bth44

Is it customary for people to receive HIV test results in person only, even if the results are negative? I got paperwork back from the doctor's office, reporting all my pregnancy, pap smear, and STD tests as negative, but saying that the results of the HIV test have to be received in person. I was hoping some one here would know if this is just done for everyone because of confidentiality and legal reasons, or if I could have possibly had a positive result.

Ever since I graduated nursing school, I've worked at a reasonably-sized hospital, and the nurses only work with attendings there. Our hospital is considered a rural rotation. I only time I've ever met a med student was when one came in to shadow a family practice doc for a day, and I think I remember a student touring the hospital with a GP a while ago. So, the big change for me this month is that I've accepted a position at a very large university hospital in a big city. LOTS of students. A minor concern of mine is what to expect with all the residents and interns running around. I have no idea of the succession of medical student, intern, resident...is it even in that order? What's within each's scope of practice? Do I have to wait for an attending to give a looksee over orders before I act on them? How's their demeanor compared to attendings? Oh...are the attendings cocky because they have students under them? I'm sure that residents and interns are different from attendings. Can anyone give me any information on what to expect?

HAAAH! I thought I was the only one who noticed!!

I'm finishing up my resume, and I thought it was appropriate to include clinical opportunities that not everyone in my program was able to do. For instance, I listed, under my education of course, that I assisted school nurses with wellness checks, and worked with nurses in the state health department. Would including that be a bad idea?

I think I'm ready to leave my hometown and move to the next largest city. I've been a nurse for, hmm, a little over a year and half. When I got my job here, it was really easy, because I worked at the hospital as a CNA for over a year, so I pretty much just started working as a nurse after I got my RN license. And, I got the CNA job because I was a student nurse there. So, I'm a little ignorant at job search etiquette. Portland is about four hours away by car. I've made plans with my friend, whom I'll be living with, to go up there and look for apartments next month. I've looked at hospital websites and I see postings that would be a good fit for me, but I'm unsure of how to act. Here's my thoughts: Should I apply online at the hospital websites, and hope for calls back to set up interviews before I leave? Should I go on my trip without applying online, and then just visit the hospital recruiters and human resources offices, hoping that they'll have time to talk with me whenever I just show up? Should I apply online, and then visit without an invitation, and tell them, "Yes, I've applied online, I was just checking up on it"? Oh, and about online applications anyway: Is applying online better or worse than printing up applications and sending them off? Is it absolutely critical to have a resume? I know I could just call recruiters and human resources offices for more information. But what do I say when they answer the phone? How can I not sound like an idiot? I really don't expect anyone to answer all of these questions I have in my mind, but I'd love any kind of input anyone has to offer. Thanks in advance!

The hospital I work at uses summary charting. I find it's not working for me because I'm too wordy and I go on and on and do a lot of double charting. I'm trying to meet up with a supervisor every so often who's teaching me focused charting, specifically using the D A R method. I believe it stands for Data, Action, and Resolve (?). I feel I'd do better with it if I could read some examples in a book, or at least hear the basics from more than one nurse. This supervisor doesn't have the time to really sit down with me and chart with me at times. Does anyone else here use focused charting? Any websites I can turn to for help? Any examples of what will be good focused charting? I really want to become proficient at this type of charting, but I can't rely entirely on this one supervisor who has their own job to do.

That's a great idea too. Thank you!

