SUBQ

If you feel that it is unsafe...than by all means go by what you feel. I quit an excellent paying job due to unsafe staffing to patient ratios. It is your license and the patients life that is at risk.

It is far easier to quit a job like this one and find another one than it is to get your name and license tarnished by working for a cut-throat hospital. They will pay dearly for there mistakes. They will find out the reality that when you cut cost by cutting back on nurses and aides, that morale goes down the toilet: med errors increase, people call in sick more often, people quit, transcription and procedure errors will rise and what little they saved by cutting costs--will kick their A$$ in lawsuits!!! Think about it...

I have a little down time so I'll cast a peeve of mine. I just can't stand anyone who comes to work with cologne or perfume. Don't these people know that in a hospital that there are patients w/ respiratory problems, and that the odor could trigger a bronchospasm? One other thing: Nurses and their damn fingernails. I can't count how many nurses that I have worked with who have long NASTY fingernails. Not that I object to pretty fingernails; however, nursing is not a place to be sporting long fingernails. As we all know, long fingernails are not sanitary and therefore can promote nosocomial infections. So in another words, don't wear the Channel No.9 and those skanky Lee Press On Nails to work.

Hey: I just quit my job in 1-2000. I was tired of having my license being put at risk--so I quit. I came to work and was assigned 12 heavy patients. The normal is 8. They refused to bring in help. Therefore, I quit. I flat out REFUSED the assignment. The bottom line: If you accept the assignment, you can and will be held accountable for those patients. If you can't take care of the patients, you better walk...it is better to lose your job than it is to lose your license; or worse, a patients life.

Is losing your license worth dealing with a psycho co-worker? These are the kind of people that will see too it that you not only lose your job--but lose your license. If you can't change the situation: then its time move on to somewhere else. And all that jazz about doing the job of 2 or 3 nurses--that not only comprimises the safety of your patients, but it will catch up to you. You will find that all sorts of errors will multiply when you take on more than you can handle. You may think that you are doing ok--and so far no one has gotten hurt or nothing bad happened--but it will sneek up on you and you will be in a situation that you had not planned on and BAM!!!! someone codes, or everything that can go wrong does... That is part of the problem in nursing: too many nurses don't know when to back off. If you come to work in a place that you feel that your co-worker is trying to do you in and they are making work more than you are scheduled and short staffed...then its time to move on!!!!!!!!! You can get another job. But once your license is gone: IT IS GONE. And once someone is dead. You can't bring 'em back. Either fix the problem or get out. Otherwise, you are just asking for TROUBLE...

I get this kinda thing all the time. It reall cracks me up! How many doctors take their pts. to the restroom? I have several pts. ask me if I'm their M.D. after I take them to the restroom and help them wipe their tail. ------------------ http://members.tripod.com/~SUBQ/

Hey: Sorry to hear about your troubles. I think what the problem was--was that your patient is a nurse. And some nurses just love to let other people know that they are nurses. I would much rather keep quiet when I'm a pt. and not let on that I'm a nurse. That way I can tell if I have a GOOD nurse or a GOOD P.A.C. or A GOOD M.A. I don't know why it is; I can just assume that it is some self-righteous character twitch--that wants to flaunt their status in front of others. I once had a pt. who was a retired nurse. When I introduced myself as her nurse she said "so, are you a little vein nurse or a real nurse." I asked her to clarify what she meant by that: she more or less told my that an lvn is a glorified cna and not a real nurse. Well, I guess she graduated from "old school" nursing. Where LVNs were limited in the scope of their responsibilities. I brought her up to speed that just about the only thing that we can't do in our area is hang blood. We can push IV meds; be charge nurses; start IVs; hang tpn; insert ngt-corpaks; draw blood...you name it. Just can't hang blood. You are always gonna come across these types. The best way to handle it is w/ a grain of salt. There is always someone somwhere who wants you to know that they perceive that they are higher up in the food chain than you are. Forget about it...

