jannecdote

When I worked nights in our LTAC med/surg, we got 8 to 9 patients each with usually one or two RN's. A staff RN demanded safe harbor one night, stating she was unable to provide adequate care under the circumstances. She got laughed at and ridiculed by administration (behind her back, of course--and I am just stating what I heard, by the way). She actually got into trouble over that one because they said if other nurses could handle it so could she and safe harbor was not an option under the circumstances.

True story. A morbidly obese woman who had died was being transported to the morgue or funeral home via ambulance here in the city. While going over a busy overpass, the back doors somehow opened and the body fell out onto the highway. I have always wondered what was in the minds of the people who happened to be driving behind the ambulance when this happened.

I became an LPN because it was faster and cheaper than going the RN route and then I let one thing or another come up and never finished getting my RN. I regret not having the extra money, but I enjoy being a nurse, I am content where I am and I know that I am a good nurse irregardless. I have always been a follower and not a leader and I know that I am an asset to the RN's I work with. They know they can count on me when they ask for any help. And I don't suffer any inferiority complexes over it.

Here's what happened to me this past weekend. My CNA and I had a patient whose family had complained to management, administration, etc. about the quality of care Mr. X had been getting. When I came on duty Friday, the social worker was there trying to straighten out some lingering customer service issues with the wife. I thought, okay, I'll have this patient the entire weekend because they know I will bend over backwards to make this man as comfortable as possible. I told the CNA to make sure Mr. X was turned every two hours (explaining the above scenario to her). All went well until Sunday. During rounds he told me that he was hurting really bad,"I think I've been in this position too long". I asked him if he was being turned often enough by the CNA and he frowned. He also asked to have perineal care given because he was itching down there. I went to get pain meds, asked the CNA to make sure she turned him and to give him perineal care. ( I personally had turned him several times myself and attended to various needs during the shift.) She told me that she had just done it an hour before and walked away in a huff. When I went back into the room he said that "she just handed me the washcloth" and stood there. He was not a happy camper. I could see that this might be leading to more complaints to administration, so I spoke with the supervisor, the CNA, etc and documented that the patient had full BUE ROM and could clean himself and to see the flowsheet for turning (every two hours). I just wanted to nip any future problems in the bud and didn't think much else about it. This is a Rehab floor by the way. But, the CNA got royally upset thinking I had reported her to the supervisor and had documented something bad about her so she went into the patient's room and asked the patient why did he report her to the nurse for these things. I was appalled!!!! Then he asked to speak with me because he told her that he hadn't said anything. Sheesh. I told the CNA I could not believe she confronted the patient like that--and she had taken an Amazon of another CNA in there with her when she did it. If I was the patient, I would have been scared to death. I showed the CNA what I had documented. It did not reflect bad on her at all. I spoke with the supervisor again and told her I was not going back into that room--shift was almost over. He was either going to call me a liar or yell at me for repeating what he said and I wasn't going to be the fall guy. And, I was not going to call him a liar even if he has been a difficult patient. It just made me so angry that this CNA had to make things much more difficult. Shift was almost over, all she had to do was turn him in a timely manner and keep him clean and dry. After it was all said and done, I wish I would have reported her because what she did was not professional at all and reflected badly on the both of us. If I could go back and do it again, I would have handled the situation differently.

My question is, if she told the husband the day before that she was going to sacrifice the baby to God, why did he leave her alone with the baby? If psychosis is present or thought to be present, and in light of previous incidents here in Texas involving psychotic mothers, why in heaven's name didn't the spouse or other loved ones step in and protect this innocent life? It's better to be safe than sorry. My kids were telling me about the news story and I was so upset that I couldn't even read about it until the next day. I was so overwhelmed by grief at the thought of another child's life being taken in such a hideous manner.

