RNtoThe3rd

Thank you to all the nurses and people who responded; I was very emotional when I wrote and I thank you for taking the time to help me step down from the ledge and breathe and regroup. I do just need to relax. I apologize to the one who I thought I was coming off as judgmental as I never had the intentions to make it seem that way. I just more so wanted to hear how other nurses rebounded from their first write up. I also was trying to convey to how unfair I think is that WE ALL as nurses (not just any one individual) go out of our way and do great things and yet we do not receive credit for it on our evaluation; the one slip up is the thing that get us and not the 1,000,000 things we did great. Please know, I was not trying to say I alone am a "super nurse" because I view what I did that night as acts what any nurse would do (just not the slip!). I am my number one critic and I was beating myself up about doing something wrong and I do realize my mistake but I'm now seeing it could have been a staffing issue--but I still have to be more careful :) I was just frustrated by the fact that my co-workers have made a pact to go on 2 hour breaks (1 hour longer than the allotted time)...hence the quotes around union break when I commented earlier. I do believe in breaks as we are under stress as nurses but to take advantage of your co-workers I feel is unfair. I don't do their break which makes them nervous I will tell. The other night they got caught doing it so now there's another issue that I do not wish to keep commenting on in this post because in the end, I made the mistake, not anyone else. Thank you for all the support, tough love, love, stories and just being a nurse. I really love our profession and still happy I chose it after 6 years! I think nurses are vital and smart in our healthcare system and I did not make a smart decision--I hate the fact I added a negative statistic to nursing. I just want to do us good! I will be more careful and speak to my union rep about my punishment --who said my manager cannot fire me since it's my first offense. Graci!

Thank you everyone and thanks for the advice. I need to get over it and hoping to get it out of my system soon. I did contact my union rep and waiting for my manager to speak to higher ups. I am just upset because I just transferred here from another hospital a couple of months ago and I just hate how my first blunder had to happen so early in meeting them. It seems like this is how nurses break on the unit which is a little different from my old unit where people would come back if we were drowning but I guess everyone's different? I'm not used to going on more than a 30 minute break so it's been hard adjusting to people taking their "union breaks" and some. In the end, I blame myself, and will have to get over it. I'll keep you posted.

I did it. I made my first MAJOR mistake of my nursing career. I mislabeled lab specimens. JACHO mess-up. And now I'm going to get written up. I realized it 1 hours after I did it. The unit was a mess. 10 patients, 3 nurses (Yes, ICU). 2 Nurses were on break. 1 patient was actively crashing with a nurse, a fellow and a resident trying desperately to throw a line in, the second nurse was getting an admission, and I was watching the 7 other patients. Between running for the crashing patient's nurse, answering call bells (did I mention the tech was on break and no BA?), and drawing my neighbor's morning blood work, the phone rings for our 5th admission of the night. Blood in hand, I ask them to hold so "I don't mess up my blood." Well, yup, I did it. I mislabeled even though I realized I was about too. I cried on the spot. I was walking around the unit, checking on everyone's patients, when I realized I mixed the names up. My heart fell. I immediately look up the labs and only the CBC came in. I immediately told the doctors and the primary nurses about the mix up. I filled out an incident report and called the lab to see if the could write a note to ignore or cancel it. And then I went in the back room and cried. I never made a mistake like that before. I cried in anticipation of what would happen; I cried because I heard I was going to get written up. My manager came in and I asked to speak with her privately. I told her what I did and the steps I took to correct myself. I found out today that I will need to meet with her again...this time with an union rep. I cried again when I got home; I'm crying now as I type this. I am a good nurse and I know I'm not perfect. I should have been more careful. It just sucks though. When you look at next year's performance evaluation, you are going to see a big fat red marking about how I'm unsafe with patient blood. But you know what you are not going to see? You are not going to see that there were only 3 nurses on the floor. You are not going to see that, when on patient was crashing, I was able to throw in 2 #18s/start Levo/bag the patient/set-up an a-line for my friend. You are not going to see I was watching 4 patients. You are not going to see that a family member came back in and gave me a big hug and try to give me a keychain (because that's all she could afford) thanking me for setting her up with pillows and a blanket in the waiting room. You are not going to see that I eased a patient's mind about surgery for her heart transplant the next day by educating her and showing her pictures. You are also not going to see that the residents were thankful I caught some orders or that I was able to keep my own two patients alive. You definitely won't see my nursing friends thank me for helping nor the hugs I got from the family. No, you will just see "Unsafe." And this kill me. Maybe I'm being bitter but I see it too much. Nurses who fly under the radar and get a satisfactory score by doing the bare minimum. They don't sit with their patients. They don't "think outside the box" and some take the short cut. Here I am, day after day, being nice to my patient and their family, going the extra mile, and going above and beyond for the good of my patient. I know my limits and won't take on more than I can chew--heck! I asked to take report later because I didn't want to mess up the blood. And I did. It's just so frustrating that when you get written up, you automatically look worse than the person who does nothing therefore has nothing on their eval except black and white. I'm so incredibly devastated that I got myself into this position in the first place. Thanks for letting me vent.

