Antikigirl

I don't know if this will help, but in my hospital we have a nurses union and they have forms to fill out when we have unsafe patient ratios. They don't take long to fill out, and go directly to the Union that goes over them and sends them back to the hospital to fix and get a plan of action... I find, however, this only works well if all the nurses on that shift complete one! We have done this several times and it is laxing a bit..then goes up...we do it again...and so on and so on...but it does help a bit!

A patient has the rights to many things...smoking included! HOWEVER, that does not give the patient full run of employees to take them out or help with this endevor! I mean, would you take that diabetic patient with high blood pressure and cholesterol issues to a bakery to get her sugar/cholesterol fix??? No, that is inappropriate and against our objectives...so there is a line! The administration of the facility must become involved and a care plan with family must be made for the smoking to happen and how...OR, a plan to stop the patient from smoking, and what to do if they were to leave their rooms/facility grounds/etc to have one! All plans must be documented and the patients rights observed! That way liablity is covered and if the patient was to sneek off and get injured, a plan was in place and the patient didn't observe it...therefore not a liablity of the facility! As far as any healthcare staff taking someone out to smoke...I say no way!

I so understood Earls statment...only because I see what Earl is saying....no not verbatum as servant...but, sorry guys and gals...we are to a higher level then what we interpret as 'servants'. No heck no we don't get physically beat now a days (or do we?), stented with verbal abuse (or do we), or have to do our jobs only to actually be judged by the MD's or worse....the admin! No not like servants! Oh can I go on to patient care? No..we are not that way because we can quit....oh wow...that is the main difference...hmmmmmmmmm All this over someone thought and choice of wordage....well get this "I tire of prostituting my being and emotions over someone I don't know...but I still do it...and my pimp is an administration that does no6t beat me, but threatens my family by saying if I don't shut up and take it...I will have no money for food or rent! And wow....I thought I was choosing a profession! stated on blog this year!

LOL...I will repeat....gut with the best fat tissue! LOL! And man I am a heparin givers best friend! LOL!!!!!!!!! (gut meaning abdomen for you newbies that don't get old school speak! LOL). WIth hep...fast hard done....and for those using most of those thick blunters of a needle system...KEEP the bubble in there...don't take that out..that is the seal system..and sadly, it is part of the COST! UHHHHHHHHH where do I go to have a bubble cost!!!??????

Oh yeah, I also call MD's by their professional title not just out of habit, but out of professional respect. It seems natural to me, and the times I have called them their first name, by accident, it was typically a friendly 'because I know you" deal, like saying when they look ill or helping on an individual level...because saying "Doc so in so...you look pale, are you feeling okay? just doesn't have the same ring as the first name...that becomes socially personal, and I use that when I am being such...AND away from the RN desk or other people when I do that!". The hardest part for me was (and is) the transition from the years I did ALF and calling people honey or sweetheart (that was preferred at that facility to establish a 'home' quality and family style trust...). I say it on occasion now automatically...and correct myself...typically with a joke or two "oh my...did you hear that...sorry, I think I may like you very well and it busted out!" or "oh now..you see that...just called you hon...dog gone it quit being so wonderful, you are making me all mooshy!"...or things like that! I don't mind if they call me hon or sweety myself...I know I have gained favor if they do!

OMG! I just did an experiment for three weeks so far on having patients and other staff call me 'nurse' and by my last name! I have been treated more professionally by patients, and since I am not on a first name basis with patients...they don't load up on me with complaints or tasks as they did when I was using my first name!!!!! I was shocked and HECK YES...I will continue this!!!!!! I call my patient by their last name and approprite title, Docs by theirs...nurses...whatever they go by by their choice....it is turning out great. Okay I get teased every once in a while, but they are seeing the benifits and thinking about doing it too! Funniest thing of all...this started happening just before I chose to go with my last name. You see...I went from dirty blonde hair to black (and yes...I pulled that off well with my complexion, I am dark brown naturally)...and patients treated me different! I can't explain why, but I noted it right off the bat! I am thinking maybe it has to do with seeing my eyes better (I have very light blue staring eyes...). It made a difference as well, although oddly! Anywhooooooo...yep, last name and dark hair from this day on!

