psu_213

First, any time the system does not register the patient correctly or deletes the memory, I would enter a safety occurrence (I'm totally blanking if this is the correct word--whatever your reporting system is for safety issues). Hopefully your facility takes those seriously and will investigate. For the issue of alarm fatigue: is it possible to change the parameters for when it alarms--for example, can you change the low limit to 85% for SaO2 for the COPD patient that always runs low?

I guess that as a clinical instructor, she has been asked before for letters of rec, so I don't think that asking is 'needy.' I would go to her in person rather than asking via email. Compliment here without being fake/sappy ("I've always appreciated being in your group for clinicals," or whatever). Give her anything for the residency program (where to send it, a form they may have, etc.), and ask her if there is anything else you can get for her (she may ask for a resume or a letter with your intentions for the programs(s), etc.). A few weeks later, write her a personalized thank you note (I think cards work better than e-mail for this) whether or not you get into the residency program.

No HH experience here, but I, personally, would refrain from calling out a person by name in a shared document. In an email to your supervisor(s) sure, but I feel like if you use the nurse's name in the log, the log could just spiral downward and become a forum for "tattling" on fellow employees.

The 'A' part of A&O should be pretty easy to figure out. As for the O part--is he able to communicate in any way? If so, would you be able to test him on the various spheres of orientation without him actually speaking answers? While it is easy just to be able to say A&Ox3, it is more than just a "check box" type of assessment.

I added numbers so you could more easily see what I am referencing.... 1. If this happened, obviously it is totally inappropriate. However, unless you actually witnessed her lie about her identity--she says "Yes, this is Sally Smith," when she is actually June Jones--then there is really nothing you can do. At this point, it's just gossip...no matter how much you trust whomever told you about it. 2. If I were the potential employer, I would expect the reference to "tell the truth." If I were to ask about weaknesses, and the reference says "she doesn't have any," then that would, in my mind, put the validity of the entire refence into question. Everyone has weakness, and I would think that "anxiety under pressure" is a fairly common one. 3. Not my place to tell you how you should feel, but this feels a bit extreme. Don't let this person's petty behavior take up room in your mind; especially since all you have is 2nd or 3rd hand gossip.

Uhh...no. He can not bring it inside in the first place, or he can hand it to security. Any delay would be his fault. But it is very American of him not only to have a misguided view of the 2nd Amendment, but, furthermore, believe that he will prevail just because he says "lawsuit."

Yeah, that's what I don't understand. I do agree it is not appropriate (in any situation) to have a phone conversation on speaker phone without all involved parties knowing it is on speaker phone. But it seems pretty straight forward to me: "are we on speaker phone?" "Is anyone else present." If you don't want someone else present "I cannot continue this conversation on speak phone with someone else there."

Perhaps it was flagged in the system that this person was opening a bunch of charts of people who weren't active patients in her unit. That caused IT/informatics/etc. to dig deeper...

First, to the OP, no reason to feel guilty about having a day off. Exactly what I was thinking. Just looking at it from a process stand point--why was it delegated to 6 people? This is sounds like the classic "everyone thought someone else would do it, so no one did it." Also, it sounds like it is important to evaluate how information and "to do" tasks are passed on from shift to shift.

Is your hope to move to a permanent unit in this hospital or to move to another facility all together? If they are serious about this "verbal contract," they might be fairly unlikely to let you leave the float pool, but stay in the hospital. You can ask your supervisor though, share your concerns with her, and be honest about why you want to leave the float pool and move to a steady unit. If the hospital practices in the "sprit" of Magnet, they are more likely to let you make the change. If you did not actually sign a contract, there should be no issues with getting a position at another hospital and leaving this position behind--easier said than done, I know.

Of course many of use earned our antibodies the old fashioned way for that one. ?

I don't have any words of wisdom about this particular situation, and I hope it works out well for you. However, let this be a warning to others--just don't post anything at all about work. Period. Even saying "it was a tough day at work" or "this one patient today...." can be taken out of context. Just stay away from it!

Is this LTC. It has been a while since I worked in LTC, but do you take everyone's BP every day?

