zaleah

Very old letter, should be poster size, laminated and in everyone's waiting room!!

Final grade of high school with no idea what I wanted to do other then being a Vet, but I failed physics and they would not take me...... My best friend was filling out an app for nursing school at a technical college, I said "give me one of those and we can go together". I had never thought about nursing as a career. I got in, she did not......... Here I am and she is living in the Bahamas making great money and living on the beach.

Our institution has brought in this new 'rotating role' to our department the CCL. Essentially the clinical care leader is the charge nurse. One is expected to be a leader, mentor, educator and problem solver. The kicker is that is an '18 month rotating position' to offer all a chance to lead. It comes with a 3$ an hour raise. I have been doing charge, facilitating, team leading (what ever name they want to call it) and have been a CCL for the past 18 months for a total of almost 9 years now. I have never had a performance review, nor have I had any negative situations (I have never been 'written up' nor taken into the office for any problems) The team I work with respect me and I often hear comments like "Thank God you were in charge, if so and so was here it would have been a nightmare", or just stated the other night--" you are working the weekend right? I don't want to come in if you are not in charge" I am now being told by my manager that I cannot re-apply for CCL, I will only be in charge if they are stuck, and that I am to mentor the new CCL's, and yes I lose the money. I understand the organizations's point in trying to offer leadership positions, but I am feeling very hurt by this. It almost feels like they are trying to get me to leave. Any one have any thoughts?

Pen behind my ear, stethescope looped in my ties for my scrubs, hemostats on my thigh with tape and a tourniquit, and my trauma shears tuck int he waist band of my scrubs on the left side. (I can't stand anything around my neck) I even reach for the shears at home when someone needs scissors or behind my ear for the pen......LOL I do not carry other stuff in my pockets--lost too much stuff. I know where the resources are for drugs and procedures.

Our institution has brought in this new 'role' to our department. Essentially the clinical care leader is the charge nurse. One is expected to be a leader, mentor, educator and problem solver. The kicker is that is an '18 month rotating position' to offer all a chance to lead. It comes with a 3$ an hour raise. I have been doing charge, facilitating, team leading (what ever name they want to call it) and have been a CCL for the past 18 months for a total of almost 9 years now. I have never had a performance review, nor have I had any negative situations (I have never been 'written up' nor taken into the office for any problems) The team I work with respect me and I often hear comments like "Thank God you were in charge, if so and so was here it would have been a nightmare", or just stated the other night--" you are working the weekend right? I don't want to come in if you are not in charge" I am now being told by my manager that I cannot re-apply for CCL, I will only be in charge if they are stuck, and that I am to mentor the new CCL's, and yes I lose the money. I understand the organizations's point in trying to offer leadership positions, but I am feeling very hurt by this. It almost feels like they are trying to get me to leave. Any one have any thoughts? thanks Tracey

I too have always been a night owl....worked nights for 22 odd years now, as a waitress in a bar--not getting home til 3, then onto nursing, where I only work nights. On my days off I do try to switch, as you are right you have to be awake during the day. On my last day after a few in a row I try to sleep only 4 hours or so, and often I need sleep aids--beer works for me 2-3 and I am out, some prefer gravol (dramamine to you americans) or ativan. My first night back often sucks as I am up at 0730 with the kids the day of the night shift, that night I often nap on my break. I try to group my shifts, it helps. Doing 6-7 in a row is better then 2 here and 3 there. I did a day shift by accident a few weeks ago and realized why I hate days so much. Far to many people, far too many chiefs, the indians are being bullied and the noise level----OH MY GOSH!!! Also no autonomy--at night I have no manager to run to, the Doc is busy, I have to choose and decide--and I do. Love the night shift----- Tracey