This question couldn't have come at a better time for me, and thank you so much Pax Ramona for that link! The situation is, I work in a medium sized rural hospital that has a huge patient base due to sudden expantion and people moving in. Our hospital can't handle it all. Well, in order to try to make things better we suddenly and without proper training went to computers. I am quick at computers, and was able to do my best and get things done quickly (without time to actually see or help my patients...GRRRRRRR!). Well...not all the staff is able to handle things this way...and yesterday and the day before, I had a Doc throw a chart at me, been yelled at solid when all I try to do is help, haven't been able to do my job because of all this, and have lost the trust and relationships with my Docs and patients because I can't seem to get anything done because I am busy trying to correct probelms or unprofessional behavior from staff! My workplace is a harassment right now on every level, and although I am cool and understand that chaos is normal...well, I need to have staff that understands that as well as I do, and tries to be proactive instead of complaining and harrassing about something past! Doesn't anyone care about patient care around my place??? Harassment by patients at this time I can understand, they are getting the bare min of care due to this, and still have to pay the full cost...do I sympathize with them, and have the social skills to turn that around as quickly as I can...but staff!!!!! I shouldn't have to. WHen that MD threw the chart at me, I asked my overrun Charge nurse (who is a dear sweet gal that never gets flustered...oh she is beyond flustered and is having physical s/sx and I am very worried about her!) who I can report that too...she had no clue...I said "THAT must be changed NOW!". I have written a probelm/solve list today, will check it again tomorrow to make sure I am not being anywhere near unprofessional (I find a day later a good edit is good!)...and will submit it asking for a protocol and chain of command for harrassment reporting. If I don't get an answer, then I call the BON and State Labor Board! That link will help tremendously!!!!!! Hello JAC!

awesome babe! Yes, play it by ear...but do make sure you documented your findings...that is all you need because...in the law, anything reported by a average nurse as part of clincial findings is just..and hi ya, we all said we would so you are good. As long as you documented your findings...and dependant on what type of charting your facility does (mine is by exception...but if you are worried about CYA we document WHOM we told...good thing always actually) you are in the clear!

LOL darlin...the first thing I thought from your last post..."at least someone was!"...LOL! Hey sweety...can you do me a favor and read my post on WORRIED, preceptee. You could really help me out! THANKS!!!!!!!

It was very awesome yesterday! I had a preceptee for my first time (just for the day because her preceptor was low censused) and a DOC actually brought up honestly to this wonderful SN that...(Oh please check out post on preceptee...I need help!) "There are days where you wonder...well, what the heck am I doing here! Then, there is that smile, or that thank you...or that one time you know they will listen...and frankly that joy lasts quiet a while...keep looking for that..." He also added...LOL "don't make them MAKE you take night shifts if that doesn't fit with you...that is BS!" (had to say I laughed and said "yep, he is right!"). How cool is that to have an MD talk to a student with so much caring and good advice! I work with awesome MD's!!!! They know that nurses are their backbone, and training them is only good for them and their patients! AWESOME!!!!!!! Keep looking for those smiles dear...they speak louder than a thank you ever did...and at times...when someone can't smile or say thank you...well, there are other ways the body says it!

Thank you so much...got a tear there honestly! I teach that you may organize different because your brain is unique! I teach my skills because I write everything down, and finally learned to do it after about 5 years in something that someone could actually read and understand (thanks to this site!!!!!!!). Oh before...my notes..oh Lordie..LOL! I do try to teach a basic plan for organization but am open to learn myself to newer approaches, but so far...LOL, even the nurses on my floor have adapted mine (which kinda sucks because I use to be able to find my clipboard by my markings...LOL, now I have to look harder when I loose it...LOL!). Thank you again so much...I appreciate this advice very very much! I want to be the preceptor I never got!!!!! Like I said to the student yesterday...if I didn't learn 1-3 things new in a day...I am sorely missing something important and need to recheck everything I did! LOL

If someone dared to leave me weight loss advice, oh man...I will not going into my personal and professional implemenations on letting them know that was less than compassionate or HUMAN! And believe me, they would be feeling WORSE then they left me feeling...and that would be very very sad! As I said, it is NOT anyones place to make the choice on dress code except for administration! If you choose to make a statement...think of how you would broach the situtation to a patient or even an MD! (I would prefer the MD one!). Casual helpful non-judgemental acknowledgement is good "see some skin here hon" or if it bothers you so very much and you choose in your busy day to take on that challenge...tell the charge nurse (and hope the grapevine was either not there or cut!). I do not judge, I do not rate someone on how they are dressed...that is my JOB as a nurse! I care, and am compassionate, and helpful as I deem fit for not only social dynamics and ramifications...but thoughtful of the choices I make in those challenges!!!!!! (some challenges are not worth my efforts at the time, or ever!). And I agree...you can leave yourself open for all sorts of harrassment charges!!!!!!!