I've developed a bad habit that's totally bit me in the you-know-where. I work on a med/surg unit that has 16 beds, my usual patient load is six to seven patients, and I get pretty busy most of the time. When I receive report at the beginning of the shift, I write down the assessments of the previous shift on my report sheet (lung sounds, bowel tones, colors of any drainage, etc.). I go do my assessments, then, if I assess something different in that patient from what I heard in report, I'll make a note of the new finding on that sheet by writing it down. If nothing has changed, I'll just circle the note I made during report, and then document what I circled as my finding. Then when I give a verbal report to the charge nurse in the middle of the shift, I just go by the report sheet. This has saved me time, but it's cost me a few things. What's happened as a result of doing this is that sometimes, I'll mistakenly circle "decreased lungs" when I heard them to be clear, then I'll relay the wrong information to the charge nurse. Sometimes, I'll say something like, "The stoma is pink...no wait, I'm sorry, it's really beefy red" when I've read the incorrect assessment note and corrected myself. This either results in my getting lectured for appearing to second guess myself, or what's worse, getting accused of not doing my assessments and just telling the charge what was going last shift and saying that that was MY assessment. The charge nurse assumes this because I'm reading from my report sheet. I can't really explain myself, because this certain nurse yells at me for making excuses, so I've just learned to say, "You're right, I'm sorry." Ugh. So, I've decided that instead of fighting her, I'll just improve myself and what I need to do. What I'm asking is, is there something online that I can use as a resource, or does some have a template that they use at work that they helps them make notes from their assessments? I'd like a "cheat sheet" that allows me to quickly (and accurately) make note of what I've assessed, and maybe even lets me fill in the blank of what IV fluid and rate the patient is getting, diet order, etc. I thought that my usual way of just circling each finding would save me time. It does, but it's not 100% reliable for me. I've learned that to do a good job, I need more structure and preparation. If no one has a template to offer, can anyone suggest anything else that's helped them that might help me succeed? I really want to make this change.

At my place of employment, you tend to get guilted into coming in. I'm nights, and we're understaffed and we get called in as extra staff on top of who's already there, too. In the past, when I'd get a call, I was empathetic towards the nurses scheduled and I play the karma card on myself and think, "Boy, I'd sure want another nurse to agree to come in on their day off and help me out the next time I'm sinking." The guilt trip I'd let the supervisor play on me, as well as the time and a half, was enough of an incentive to have me once work up to six nights in a row, have a night off (which all of us night nurses agree isn't like a day off at all) and then work another six. I'm exhausted, my performance sucked those days and I'm waiting impatiently for my first two nights off in a row since last month. Blegh. I feel so burnt out. From now on, I'll just say, when they call me at 9:30pm to ask if I'll come in at 11; "I'm sorry, I haven't slept today, I wouldn't be safe." :l

"distinct personality difference"? What differences do you see between the staff on the shifts?

I work in a 200-bed rural hospital. It's the only hospital I've worked in since graduating nursing a couple years ago, so it's the only thing I know. :) As time goes on, it's becoming more apparent to me that the staff on certain shifts are nastier than others. My shift (night) and the evening shift staff get along well and socialize a bit at shift change. But day shift on our unit aren't as chummy, they only talk amongst themselves when they arrive, despite attempts by my shift to make small talk with them. I've come to realize that this has always been the case, but recently, it's been getting worse. Some of them only say good morning to our shift after we tell them good morning first, but they rarely say anything to us. Actually 98% of the time, the only times that day shift says anything to us is to tell us what we did wrong the day before. When they say nothing to me except to tell me what I did wrong or what I should have done, it makes me feel like they think I'm incompetent. It's getting to the point that they don't even talk to us, and we just approach them if there's a change in a patient's condition while they were in hearing report. I know it shouldn't bother me, but they're so unfriendly that I can't help but to take it personally and feel bad. Everyone on night shift went to the manager in hopes that they can fix this problems between the shifts, so I hope the situation resolves or at least go back to the way it was when they'd at least say hi first. The question I have for all of you is this: I'm going to move to a larger city later next year and hope to work at one of the major hospitals. I worry if what's currently going on on my unit is the case at all hospitals. At my future new job, I really hope to work with friendly, helpful people who'll make me feel like I fit in, or at least give me positive feedback. Or should I just get used to other nurses (and shifts as a whole) being snobby to others like this?

Yep, I agree on that one. The 6th and 7th MUST be rationale and documentation.