I was very idealistic when I first got out of school and wanted to make a difference in the lives of others. After so many years, I can truthfully say that it is just another job to me but one that brings a bigger paycheck. I will probably do it until I retire. There are still some days that bring me lots of satisfaction--like when I catch changes in a patient's status and help avert an impending problem--so I am not totally burnt out with nursing. I even think it was my destiny because no matter what I did prior to nursing I kept getting steered back into the nursing field. And here I am. :rotfl:

This makes me wonder now about where I work. Our night supervisor was telling us about a nurse that was stopped as he was about to leave because he had a Vicodin in his pocket. He said he had forgotten it was there. When us nurses asked how management knew he had it, she just smiled and shrugged her shoulders. Maybe we have a camera in our med room?!! I will have to check the clock.

Glad to hear that Mattsmom. I hadn't had opportunity to speak with my supervisor yet and was thinking about this thread yesterday. Good luck.:)

omg!! if i had been the nurse who did this, i think it would have ended my nursing career--i would have died on the spot.:uhoh21:

Team nursing sucks if the people on your team are lazy and you have to pick up the slack. I did it once 10 years ago. The RN was unit coordinator and stayed at the desk, made us aware of new orders, made rounds with the docs. Usually had 10 or 11 patients. Even though I'm an LPN, I was usually team leader, other LPN passed meds, and a CNA. I assessed the patients and the RN would come behind and sign after me. I worked my tail end off. The LPN would pass meds and nothing else. I would be starting foleys, IV's, address changes in patient's status, assist patient's on the bedpan when the CNA was busy elsewhere, etc. Responsible for all the charting and signing off new orders, making sure they were all carried out. Busy med/surg floor. It was a horrible experience and I wouldn't wish it on anybody. As far as co-workers go, it's like a box of chocolates. You never know who you're gonna get.

Interesting thread. When and if the BON addresses the situation I hope someone posts an update here. I would really like to know the outcome of the whole thing.

If you possibly can, try not to focus too much on making a mistake during clinicals because the more you focus on it, the more your anxiety is going to build and the harder you try not to make a mistake that's when it happens. Just focus on what you need to do, ask the instructor for help, be receptive to any communications from her and pray, pray, pray. My heart goes out to you. Hang in there and good luck.

I agree.

Unusual occurence here. Got a call from the supervisor last night warning any nurses going outside the hospital to be on the lookout for a guy who was approaching people asking for needles and drugs. Drug seeker..mmm...ya think?

I work with a supervisor who inserts PICC lines--DFW area (Arlington). Would you like me to fish around for some info? She has been a nurse around here forever, so I am assuming she picked up the PICC skills around here somewhere.

I work with a supervisor who inserts PICC lines--DFW area (Arlington). Would you like me to fish around for some info? She has been a nurse around here forever, so I am assuming she picked up the PICC skills around here somewhere.

:rotfl: :rotfl: :rotfl:

PCT's do our accu checks. The only problem I have with it is when they get a blood sugar that is very high or very low and chart "Nurse aware" or "Nurse notified" when in fact, they have neither notified me nor made me aware of it. Their response to this is that the accu-check results are logged into a folder easily accessible to the nurses on the floor and since we know when the blood sugars are due, we can easily look into the book to see the results. I just have this nagging fear that I will be really busy and forget to look and .......well, you know the rest.

I've seen a trend over the years where patients and/or families seem to be more demanding and rude. Television programs have demystified the medical community --there are all types of programs that realistically and unrealistically portray what we do and some people believe it all. Patient/nurse ratios don't help and involving patient's in their care is wonderful except some patients go to the extremes--thinking we're the Hilton, standing by to wait on them hand and foot. I actually had a 28 year old post/op lap cholecystectomy call me to her room to hand her the water cup on the day she was to be discharged. It was within her reach! When I told her she could do this herself and needed to do as much for herself as she could, she actually told me she thought that was what I was there for. :uhoh21: I've been lucky too about being able to get along with my patients, validating their legitimate concerns and finding a solution that calms them down--with the exception of one guy who was just mean and cruel for no reason. That's one reason I work nights now. I'm gettin' too old for a lot of this nonsense. I hate when management says to be extra nice to a patient/family because they are demanding and complain a lot. The family knows this and uses it to their advantage--and even then, they usually find something else to complain about. Last week I wound up staying in this room for 50 minutes because the family kept asking me to do mundane things and I was gowned and masked and hotter than the Mojave desert and I had 7 other patients to tend too. I know the patient was sick, but so were the other patients I had. And the pillows I kept fluffing could have been fluffed by one of the four family members in the room!!!!!