Are you serious? ------------------ http://members.tripod.com/~SUBQ/

Hey: Follow this link http://www.salary.com/home/layoutscripts/sall_home.asp Select Healthcare and Practitioners. Then select the state that you want to work. That should give you an idea of what the payscale is for that area. Later, SUBQ! ------------------

OK, I have what seems to be a logical argument from Canoehead. I have inculede Canoeheads post from below and will answer the questions that Canoehead posed: Canoehead Writes: canoehead Wait. What are the alternatives? He informs the charge nurse that he cannot accept this assignment, then what? There is no one available to take the overflow. So does he wait until they assign him fewer patients, but the most acute? That is even worse. If he says he can take these 8 but not these 4 do they need to agree, or is it his call? (I don't think so) If they say this is it, suck it up, does he go home, leaving everyone, and losing his job? Is there recourse if he is dismissed for insubordination? If he properly goes up the chain of command without results who outside the hospital is prepared, and has authority to make the changes. While he's doing this, and falling further behind what is happening to his patients? (abandonment) If he takes report has he "accepted the assignment" and now is abandoning them. If report is not given how can he say he can't handle the load? It takes balls of steel to take a stand against admin, and sometimes your coworkers. We need more information before jumping into this lava pit. Ok Canoehead, First of all the nurse is aware from expereince that 12 acute pts. is 4 too many. After all 8 is the normal load. This nurse should use good judgement and should NOT accepet this assingment. Therefore he is in no way falling under the term "ABANDONMENT". While he goes through the chain of command he informs his charge nurse and CEO of the facility that 12 is dangerous and unacceptable: quality nsg care WILL BE COPMROMISED! They balk and tell him "thats just the way it is" He is FUMED! However, he suggests that his hospital call in a PRN AGENCY NURSE to get them thru the crunch. Once again they balk. They state: "that's not how we do things here, it is not in our budget, and you'll have to suck it up and deal w/ it. the other nurses have been working short as well." This is usually the argument. And one that I have been thru personally. I walked out of an assignment just like the one described above. However, the one above is fictional and was used to illustrate a point that so many nurses cave in and accept these unacceptable assignments w/ little concern for what may possibly happen during a shift: Its what I like to view as the worst case scenario. Although not a pessimist, I am a realist and when I come into my facility and start to get report, I look for RED FLAGS! If I find that the pt acuity is TOO HIGH or I have received and overwhelming load, I ask that the schedule or assignment be changed. Unfortunately, the last time that I asked for a schedule change--when I was assigned 12 bedfast pts--all with high co-morbidity factors, I was denied. And I said the hell with it. Because I looked at the worst case scenario for this group of pts. and it did not look to good. There were too many negative factors that could have triggered a night of horrors! I also looked at the best case scenario. And I could not foresee anything positive happening for these pts this shift. All of them would have received less than adequate care. I did not go to school and graduate to give less than adequate care. I give EXCELLENT PATIENT CARE! Or I do not give care at all. Now, another argument is: what about my co-workers? I'm leaving them hanging by not accepting this assignment. True! However, I did not go to school to take care of healthy nurses. It is sad that they are left in this position; however, they could have walked as well. But they did not. They decided to stick it out--take up the slack and keep on trucking. They were lucky. No one coded. However, I know for a fact that every single pt suffered in that hospital that night. I know that they received less than adequate care. However, THE HOSPITAL IS RESPONSIBLE TO THE PATIENTS THAT THEY ADMIT. IT IS THEIR RESPONSIBILITY TO STAFF IT ADEQUATELY SO PATIENTS RECEIVE QUALITY CARE. However, many nurses cave in under pressure and continually accept dangerous pt loads. AND THAT MY FRIEND, CAN COMPROMISE SAFETY, LIVES AND YOUR LICENSE. I quit my last job due to a nightmare situation just like above. And guess what? I have had more than 5 offers to go work at other facilities. And all of them know that I quit my last job w/o a 2 week notice. As a matter of fact, everyone that I have spoken with has commended me for doing so. So if you are faced with a similar circumstance, I can't tell you what to do. However, I can tell you this: THAT YOU CAN LOSE YOUR LICENSE FOR BEING OVERBURDENED. AFTERALL, ITS YOU THAT ACCEPTED THE REPORT AND ACCEPTED THE ASSIGNMENT. Its your license...think about it

3-11PM. Don't need an alarm clock to wake for this shift. ------------------ http://photos.yahoo.com/bc/douglas_jones_1999?e&.intl=us&.flabel=fld4&.from=d&.pindex=3&start=1&.src=ph&.done=http%3a//photos.yahoo.com/bc/douglas_jones_1999%3fd%26.flabel=fld4%26.intl=us%26.src=ph

I really don't care if someone has piercings or tatoos. What I care about is: does that nurse know how to give quality care? Personally, I don't understand why anyone would want piercings on the brow. I can't understand nose piercings. How can someone pick their nose with a nose ring? It seems like boogers would get encrusted around the stud. But, really I don't care. Just as long as someone is competent. That's all that matters to me.