Expiration date can be considered a right. I learned it as P-DART-E. Patient Drug Amount of drug Route Time and Expiration. I don't know of a seventh one, but if I can take a wild guess, I'd say Patients' birthdate? It helps ensure that the patient is who they say they are. I'm going to keep a lookout on this thread, because I'm really curious about the extra rights. :)

Your flushes sound like ours. They do say "0.9% Sodium Chloride" on them. And I thought about the morphine or other drug in the syringe, but then I thought about how the patient didn't have IV push meds ordered. I do know who wrote me up. On the incident report, the person who's reporting has to sign it.

I got written up for leaving a saline flush in a patient's room. I had went in the room with it already having the plastic cannula on it, ready to use, but the previous shift didn't tell me that the patient was getting an IV at TKO, so turns out I didn't need it. I didn't throw it in the sharps container. I think I left it on the IV pump. So, the next night, I received a med error report in my mailbox, saying I left a "syringe with an unknown medication in it in a patient's room". The patient didn't even have IV push meds ordered, and the syringe already had "NORMAL SALINE" printed on it, so it couldn't have been an unknown med. So, on paper, it just looks bad, when in reality, it's something that every nurse has probably done on accident without discipline. I'm starting to think that if the next shift has time to write up reports like this on me, then they're probably over-staffed or is out to get me. Has anyone been written up for something like this? Or have you written someone up for this kind of thing? I realize what I did was wrong, but filling out a report with "unknown medication" on it seems petty to me. This could have easily been resolved with a quick, "Oh, by the way, here's something to remember..." Any thoughts? And how can I defend myself well on this? It just doesn't look good when the only thing I can think of to say in defense was that I was ditzy at that moment.

I do think I should bring up some things that have came up in my mind after reading the posts so far that I should have included in the first post. The CNA in question has a sarcastic sense of humor, from what I have gathered from working with her in the past. At that point in time, I figured that the joke was something she could take, as we built a little bit of a rapport and knew she'd think it was a joke. It's not as if I arrive at work, and just speak to everyone in a monotone voice and walk around like a zombie. I kid around with the people I work with and make jokes. BUT, I'm also a shy person with new people, take my job very seriously, and I determine who I can joke with and who I can't before I say anything. I figure out what kind of person someone is before I open my mouth; what I say in front of a prim and proper older nurse is certainly different than what I say to a wild and crazy young doctor. As for what I said to her; yes, I am aware I was a dork. But, if I thought I was 100% innocent in the situation, I wouldn't have posted the thread, asking for input. And I appreciate all of the input, whether it's someone that believes that nothing I could have said to her was any excuse to hit me, all the way to the joke was justified with a jab and to call it even and not whine about it anymore. I think the main point is that she knew I was kidding around, and her way of joking around with me was a pretty swift punch to my back that took my breath away for a second, hurt pretty good at the time, and it still sore a few days after.

Actually, this is kind of interesting, too. I tried to get feedback from my charge nurse about it that night. She said she was standing nearby, but wasn't pay attention. She's very knowledgable about things specific to nursing, but not helpful when it comes to interpersonal relationships or giving advice related to talking and dealing with people. The only feedback I got from her was, "Well, now you know that you probably shouldn't joke with her like that." But, the other CNA who was there and saw what happened said that they thought it was a bit much, saying that the punishment didn't really fit the crime, so to speak. And they were surprised that she did what she did.

Actually, this is kind of interesting, too. I tried to get feedback from my charge nurse about it that night. She said she was standing nearby, but wasn't pay attention. She's very knowledgable about things specific to nursing, but not helpful when it comes to interpersonal relationships or giving advice related to talking and dealing with people. The only feedback I got from her was, "Well, now you know that you probably shouldn't joke with her like that." But, the other CNA who was there and saw what happened said that they thought it was a bit much, saying that the punishment didn't really fit the crime, so to speak. And they were surprised that she did what she did.

