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Very insightful! Thank you ? it certainly helps to know what to strive for during the application process and what to expect. Congrats again ?

Congratulations!!! Would you mind posting your stats for the rest of us? Also, how’d you feel about the interview process?

I have a similar question. If the extended application deadline was August 1st, would they extend interviews too? I submitted my app on August 1st but haven’t heard anything. It also hasn’t been that long I suppose.

A little delayed but I truly thank each of you for your input and support. I'm learning that my stubbornness for change and emotions (god forbid!) can help me gain support from my peers so that change can be made. It's not going to be easy, but I won't give up without a fight. Thank you all very much for keeping me on the path to make a difference in our profession.

Thank you. After a little sleep and some reflection I think you're right..exp626. I shouldn't lower my standards of nursing because management like this. My patients ( and my sanity) shouldn't take the beating for the units downfalls.

Just an additional side note, but falls are at a record high as well and on night shift alone we've averaged 7 transfers a month to the ICU or telemetry units which equates to about 50% of the total critical transfers on our floor. Days and eves combined transfer the other 50% ..and we care for almost double the number of patients on nights 1:7 (sometimes 1:8) nurse ratio vs 1:4/ 1:5 on days.

Patient satisfaction is down significantly (I want to say 15-20% lower than our hospital average) and our staff satisfaction results have not come back yet but the last round were the lowest they've ever been for our floor. I hate to say it but I expect the results to be even worse this time. I want to encourage a change but I think everyone is tired of trying with no results. There are a lot of relatively new staff and we are always told by the senior nurses to keep our mouths shut because it's more or less a waste of breath. It's really discouraging.

This is more than embarrassing.. I just cried at a staff meeting. I've been working 3rd shift on a very busy/heavy floor for over a year, and since that day have been severely understaffed with few prospects for change in the horizon (although always promised things will get better but never do). I'd detail more but I think you get the gist. Back to my embarrassing moment. The women and men I work with are phenomenal and we each take turns being to glue that holds us all together, but today during a staff meeting I just couldn't contain my frustration.. And frustration turned to tears. I am so let down by myself. I feel like while my co-workers were holding it together (and keeping silent to get the meeting over with so we could sleep!) I just couldn't contain myself. The tears boiled over when I brought my concern for our decreasing quality of care due to staffing and was met with, " no you all are delivering great care! You're care is excellent!" Tears.., everywhere. Because a) I'm frustrated that management doesn't understand, b) this compliment was completely unfounded (we all go home every day feeling like we could have done sooo much better, and c) my co-workers not wanting to stir the pot just smiled and nodded. Despite moments earlier carrying on about how things are getting so bad. i wish I could have done the latter, but no, I teared up and the 5 women surrounding me pretended not to notice. I'm pretty humiliated that I let my guard down but I know I'm not wrong about why it happened. Im considering emailing my manager and explaining myself but honestly I don't know that is the best option. I'm clearly a little burnt out but I would appreciate some input as to how I should handle this. Or maybe suggestions on how to deal with these types of emotions at work?

Again to be clear, my language was not clinical but what I was saying was the labs were cancelled by the MD when I notified him of the unsuccessful foot draws.

Dansamy- I did. We had a foot draw order. I had notified the MD. And again to let him know we could not get the draw. Doc had no other suggestions and the trops went out the door when the EKG came back unchanged.

Exactly on both comments above. My concern moving forward is this apparent communication issue and the fact that she was very unwilling to at least hear me out and I was trying (not as effectively as I thought!) to communicate with her to explain both why the doctor had told me, what I had received in report, and why I knew I couldn't draw from the line. I understand her sense of urgency- I was panicked too of course- but in this situation, communication went out the door and a power struggle of sorts that I was not prepared for prevailed. I just never want this to happen again and am trying to think back to how this could be prevented.

