mikala3

That is exactly why I asked...there are times when changing nurses just gets another nurse into a bad mood as well. At least we are talking about patients that are few and far between..if I get one a year I feel unlucky. I just havent yet come across a good way to deal with them. Although calling security on the one that said I hit her was a good call, now her bad behavior is documented not only by me and my witness but by security as well.

I am an experienced nurse and the one thing that I just cant seem to handle is narcissist patients. I dont run into them often, but when I do, I crash and seem to fall for their games. At this one hospital I worked for, we had a program that wouldnt let you see the patient's diet until you answered some basic questions about them. There were maybe 10 including their pharmacy. I didnt have to answer them in detail, like if they had a different pharmacy, it allowed me to mark that their pharmacy had changed and get the details later. So I got a narc who was demanding water and I told her we needed to answer the questions for me to see her diet, but that they would be as quick as I could do them. We got to the pharmacy question and she went off because it was not her pharmacy. I could not calm her down, she was screaming. Luckily someone came into the room and stood beside me (unknown to the patient). In the middle of her fit, she asked for her pain button and I handed it to her. She threw it and as I went to get it, she pinched me. I said OUCH! and dropped her pain button onto her chest and backed up (all seen by my witness). The patient started screaming that I hit her. Luckily, she had not seen the other person in the room who had witnessed the entire thing, so her fake accusations got no where. Security was called and she backed down when she found out there was a witness. So I have started refusing to care for narcissist patients that go after me. Last week, I had one screaming at me that her meds were "late" because it was 10 minutes after 8 and they were due at 8. When I explained that I had an hour to get them to her, she said I was being rude and called our patient advocate. I sent the charge nurse in and I heard her tell him everything was fine, then she got on the phone asking for our manager and an advocate. She then trashed talked me to several other people on the phone loud enough that several nurses asked me about it. I refused to go back into her room and asked for a different patient. I figured at that point, she was after my license and she was going to TRY to get it all day long and it was only 9am. My manager pulled me aside and said I could be written up for refusing to care for her for the entire shift and I said...so write me up, but I am not going back into her room, change the assignment. They also do this thing where they scream at you to get out, then they call you back into the room for something and its a set up so they can cause more problems. At this point, my only tool is to refuse to care for them and I know there has to be a better way. I am not talking about the hard to deal with patients, I dont really have an issue with them, but these are the worst of the worst and they are too demanding.

if that guy refuses labs and an iv, i would personally "educate" him every few minutes then document my attempt each and every time. That way when his family sues because he wasnt treated, they lose.

Our school said that anyone could teach a nurse a skill. Being a travel nurse, I have figured out that some hospitals are better at it than others. I left nursing school having never started an IV because we werent allowed to start them as students. Pretty much my first year, I failed at all of them (knowing what I know now, I didnt have my tourniquet tight enough). After that, I got better. I still blow one from time to time even after a few years experience because I dont have the opportunity to start them often enough on my unit. Most patients come to the floor with two lines, so it's pretty rare to need to start one, but I can do it now. The first few times I cared for a trach patient I asked respiratory to watch me and that was very helpful. Then I got a job at a hospital that loves hands on education and wow, what a difference. I felt like I learned more there in my orientation than I did at my two years at the first hospital.

So I am a travel nurse, and I finished an assignment a while back and something still bugs me. The patients there had a "scent" that I couldnt seem to wash off. One night, we were in for some very bad weather and being that I am not a northerner and I have no snow driving skills, I decided to spend the night at the hospital. I grabbed a blanket from clean linen and took it to my cubby. The clean blanket had that smell that the patients have. I walked back out to the clean linen area and took a sniff...nothing in the clean linen closet had that smell except the blankets, and they all had it. Now I am not accusing anyone of not cleaning a blanket., just that maybe they didnt seem to be dried long enough and picked up a scent. I didnt think to bring it up to the manager, but she emailed me a few days ago to say that she is going to give the agency I work for another contract and that if I want it to go ask for it. Do you think I should mention it to her? I dont work there now, so I cant go and re-sniff the blankets...again, I am making no accusations, but something the laundry company uses on those blankets (or doesnt use) makes them smell horrible.

I also skipped UTA after finding out I had to take History of Texas. I just dont need it in Minnesota!

Sounds like she was just mad at having to clean a patient up. It happens.