Okay I am going to be brutially honest here...I do not necessarily appreciate the Administrative nurse that hasn't gone "into the trenches" as they say (in other words...worked in the arena they are overlooking and making choices for). I feel that is not helpful or representitive of the staff you are charge for if you can't even appreciate what it is they do or strive so hard to achieve! One needs to know the employees they are working with, and unless you have been there...well frankly, anyone with common sense will see you as "administration" vs anyone that will help in cases other than fiscal or hard nosed reality based hospital/clinical management....in other words..."the ones hard working folks fear when seen!"... Now, before people get all upset over that...I was in administration. It was the biggest eye opener for me! I have always been a employee based believer...wanting to know what "our team" was thinking and based choices on them...okay anyone in administration knows that that is ALMOST impossible now a days...and to do your job you can't be anyones buddy or friend...or even be liked on some descisions...so I get that...but seeing it again, after being one, from "one in the trenches" I do know...you haven't been there...you can't complain, run or do anything that will benifit me or staff in any significant way that I will truely trust... With that said...you may want to at least spend a bit of time "in the trenches"...it is a humbling experience, and the actual HEART of what it is we do! Very important!

I would love to be a SN teacher! But not going to get my masters so kinda blocked there...LOL! I didn't have very many if at all...good teachers, so I learned on my own. So I teach how I learned. I took a situation that was not proactive and told myself...well, I need to make it proactive myself...so I did, and did suceed with many hardships and frustrations along the way...I don't ever want anyone to have to do that if they can learn it through me first (some things you have to learn on your own, but most of the things I dealt with....well, I should have had guidance, and I didn't!). Thank you so much! I do want to teach, but I want to teach fairly and right...it is that important to me to make sure someone learning from me not only looks at is as enjoyable, but practical and benificial too!

Multitasking Chaos Effectively! or if you read one of my grimmer posts from a bad day... Sympathetic Prostitution of Compassion (seasoned nurses will think and get that one) LOL!

AWESOME!!!!!!! You have insight into yourself and the honor it really is to be there and holding a hand at the end! Good for you!!!!!! I tell students to understand their own feelings of death and dying so that they may help others in a way that will make the experience honorable in their hearts! You did it!!!!!!!!!!!!!! I don't even know you and I am so proud of you! This will be the best thing...and help in every other arena in nursing...

Oh...not with staff but patients...funny story that makes many giggle still! You always have those male patients that don't seem to know, or rather like having their privates showing. Well one day I had a gent that was constantly tearing off his gown and going 'commando'. He was confused so right in front of the RN desk for monitoring....well I walked in and gasped on purpose and said "oh darling..don't want to let the stalion out of the barn like that all the time..what would the mares think????". For some reason...IT worked!!!!! Now I hear the other nurses using the same phrase like "oops, stalion is out of the barn sir"...or "Keep that stalion in the barn today sir"...it is hillarious!!!!!!!

You got it going on!!!!!! Awesome! Way to nurse!!!!! Yeah, I learned the hard way about the old dyanmaps, and don't use them anymore...LOL! And yes, although a patient may be up in the danger zone on BP...it is our jobs to try to guide the MD into getting it..LOL! You responded perfectly, and sorry about that RN giving you the old standard of "your place is....". I was just talking to a student who was told she stepped out of bounds once...and she isn't that way at all!!!!!!! I was floored infact, this gal was so appropriate, asked awesome questions (even if she felt they were stupid..LOL...I remember that so well..and well heck...still do! LOL!). But go figure, she was brought into a charge nurse office too...man it about killed her emotionally..and like nursing school doesn't give you enough of that??? Nope, I think from day one of RN school (even before) we have the test on our stress levels very well underway...LOL! Keep with it hon...you did right on!!! I was just trying to help by playing the evil nurse role there for ya...LOL! (actually quite a good thing to think about at times...because you not only run into nurses, charge nurses, administration and MD's that will gladly and almost instinctively do this to you on a whim!). Reminds me of yesterday going over the preceptees charting...we actually played a game of Lawyer and Nurse...I went over every single word and we joked about what they would say in a court...it was informative and fun...but real too...well, sadly this incidence for you was real and not fun! But informative yes..because YOU took the opportunity to make it so!!!!!!!!!!!! THIS is a sign of an RN!!!!!! Huggles!!!!!!!!