At the hospital I work at, everyone on the nursing staff is on probation for the first 90 days of employment. Then, there are peer evaluations done by the RNs. If the employee shows that they work hard and do well, then they'll be considered permanent employees after 90 days. If they perform poorly, they'll be given another 45 days of probation to "shape up or ship out". Then it's either permanent employment or dismissal. I work with a CNA, hired for a different ward, but who floats over to ours occasionally, who recieved a lackluster evaluation after her first 90 days of employment. She's currently going through her 45 days. I became aware of all this when a nurse from this CNA's home ward asked me how she was doing over my ward, I gave her a briefing on her performance. She thanked me, saying that the nurses have to finish up the peer evaluations on her and any input is helpful. Not too long ago, when the CNA worked with us, I brought some photos of a party that the people on our unit had a month or so ago. The CNA came up behind me to look at the pictures and said, "I'd like to look, because I didn't go to the party." At that point, I said, sarcastically, "Oh, well, that's because you weren't invited." Then I started chuckling a little bit, turned away from her, back to look at the pictures and said, "Oh, I'm just kidding, everyone in the hospital was welcome to-OW! Did you just punch me?!" After I turned back to look at the pictures again, she had decided to hit me on my back with her fist, right over my scapula. I said, "Why did you do that? Please don't hit me. That really, really hurt. It's always been a little sore since hurting it playing sports in high school" At that point she said, "Oh, I didn't know you had a bad shoulder" and apologized. Now, yes, I admit, I probably shouldn't have been sarcastic. But, I know that right before she hit me, I was telling her that I was joking around and that she was welcome to go. I believe that she knew I was kidding around with her, and she just thought it would be funny to hit me for some reason. But isn't making jokes to someone, like I did, a little less offensive than hitting someone, like she did to me? It may just be the way I think, but I was raised to understand that there is no reason and no good excuse to hit anyone, and that there's certainly no reason to just sit there and take it. Having this mindset about people hitting others makes me feel like it's necessary for me to go to my manager, and tell her about the incident. But, I don't know if I should. I understand she's had her probabtion extended for not performing well, so going to the manager with this could play a big part in her being fired. Part of me thinks that I'm partly at fault, because of my sarcasm right before her hitting me. The other part stands by the thought that she really had no right to hit me, and that the way she reacted was completely out of line. I do know that if I was the manager, I'd want to hear about someone who's working on my unit who reacts in such a way. I guess what I'm requesting from all of you who read through this long post is if I should just go to the manager and tell her what happened or, just leave it be since the CNA is aware that I won't tolerate being hit anymore, and not say anything at all. Now, I'm just flabbergasted because I never thought, being a nurse working in a hospital with other health-care professionals, that I'd feel the need to write a post to request opinions and advice about a co-worker smacking me. The entire situation makes me feel like I'm in middle school all over again.

It's one of the next big goals of mine I want to achieve. I'd like to gain a few year's experience in ICU and then try my chance to be accepted into a CRNA program.

I graduated from school a couple years ago and have been working at a 200-bed hospital in med/surg with opprotunites to float to other units since then. This is the only hospital in the area, and it's our small town's largest employer. I've learned a lot and I've been given a lot of opprotunities. I have no problem with management, but I do have a problem with other nurses and CNAs. Shortly after working at this hospital, I've started to notice the lack of attention to detail, and sometimes even the lack of competence, in nurses and CNAs I work with. I've also noticed problems with nurses on other shifts. Some of them forget to chart, are late to work, and even dump tasks onto the next shift, like, PICC dressing changes and restarting IVs. If there's a med error, I'll write up an incident report. I'll overlook wrong IV fluid infusion rates or not signing the MAR for pain medication, but regardless of how severe, some nurses see it as a personal vendetta against them and get crabby from then on. I'm just wondering if this is the norm at every hospital I will work at. I'm hoping to relocate to a larger metro area in my state (portland, OR), with lots of hospitals, many of which are regarded as being cream of the crop as far as healthcare goes. My mother (who coincidentally, doesn't really want me to leave home) says, "You're going to find that at every hospital you work at. You're not going to see perfection." I'm not looking for perfection, but I'm looking for co-workers who strive for it. I'm just wondering, since I've worked in just one hospital so far, if I should expect this sort of thing everywhere I go, or try my hardest to find a hospital who expects nothing less than their employees trying their best.

