a vicious circle where everyone could do it , what they want, because they can. And then will be two circles "hunters" and "the goose" .... very bad approach! The name of this type of phenomenon is "lack of management and leadership style" "10.000 like you are on the door" is not a wise management approach at all! BUT also you could not tolerate this type of deviant behavior at all... Make the rules to be POLICY, let employees know it, educate them, show them what will be happen, good and bad if they will or not fallow up with rules. Make clean and clear the place! Let them to speak out, to know what is wrong and why they are unhappy. Sue.... mellow down you need support from up top management, ask for help! Hugs!
  8. zuzi

    Defiant and Insubordinate

    Nop, nop, nop... is just a bad communication style from both parts and yes probably and some "personality" style issues. Again NURSING IS NOT MILITARY! INSUBORDONATION could be used when everything is CLARE and she refused to do it! Attitude? I have BIG doubts on it! Both parts has attitude! I know some time, many time we "the big RNs" we have RIGHT! But some time NOT! I know I know we have right.... but life teach me that EVEN when we have right, and we have proves that we have right.... depend how you TELL the right thinks. And if we have right and we can not make us understanded ask for help from education departm, DON, management. And if you don't have it, instead to work in ARMY with army methods... you are the only one able to choose your nursing style to be! And better insted to tell is to WRITE! If you want to write her up is NOT for insubordonation BUT IT IS for a BAD NURSING JUDGEMENT! And send her to education department and let her to write an agreement related what she will do in all other situation like this one. Make an inservice for all nurses and let them all to know about and sign a agreement that they know what to do next time! And tell them what will be happen if they will elopes the contract! And even like that, who had a bad nursing judgement..only HER? OR ALL the team???? NO ONE CALL THE DR FOR HIGH FS! THIS IS THE BIGEST PROBLEM, that I seen! For me like RN, the situation wasn't clare at all! 1. She didn't had the DR ORDERS for meds that was in late, you needed to let her know that is a facility policy to not call dr and you notes already on patient chart. 2. Very bad judgement to give Lantus for a high level of insulin, WITHOUT calling the doctor first! 3. Who assesed the patient? I didn't readed NOTHING about? SHE HAD THE RIGHT to have doubts! BUT what she did TOTALLY WRONG... is that she had doubts why she didn't call the doctor????? She did very bad because she didn't call the doctor by HER SELF! And that was happend because : - wanted to pass accountabilty on you...and she could be able to stay clean away of this mess - think at her comfort first before to think to patient - and yes Sue probably she dosen't like you because you are the boss (is happen always with all bosses, lol ) Agree with it! They need an educational time related WHAT IS SCOPE OF PROFESSION for a aide, read and sign the educational paper, and let them know what will be good or bad measures if they are in or out of scope of profession. Why I have the felling that many of your "subordonee" read AN and your postings??? :lol2::lol2: Be carefull!
  9. zuzi

    Defiant and Insubordinate

    I try to not be on the evil side and I will do it, because sometime WE think just looking at OUR own position, without making conexions with others and REALITY!. This history is a TYPICAL nursing case of passing liability, passing accountability! Who discover the missing meds doses? THAT person is accountable about everythink that was happend after. WHO discoverd the med error/missing, huh? Is her accountability! THAT PERSON needed to announce FIRST THE DOCTOR! Special with a FS high! Is her discovery she need IN PERSON to contact the doctor! Lantus given even with 1 hour and half late was not the best care judgemment for a high FS. Doctor needed to know THEN and take the measures RIGHT THE WAY! 2. If someone else announced the doctor, needs to write the nurses note and to specify in then...."endoresed to LPN nurse Lola the doctor decision, to give meds from 5 am now at 7.30 am" . Sue your LPN, tried to take off the charcol from fire with your hands and pass the accountability on YOU. Is happen often! Verba volant scripta manet..... when you told her to give meds, you needed to write a nursing note about.... and to tell her.... "You have a note in nursing notes and a new order approved by doctor to give missing meds NOW, so please give it NOW", and let her away.... after that you go back and verify her, plus if she writes the notes about. If not.... bad choice! ALL of us we need to be accountable for OUR OWN decisions or mistakes, not to pass acountability to another one... Next time...let her to call the doctor and verify! If you are smart prove that you are! IS NOT AT ALL ABOUT AUTHORITY! Why remember me about military...OMG! Is about good nurses and others.......if you are a good one prove it, take the good decisions or admit when others had a much better ideas than you or you did a bad one, and NOT pass the accountability...
  10. zuzi

    behavior monitoring

    Insomnia is not a behavior (may be she couldn't expain ok), but you need to monitor the number of sleep hours for people with ambien..ROUTINELY and ADSE. Let's say that you have a patient with routinely 0.5 ambien at bed time, normal logical mind tell me to monitor hours of sleep to know if it is effective or not, and to monitor side effect also. What is happen if is too much for him or is is not well tolerared, or is not enough and he could not sleep or if is an addiction, or if he already took and many other meds that interact with ambien and he could not sleep.... or if he is dizzy and could fall down because US we overdrug him/her and we didn't monitor it??? If a patient is still on ambien and dosen't work and he could not sleep, or sleep bad...we need to document it. You don't need to document LIKE BEHAVIOR, you need to document like HOURS OF SLEEP PER SHIFT and ASE thinking and calling the doctor! If the policy and procedures don't tell you to do it, the first good lawyer hired by family, will have a perfect "money-maker" case proving that "the patient" was overseadated dizzy or neglected because someone gave him/her ambien each night/or not gave it, without any documentation of s/s monitoring or for what reason and how the patient reacted at! And at ONE POINT, they could have RIGHT! I keep my opinion... everything is happen for a reason and we like nurses we need to monitor, asses, reasses, and take an action based on fidings. Any policy or procedure for any company will not keep you safe in the front of law if you keep to give each evening ambien to a patient that is drowsy all day long, and you didn't documented/monitor it and take actions. Any policy and procedure for any company, will not keep you safe if you give 5 mg of ambien each night to a patinet that cmplain that he/she could not sleep and you didn't monitored it and take actions. Is my opinion and i am stuck on it! Monitor!
  11. zuzi