I took the order with the suggestion of a foot draw because he had been successful with them in the past. So I had an option. The problem is that the hospitalist, just like me, was obligated to follow the order of the specialist who placed the line and wrote a do not draw order, as well as our policy that does not allow draws from midlines. The Hospitalist wasn't permitting me to draw from the midline, Im not sure if you were understanding that. NO ONE, but my charge, was telling me to draw from the line, a line she wouldn't draw from herself. I'm sorry if it was unclear, but I was being ordered NOT to draw by everyone but my charge. I hope that clarifies things.

I agree and unfortunately calling the specialist at 0100 was not an option so I really relied on the hospitalist's orders and the experience of my charge. When I found the order from the doc that placed the line that stated not to draw an showed it to her... Crickets... Not a word. She looked at it, mumbled "don't draw from it" and said nothing else.

I guess there are two issues here so maybe i should just focus on the one thats not policy related because that varies place to place. I'm just concerned for the future relationship between myself and the charge. We really rely on each other on nights and it felt to me like she saw it as a power struggle- as you say- and I was focused in doing what I thought was right.

I'm just confused because I did the right thing but it sounds like everyone would have drawn against the order and against hospital policy and that would be ok, no reprimand. What am I missing here because I know I would have gotten screamed at by management and the doc who placed the line and wrote the order not to draw.

For a charge to demand a staff nurse to do something she won't do herself is insane in my opinion... And scary.

I think your missing the point. You can not draw from a midline. The French is to small and drawing from it causes hemolysis of the sample and makes it useless. Not only that but drawing from too small of a French increases the risk of clot. This patient already had a DVT in the other arm. How is putting the pt at an unnecessary risk beneficial just for the sake of drawing a sample that will be useless?

I had suggested that if she were comfortable drawing off the line that she could. She declined and that made me think if she weren't willing to take the chance, why was she willing to let me?

The fistula that the dialysis nurse accesses at the time of treatment.

Not only that, but I infact had the MDs order NOT to draw from the line. Having gone against the order based in her decision would have landed me in hot water.

Thanks for your response! I could use the line for fluids and to administer medications but our policy just won't allow draws from midlines. The EKG showed similar post MI changes to the previous EKG, so nothing astounding there, and the patients condition returned to baseline shortly after. I'm just astounded at my charge's behavior. I'm a new nurse in the hospital setting and there are many things that I'm still learning. The fact that she demanded I follow what she called an "order" just because she said so and yelled at me to "just do it" when I told her I was not comfortable doing so without more information really bothers me.

6-7 and I work nights on an ortho floor, but we also get many post op spinal and Neuro patients. All those Q2h CSM, Neuro exams, and Prn pain meds makes for a very busy night. No one sleeps on my unit.

so, my pt suddenly developed chest pain, SOB, and extreme dizziness right at the start of shift and I immediately went to my charge to notify her that I'd be calling the MD. I received orders for a stat EKG and troponin level. Unfortunately this pt only had access through a Midline in the subclavian, and due to the patients stage V renal failure, was pitting 4 edema without a vein in site. Per policy we are not allowed to draw blood from midlines. I requested an order for a foot draw, but the draw was unsuccessful. My charge, in front of everyone at the nurses station, grabbed my patients chart and started to demand that I draw from the midline because according to her it was intact a PICC. I knew that I should not draw from the line as I had been reported by the previous shift NOT to, and I also knew that the line was in fact a midline... But she continued. She raised her voice for all to hear demanding to know why I wouldn't draw and stating over and over that I have an ORDER to draw (which was really the radiologist sign off saying I could "use" the line but never stated I could draw from it.) I politely told her I was not comfortable with drawing from the line since I had been told not to and that I would need confirmation to draw. She was infuriated. I knew somewhere there had to be more clarification documented so I searched through his/her chart and found the MDs order NOT to draw. I was so proud of myself for doing what I knew was right, but now I fear my charge is reckless and as a new nurse feel out of sorts with everything that happened. Has anyone else experienced this type of hierarchal bullying? What did you do? Especially as a new nurse I feel like I've lost my leader.