Very interesting thread going in the general discussion, a med error caused a death and the nurse that hung the med is looking for support or others... she/he states that 7,000 med errors occur every year....I think it is higher then this. Let's offer some support---- What is your worst med error? Have you witnessed a med error by a doc? I posted this in the general discussion--this is my nightmare... I too have made errors. In 15 years I have made 2 significant (sp) errors that were potentially deadly. The first actually ended up benifitting the patient. I work ED and was fighting with the internal med team to intubate and sedate a very sick septic pt, they did not want to as he was 'not an ICU candidate', I got mad and finally said "you have got to at least sedate him--he is going to fall off the bed and he is ripping his lines out." They ordered 20mg of Valium (hx of etoh abuse) I thought they meant IV, they meant IM. I gave 10mg, waited 10 min and gave the 2nd 10 mg. As the team rounded on the pt he resp arrested. The attending was not pleased, they were forced to intubate, the ICU guy was livid, but the man got appropriate care, I just got the greif. The second was not so good for the pt. A very anxious mother and daughter team, the Mom had a picc line for chemo--they were harrassing us all day for minor stuff, and I cannot even remember why she was there, "she is near someone coughing", "the sheets have a spot", "was this room cleaned properly", etc..... Mom finally got her get out of the ED card and I went to D/C her picc and flush her line so she could go. I grabbed the heparin and a 10cc syringe and ran in so I could get rid of these pains in the )&*&(. As I slammed the syringe full of fluid in, I realized what I had just done---flushed the line with 10cc of 10,000u/ml of heparin. I was freaked. The doc on was surpizingly wonderful--he has a reputation of not caring about anyone but himself, but let me tell you, he sure went to bat for me. He called hemetology to find out if we should give the antidote for heparin (that my brain cells are blanking on right now cause we never use it) and they said no, just moniter as there are too many side effects. I went to the Mom and Daughter team and explained everything and apologized. Lots of tears, and the daughter went nuts--unitl she realized Mom was now going to be admitted for observation. I followed the pt, and her clotting times did not come down for over 5 days--they should have been down the next day!!! I lived on egg shells!! Mistakes happen, we are busy ----WE ARE HUMAN!!!!!!!!!!!!! Is your work supporting you, are your collgues and manager behind you? What about the docs? Is there an internal support phone line? You are right we need a support group--if either of those pts died because of me I would be freaked out, but looking back on my 2 near misses I realize there are system errors that also occured and my shoulders need not be that broad. NOR DO YOURS. You are a good nurse, and as everyone else has said--think of the good you have done. Could you start a thread "What is you worst med error?" some version of a support group? it is all annonymous right? Are we not supposed to be learning rather then blaming? If anyone can offer support here is the link for Julie who started the main thread... https://allnurses.com/forums/f8/7000-fatal-med-errors-last-year-where-theses-nurses-171356-new-post.html this is a good one... it is about supporting with honesty, not hiding errors and learning from them.

I too have made errors. In 15 years I have made 2 significant (sp) errors that were potentially deadly. The first actually ended up benifitting the patient. I work ED and was fighting with the internal med team to intubate and sedate a very sick septic pt, they did not want to as he was 'not an ICU candidate', I got mad and finally said "you have got to at least sedate him--he is going to fall off the bed and he is ripping his lines out." They ordered 20mg of Valium (hx of etoh abuse) I thought they meant IV, they meant IM. I gave 10mg, waited 10 min and gave the 2nd 10 mg. As the team rounded on the pt he resp arrested. The attending was not pleased, they were forced to intubate, the ICU guy was livid, but the man got appropriate care, I just got the greif. The second was not so good for the pt. A very anxious mother and daughter team, the Mom had a picc line for chemo--they were harrassing us all day for minor stuff, and I cannot even remember why she was there, "she is near someone coughing", "the sheets have a spot", "was this room cleaned properly", etc..... Mom finally got her get out of the ED card and I went to D/C her picc and flush her line so she could go. I grabbed the heparin and a 10cc syringe and ran in so I could get rid of these pains in the )&*&(. As I slammed the syringe full of fluid in, I realized what I had just done---flushed the line with 10cc of 10,000u/ml of heparin. I was freaked. The doc on was surpizingly wonderful--he has a reputation of not caring about anyone but himself, but let me tell you, he sure went to bat for me. He called hemetology to find out if we should give the antidote for heparin (that my brain cells are blanking on right now cause we never use it) and they said no, just moniter as there are too many side effects. I went to the Mom and Daughter team and explained everything and apologized. Lots of tears, and the daughter went nuts--unitl she realized Mom was now going to be admitted for observation. I followed the pt, and her clotting times did not come down for over 5 days--they should have been down the next day!!! I lived on egg shells!! Mistakes happen, we are busy ----WE ARE HUMAN!!!!!!!!!!!!! Is your work supporting you, are your collgues and manager behind you? What about the docs? Is there an internal support phone line? You are right we need a support group--if either of those pts died because of me I would be freaked out, but looking back on my 2 near misses I realize there are system errors that also occured and my shoulders need not be that broad. NOR DO YOURS. You are a good nurse, and as everyone else has said--think of the good you have done. Could you start a thread "What is you worst med error?" some version of a support group? it is all annonymous right? Are we not supposed to be learning rather then blaming?