I work on a floor where practically everyone is either on dialysis, tons of steroids or both. Nurses on my unit do not start IV's. I have been told that it is because all of the patients are "impossible" to stick. I asked about getting certified to start IV's. I was told that my boss sees it as a sign that you want to leave, and will start treating you like you are a nurse that wants off her floor (she takes it personally). I dont want to start anything with my boss, and I dont want to leave the floor, but I would like to learn to start IV's. I feel it's part of a nurses job. To learn to start one, I would have to spend time with our team that starts them until they feel that I am ready. It would mean being off the clock but being at work. How do you feel about this policy? Would you push to learn the task?

We are expected to do both, our job and the NA's job if the NA's have to sit. I would DIE to do one or the other. It stinks when I have six patients, four are totals and one has over 30 meds to be given NOW.

We have a lateral violence policy where I work. It says that things need to be handled in private. If anyone is rude to anyone for any reason in front of a third person, that's a voilation of policy and a write up. Not that doctor's still arent rude, they are. They just do it over the phone.

I am a new nurse. I have today off and still do not want to go back tomorrow. It was too stressful.

I am starting to think that six patients is too much for me and I will never be able to be a good nurse. I just had a really bad week. I had three doctors yell at me. One yelled at me because a patient left the hospital and he thinks I should have known the guy was going to leave (I was in a code when the guy left the floor). I got yelled at for not knowing a patient was scheduled for dialysis when there was no order for him to go. I got yelled at because my computer crashed just as a dr phoned me back and I couldnt give him the info he needed. I even had a patient's family member yell at me because I was doing another nurse a favor. I walked in and gave the patient a shot of insulin. Apparantly "the doctor said she dont need no insulins ever again, she is cured and 197 is a great sugar that dont need no treatments". He walked down the hallway yelling at me while I told him to take it up with the charge nurse, it was already done, I couldnt take it back now. I left work considering quitting. My charge nurse says I am effective and good and she is always saying she is impressed with my work. My Manager walked onto the floor and said she is glad she hired me. But I dont FEEL like they know what they are saying. I feel ineffective, unprepared and honestly like I am ready to yell back at someone. Is that normal?

I was working yesterday, and found a nurse I was working with in a total meltdown. She had been overwhelmed all night long, and other people were trying to help her out, but her patient's required a LOT of care. She told me the breaking point was that she made a mistake and had to fill out error reports on herself. It was kinda a big mistake, but I went and looked at her patient, and I would have missed it myself. She was giving meds through an IV and they infiltrated. She didnt know that the catheter in the patient was long, so she was not assessing far enough up under the arm. I looked at the patient, and I would have missed it also, the infiltration was up under his arm. That made me very nervous that I would have missed it too. So here is my question. How do you know things like that? How would she have known that the patient had a different catheter? How do you know "what you dont know"? I am still pretty new and the thought overwhelms me. One of the nurse managers came in and said to her that we all make mistakes, and that she would get through it and sent her off to document. I felt like they were downplaying it a bit because she was so upset, but it made me feel like I could make a huge mistake like that and not know it. Should I say to my boss that I would have missed it too? It is making me question how much I know. (I have been on the floor for 3 months).

The floor I am on has at least 5 new grads at a time working over different shifts. My boss asked me if I would lead a new graduate discussion group to help ease them into the role. When I asked her for topic suggestions, she said she just does not want it to be negative. Other than that, I am free to discuss anything. Being a new grad myself, that is a little too broad. Does anyone have ideas of topics? I thought we could start with: How is your transition going, are there any policies or procedures that you feel are ineffective or could be improved? Has anyone been a great help to your transition? (so we can recognize those that have helped us) Not sure what else to include.

We are assigned a "buddy" at the start of the shift and at shift change we discuss what time we like our break...it's pretty soft schedule, I mean, if I have a patient not doing so great at 1:30, I cant go even if I said I would. I have six patients and my buddy has six, so for the time we are off the floor, we have 12 patients each. We also are pretty good about covering for everyone during that time. If our call bell attendant says a patient wants pain meds, someone will go give them.

The call bell attendant answers the bells and tells the person the nurse will be with them shortly. Then she calls us in. She does not leave her seat, however, our pharmacy supplies and bp machines are right beside her.

Oh one more example was that I had two of my six patients that were not doing so hot. Both were complaining of being short of breath and I was trying to deal with both at the same time. Meanwhile a patient was calling for pain meds that she cannot have for 2 more hours. I told the call bell attendant that I could not get to her, that she cannot have the meds, I would get to her after my patients were stable. She rolled her eyes at me, and called me back every 5 mins pointing out that I had not answered the bell yet. How would you have handled that situation? The charge nurse was in the room with the patients, she was not aware that the bell attendant was being so snotty.

