Melanin

Ugh! So yesterday at the end of my (day) shift, the MD ordered a PCA. I am new on my unit, so to assist me, another nurse grabbed the pump, key, and medication & had me program the PCA while the other nurse verified that what I programmed in matc...

I work in ambulatory with surgeons, and I have been told that the RNs should not venture so far as to recommend conservative pain relief strategies such as icing or warm compresses because we are practicing "out of our scope." I have approached a sur...

That's what I was thinking - wait for a year (or maybe two) and then look elsewhere. It would be nice to leave this behind me because even if the new place was short-staffed and crazy, if the MDs behaved as though we were on the same team it'd make a...

Whoah whoah whoah- I very much appreciate the strong, kind wisdom and concern, but I am NOT suicidal! I was talking about how stress shortens our lives. Thank you very much for supporting me, you awesome nurses. I may well try family practice next. ?

I don't think reporting people is a good first step, either. At my practice, the surgeons have made a practice of reporting the RNs directly to our manager who then passes their complaints along to the RNs every week at our meeting. Some complaints a...

Ha ha, that explains a lot. It looks like you have some experience. I'm pretty new (5 years now, second career). Thank you!

Ok, I should probably explain myself better in regards to the "I don't care" thing, since I don't want people to assume that I fit neatly into the (apparent) stereotype of the RN who asks a million irrelevant & stupid questions - at least, not in...

I sometimes do that if the patient has an upcoming appointment within the next few days, that's for sure! It's a bit of a Catch-22, because the surgeons don't want us to pester them with questions they think we should be able to answer, but they can ...

Maybe I don't understand it either. . . basically, we field all phone calls and messages from patients and if it seems like the patient's complaints warrant a visit or trip to the ED we send them on. But we also provide a lot of advice and anxiety ma...

I hope that made sense. I am a triage nurse who works in an outpatient clinic with providers who provide numerous interventions, including surgeries. I don't work in the operating room.

I work in an ambulatory setting in a specialty where patients come in for treatment. Sometimes the patient needs surgery. Sometimes over the course of the years they need repeat surgeries. Sometimes the patient needs to try medications for a while to...

While I know that they are busy and I admit that reading the room isn’t my greatest talent, I do know that I am not chatty and I have been told that I need to be more forward and ask more questions. Although now that you mention it, maybe I could hav...

This one was a heparin drip, and I misread the order, which said that if the factor Xa is above ___, turn off the heparin for 60 minutes and then restart the heparin but decrease the dose by 300 units/hour. Well, I for some reason I read the order as...

Understood. But like I mentioned, if I review charts before clocking in, as has been my habit, I have been warned by other RNs - some in a kind way, some in a sort of "if you don't get off my computer, you'll regret it" way - that I could get fired f...

That sounds like a great system! It would help so much!

True! One barrier I run into is that we're expected to start the shift by taking report at 0700 so that the night shift can leave by 0730 - which seems like plenty of time, but there's a lot going on sometimes. . . From 0730-0800 we start passing the...

That's a very good question. I wonder if we could have a certain allotted time in the am to examine all the contingency orders and get the straight, rather than being expected to pick them up on the fly. That is, I don't regularly have enough time du...

Nobody was harmed (thought the potential was there). I made an error that the next nurse caught for me an hour too late, which could be a good learning experience, except that it sucks to have to learn this way. My facility is very punitive, so I fig...

Ugh, one thing that has happened on my unit was that I was ordered in writing to get a signed consent for a patient who was A&O x zero/1. So I had to spend a lot of time trying to find a responsible contact, leaving a VM for that contact, receivi...

Wow, this is confusing - at my facility, before a patient goes for an EGD (for instance), I'm pressured/expected to obtain a signature for consent for 1. surgery (procedure) and 2. anesthesia. Most typically, the patient is picked up for the procedur...

Yeah, I'm pretty bad at delegating & dislike having to do it when I don't have a relationship with the person yet but sense that they are testing my boundaries.

I just transferred to a new unit, and yes, I realize it takes a while to fit in and maybe I'm being tested, I don't know. Anyway, one (of many) incidents stands out - I came into a room during morning med pass to give a patient a bunch of medications...

When I was new at my hospital, I called an MD and after identifying the patient about whom I was calling I didn't give a complete SBAR, because I guess the MD seemed to indicate at the beginning of our conversation that he was familiar with the patie...

I sometimes get caught between what the managers keep harping on us to do, as opposed to what makes sense at the time. In meetings, managers love to bring up MD complaints about nurses who aren't consistently giving SBAR, but it sounds like SBAR is s...

I appreciate the feedback - they act like it's a huge deal & while I know I need to be super careful, sometimes I can't tell if/when I'm in big trouble. . .