raindrop

Gtubes: aspirate gastric content? How much is too much...as in...when should doc be notified? Is checking placement via air bolus still OK? J tubes: usually no aspirating, right? And no air bolus? How to check placement? same questions with NG, keofed, dobhoff.

Yes, nurses in general have a reputation for being awful, lateral violence in nursing is no joke. But this is my first correctional job where the nurses are state workers and protected by the union. This environment is very toxic, One minute they are talking smack about eachother, the next minute they are talking about getting drunk together on their next day off, I'm new and I'm their hit list because my pay is high, everyone's pay grade is accessible on the state Intranet. I have been thisclose to quitting since day 1. I have been told that my preceptors loaded me heavy with work and abusive behavior because they wanted me to quit, I'm the one who is going to take away their overtime. What are some common ways they can get me introuble if they wanted? I'm asking because I'm not used to this behavior. For example, in the hospital, the charge ongoing and off going would count sharps/narcs together. Not here. Usually the offgoing tells oncoming "I counted at 6 am, all is good" and the oncoming nurses just signs off. They do this because they trust eachother and it's soooo busy at 6 am that counting would throw off that nurses day. But I do t feel comfortable not counting and I'm getting grief for it…”you are slowing up the early NSC visits or intakes and putting all the work on us jusr because you are busy counting for am hour.”

At My last hospital, vitals for patients who were on the Amio maintenance dose at 16 ml/hr were only required q 4 vitals unless nurse discretion to check more often. But at this place, vitals are q1hr for Amio gtts. My Patient was on the drip for at least 20 Hours and her pressure was checked Every hour. That seems like overkill, don't you think? Pressures/rate were stable.

My sister says the same thing, but she sounded SO young, It is a smallish town so it is possible, but the bully nurse “girls” and the manager from 2004 are likely old enough to be her mom. Nothing against young nurses, but it was also quite condescending of her, a young nurse and already at a desk job, to question me so harshly about 20 years ago.

Shocked, fumbling her words. She said twice “I mean...it’s pretty much standard to ask about past employment” and both times I told her “you haven’t asked me anything about past employment, you have only asked me what happened 20 years ago at this hospital.” After that she finally said “so your sure you don’t want to move forward with the interview?” and I said “I’m sure, I have other opportunities, this one is clearly not for me.” She then said “good luck” and I said “good luck to you, too.” I’m mad at myself for not asking: “why are you grilling me? I did nothing wrong, I was the victim of bullying and hazing, what should have happened back in 2004 was a reprimand to the bully nurses, instead of allowing them to push me out.” But it is what it is. Super annoying. I’m , she grilled me and then “sighed” because she didn’t like honest response about why I quit, she wanted to hear the standard “it wasn’t a good fit for me” and I wasn’t going there, so I heard a “sigh” on her end and then another condescending tone/question, and I had enough. I know my worth, and I’m not ever ignoring my gut-which was in overdrive during our conversation similar to when I worked there, just that yucky gut feeling every morning. Nope. Never again.

Thanks!! It felt really good to flip the switch. Bad vibes all the way.

Had a interview at a job that I worked at 20 years ago as a new grad, I quit while I was still on orientation. I tried transferring, but that was against their policy, and I tried to tell my manager that I need better training and by a preceptor who isn’t bullying me, but it fell on deaf ears. So, I decided to put a notice in, but they told me that I would be taken off the schedule immediately since I was still in orientation. At present day, 20 years later. I reapplied, and the recruiter didn’t ask what I’ve accomplished the past 20 years, she went straight to 2003 and grilled me on what happened. I asked her if I was rehirable, and she said I am marked as rehirable, but she wanted to get to the bottom of what happened. I ended my interview after I told her what happened (the bullying, lack of training), and she kept rehashing it, and kept trying to dig deeper. I ended the interview. I told her she hadn’t asked me about my Daisy awards over the years, she hadn’t asked about accomplishments, goals, certs...she’s focusing on 20 years ago when I wax a new grad, and I can see this isn’t a place where I’d like to work.

I’m actually very nice, I’m just unhappy and frustrated with the unprofessionalism of recruiters lately. I am not needy and don’t need them for anything except submitting me. I don’t understand why she can’t answer a text with 3 words max though letting me know if I’m hired or not. Anyway, traveling is trendy now, and it’s just not the same.

