foggnm

'Rude and lazy' aren't really specific behaviors that can be addressed by management. I'd suggest you just let it go since it is a short assignment. Or make a list of the people and the actual offenses that interfered with patient care and report that to their supervisor. That said, my first tact is always to take issues up with a person directly if it is someone you will interact with on a long-term basis. God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.

In general nurses don't document what providers do. However if for some reason a provider gave an injection and asked me to enter it, I might and just put administered by Dr. X so it would be correctly entered (e.g., an immunization). You aren't being asked to enter something you didn't do, you're just being asked to enter it was done. For the most part, I'd just put it back on the provider. Say, "hey this is where you can document your injections in our electronic medical record." Nurses carry out doctor's orders, however we are not their subordinates. But in some clinical practices there is still a bad habit of nurses acting as medical assistants. Help with provider documentation should be done by medical assistants, scribes, or clerks not nurses.

I'd like to be referred to by my proper title: murse. LOL. You can't be a man and a nurse and not expect, at some point, to hear some emasculating comments. However, in general, as a man the advantages far outweigh any snide remarks. I think our female counterparts also enjoy having a little diversity in the pool.

If you have the option and you don't want to work at nights, then no. Learning wise being on days as a new nurse is better. It is typically much busier and you learn more about patient discharge, care planning, procedures, etc. Things are more typically done 'by the book' during the day since management is around, so you learn policy. I can see no advantage to nights unless you actually enjoy night shift. I have heard a few new nurses say they like the slower pace of nights, which is fine. Really depends on your personality and what you want over the next few years.

That makes sense but not trusting 'one in particular' means you calibrate by using a different one. I just think it is silly that we have all these very sophisticated medical devices and when we don't like the number we say "I don't believe that." That's not saying we shouldn't double check, but it doesn't have to be a manual check. People should put faith in the devices they use. To me the mistake is to say the manual is 'better.' In some cases it may be, in some cases it may not. The most prudent thing would be just to recheck with a similar device (another machine). When I was in the ER if something wasn't right with a BP I wouldn't go grab a manual cuff, I'd go grab another machine and see if I got similar results. If all else failed then maybe do a manual. I have nothing against doing it manual, just that as a policy it should first be to check your equipment's reading against similar equipment that way if the equipment was in need of servicing you addressed that issue as well as the patient care one.

Where I get my outpatient care, all pressures are manual. However, working in the hospital 7 years all pressures were with a machine or an arterial line. Maybe manual in a case of 'we can't get a cuff pressure.' Machines are very reliable and if we trust them in the ICU to make treatment decisions, then we should every where else. The more important thing, I think, is that for outpatient measures the patient's pressure is checked after a few minutes of rest with their arm in the proper position. In the hospital one blood pressure generally doesn't drive a lot of decisions, it is more what the pressures are over the day except in more abnormal circumstance, for example your patient's pressure is 190/100 and it is repeated twice with similar results and the physician decides to give a little hydralazine or labetalol. I truly believe machines are more reliable than people in most cases and we need to trust the tools we use to make decisions.

Have you considered doing flight nursing? At least where I live Paramedics generally make a lot less than RNs by sometimes up to 50%. I'd hate to see you go broke for a different but similar job. Flight nursing has that similar 1 patient transport thing. While it is not generally a 'first response,' you get to do a lot of critical care and focus on one person.

Yes, you can use a PCA with a basal rate and the nurse can administer bolus doses if the orders reflect it. Or alternately they can do a continuous pca with IV boluses by the nurse. The PCA just makes it more convenient. It is quite legal and quite safe for your license. But your med surg floor probably has a pharmacy policy on what drugs can/not be used and how. And usually those policies are stricter on med surg floors (vs ICU) because of the higher nursing ratio.

Depends on your facility's policy, contact your HR department. It isn't always reported to the board depending on why the test was done, what drug, and the circumstances surrounding testing.

Nursing is indeed a thankless job. So thank you for taking the time to listen to your psych patients. It sounds to me like you might not be in the most positive environment. I worked in an ER a couple years ago where there was a culture of talking negative about others. It was mostly harmless stuff but I realized it permeated the unit. The nursing manager would say negative things about the docs and other nurses, the techs would say tasteless remarks about some of the nurses and docs and vice versa, the clerks would say negative things about everyone. The docs were perhaps the only ones smart enough to stay professional and not make such remarks. It was quite dysfunctional. A occasional criticism about a coworker isn't anything worth rioting over but if that kind of talk and gossip is common (and not just about you), then maybe it is time to search for another job?

God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.

Perhaps if paying cash which means no insurance or perhaps for certain elective procedures. But since the affordable care act mandates all residents have insurance (and fines them at tax time if they don't), then I'd say it should be less common. The funny thing is she was told to go the the ER for a BP check. I would hope any medical practice knows there are much easier and more appropriate places for a simple BP check. I do know people go to Mexico for a lot of dental procedures because dental insurance doesn't cover surgeries very well.

Don't be ashamed of your GPA. I actually compliment you for being smart enough to realize a 4.0 wouldn't have changed the outcome. Either way you are a nurse. You will be able to get in to NP school. Just look at the requirements for a few schools (GRE, gpa, experience, focus, etc.). College grades are so unimportant in the big picture of life.

I have often referred to nursing as blue collar to others. Hospital nursing is mundane, repetitive, dirty work (receive report, assess patient, pass meds, perform procedures, chart, rinse/repeat, do I/Os, give report). Outpatient is different, but similarly repetitive. Assessment is perhaps the only part of our jobs where real thinking and problem solving is done (and the part where you see the difference between regular and exceptional nurses). When you walk in to a shift 95% of your day is based on orders and the remaining 5% is for your creativity or intellect. Can we stop pretending that it is white collar and requiring these 20 year old nursing students to get 4.0 GPAs to get in to programs that result in jobs where you pass meds, chart novels on unimportant events, and give enemas. I had a true white collar profession before becoming a nurse where every day my work varied significantly and there were lots of interesting things to learn; nursing hasn't been like that at all. In short, nursing is a blue collar job but does require a lot of different skills. But don't expect your coworkers to act differently, the hospital isn't an accounting office.

I'm sorry your mom passed. I hope your heart can find peace during this time of sorrow.