I never let my kids ride a cycle or ATV growing up. Too scared. A family at our church let their 4 year old ride a four wheeler and thought it was great that he could do that at such a young age. One day he rode right out of the woods and into the path of a truck on the paved road. He died immediately. Family was heartbroken and wracked by guilt.

We had a retired RN, frequent flyer, diabetic, non-healing foot wounds. She received lots of pain meds but her favorite was Dilaudid. She was on Dilaudid 4mg IVP q 3 hours until her last admission. The doc changed her dose to 8mg po every six hours. I remember thinking that I had never given anybody that much Dilaudid at one time. She scared us because she would be talking like a drunk woman and asking for more pain meds. When the doc would try to wean her dosages down, all hell would break loose in dealing with this woman and invariably, her dosage would remain the same. She was given the same script upon discharge. Within a week, she was found unresponsive at home and died. I think she Dilaudided(??) herself to death. I know this is wandering off the threaded path here, but I thought about this lady when reading the posts.

Guy walks up to the desk at the crowded clinic I worked at years ago and says he swallowed a fish bone and thinks it's stuck crossways "in my butt" because he's got pain down there. The waiting area got awful quiet when I said,"Excuse me?" and he repeated it all over again. :rotfl: (By the way, it was hemorroid pain.)

These posts remind me of the days I worked hospital med/surg. I've seen nurses who were so overwhelmed they couldn't or didn't want to take report, ER waiting until change of shift to send someone up to dump it on the next shift, floor nurses who told housekeeping to take their time cleaning a room because they didn't want the patient and shift change was two hours away and they were going to try every ploy possible to postpone an admission, etc. I remember being overwhelmed on some occasions, but usually I was so focused all day on getting done on time that I did, and I got to where I would just help the other nurses with their admits or do everything except the RN assessment. But ya know, trying to help backfired after a while because I started getting all the end of shift admissions. The charge nurse knew I was caught up and would not raise a stink about taking an admission. There is no such thing as one-sided teamwork. It's a good way to run off a good nurse. I never griped about it back then, it's not my style , but I can see why these problems still exist. As an agency nurse, I worked an ER holding area and I think it's a great idea. We admitted the patients, got the admit orders done, etc. It took a load off of ER and the floor nurses too. And most importantly, it was advantageous to the patients.

I worked med/surg right out of school and floated to just about every department in the hospital except L&D and outpt surgery. This helped when I worked agency as I had a good solid background in ICU, med/surg, post-partum, ER, etc. One of my favorite jobs was working as an IV nurse, but it hurt my one-on-one patient skills in the long run. I even tried ALF/Alzheimer's unit (not for me). By chance I got called about a job in an extended care facility with a Rehab and med/surg floor. I love it. Just about all my past experiences have helped me--especially IV, cardiac and pulmonary. I feel really comfortable in this position and think that I might pass my 3 1/2 year record of staying in the same place for a while. Point being, it may take a while to figure out what you like. But when you find your niche, you'll know it.

We had an alcholic patient in his 50's, a smoker, who was at the end of the hall on med/surg. He was wearing oxygen per nasal cannula and had been warned about not smoking while wearing the O2. Anyway, we were all at the nursing station--which is odd considering how busy we always were--when we hear this loud KABOOM down the hallway. We all looked at each other and then took off running toward this guys room. We find him staring blankly at the wall, oxygen tubing melted to his mustache, black soot-like stuff around his mouth and nose, lighter on the bed next to a pack of smokes. I don't remember if we found the cigarette he had been smoking or not. Funny thing, this guy never acknowledged he had been smoking. His wife later admits she had brought him the cigs/lighter but never imagined anything like this could happen. I know this could have ended up more serious than it did, but the guy was all right, superficial burns on his lip healed quickly, etc. Don't :uhoh21: at me for saying this, but every time I think about that blank look he had on his face I can't help but laugh.