Don't take this as a defense of the hospital, merely a statement about this particular article. I'm not saying the article is wrong, I'm not saying that this actually is a good hospital. I am not a expert in pediatric cardiology/cardiac surgery; however, I do know that it complicated. I think it may be a bit unfair to compare numbers from one facility to the next without any sort of context. When I was a kid, the local paper in my hometown of approx. 100,000 people published data on the cardiac surgeons from the 2 hospitals in town. They singled out a surgeon who had some of the worse mortality numbers. It was brought to my attention by a family member (who was not involved in the data and has no connection to the surgeons, other than the fact she worked in one of the hospitals--the one that this particular surgeon did not work for) stated that this doctor is known for taking high risk candidates, which was reflected in his data. We can certainly question his judgment about taking high risk patients, but the article basically said, "his number are the worst, don't go to him," with no context or background given on said numbers. Again, I'm not saying everything was fine at this hospital in Florida, but I'm going to reserve passing judgment until we know more about the nature of the patients--which is information we may never really know.

180? Yikes! So glad I can accrue more. I think it stinks that your cap is so low, but it seems to be and easy problem to work around. As others have said, plan you time so that you have to use hours. Take a calendar week off rather than taking parts of 2 weeks, so that way you are forced to use PTO. Try taking a day here and there to give yourself long weekends. If you are taking Wednesday through Monday off, add some days immediately before and after these days. However you decide to do it, I don't think you should have to be forced into a situation where you lose PTO.

What drove me nuts was how he would always announce what he believed was the correct diagnosis with certainty. For example, "it is amylase transference disease. Give him steroids, he can be discharged tomorrow." Umm, we are only 15 minutes into the show. That is not it. For someone who is supposedly so smart, he does this over and over. Oh well, dramatic license, I suppose. Anyway, the team finds out House is wrong right as one of the doctors is getting ready to push the steroids, which is the biggest inaccuracy of all!

I would agree if this happens repeatedly, but the OP states that she does not feel safe driving nor caring for pts. Just the driving issue alone: call me selfish, but I would't want to be hit/injured/worse by someone who fell asleep at the wheel, even if they are on the road with the best of intentions. If she can't work it out down the road, sure the employer is well within their rights to let her go. For this occasion though, I say this would be a justified call off.

And in other news: "a nurse gave medication that is frequently used to commit suicide. That medicine is called acetaminophen."

Makes me grateful that at my hospital, one of the written pt responsibilities is that the patient will "accept their room assignment." Refusing transfer is not an option.

I put the pills in a plastic med cup, nestle in another plastic med cup on top of them, and use the butt end of a 10cc syringe to press down and crush the pills.

I've never personally have a problem, but I do my best to make sure that I am not going to make a cloud 'o crushed pills.

A lot of individuals have a low HR when then sleep. Does he also have episodes of this when he is awake--i.e., go suddenly from awake and alert to unresponsive with a low pulse? Report it to the physician, but in the end, it is going to be a cardiologist's call as to whether or not this individual needs/gets a pacer.

I found House (for the most part) entertaining. I found ER (for the most part) entertaining. I also realize they are, besides for some scientific truths, very poor representations of real life medicine/nursing. If you are suspending disbelief, they can be fun, at times, to watch; however, there are too many plot elements that are introduced purely for drama that they make the show difficult to watch if you are looking for "real" critical thinking.

Speaking as someone who was responsible for approving schedules (after the scheduling committee constructed it) in a fairly large department, this statement is a bit unfair. We had a robust weekend program on nights, so most straight night shifters did not have to work many weekend days. However, there were so many different preferences, there were times that people did not get what they wanted. Some wanted 3 in a row...some, absolutely not. Some wanted 2 on, 1 off, 1 on. Some wanted every Tuesday off. Some didn't really care, but made requests now and then to attend functions with their child. While the best effort was made to accommodate all those various preferences, there were times when people did not get what they wanted. If people didn't get what they wanted, it was not because I was not flexible or that I was not spoon fed; it is because the #1 priority is staffing the department, and sometimes that means some preferences are not reflected in the schedule.

Everywhere I have worked, unopened meds are returned to the Pyxis under the pt's name. If the packaging is opening, it is wasted under the pt's name (not witness required if not a controlled med), and the med is disposed of per policy (trash, sink, wasted med bin). I did work one place that had a mailbox style bin for wasted/unused meds. The med still had to be wasted in the Pyxis. Either way, ask you manager about the correct policy. I like the idea of doing by email to keep a "paper" trail.