CHeck out the local univerity hospitals (Jeff, Cooper, Penn, Hup) and the courses that they offer their nurses--most of the time they open up to outside RNs as well. You will have to pay but you'll earn your CEUs and they are great refresher courses--everything from vent management to EKG interpretation. As for clinical, perhaps contact a department and shadow a RN? I'm from the area and have (as a current staff nurse) shadowed clinical specialist and CRNAs. Everyone was really nice! Not sure if there are review courses out but I'll keep my ears open!

Thank you all for your support...I had a spare minute to read and I thank you! I have nothing but the utmost respect for doctors and respect for them. However, I am such a mother hen when it comes to my patient's safety I will protect that patient as would all nurses. Messing with me is one thing but my patient or even worse...both?? I'm just mad about being disrespected in front of my fellow colleagues and his. Quick Update: My note in the computer was written and accepted at 1953 stating what the patient wanted in quotes and how I educated about everything. The resident didn't write his until 2 AM and he wrote "made full code but wishes to be DNR/DNI." Yes, the attending saw this. I came back on and she is the proper DNR/DNI status (only accepting shocks and drugs). I was also informed that some of my senior nurses witnessed the event and had written emails as well and apparently he was doing other unsafe stuff; formal complaint was written about him. I'm very happy that I had such a great supporting crew here and at work--it's truely and honor to be a nurse with you all! It's funny, you learn you are the patient's advocate in school but when the words "I am the patient's advocate and I am advocating for her" came out of my mouth, I felt a huge sense of pride in being nurse. Thank you again and I will keep swimming :)