I’m aware of the bait n hook tactics that recruiters use, but it seems like it’s becoming more common nowadays than years ago. Recruiter: Are you giving me permission to submit you? do you need any time off or are there certain days you can’t work? OK, great..I’ll get you submitted, and oh, it looks like the hospital will want to interview you so have your phone on over the next day. Oh, and your start date will be 4/11, is that OK? As a seasoned traveler, I was wondering why on earth the recruiter is submitting me without any updates profile - my competencies and skills check list are old. And I wondered why this job that she presented me with is not listed on the job board which is supposedly updated constantly. But I went along with it, I wanted to see how it would all pan out. And then the next day, which is 1 day after getting submitted... I received an email from the competency department, they wanted me full out the standard forms: Background check, W2, emergency contact, etc. And then a couple hours later, another email that said I’d get the competency tests that the hospital itself is mandating. So I text my recruiter, asking if I got the job without an interview? No response. The text I sent was at 10 am Friday. I didn’t hear from her over the weekend (not surprised) or at all on Monday. I then text her this morning (Tuesday) and asked if I got the job, and if so, please send the contract. No response thus far (5 hours now). And then I Emailed competency today (Tuesday) and told them I haven’t received any competency exams from the hospital or at all. She replied “Will resend.” I waited an hour, nothing. I emailed her back “not received in my inbox or spam,” and then I suddenly received it. Her email response was in a passive aggressive manner: “I’m sorry you are having problems, but I am happy to help you. Let me know if you have any other issues and I’ll get right on it! Have a great day!” I’m not having problems, the problem was on her end. And oh, the link she sent to the competency exams isn’t working, and I tried on different browsers. And still nothing from my recruiter. Please explain...why they play these games? I’m not wired to understand child’s play.

Thanks so much!! It is what it is. I’m sure I’ll find an even better agency.

Thank you so much for your kind responses. I’ve been consistently traveling since 2014, and have only used 2 agencies/recruiters , which includes the agency that apparently canned me. I really liked this company, especially their phenomenal health insurance. Oh well, back to the drawing board.

I’ve been loyal to a well-known and reputable travel company for 2 years, only taking contracts with them. So needless to say, I’ve gotten to know my recruiter well. My last contract... I did not extend; and it ended in November. The extension was offered, but I declined because I wanted to take a few months off to concentrate on finishing my MSN, and well...it was a danger to my license. My recruiter told me she has heard nightmare stories from other travelers about this hospital, and the hospital has been firing travelers without good reason from her company. So, yeah, contract ended in November, and I’ve been busy with school; however I did send my recruiter a standard e-card at Christmas with an amazon gift card, and I thought it was kinda strange that she didn’t reply per usual, but I didn’t give it too much thought until recently. So, I’m ready to travel again, and a few days ago I sent my recruiter a text telling her hello, and how I’m interested in XYZ job listings that were just posted on the job board. She quickly replied “those are filled, I’ll call you when any in those states come up.” In the past, she’s always been big on getting my profile updated and competencies taken so if something does pop up, I was ready for submission. So yesterday, I looked on the job board and several new listing ms were just posted. I text her about my interest, no response. And nothing today. I think I’ve probably been fired, likely due to a bogus “do not return” from my last hospital. I expected to be on their list, but I also thought my recruiter would ask me about it and not ignore me. And also, I have several contracts under my belt with them and I’ve always received rave reviews from past jobs, but I guess that doesn’t really matter. Ill admit, I’m hurt by this. And eventually I’m going entertain getting a staff position, which means the prospective employer will ask this agency if I’m rehirable, and they’ll get a NO. Has this ever happened to you? Any advice? Just shows that recruiters/companies are more loyal to the facilities.

Hi everyone, I am in an online program and my course instructor doesn’t have any availability until Wednesday, so I’m hoping you can help me out. I have looked everywhere for the past 2 days, and I cannot figure out how to connect A to B to C. This is a modified quality improvement project..in other words...I’m not really implementing it or presenting it to my facility. I am just going through the steps as if it were a real project. SO... A: my short term KPI is to have a 10 percent reduction within 6 months with our CAUTI rates within the adult ICU by rolling out a CAUTI prevention program. B: The benchmark that I chose is the CMS NHSN. Why? That’s where all my research has led me to. I even described how the CAUTI RATES can be calculated at the end of every month using a NHSN formula. Now I need to show how I will a compare my (fake) projects outcomes in comparison to the benchmarks. I cannot find any data on how my projects outcomes compare to local/state/national levels because the data is not out there for me to find. Help??

