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I'm looking around for a change of scenery and I saw an opening available in a speciality clinic associated with the medical center I work at as an ICU nurse. The reason I'm on here asking for some insight from you all is that I've been a patient at this specific clinic for the past couple years and intend to keep going. I really believe my primary specialist there is a leader in his field and I want to benefit from his expertise as a patient. I've been seen by two physicians in this clinic and have interacted with nearly every other staff member during my appointments; everyone is wonderful. But, I could see how odd it would be for them all to see me as a patient for this long, and then have to see me as a co-worker. I feel that this major detail would wreck my chances of being hired there. Do you think being a current patient seeking treatment would be some sort of a conflict of interest that could keep me from being hired?

Wonderful! Thank you!

EXACTLY! I feel like your statement describes the entire situation in a nutshell! I think some people who replied missed a key point that I guess I should have elaborated on: she was perfectly capable of doing it herself (to clarify, she was definitely able to reach), but she wanted me to do it instead. I provided education, stating explicitly what exactly needed to be done. I acknowledged that she might feel uncomfortable if someone else did it, and that she might feel better about it if she did it herself. I had just witnessed her washing her face, applying La Mer cream, and then some makeup. I figured if she was able-bodied enough to do that, then she would probably prefer to do it herself. I always offer set-up assistance for my neuro intact patients who are reasonably independent, because I think it would be odd to not offer it. I figured that she probably wouldn't have wanted that I touch her in such a private area (she definitely didn't want me touching her expensive face cream), and I offered to bring her the supplies so she could do it herself, with plenty of explicit instruction and support. "No, you can just do it." I'm not going to be jerk and say no (and I don't want anyone to get a CAUTI on my watch!), so I did it for her. I've had countless patients apologize to me about having to do things of a sensitive nature for them, but a huge majority of them were too sick, too painful, couldn't reach, or otherwise incapable of doing it on their own. It's no problem to help someone like that. That's why I do this job. However, this time around, I found myself offended because the patient was able to do it herself, but basically insisted that I do it for her. Then, right in the middle of it, say, "Don't you find doing this degrading?" I wanted to say, "Well... only when I have to do this for people who could do it for themselves but prefer to have "the help" do it instead!" :/

I had a well-spoken, educated woman as my patient. She had this pretentious vibe to her, but I found her to be polite. That is, until I explained that cath care needed to be done and the rationale behind having to do it.As I'm performing the cath care, she said, "Don't you find this degrading? I would never do this!" I was offended, of course. It's not like I'm a stripper or something, I'm taking care of people here. How can that truly be degrading to me? And I think I was mostly annoyed, too, because I offered to give her what she needed to do the cath care herself, but she declined. If you're not happy about someone else washing you, you'd do whatever to ensure you could to wash yourself, right? In this instance, I said, "Well, Im used to doing this sort of thing. It's important that you don't get a UTI" because I didn't know what else to say. If/when someone has said something similar to you, what did you say to them? And... What did you REALLY want to say instead? :)

But with that plan, you're assuming that she'll actually read the policy. You know, like she was supposed to BEFORE she "changed" the dressing. Haha.

Oh, I just remembered something I think I should add. If you've already been doing this, wonderful, but if someone else is reading this and is being harassed, I wanted to stress the point to you that you should document everything! Like, seriously, bring a notepad and write down anything that can make your case if you have to go to your manager or HR! At my previous job right before I took my current job, our unit secretary started nursing school, and a few months after that, she got too big for her britches, developed a rude, holier-than-thou attitude, and started condescendingly "suggesting" to very experienced nurses (like, they've been nurses 15+ years) how to do their job. Yeah, I'm not kidding. I left before it got too bad, but my friends on the unit kept me in the loop because they wanted me to go to HR with them to report everything I had to deal with before I left. My friends filed a hostile work environment claim. The secretary found out about their claim and immediately filed a sexual harassment claim against them. Why? Well, in her mind, if they were filing a claim against her and trying to get her fired, it was most likely because they didn't like her because she was gay. Her behavior had nothing to do with her being gay. No, they didn't like her because she was a crazy, mean b*tch! Anyway, her claim fell through because she didn't have any documentation that anyone was sexually harassing her (which makes sense, because no one was harassing her!). Unfortunately, my friends who had good reason to report her lousy behavior never thought to write every rude thing down that she did or said, and since they had nothing in writing, the unit secretary was allowed to come back and work after stretch of administrative leave. My friend told me it made for a very awkward work environment until the secretary transferred to another unit some months later. HR told the unit that they could see right through the secretary and felt something was off about her, and she definitely would have definitely been fired if someone wrote down dates, times, who said what, who did what, etc. But from a legality standpoint, no one in that situation had a real leg to stand on because it was basically all heresay. Backing up your claims with everything in writing definitely gives you more clout to the powers that be. If you don't, it seems to really keep their hands tied and they cannot give the appropriate punishment. Okay, off my soapbox!