I'm hoping to increase nsg awareness on the topic of defensive nursing. Most of you are aware of defensive charting practices. The practice of stating facts--not opinions. However, many nurses seem to throw caution to the wind when they accept nursing assingments. I have observed many nurses trying to handle dangerous heavy pt loads. Loads that are so high and unsafe that pt care is compromise. One example is nurse Jane Doe or John Doe comes into work and is assigned a dangerous asignment of 12 patients instead of his normal 8. Being a kind and thoughful person, he naturally decides not to let his co-workers down and accepts the assignment. However, his kindness can not effectively manage to do his job in a manner that is deemed safe. As a matter of fact, many of his patients do not receive prn meds in a timely manner; treatments are delayed; and numerous Now and Stat orders are on his charts wating to be noted. Furthermore, he is so swamped that he is not able to CHART AS THE SHIFT progresses; therefore, he forgets to chart defensively and accurately. As the shift progresses, the nurse is constantly besieged by his patients to come to their aid when they use the call light. As a result of this nurse being swamped, he cannot pass schd meds on time and is often very late passing prn pain meds. His patients are frustrated because they are not being waited on in a timely manner. And as a result, complaints are filed against this nurse. And to top it all off, he has a patient code which later died. He also had a confused patient crawl out of bed and as a result of confusion and overall general weakness, this patient is transferred to ICU for head trauma. As a consequence to the fall that one patient received, that patients family decides to sue nurse John Doe and the hospital that he was working at. Another family is also pursuing a claim of negligence d/t their beloved family member not receiving prn pain meds until a hour after requesting them. Keep in mind that John Doe is a excellent nurse but has bit off more than he can chew by accepting this assignment of 12 patients who are all over 65, have high co-morbidity factors, are all bedfast and need constant one on one supervision while they are using the restroom, who need patient teaching, need f/u on schd insulin, etc. John has been informed that he is named in a suit for negligence, For the patient who fell and later went to ICU and died. He is also named in another negligence suit d/t not giving prn meds w/in a resonable amount of time. The suit states that the patient suffered severe emotional distress as a direct result of not being medicated in a timely manner. John, was not trying to give less than quality care. As a matter of fact he is known for delivering exceptional nursing care. However, on this fateful shift, John was overwhelmed w/ stat and now orders. He also had to start IV's on several patients and was also monitoring a pt receiving 2 units of PRBC's. He was also overwhelemed by having to answer call light after call light. John had one aid and that aide had 16 pts to care for. John was unable to get assistance from his coworker, for they were overwhelmed as well. Johns charge nurse could rarely offer John any help for she was tied up with her duties. So to make a long story short, John did the best that he could with what he had. However, his best was not good enough for John could not keep pace with the problems that arose. QUESTION: Could John loose his license as a result of the events that transpired on his shift? Yes! Even though John did every thing that he could to keep pace w/ the mounting problems, he invariably was unable to monitor his patients--to access for changes in status--on a regular basis. Except for the quick focal assesment that he gave everyone on arrival to the floor, he was unable to give head to to assessments. Remeber John was responding to now and stat orders. And also monitoring blood, as well as answer call lights, etc. Do you think that John could possibly loose his license? Do you think that John could face criminal charges? Yes, to both above. No matter how kind and compassinate John is. John made the fateful error of accepting a pt load that he could not handle. Therefor, as a cosequence, a patient died, and another did not receive prn meds on time. Attorney's have won their settlement, John's nursing insurance paid the claim. However, the nursing board in John's state found him liable for negligence and providing inadequate nursing care and has revoked his license and to make matters worse criminal charges are pending for negligence. Is this fair? No. John should have made his charge nurse aware that he could not handle that many patients. But out of fear from termination and out of fear for letting his co-workers down and out of pity for his patients, John accepted the assignment. Accepting the assignment was John's undoing. He placed fear from termination and fear from not being their for his coworkers above the safety of his patients. And now John is facing jail time, and lost his license to practice. But John being naive, accepted the unacceptable. Afterall, he has seen countless other nurses do the same thing. And on several other occassions, John accepted more pts than he normally gets--and not once did anything major happen. But see that's the problem: no one comes to work ready and prepared for the worst case scenario. But nurses, I don't know about your state, but the state of Texas sends out quarterly newsbriefs on LVN nursing and in these briefs there are countless pages of people who have lost their license by putting themselves in a jam. I have seen instances where nurses lost their license d/t not giving a prn med on time or d/t a pt falling resulting in death. Your license is everything. You worked hard for it. Don't make the mistake that John did. He tried to be SUPERNURSE. Everyday hospitals are constantly asking nurses to accept higher and higher loads and nurses give in; however, it can be to their own undoing. This story is not a real story. Howver, it could very well happen. And I'm sure that countless nurses have lost their license by being suckered into accepting assignments that are too dangerous. It is your license...Think about it.