Mona is the acronym for Morphine, oxygen, nitro sublingual, aspirin. Mona should be given for any Patient with chest pain.

Thank you so much. In my mind, I did do everything but I am kicking myself for not asking for morphine, nitro or putting him on 02 during his CP episode (Mona). I was running around like crazy and when I saw that his EKG was normal and Trops fine, I let it go. I gave him the Lovenox and Tylenol, he was better afterwards. I would have called the doctor and asked for MONA orders, but I could barely understand him when I called to get admission orders - he had a very strong and different accent than mine, and his phone connection was bad. I also had to page twice for orders because he didn’t call after my first page. I did the bare minimum to get the patient thru it because I had too much going on than to keep paying him. I wish I would have listened to my gut and gotten MONA orders and a Mag, but at the same time, I’m not the doctor, why didn’t he open up his computer and put orders in himself, ya know? I hope the patient is good, getting TPA, and not in a “vegetable” state now. I know he’s still in ICU, but I don’t know his condition.

I’ve been on FMLA for a while and last night was my first night back on my med/surge/tele floor. I got an 87 yo old male admission mid shift who presented to the ED with falls, AMS, and abdominal pain. ED worked him up with a head CT, CXR, CT abdomen - everything negative for anything acute, no bleeding on CT. Literally had perfect labs and no UTI, negative Trop. When I got him, he was fine and then for about an hour and then he said his chest hurt. We drew a stat trop and stat EKG, all were normal except a slight bump in his QTC when compared to the ED EKG; however, it remained under 500. His pain quickly subsided and he fell asleep. During rounds every 2 hours, he was fine and states he felt better. Trops were repeated 6 hours later and it was WNL. On tele patient was NSR with occ PVCs. No magnesium level was ordered and I’m kicking myself for not ordering it myself since he was having PVCs. Morning shift care onboard and I gave a bedside report to the day nurse. The patient was chipper, joking, laughing and looked great. Ten minutes later, tele called and said he was on SVT - sure enough, he was. A code was called, and I got ripped a new one by the ICU nurse for giving him Lovenox last night, I told her his CT was fine in the ED so I saw no reason to hold it. The patient takes no home meds, and his labs were fine, why would I hold it? The code team called a CODE stroke and he went to head CT - again, nothing acute on there and no bleed. During the code stroke, the patient was thrashing his arms around and acting incoherent, not able to understand commands because he was so altered in mentation. I guess the we’re going to scan his neck, but I do not know the outcome since my shift was long over and I was told to go home of my work was done. A CNA text me thar he went to ICU but she doesn’t know what they found. I am not going back to work for a week, and I will float so I probably won’t ever find out. I do not know any of the nurses well enough to ask what his outcome was. I am hoping he had a good outcome, I hope he went to the ICU for TPA and will bounce back, do you think that’s a possibility? Wouldn’t the CT show a clot though? I doubt if it was a MI because his 3rd trop was drawn 15 minutes before this happened and it was fine.

“Threatening” is OK, it really is! Threats are only words. He was on Meth, did you expect him to be A/OX3 and rationale? “Your” ER? Hello EGO! Check yo’self before you wreck yo’self.

Actually I love the ER, it is wild and crazy alright. But despite getting smacked, spit and punched more times than I can recollect, I’ve never had to put my knee on the neck of a patient, or tase them, or tackle them to the ground with 5 others. I handle it. And ironically, most of the people that police officers brutally attack already have handcuffs on; handcuffs make the suspect less of a threat, so why tase or attack or grind the knee into their carotid? The EGO.

Haha Dr. Jill Biden was recently slammed for using “Doctor” with her name when she’s not a medical doctor. She was baffled that she would get bullied over something so silly. I have a family member with a Doctorate as an NP but she NEVER goes by Dr. When her mom passed away, she wrote the obituary and decided to list herself as Dr. Lindsey Smith as the surviving daughter in the obituary. She did this because her mom was SO PrOUD of those initials, especially considering that she (the daughter) was a HS dropout. Jealousy is ugly, the extended family have her a hard time by insinuating she was trying to show off to the community in a tacky and sneaky fashion. I’m the only extended family she talks to now.

