travkitty

I guess I forgot to add that this bullying is making my physically ill from the anxiety & stress. I get nauseated on my way to work. I can't do this for 3 more years. Sad that the climate with dealing with bullying in nursing seems to be just to take it rather than have someone fix the problem. My husband is encouraging me to go to HR, as he had a problem manager, went to HR & it fixed things. That manager is no longer a problem. Obviously, I'm skittish of doing so in my case because there are so many horror stories of retribution....even though legally there's supposed to not be any. My husband also said to look for a different job with another hospital if need be. It would hurt, but paying back the tuition isn't the end of the world....as well as paying most of the upcoming tuition. He said it's only money & he hates seeing me coming home a basket case & in tears.

I have a manager who is the textbook of psychological bullying. She constantly creates drama by telling me & others things about others, spreading gossip about people having nonexistent affairs with each other, admonishing you for doing exactly what she told you to do that morning & denying she even said it (even sometimes with witnesses). I was bullied by a unit secretary as a new grad & feel the same type of anxiety as I did then, except I could go to my manager (a different job & company) about it, which I did. Someone else went to my manager's manager with our concerns (it's not just me, though I'm the only one saying it's bullying). That manager basically said she didn't want to hear what our concerns are & that she would back the manager no matter what. I love my job except for my manager. It has the location, hours & co-workers that I get along with & we've gotten very close. I'm in graduate school, so my schedule & hours is very important to try to keep consistent. The rub is that there are years between openings in my position, so a complementary transfer is almost impossible. I'd likely lose my great hours for school & perfect commute if I transferred within my current company. However, I have gotten tuition reimbursement from this smaller hospital & if I left before my obligation, I'd have to pay back 10K+ that they have paid already. I'm stuck in a toxic environment, it seems. My husband wondered if I'd even have to pay back the tuition if they can't accommodate a complementary position given that I am in a hostile work environment. Has anyone encountered this? I know I should probably go to HR with this question, but if the boss's boss doesn't care about me, should I even expect to not see brushback if I pursue this?

I'm currently in the USI ACNP program, but I'm hearing from people who just graduated with FNP & ACNP who are having trouble finding jobs. I've always had an interest in psychiatry, & would likely be a psychiatrist if I had gone to medical school. I'm just wondering what a day in the life of a PMHNP might be like. I hear they are in mega demand in many parts of the US (esp Florida, where I wish to relocate down the line).

We've had people check in for "cramping" after drinking mag citrate. *facepalm*

1600 in a frequent flier in our ED & ICU. Type 1 Diabetic who just insists on not using his pump. Every other week he comes in at death's door, we get him stable, ship him to ICU for a week with his sugars looking awesome, then he's back over 1000 a week later. Idiot. When EMS calls with a 20-something, male diabetic, we're all like, "I bet it's Fred (name changed)." I feel like smacking my head against the wall each time. So many resources for someone who really doesn't give a crap. I posed the question of ordering an inpatient psych consult for him next time because he seems passively suicidal if you ask me.

I applied for the Acute Care NP program for Fall. Does anyone have an inea of how long it takes for the application to be reviewed & to be accepted/denied?

Ah. That option wasn't there when I went through the accelerated program in 2009-2010. So, can't offer you any advice as I don't know how it is.

sbain51, are you traditional track or accelerated?

I just started the certificate program with UC-Riverside. So far, so good!

*standing ovation*

OMG, Christy1019, this is a fantastic idea! My ED needs this badly.

From what I understand, though I wasn't there, she did rouse with sternal at med time & the nurse called a raid response. The MD ordered an ABG. During the ABG, the pt must have responded good enough, & the ABG indicated, that she was okay to just sleep it off with q15 checks. I'm off today & I haven't gotten any calls from work, so I'm assuming all is well at this point. When I sent her, she would rouse to less than sternal, satting fine on RA, which is absolutely what I see on patients who get the same meds. All the same, looking back, I probably should have given her half of the amount, with the rest ready just in case. I admit, when I was a floor nurse, I would have freaked more easily than I do now in the ED, just because there is sick & then there is SICK. Sometimes I forget that psych or floor nurses haven't dealt with possibly unstable or out of norm patients as much, therefore they are likely more apt to pull the trigger on a rapid response.

So, today in my ED I was in charge of our psych holds. One female, who I've had before, & is normally a smidge anxious but always able to be talked down, was quite over-the-top on the manic spectrum today. She was unable to stay in her room & would not stop talking, not to mention not listening. She did take 1mg Xanax PO willingly, but it seemed to have no effect. At one point, she was almost uncontrollable, almost hyperventilating, & the MD ordered 10mg Zyprexa IM & 2mg Ativan IM. I have given this mix before with no issues. They go into deep sleep for almost the whole day. She got the shots, then did fall asleep. Rise/fall of chest was fine, RR was 14, BP of 98/54 which can be normal for her. 97% on RA. Lo & behold, her psych room became available & report was called. They were told that she was sedated because she was agitated & could not be de-escalated or redirected. When we went to place her in the chair, she was obviously REALLY sleeping, but did rouse with verbal stimulus & squeeze my hand when asked. She was a bit mumbly & fell back asleep quickly. Again, this is what I usually see in the first hour of getting this mix. She was sent to psych with a PCT & security. From the report I got, she roused with sternal rub & mumbled when they arrived to psych. Again, this is pretty typical. They almost wouldn't take her in, but they did. I found out that they rapid responsed her about 3 hours later when she only stirred with sternal rub for her evening meds. They did an ABG, which apparently got a much better response from her, but again, she went right back to sleep. ABG was nothing remarkable for someone in a deep sleep on those meds. The only thing atypical is that I've never sent a patient over to psych so soon after sedation. In fact, our psych beds were coming open about 15 hours sooner than they normally do, so I've never had this issue. Do patients not get sedated for agitation on psych floors or something? It just seems like someone freaked out there, so now I'm wondering if they will attempt to write me up. They did accept the patient & the rapid response was 3 hours later. I just have never sent a sedated psych patient to psych before (& maybe that psych nurse never received one before...don't know). Just picking some brains.

I had a critically ill patient in the ER, intubated, extremely hypotensive, even after 10 bags of fluid & 4 units of blood. It was about 6:45 pm, shift change at 7pm. I was basically stuck in this room with the patient until he was ready for a head CT & then went up to ICU. An RN needed to stay with him, but he was my patient & I was with him at the time. I asked my PCT to grab me something like a flush or something innocuous & simple that would take 5 minutes. Her reply, "I can't help you...I get off in 15 minutes" & scampered away. I imagine my jaw may have literally hit the floor. Basically, I ran to grab what I needed & hurried back, infuriated. Of course, I was so busy in the meantime that when the patient was finally upstairs & I spent my 2 hours catching up on the charting AND taking care of my other 3 patients who had been waiting patiently while I semi-stabilized my critical, I was too exhausted to say anything to anyone about it...& it was like 11pm, so there wasn't anyone around to tell of any consequence. This tech is known for being lazy...& a know-it-all. It makes me appreciate the vast majority of good ones. I wonder if she would have given the same excuse had my patient needed CPR at that moment, "I can't help. I get off in 15 minutes."

You could always meet in the middle & find a job that offers a mid-shift. I am a night owl, but 7p-7a messed with my real life too much. I can't function at 7a, so that shift was out. So, I found my perfect 3p-3a ER gig. Problems solved!