I really hope your meeting stops this goon's acts right now. I can understand how co-workers get comfortable with each other and they crack off a rude joke every now and then, but most people tend to really stop in their tracks and start behaving themselves if anyone says, "Whoa, that was a little much. Knock it off." Because this guy was told to stop and keeps doing it? No excuse for that, no matter how dim you may be. I suspect he's a lunatic. I will say that you get brownie points for going directly to him first and telling him to stop privately. You can definitely use that to your advantage. Good luck to you!

A nurse I once worked with was upset one day because payroll found out she erroneously got a wage increase. She had known that she got the raise and wasn't supposed to, but she kept quiet. Someone in payroll eventually found out about the mistake. They figured out how much they had overpaid her over time, then they took the money back in installments over a few months. She was expecting us to feel bad for her, but she got no sympathy because all of us she was telling this to were like, "Hey, if you knew you got an increase you weren't supposed to get and did nothing about making it right, you were being a tad dishonest there!" You can always look in your union contract to read about nursing pay raises if your hospital has a nurse's union. Usually, it's very explicitly written in union contracts. Since payroll hasn't notified you of any mistake after so long, it's probably not a mistake at all and it's an increase you're entitled to. A $2.00 raise after six months (presumably after you made it through your six-month probation) doesn't seen that out of the ordinary. If there's no nurse's union, or if just knowing for sure would make you feel better, I'd address it with someone. But it sounds like you have nothing to worry about. Good luck!

Just last weekend, I extubated my brain dead patient. As you would expect, prior to extubation, he had no purposeful movement, no localizing, not posturing, etc. A few minutes after extubation, as his sats were dropping and he stopped breathing, it appeared to me that his entire body just tensed up severely. It looked like neuro-storming in slow motion (to me, at least). I really wasn't expecting him to actually move at all, but what I saw didn't really shock me either. I surmised that his body was experiencing profound air hunger and the movement was the consequence of that. I pushed 10 mg of morphine, and he went asystole about two minutes later. Withdrawing care from a patient is never a walk in the park for me, and I felt very gloomy the rest of the evening. Reading the OP's original question, I thought that perhaps what I experienced was similar. Does anyone agree with me?

Pretty darn interesting... I'll present this to my unit's nurse educators and see if we can get a dialogue going on what is ACTUALLY best practice!

Just letting you know that we use CHG wipes in our ICU's. We use them when inserting lines, on blood culture draws (AND on the blood culture bottles), and lab draws. We just don't really use them when pushing IV meds; we use alcohol wipes instead. I really don't know why you are being told to not to use them; it really is best practice.

I think all of us here would use some common sense and NOT post stories about male, underage patients that reflect poorly on us as the nursing professionals who care for them. Whatever a creepy pedophile wanted to hear about, I really doubt we would comply and give them any of the indecent stories that they desire. Sadly, someone like that probably knows where they can obtain abhorrent things like that online. Since I have a younger teenaged brother, male cousins ranging in age, and am married to a former Marine (who was raised in a house full of boys and no sisters), I can without any doubt state that the "gross" mentioned in the OP had more to do with BOOGERS than anything else. So to lighten the mood, here's a list of things that landed all of these fellows I'm related to in the ER, some with the possibility of an overnight stay in the hospital (cue "Jackass" theme song): 1) Inserting keys into an electrical outlet (toddler was just fine! It just dimmed all the lights in the Coast Guard Base for a few seconds) 2) Rollerskating down slide. 3) "Sledding" down stairs in a laundry basket. 4) Sliding down a slide on river rafting sandaled- feet. 5) Thinking Dimetapp has a yummy grape candy flavor, and drinking four bottles of it. 6) Deciding riding a razor scooter down a steep, grassy incline while wearing a backpack full of high school textbooks is a great idea. 7) Thinking jumping on a bed is enjoyable (they all did this, and our family has pictures of all of them with all their black eyes- none of us girls did this!). 8) Beans up nose. 9 Button up nose. 10) Bean in ear. 11) Bug in ear. 12) Accidentally swallowing Crash Test Dummies action figures heads (see: http://en.wikipedia.org/wiki/The_Incredible_Crash_Dummies) 13) Pretended that the porch was a "tightrope", attempted to "walk the tightrope" and then promptly fell off and broke arm. 14) "Homemade fireworks" 15) Offensive warfare with wiffle bats. Near misses I should include that could have resulted in injury if it wasn't for an adult stopping them: 1) Offensive warfare with claw hammers. 2) Jumping off top bunk of bunk bed holding a plastic grocery shopping bag "parachute" 3) Jumping from roof, onto trampoline, with intent of jumping on trampoline, then off trampoline, then flying through the air and landing in swimming pool. And last, but not least: 4) Feeding the very hungry arabian stallion a carrot "like a mommy bird does a baby bird". Despite what you might assume (people who are childless/was never a young boy/never grew up with young male relatives), we were not raised by terrible parents; us girls in the family NEVER got hurt and all of us are still alive to this day. I think it's just a boy thing. Now, I don't think anyone of them did anything weird, funny, or gross while in the hospital because mom was so mad at them for landing themselves in the hospital, all they did was lay there in fear and do exactly what they were told! :)