Julie w. You totally understand what it is that I'm TRYING to convey. Your point on "nurses writing each other up over a missed med vs. just giving the fricken med" is just one of the many different illustrations that I was trying to convey to zdjoe. He wanted an honest opinion. I gave it. >>>>In know way did I mean to insult women TRAMA R US: You are a PRIME example of just how unsympathetic nursing can be. What in the hell do you mean "get out of nursing if it does not meet my expectation"? It has nothing to do w/ meeting my expectation: IT HAS EVERYTHING TO DO W/ QUALITY PT CARE. It has everything to do w/ being an advocate; not a passive A$$kisser. And while your at it TRAMA R US, why don't you go ahead and discourage other nurses who want to vent their opinions. After all, its nurses like you who can take on any number of patients and keep on trucking. 'Ah hell, it don't matter if someone gets their pain meds when they ask for them--know one ever died from pain' I can't tell you how many times that I heard that phrase from a SUPERNURSE. Ok, and finally I get to Tracy RN: another prime example of someone TAKING WHAT I SAID OUT OF CONTEXT. I was using the point that COPS generally stick up for one another. Its called TEAMWORK. I was not in any was inferring to whether cops have a wonderful LEAVE IT TO BEAVER home-life. I'm sure that EVERY profession has its STEREOTYPES. Yeah, I'm sure that there are a lot of cops who go home disgruntled, knock down a bottle of Jim Beam and crak their old lady over the head w/ the bottle. But that is NOT what I was refering to. I was refering to TEAMWORK. But once again, some little ms. no it all, half a$$ed read my thread and went off half-cocked. Damn, its no wonder so many med errors are made. If you can't read a post and figure out what the main THEME is, how in the hell can you read an order and not read into it something that is NOT THERE! GO BACK AND READ MY POST AGAIN. DAMN! HERE IS YOUR FUNKY OPINION ABOUT COPS: HOW IN THE HELL YOU SPUN THIS TWIST INTO MY THREAD--I HAVE NOT A CLUE. I have to dispute the glowing example of cops being paragons of virtue. A worse group of good ol' boys cannot be found for the aforementioned sins that are attributed mainly to women by SubQ. Ask the spouse/SO of any cop and they will tell you the same. The biggest difference is that, even if they hate each other, good cops always back each other up when in need. Perhaps that's the lesson we could take from them, SubQ.