Okay, well I have been a nurse for almost 9 years now, and for those that know me here...I have a very down to earth style and use common sense mixed with old nursing style to get the job done. After years of getting compliments and positive responces here and at work...I think I am ready to make the next leap to actually taking on a preceptee!!!! I had one yesterday because her nurse couldn't make it in...now I have a totally different teaching style, which I told her right off (even though she knew me for the 3 months she had been precepting at my work) and her responce..."come on hon, who do I come to when my RN isn't available!!! I kinda like you you know, you have a different perspective!". I felt soooooooo great to just hear that!!!! Then I guess she told others and I got a work load of folks encouraging me to take one on and that I would be great at it...talk about a great day yesterday! LOL!!!!!! The fear I have is that I may be a bit to wordy (seen my posts??? LOL!) and a bit too...oh man what is the word I am looking for...not casual, but I don't fret and get things done in a timely but non-urgent looking way, and I TEACH that! I am not a teacher of the black and white of nursing...I teach the greyer areas, the times when you are up to your neck in situations, and you have to do everything in order of importance and not really necessarily going from step a-b-c but jumping as you multitask according to priority.... I was told that I am very easy to approach, and I teach well by stories and a laugh or two that tends to actually stick in minds better than just going through the motions...but is that what a student needs??? Shouldn't they learn the A-B-C so they can adjust appropriately as they grow as their own individual nurse??? I am scared actually...I want to teach very badly...and I will not be perfect, especially as I learn to teach (and I take and ask for help doing that from my students too!!!!!!!). I really feel I should teach strictly by the book, but that isn't me... What do you students or other nurses that taught feel? I would love the feedback!!!!!!!! Thanks!!!!!! :)

I have seen this too, but frankly I feel it is NONE of my business, but ALL of my administrations if they care to do anything about it! At times I have done what I have done with patients when their gowns are open...a little whisper of "Oh dear, seeing a little too much skin showing there". Typically the person realizes it and fixes it and lo and behold...those particular items are either not seen again, or with appropriate other clothing items to cover it...

We had an instance at my work where someone took a yogurt from the fridge and ate it...and it wasn't theirs (personally...I CAN'T eat someone elses food, how rude...and knowing our fridge, ummmmm how long has it been there...ewwwwww LOL!). Anywhooooo...there was a two week WAR on our writer boards in the break room about it and it really got moral down! I mean seirous catty mean things!!!! I couldn't believe the things I saw written on the board over a yogurt!!!!!!! My personal take...forget about it, someone was rude...but we deal with that DAILY if not HOURLY in our jobs. Next time med tape the top so they will have to undo that to open it! Seems silly, but it may detour someone! Also asking your CHARGE to put up a sign saying that this fridge is for personal home brought food, and not to be taken if it is not yours would help.

We are no longer allowed to have a personal one because of contamination risk! We have to get a cleaned one, and leave it in the rooms. We have chosen to put it on top of our sharps or gloves containers (we have a flat surface on top not touching either containers for safety) which can be seen from the doorway so we don't wind up with 30 tubexes in a room from us all bringing them in...LOL! As far as getting them when we need them, I let my charge nurse know so they can order some through work. If I can't have my own...then sorry...not my dime then either! LOL! I rarely use them anyway...I transfer them via needle to a lurlock syringe because most of my patients get kinda freaked out or feel I am OLD school if I use them...LOL! Plus, heck...I don't want to have to explain time and time again "what is that thing????". LOL!