For me, it's confrontational family members or patients who get right in my face, point fingers, and yell at me over things I cannot (actually, NO ONE, for that matter) can control. I think an adult yelling at a professional who's doing their job to help just shows a lot of immaturity and weakness in that person, and I can't help but think those type of people are really close to physically assaulting whomever they're unleashing their rage onto. And the threat of getting physically assaulted is what really scares me. Sometimes they do swing, but it's just the ones who are, without a doubt, actually mentally ill. I've been lucky everytime so far; I'm just good at ducking and running!

Thanks, everybody! All your comments really contribute. To clarify, DH documented something along the lines of, "Hospitalist paged a second time per Code Team/ED doctor's request. Hospitalist called unit approximately 5 minutes later, stating over phone to this nurse, 'I'll be there in 20 minutes. I left the hospital to get a cup of coffee.' Message relayed immediately to ED doctor." And with regards to what xtxrn mentioned above, I suspect my husband's charge told him to document it in the patient's chart because there's probably very few nurses at this hospital who really trust that an incident report will actually be filed. I think it's easier to "lose" an incident report that incriminates a doctor than it would be to "lose" a piece of a patient's chart.

My husband is a nurse who works at a different hospital than I do, and he been there a few years. We're just biding our time until he can find a job at a different place. The stories he tells me about what he has to put up with makes my hair curl. I would love to tell you a few nightmares that stick out in my head just to feel better from venting about them, but I really wish for advice or perceptions from any experienced nurses and anyone in nursing administration on this one incident that recently occured. A patient (not my husband's) unfortunately coded early in the AM on NOC shift and this patient did not survive. This was a major shock to everyone involved; this patient, even though in their 60's, was rock stable, and was awaiting to go to surgery to have a lap chole. The protocol at his facility is that the ED physician comes to the unit to run the code, but the hospitalist (who's the patient's PCP during night shift) needs to be present to help recount patient's history, work through H's and T's, etc. The hospitalist on shift is notorious for being sub-par (writing the most ridiculous orders, taking forever to call back when paged, etc.) and did not arrive when paged for this code. This was no surprise to my husband, because he overheard this particular doctor say once, "Oh, it's silly for me to go to my patient's codes, because the ED docs always run the codes anyway." The ED doc asked my husband to page them again. He did, and when they called back, the hospitalist said to my husband, "I'll be there in 20 minutes (!!!)... mumble...mumble." He said, "I didn't hear what you said." And after some more coaxing, they finally said, "I said, 'I'll be there in 20 minutes (again... can you believe that crap!?). I left the hospital to get a cup of coffee." My husband relayed that to the ED doc and, of course, the ED doc went nuts. Apparently, leaving the hospital while on duty is typical for this particular hospitalist, but this ED doc only had heard rumors until now. He wanted the whole incident written up, and rightly so, because from what my husband understood, there was no way anyone could have foreseen this patient dying. The charge nurse (who was this patient's nurse) encouraged my husband to document the phone conversation in the patient's chart, and as a result, all of the hospitalists are mad at him now for documenting it. His nurse manager has just given him a warning, and I think this is just another incident that's going to make him look harder for a job elsewhere. I'm just baffled and I don't know what to tell him. I work at a large university hospital, and I usually have to kick doctors out of codes for just being in the way and gawking, so being told about there being not enough doctors at a code is foreign to me! My biggest question is this: Do you think it was wrong for my husband to document the phone conversation? I feel like all objective data should be documented, and that this doctor has been playing with fire for a while now and should pay the price for their negligence. Even if their presence probably wouldn't improve the outcome, I still feel that they should have been there. I also feel that since the hospitalists are employed by the hospital, they should NOT leave the hospital for any reason whatsoever, and certainly should notify another MD to sign out to them if they absolutely have to. I can understand how it can be viewed at "tattling" by the hospitalist team, as well, but hearing about this "'good ol' boy mentality" among the hospitalist team ticks me off. What do you think of this situation? What's protocol at your hospital? Thanks everyone!