KdaY: You obviously have no sense of perception. You read into my statements what you want to. You said that every statement that I have made on this site is negative and hostile. Well, I hope there is some sense of hostility in my tone. It is obvious that being a passive A$$ kisser is not the path to take! An this thing about a male utopia, what the hell is that? Telling me to join the police force, who are you to tell me what to do? And that wise a$$ comment about MD's not gossiping: that's a damn shame, any nurse will be quick to tell you that MD's whether they be male or female, are less likely to get caught up in gossip. That is not to say that they don't. However, if you are working in a hospital that has MD's that have the time to spat gossip, let me know where it is so I can steer clear of it. The majority of MD's male and female have little time for chit chat--their busy. And as far as good riddence: you would bend over a$$ backwards to work on my shift. I have enough compassion for my patients that I'm not stupid enough to place them in harms way by accepting some dumb A$$ dangerous assignment. Not only that, the CNA's that I work w/ look forward to being assigned w/ me because I help them--not just delagate tasks for them to do. My co-workers always seem to forward to my being there as well. They tell me how much they appreciate my help and my strong opinion. As a matter of fact, I had several of them encorage me to take a stand for the diservice that we have endured. They implored me to write a letter to show our disdain for being assigned unacceptable assignments. They know that I back my word up. That means if I have to raise hell and write letters that it will be done. I don't sit back on my lazy a$$ and gossip. I work. I don't co-enable a corrupt system--I buck it! I don't know what your agenda is, but it seems to be clear that you have no concept of how to READ A LETTER. You don't seem to understand that facts speaks for themselves. This is a F/M dominated proffession: that is a fact! It is a FACT that FEMALES get the short end of the stick--not always, but mostly. And this short end of the stick is in relation to equal pay for equal work. That also translates into females not having a loud enough voice to be COUNTED! That is a FACT. Just like it is a fact that it was not that long ago that women was allowed to VOTE. That is a FACT! I am saying all of this not to discredit women. I am saying all of this to illustrate a P-O-I-N-T..................... To contrast the difference between it being a primarily FEMALE dominated profession--and what men are normally accustomed to in the work place. I have worked in construction, warehouse, cafes, grocery stores, you name it. However, NO OTHER JOB THAT A MAN ACCEPTS WILL PREPARE HIM FOR WHAT HE WILL EXPEREINCE WHEN HE FINALLY SWITCHES FIELDS LIKE THE NURSING FIELD. THE GUY ASKED A SIMPLE QUESTION. HE WANTED SOME FEEDBACK. AND INSTEAD OF HITTING HIM WITH THE USUAL: "OH ITS A WONDERFUL OCCUPATION, AND YOU'LL LOVE IT", I DECIDED TO GIVE THE GUY A GUYS PERSPECTIVE OF HOW IT IS. I TELL YOU WHAT, SUIT UP FOR THE DALLAS COWBOYS, AND PLAY A COUPLE OF SCRIMMAGE GAMES WITH THEM AND THEN COME BACK AND GIVE ME A WOMENS PERSPECTIVE OF A MALE DOMINATED SPORT. BETTER YET, TELL ME WHY WOMENS SPORTS TEAMS ARE UNDERPAID? IS IT BECAUSE THEY ARE LESS OF ATHELETES THAN THEIR MALE COUNTERPARTS, OR IS IT THE FACT THAT THIS IS ANOTHER ILLUSTRATION OF HOW WOMEN GET THE SHORT END OF THE STICK. HELL, I'M IN THEIR FIGHTING FOR YOU GUYS; BETTER WORKING CONDITIONS AND ALL. HOWEVER, I CAN NOT MAKE THINGS BETTER BY IGNORING FACTS! AND ONE OTHER THING, YOU SEEM TO THINK THAT I'M DISRESPECTING WOMEN. THAT IS B.S. THAT IS YOUR OPINION. I LOVE WOMEN AND I KNOW THAT SOCIETY WOULD CEASE TO FUNCTION PROPERLY IF WOMEN AND THEIR RIGHTS ARE IGNORED. BUT ONCE AGAIN, I'M SURE YOU'LL FIND FAULT WITH MY MESSAGE. BUT BEFORE YOU READ INTO THIS MESSAGE WHAT YOU WILL, TAKE YOUR TIME WHEN YOU READ IT. READ IT VERY CAREFULLY. AND REMEMBER THAT THIS IS WORDS WRITTEN IN CYBERSPACE, AND LIKE ALL WRITING IT IS SUBJECT TO INTERPRETATION. KINDA LIKE THE BIBLE: DAVID KORESH THOUGHT THAT HE WAS THE MESSIAH, AND ALL OF HIS FOLLOWERS MISINTERPRETED THE BIBLE--JUST THE SAME WAY THAT HE DID. SO PLEASE, DON'T MISINTERPRET WHAT I HAVE SAID. GOD BLESS YA!!! SO JOE, NOT TO DISCOURAGE YOU, BUT WHAT YOU READ ON THIS BOARD IS A SMALL GLIMPSE OF WHAT THE PROFESSION IS REALLY LIKE. I TOO WANT TO MAKE A DIFFERENCE. I ENJOY SEEING A SMILE ON SOMEONES FACE THAT I CARE FOR. I LIKE DOING MY JOB--THAT IS WHEN IT DOES NOT INFRINGE UPON COMPROMISING MY VALUES. HOWEVER, THINK ABOUT IT VERY CAREFULLY. LOOK AT ALL THE NURSING SHORTAGES ACROSS THE NATION AND ASK YOURSELF THIS ONE QUESTION: IF IT IS SUCH A COOL PROFESSION AND PEOPLE REALLY GET JOB SATISFACTION LIKE THEY SAY THEY DO LIKE: PUTTING SMILES ON PATIENTS FACES AND MAKING A DIFFERENCE IN SOMEONES LIFE; AND THE MONEY IS SO AWESOME--THEN WHY IS THERE A SHORTAGE? SIMPLE: NURSES ARE ASKED TO WORK LONG AND DANGEROUS HOURS, HANDLE UNSAFE PT LOADS, AND ASKED TO COMPROMISE VALUES. WHERE IS JOB SATISFACTION IN THAT? THAT IS WHY THERE IS SUCH A SHORTAGE... IT WOULD BE A GREAT FIELD TO GO INTO IF ONE COULD ACTUALLY BE THE NURSE THAT THEY SET OUT TO BE.