Hi all, I am venting because I have to go back to work for the next 2 nights and need support. Last night, I came on my shift. The previous nurse informed me that my future patient made herself DNR/DNI 10-15mins before I came in. Not a problem. However, at the end of the conversation she further went on in telling me that the patient needed her Life Vest back on as she was soon to get a defib later in the month. During report, her monitor was striaght bigemeny with 6-beat, 8,beat, 10-beat runs of V-tach. At this point, a red flag went up. I'm thinking either (A) she doesn't understand her Life Vest or (b) she didn't understand her DNR order. I asked the nurse if she was a strict or soft DNR. (At our hospital, you can be either 'DNR and REFUSES antiarrhythmics/vasopressors/cardioversion/defib' or you can be 'DNR but ACCEPTS antiarrhthmics/vasopressors/cardioversion/defib.') Needless to say, she was a strict. I went into the room and greeted my patient. I then went on and said I heard you need help with your life vest. She went on and said that the doctor said to have it on and she WANTED it on in case she needed to be shock. I then went on and said "Mrs. So-So, l have a serious question. I see, at the moment, you are wearing our pads. Now, if your heart goes into one of those lethal, but shockable rhythms your vest normally would shock...say you don't have your vest on....would you like me or any other hospital personnel to shock you?' "Absolutely, yes!" Was her reply. At this point, I closed the curtain and sat down with her. I asked her about her new code status and what it meant to her. She informed me she did not want the tube nor did she was compressions. I told her that was fine but I wanted to explore what a strict DNR was, what she was. After (literally) 30 minutes of educating what vasopressors (btw, she was SBP 60-80s), antiarrhythmics and shocking was she told me she wanted all those things, just not the CPR. Thinking this would be an easy fix, i approached my Resident. I went to my Resident, concerned, and asked if he wouldn't mind stopping by my patient's room and speaking to her about her code status that there was a grey area. I explained to him I educated the patient and she wanted to be DNI/DNR but accept shocking. His first response? "Why did you even question the order?" I was taken back. I simply explained the above. His next response? "You do realize the resident who had the discussion and put it in went home for the day...we'll have to wait till tomorrow." This is when I got upset. I informed he that HE was the doctor now and this is what the patient WANTED. He then continually and condescendingly kept saying how wrong I was for even questioning it...how I should've never asked her...I finally just said "My job as the nurse is to be the patient's ADVOCATE...I am advocating for her and she wants a chance to get out of here. She wants to be shocked she is being as clear and I'm trying to be clear." Finally he waived me off and said he would go. He was very condescending to the woman telling her it's not possible. There was a communication barrier with him and I think he was just getting frustrated. He kept telling her it was Full Code or no code. At this point, I said to the woman that if she wanted to call her POA I would be happy to call her. The woman said no multiple times and said wait till the morning. :mad:Finally, after frustration, she said she would be a Full Code till AM and that's what he did. WHen he left, she told me that's not what she wanted. I went to my manager (who was leaving in 10 mins) who was in another unit and explained the situation. She was on my side. I went to the fellow who said she would be around but that entire night, she was putting lines in the ICU all night. Change of shift comes around and I'm handing her back to the AM RN. I explained to her that we NEED to change this status because she does NOT want to be full code and to ask her team. She went right up to their report and informed them. I was summoned. THe nurse brought me over and my Resident said clairfy. So once again, I said "The patient wants to be a DNR/DNI that ACCEPTS, not REFUSES...that's all." My resident lost it. He started saying I was changing my story, how I was a liar, how I approached him and said he needed to change her status completely...meanwhile I'm introjecting explaining I NEVER said full code. He kept putting his hand in my face and waiving me off, looking away, smirking and giving me a condescending laugh. After 10 minutes of calling me a liar, he told I was done here and we all agree that you changed your story because I didn't know what the patient wanted. I finally lost it and told him he needs to stop disrespecting me and speaking down to me and that he called me over for a reason and I will not be treated as such and he needs to work on his communication problem because he is not hearing me nor the patient. Needless to say, after I signed out I went to the big boss who just so happen to bring the Head MD of the ICU into the office. I was shaking and upset because I was so offended that I would be called a liar when all I was trying to do the entire shift was advocate. I explained the situation and I'm glad I went because they were both very supportive and said I did the right thing. I know I probably should've called the attending that night and said something. I wrote a note in the computer before my resident explaining everything I said to the patient and everything she did. I'm just so upset because even though I did the "right thing," I can't stand being disrespected like that. I know I'm only almost 3 years out and will see this my whole career but...can anyone give me advice what I can do better next time? What I can say better next time? I am open to criticism, i really am. I know I just have to work on my tough skin. Ugh! Thanks for letting me vent!

Sweelin87- I,too, am trying to work in New York from another state and I just received my license in the mail a week ago! I only Mailed Form I, Form II, Child Aubuse Training result, and Infection control results. I sent Form 2 to my school. I did not send Form 3...I did www.nursys.com to verify my license. I'm looking back at the website and I see what you guys are talking about with the conflicting information--completely missed that disclaimer! So, in short, no I did not send Form 3. I did verification online. It took them 2 months to give me my license (october-december). I called them after 1 1/2 months and they were very nice in telling me the progress of my application. Sorry I can't be of anymore help but Good Luck!!

Hi fellow Nursing Friends! I'm curious, does anyone know an estimate of how long it takes to get your license approved in Australia as a foreign nurse? I'm a CCU/ICU RN with 2 1/2 years experience from the USA working in a city hospital. I already have my Work and Holiday Visa and just waiting on my license. I'm so excited to get out there and start working!! I called the board and they said they are not allowed to give approximated times. I'm just curious because I was planning on getting out there in February and I have to give my 4-week notice at my current place. It takes 2 months to transfer you license state-to-state here...I just applied for my NY license for when I get home! All I can tell you for the Australia Board is that they charged my credit card 2 weeks ago for the assessment fee... Also, do you know if I should start contacting agencies now or wait till I get my license? http://www.nursingaustralia.info/ I bought this e-book and it was written before Australia went to a national board but it has some fantastic help in there--Thought I should share! And thanks for all the posts! I've been researching like crazy on this website! Thanks in advance for any responses! I'm so exc

Hey Neeke! I'm a 2 year crit care nurse with my visa already to travel--I'm doing the Work and Holiday visa. I'm just waiting on this Australia License--it's already been 2 weeks! Did you end up going??? How's it like over there? I'm so nervous because I'm going by myself for 3-4 months! Please update us about your adventures!!