My favorite.... "I just want to get checked out". Checked out for what? This is ussually stated post minor MVC, fall, child falling off couch onto carpet, tumbling off a bike, doing new drugs, having 'relations' with people one is unsure of, etc..... and the conversation will often go like this... "I just want to get (add a 'my son or daughter)checked out." RN--"does it hurt anywhere, do you feel unwell?" "no" VSS, good colour, ambulatory etc. How do you triage this? What do they want us to check? Would a family doctor or phone line not be more appropiate? I once had a lady bring both her very well looking, playful children in to be 'checked out' after they might have had a drink of a puddle that was on the road a few hours earlier--she wanted us to pump their stomachs!!!!! HERE'S YOUR CHECK---GO HOME!!!!! LOL....

just read back in the thread and realized this had been answered, I gotta stop just trying to jump in at the end of the thread...LOL I am really liking this thread....it is amazing how smart you people are!!!! I went to ED rounds this am...amazed at the topic and interesting info...leads to a Q.. Syncope is 2% of ED population (when I was a kid it was called fainting)...50% of that 2 % we in the ED will not be able to figure out why they had a syncopal episode...... when do you need to worry?

3-5 p in my house is the "witching hours"---I hate them!!! the kids get nuts, dinner needs to be made, you have to get someone somewhere by some time...the kids are hungry but you can't let them snack too much or they will not eat dinner, you can't let them lie on the couch or they will fall asleep (thus making 2300 the witching hour) and they can't get too involved in something because they have to eat--it is all about that dinner with the family thing---LOL, DH comes home and he wants to sit, and you then want to kill him because you are running like a headless chicken, or he is so depressed about other stuff....blah blah blah it just seems to be the bad time of the day---our ED goes nuts during these hours (more til 2000 or so before it starts to slow) Has it got something to do with biorythms and this is the heightened brain time, or slow brain time (siesta?) Or just normal mon-fri 9-5 ers who stress on going home about their home being perfect?

Oh yeah... My favourite thing to do is get them off the EMS stretcher and inot the main waiting room...good pr for the folk in the waiting room, and makes the medics happy.....(sometimes they bring coffee after that!!)LOL.

when people get antsy/bitchy about the average 7.5-8 hours wait time that we have in our antiquated far too small department with 7 speciality programs that draw from way outside our catchment area.... My favourite answer remains...."You do not want to see me moving fast, if I am moving fast it is bad...for you or your loved one.....waiting is good." I generally get the confused head cock, then the smile, then the "your right but....."

at one of our sister hospitals a pt did not pursue litigation even thought the doc replaced the wrong knee. The doc went to the pt and apologized, the pt agreed the doc was remorseful--he was really upset. Obviously, the other knee was eventually replaced!!!!!!

Has anyone read the recent Time magazine article that basically concludes that 'care errors', all errors, including meds, vitals, food, allergies, dressings, x-rays, etc. are actually the 'norm' in the hospital? (They interviewed docs who had family members hospitalized--they did not chastize nursing, but......nurses are the front line) Has anyone also recently had a loved one hospitalized and watched this phenomenon? How does this make you feel about your career choice? Is it a nursing issue?, and if so...is it fixable?