I really hope someone can give me some insight(specifically someone who's a supervisor or manager), because at this time, I'm very offended and upset. I was charge nurse on a unit a few nights ago, overlooking a female CNA who has been having a little romance with a male CNA from a different unit. I believe they think that no one knows about it all. Another CNA who I often work with and regard as someone very trusting and honest, as well as a great CNA all around, confided in me that he saw these two CNAs come out of a darkened, secluded patient waiting room very early in the morning after their break. He said that he saw that the male was sweating a bit, and the female was flushed and had what he perceived as a guilty, sheepish look on her face. He never saw anything go on, but what he did see gave him the impression more was going on than sleeping while on break. Since this woman was working with me, and since this other CNA who confided in me seemed off-put by what he saw, I went to the nursing supervisor working that night. This supervispr told me that it was very inappropriate, could result in dismissal if they were caught, and that while nothing was seen, there was enough to be seen in order to raise suspicion, and the eyes will now be open. She gave me the impression that I did the right thing by telling her. She also told me to discuss this with another supervisor who will be supervising the hospital when these two CNAs are scheduled. As the first supervisor said, I went to speak with the second supervisor. This is where things get very weird for me. The second supervisor told me that our breaks aren't paid, so employees can do pretty much what they want to on their breaks, because it's their own time. She was mostly concerned about things going on in a public place, like a waiting room. She gave me the idea that she doesn't care if anyone does some sort of sexual activity on their breaks while in the hospital, as long as they go somewhere private where they won't be found. She said, and I quote, "If there's a patient room that's open, you can close the curtains, lock the door...just don't mess up the bed." I was completely horrified and, I hate to admit it, but I almost started crying. The clincher was the last thing she said to me, and that being, "If you were to knock on my locked office door and there was no answer, best to just keep walking, because my husband might be visiting me late at night." I was so shocked by what this self-proclaiming Christian said, that I didn't have the mind to say anything about it. I hurried up and got out of there quickly. It doesn't bother me that these two CNAs might have been up to no good, because the big word there is MIGHT. What really bothers me here is that one supervisor tells me that what they could have been doing was a no-no, and another supervisor pretty much telling me that breaks can be spend any which way, and that it's all really none of my business unless I catch them in the act. But, if these two CNAs aren't very good at hiding themselves (because they raised a lot of suspicion looking and acting the way they did(, I'm worried that I could catch these two in a compromising position later on, which is really something I don't have the stomach to see. So...please...anyone who's worked at a lot of hospitals, anyone who's a nursing supervisor, nurse manager, whomever, PLEASE give me your opinions about doing anything physical on the job. I personally see if offensive to the facility, lack of respect for co-workers, as well as lack of self-respect. I really don't like the idea of break being my own time so that means I could do anything I wanted. I'm sorry, but if someone knows that their lover is working that night and they'll get to fool around with them later, their mind is probably preoccupied with that and not really focused on patient care. People who drink on the job are probably preoccupied with getting a fix or being drunk, and someone would lose their license for that, so why not something that a co-worker, patient, or patient family member might see. So, please tell me if I'm wrong in this situation. All of the other nurses I confided in think that I'm right and that this 2nd superivisor has a screwy way of doing things. I'd ike to know if I'm wrong in this situation.

That's not tame at all. If I saw that, I'd pee a little! Beth ?

HAHA!

I've searched the entire forums, and I've found nothing, and I apologize if this thread is in the wrong place. My father and I were talking about the FBI, and he told me that minimum educational requirements to apply to the special agent academy in VA was a doctorate. I thought that didn't sound right, so I looked it up on the internet. I found that minimum requirements is what I believe to be is a bachelor's. It was also surprising to find that under Science, they list Nursing as a Critical skills degree. Here's a link to the special agent job listing: https://www.fbijobs.com/jobdesc.asp?requisitionid=368 And here's a link to the descriptions of each specific degree (Science is way at the bottom there): https://www.fbijobs.com/SkillDef.asp?#Science So, if can anyone provide more information, or their opinion, of how a nurse can contribute to the FBI, I greatly appreciate it. Beth :)