I once worked with a nurse who was immediately fired after a patient complained about something extremely petty. His complaint was how he felt burdensome to her because she told him he needs to stop calling every 5 minutes. Nurses are always getting reprimanded for little things, and oftentimes the BON gets called about the nurse, putting our license at risk for oftentimes petty complaints. I've been in situations where the patients realllllly challenged my patience, hit me, acted violent, cussed me out. I know all of you have, too. And we handle it, it takes teamwork and sometimes chemical or physical restraints, but at the end of the shift, we did it and we did it well. And then we're called about some BS complaint or minor documentation error. Never once have I worked with a nurse who needed to put a knee on someone's neck to get "em under control. Hell, George Floyd would've been one of my easy patients from the footage I've seen. I could've handled him with some soothing but stern words. Can you imagine what the nurse would go thru if we put our knee on someone's neck? OMG. Or recently in my town, a cop body-slammed a person and caused a seizure after being told by the person to STFU. And it's been that cops 4th major offense in 5 years, with the first three offenses requiring anger management and counseling. How many of you had patients call you every name under the sun and you still kept your composure? It really doesn't even phase me when it happens. But can you imagine what would happen to us if we got in that patients face? Or body slammed that patient? Most of us endure some form of physical abuse from patients if we work the bedside, especially ED nurses. Yet, we handle it, and rarely file police reports ourselves, and we certainly never flip out and go ape ***. Why double standards? Why aren't police officers held to the same standards as nurses? It's sickening.

Yeah I’ve been a traveler for many years. I haven’t moved permanently because my mom and sister are here and we are very close. And I have a beautiful house that I got for a VERY good deal. I love my house. But today I realized how much I really want to settle down and stop traveling, and to accomplish this, I’ll need to move. They are rather popular in town because they throw their money at people, but they don’t do it quietly, everyone sees and admired them. I wouldn’t wish this on anyone.

Hi guys, yeah I turned it down by talking to HR and the manager by phone. They both appreciated that I quit before starting since they invested nothing in me yet. I simply told them I was super excited when the job was offered, but now that the dust has settled, I realized I am not a good fit for the job. I didn’t really elaborate. But I’ll elaborate here... The MAIN reason is my narcissist stepmom and father. They are rumor starters and gossip lovers. My sister and I are no contact with them. Despite their age (70) they hang out with ppl my age, some of their friends were ppl that I went to high school with. They are very parental-like and “cool” to them, but to my sister and I and their grandkids, they are vile, controlling and just mean . As I was leaving my interview, in the lobby, I saw some of their young friends in a group talking with eachother. This is a small community and basically everyone works at one of the 2 hospitals. I said hello to them as I walked past them, and I was greeted with a hi, followed by them snickering loudly and completely turning their backs to me. Grown ups. I felt sick afterwards. I won’t have peace there. I’d always wonder who is gossiping untrue things about me, who is reporting to my N-stepmom, wondering what stepmom is saying, etc? I tried conquering my fears by not allowing the High school crap ruin what could be OK, but at the end of the day, I couldn’t get over it. I’m sure some of them will be on my floor or I’ll float to their floor. I can’t deal with them. Life is hard enough being estranged from my parents, I don't need their crap interfering with my job. How sad huh?

Two weeks ago, I accepted a job offer. But it just doesn’t feel right, it never has (7 patients, 1 CNA sometimes 2 if we’re “lucky”). I accepted it as a knee-jerk response when it was offered. It pays amazing. I got bad vibes during the interview. I haven’t been sleeping very well since accepting it because my gut is telling me that it’s not for me. This upcoming week is when I’m supposed to do the preemployment physical and other on-boarding stuff, and I think I need to back down now before the hospital pays for all that. Im going to call my recruiter Tomorrow and back down. Should I also email the manager? Any advice or opinions welcomed.

Having a DO NOT rehire is like having cancer. In my case, I cannot get on with any of the umpteen facilities that are under the same system in-state or across the state line. But Thank you everyone. I’m moving on, it just stinks. I was the one being bullied, yet I’m the one being punished years later. I swear if I am ever a big admin, one of the first things I’ll do is address bullying.

Yeah I’m clearly not rehirable. But what I don’t understand is WHY is everyone ignoring me instead of just telling me. That’s the part that’s irritating, It makes me feel like there is something awful written about me.