Think HARD and truthfully to yourself on WHY your chosen profession now is the way it is for you emotionally! This will be key in choosing another!!!! Heck, the first thing I though of, especially when I read about the diabetic...is "well if she gets dissapointed knowing they getting this valuable info and not listening...oh man welcome to my world!!!!". Heck, I can't get people to adhere to changing their dressings right, eating right, excersizing right, going to their MD's regular, treating their conditions, getting and taking their meds, or any part of their nursing plans!!!!!!! It is very upsetting...makes you feel unappreciated and "why the heck do I bother"! If that is a big part of it...you may want to look into something other than bedside or direct patient care related! Or something outside of medical... Be very honest with yourself on your reasons for feeling unfulfilled..that will help guide you well!!!! Don't feel guilty either...it is a part of yourself..and to yourself you can NOT lie...it will come back and bite you! Good luck! AND thank you so much for the job you do! I do appreciate you and I work with our dietitions (to their shock..LOL!) because I find it as valuable as me sputtering off the meds the MD orders for them...if not MORE! Bless your heart!

Oh yeah...just a learning thing here, when it comes to odd VS...always ask two things right off after getting a manual. 1. Are they symptomatic? 2. Is this out of their norm? Chances are the first thing the MD will ask you are these two questions...have those answers ready (for your RN when your are a student too!). Saves time and may just answer some of the puzzle of an odd VS! Hope that is helpful too! :)

There is such good advice and support here...I will try to be the devils advocate (although hard).... Okay...hmm...my only advice is to always remember, TREAT the patient not the machine...and along with this comes doing an immediate MANUAL BP and pulse then report to the nurse. Cause frankly...my first question would be..."Did you do this on the machine? What is the manual????". If that wasn't done, I make you go back! (and if I am not up to my eyeballs in stuff...I go with you, or have you wait till I can...not going to leave ya hanging, but that is me!). So lesson one, always do manual on any odd readings! You would not believe how many times things are solved this way by machines not working correctly or simple anatomy not meching with the machines limited diameters! :) (I take all MANUAL...I don't trust dinamaps or even pulse ox...9 times out of 10 they are incorrect and cause undo panic!). Okay the biggie in this case must have been FAMILY! Want a bad situation 50 times worse...have a family member in the room! LOL! (you students will learn this...). So oops, family member getting anxious...now we have a situation! That could very well be what set your nurse off. Many nurses are awesome with patient care, but not as good with family dynamics and communication...and this would tweek them out (especially on a busy day, and I don't mean running as much as mentally busy!). So we started with a MACHINE saying a high bp...no manual checked...and now an overly anxious family member..all from a VS check...okay high gear time with complications! ALSO! A MD may have NOT wanted the patient on their home meds because they were not working and wanted to check baseline without them to be able to prescribe something more appropriate...so don't assume that that med given by the nurse was a wrong one clinically...we run by the whim of the MD my dear...and we don't prescribe. Plus many MD's get very egosentric if you question or give suggestions...and will actually STOP where they are an order nothing! Another pearl of wisdom...KNOW your MD's and their little personality tid bits...she may have known this Doc better than you and had to approach it slowly as not to screw up the works! So okay..lets see where we are now...high bp on a MACHINE, no manual taken, anxious family member, and the social dynamics of dealing with the MD and still...get things done to satisfy the patient, family, MD, and you! I think I can safely stop here...just think about these dynamics because they happen ALL the time! Another part of the art of nursing you will learn as you go along (especially the fact that FAMILY PANIC over ANY medical term or vital sign, and expect instant results from the RN to correct it!!!!!! They don't know the hurdles we have to jump through to get a simple order!).... HOWEVER...you did excellent in reporting that BP in a timely mannor! AWESOME! Just next time take a manual then report! Being called in however...your a student...what good is that??? Oh yeah...it scared you, made you doubt yourself...not appropriate or pro learning!!!!! I think that was a catty thing to do...it isn't like you aren't stressed enough learning...shoot! I would talk to you after and during actually I did my implementations to solve the issue to teach you...so next time you know what is involved in solving a probelm on many levels! That would have been much more proactive!!!!!! Take it as a learning experience because this not only happens in school...but in the job arena as well! Learn how you deal with this personally and professionally...that would be the greatest thing to take from this!!!!! Good job! I would have totally understood your reaction and guided you through the process with a few laughs along the way (cause that is how I teach!).....