I am new. I have not had time to make a lot of friends in my new job, but I do have some. My issue is that one of the nursing assistants and an bell answer service attendant have teamed up to make it appear that I am not pulling my weight...or at least pointing everything out to the charge nurse. I was looking for a snack for a patient, and the cabinet was stocked full of cookies. My patient was diabetic. I asked the the bell attendant to order me something and she snapped at me. She said she'd already ordered for the day and she didnt order what I requested, I'd just have to put up with it. I dont feel she should talk to me that way, but I did not say anything. She also snaps at me for not answering other nurses call bells. If I know a nurse cannot get to one, I answer it, but I am not psychic and I dont like being talked to as if I'm ignoring a light. So yesterday, she pulled attitude with me several times. She got the charge nurse on board and I got called out for not answering a bell saying a patient was trying to fall out of bed (I did not answer it, I was in the middle of a nursing audit and had just realized that my hand off was far from complete and was thinking what I needed to do to make sure I did everything the patient needed and get back on track). I should have heard it, but I didnt. Nothing i can say except that I will try to do better next time. So I am getting fussed at for underperforming all evening. I decide I need a break and walk into the break room to find my nursing assistant sleeping. She was sleeping when I went on break 3 hours ago, and she is STILL sleeping. While I am sitting there, the charge nurse walks in, says something to me, and leaves. Pretending she did not even see the sleeper! You can imagine my frustration when I am being called out constantly for underperforming when the assistant is sleeping! I am not sure if I should talk to the division's manager or not. I am frustrated. I feel like I can improve, but I also feel they are using me to take the attention away from the sleeper. It is not the first time I have seen her sleeping, it's just the first time I realized it is for hours, not just her break. What would you do that would maintain peace on the floor?

I am wondering if I have the wrong job or if this is nursing. I wanted to become a nurse because I love working with people (even difficult ones) and I want to help people. I love my actual job. I love my patients, even the difficult ones. But I am finding myself dreading to go into work. I helped out a nurse that was overwhelmed and a verbal warning for not following up on a pain medication. I have not just nursing notes and shift assessments to do, but I also have three other online "forms" to fill out on patients. One of them is tricky and the program likes to delete your entry. I forgot to check that it didnt delete and was actually there..... and of course it deleted instead of saving. I got written up for not completing the proper paperwork on my patients. I got a verbal warning because I got cold and put a jacket on and it covered my name badge. I have a horrible night shift. A nurse went home sick, and one had called out leaving us short two nurses. I had three discharges, two admits and five patients that I only had "for a while" during one eight hour shift, I also gave meds to four patients that belonged to two other nurses because everyone was overwhelmed. I could care for the patients, that is not the problem, my problem is that i am now dreading answering questions about why I did or didnt do something on that day (paperwork related of course). I gave insulin that was well over an hour overdue to three patients that werent mine. I just feel a write up coming for late meds. Is this nursing? Fearing my job over petty issues? Being afraid to help someone out because I could get written up for their lateness? Do I have the wrong job? (this is my first nursing job).

I got written up for it. I am pretty angry at my preceptor.

I got an email that I have a meeting with my Nurse Manager this morning to discuss what happened. I plan to tell her the facts of what happened, but I dont know how much detail to give her on my preceptor. I checked the cabinet several times for the drug during the 2 hours, it stayed on the top of the administration list because it had not been given. My preceptor had two hours to step in and ask me why I had not given it, but she did not. My new grad brain said I needed to mark it as not administered because it was not on the floor and after 2 hours it is a medication error. I did not know what else to do besides mark it as not administered, however, after the event, my preceptor talked to me about floor policy. I now know that I should have phoned pharmacy when the item was not in the cabinet. If it had not been delievered within one hour, I should have gone to my charge nurse to see if she had any insight. My error was not asking proper questions, and I should have known to find my preceptor if she was not with me. I now know the proper procedure. I do not remember what my preceptor was doing during those 2 hours, but she was not with me. She stuck to me like glue afterwards.

I am a new grad and still have a preceptor. On my third night of working, my preceptor fillout out a safety violation report on me and I do not know what to expect. I did not know that I needed to notify the pharmacist if a medication was out of stock. Instead I documented that it was not on the floor and was not given to the patient because it was out of stock. She said I provided unsafe care and filled out the report. There is only one hospital in my area of Kentucky, and I am scared to death that I will get fired over it. Am I making too much of it?