    behavior monitoring

    Two scenarios here: 1. If is PRN ....NO... patient asks for AS NEEDED. You don't need to monitor on MAR. But even then you need to have nursing notes about effectivness of med. You gave to him with a goal.... was ok? OR not? Any ASE? What did you do if wasn't ok? Asses...and ...Call the dr... 2. Is is routinely, YES, you need to monitor hours of sleep Qshift and eventually monitor also and ASE, call the dr and dr will adjust the dose of ambien acording with the number of hour of sleep/or insomnia per shift, or any other ASE noted. A good nurse is MUST to provide all these inf for rutinely ambien to dr, if the policy and procedure of facility asks for...is not..... is their problem, lol..but you like a GOOD nurse need to fallow up with it in your nursing notes and call the DR is somenthing "unusual" seems to be.... (patient could not sleep after ambien, patien looks like having ASE on ambien, patient refuse ambien ), and let a note to your supervisor related it, annonce next shift.... WRITING! Next day IDT need to fallow up with and take an action. Much more, the nurses when they chart about the patient they MUST to write on nursing notes how many hours the patient sleep or not, if dose of ambien was effective or not and/or are present ASE/allergy manifested, and how patient looks like (arousable, slightly arousable, dizinees, drowsiness, sleepy,obnubilated...comatose..OMG, lol) Be a good nurse even if your policy is not there...look at patient, and remeber the ASE of ambien. Critical thinking... "day time drowsiness" is not ONLY because he/she could become "more acute sick", but could be also from a ASE of ambien or to a TOO high dose of... THINK! Monitor, monitor, monitor and think, note, write and report to up levels your assesment , and note again!
  12. zuzi

    How RN supervisor handled domestic dispute at work?

    Very dangerous situation with many alternatives: 1. If she knew the man and/or she is very self confident on her power of perssuasion... she did PERFECT RIGHT.... acting like a real woman, BUT she was stepping out of the supervisor position policy (she needed to call 911 first). But she seen like an emergency situation what was happend with kids... she tried to protect the kids first, she knew that the man could not make much more worst that he did, she knows that she could control situation... 2. If she didn't knew the man.... and she let her self drove by emotions then is bad. Wrong thinks could be happend..... and was possible that she could not control the situation and put kids in danger by her uncontroled emotional behavior, much more she was out of her controled supervisor policy. What could be happend if "the creepy" acted uncontrolable also??? A tragedy! She needed to call 911 and keep safe all, until police is coming. No one could not doing to her nothing wrong, because nothing wrong was happend....but could be... The man need to say her thank you, when he is back mellow because he is not with police now....because she didn't call 911! Professional: you need to call 911 Personal ...you already know my opinion....go gurl go... Balancing: call 911, and talk nice keeping on control the situation Not worries....
  13. I am so sorry to hear that. What policy has HH and hosipce, related safe and safety protection for people employed???? Is a realistic one or need to be changed? Someone screens the future patients and evironment? Is a police check background of patients before the nurses to go there???? (Is the RIGHT of nurses to know where they will go and to choose or not to go or not in dangerous areas with dangerous patients or families). Even in army, people know the risk of the place where they will go and they was agree befeore with and compensated based on. Is an incentive for dangerous work conditons? Is a special cover insurance for handicap, invalidity or death in/caused by work?
  14. zuzi

    I am sad, I am numb, am I burned out?

    The mangement need to take care of this situation appeard, and each of you need counselling, debriefing. Do you have and policy and procedure for these type of events???
  15. zuzi

    Is healthcare a right or privilege?

    Are both true! Healthcare is a RIGHT! If you refuse healthcare to ANY, you could not be considering human been! Humans are to help, care, protect not to destroy lives! Healthcare is a privillege NEED TO BE! Because I worked for my money, hard and I need to have the privillege to CHOOSE, based on my money .....my doctor. I don't want that YOU to give me one, I could choose one, pay one, the best one if I want too, the best medications if I want too. I will choose what I want not what you tell me too!
  16. zuzi

    Is nursing a sick , petty , vindictive world?

    You know why nursing become so bad? And healthcare generally? Because we talk about patients but we think about insurance MONEY! Healthcare and nursing became money makers, many came in nursing field for money, nurses are not anymore"the nurses" are money makers-nurses...who cares...is a bussiness... we need to do money, we make alliances, knew the rules, find "the opennings" in the rules, make assumptions and interpretations... ALL for insurance money. You need to adapt to this world or it will reject you, is all about! But with all of these..... please fight to be what you want to be THE NURSE, and YES WITH GOOD FELLINGS! People STILL have fellings, loool, even here, believe me.