canoehead

Agreed, Tylenol or lack of it doesn't kill (in appropriate doses). It makes people more comfortable.

Too much pain med will kill you, but some is beneficial. The same goes for water. I won't give 10mg of Dilaudid when the order says 1mg. I won't give 3L of water a day when the patient has orders restricting them to 1L. In both cases the patient may find their own source. I'll educate first, then document their intake best I can, watch for changes in their health and notify the doctor.

I'm with the group that says the patient has a right to drink water, but they don't have the right to demand I help them. Yes, I'll do as many comfort measures as I can, and educate. If I think there is a medical need for them to be NPO, I won't be a part of making their medical condition worse. If it's a judgement call, like a cup of water after midnight when they have surgery in the morning- I know water takes two hours to clear from the stomach. If it's 3am, I'll stretch the 8h NPO rule and document it. Never had a problem with that. In the ER abdominal pains are technically NPO, but I give them ice chips, until we get a surgical diagnosis. (Except those that look like death, of course) If they are vomiting, NPO until they've stopped for an hour, then chips. Those that are NPO and need it strictly held will get swabs. If the drink the swab water they don't get more. I've found that people saying "just a sip" will sip every minute they have water so they get 10cc and there's no more from me. I've had a man fifteen minutes from going to the OR and NPO for two hours suddenly start vomiting 500ml clear fluid after his family showed up. Trust no one. But if they get the water, and then pneumonia, it will be their own decision, without my help.

If a resident hates you, remind them they have the right to refuse and have it done by another RN or the next shift. Sorryif that means enemas have to be switched to days?

If they are warming it up, does it emit radiation?

If it happens again, tell the supervisor and leave it with them. If you see someone acting impaired, tell the supervisor, and follow up with a letter to your boss and the impaired employee s boss, every time it happens. If the impaired person is working with you, I'd verbally push the supervisor to send them home, send the letters, and meet with your boss. If they harm a patient, calling the police is on the menu, but know that your job may be on the line. You should know that the squeaky wheel gets annoying to its boss, even if you're right. Be careful.

I had a lawyer for the second one, but he asked to write the reply and said it was well done so that's what we sent. For the others, I wrote them myself , but I was in a union, but the same thing happened, we just sent in my replies. I was confident that I hadn't done anything wrong. In a couple cases I didn't follow hospital policy, but it was to decrease risks to patients, so there was no action. If they decide to investigate, get some coworkers to write about your treatment of other races. Since it's anonymous, and someone that wasn't involved , it's based on gossip. There's no way legally they can act against your license based on gossip. I agree, tell your employer. They need to protect you from this person, and you don't want them to hear by accident. Be as up front as you can.

You've got twenty years of nursing and this is the first racism complaint. The complaint didn't come from the kid's parent, or your employer, but from an uninvolved third party. Was that third party present, or is the whole complaint hearsay? I assume you can name a dozen witnesses to speak about your character, and your approach to different races and cultures. Maybe you can think of some initiatives you were involved in make new students or immigrants mesh with other long standing students. I also bet that you have a long paperwork record of harassment by the complainant. This is serious enough to be addressed, but don't worry about it. Let her spew venom and her nature will become self evident. If she files more than one complaint make sure you point out the harassment angle and her relationship with your ex. I am in the unenviable position of having five complaints made about me, and not one of them affected my license. It was a trip. I'm still practicing, but my level of jadedness has gone up over the decades.

Travel nurses are the paper plates of the nursing world. Disposable, just chuck the one you have and order another.

I really sincerely think you need more staff. On call is a pain for all the reasons you mentioned, but when they took a hospice job they should have been told that on call is required. Being on call 50% of the time is excessive. I think everyone needs to share the burden, and stay in reasonable distance if they are on call. That might mean some hard decisions.

I agree that if I don't have a relationship with a client the first contact shouldn't include driving them somewhere. I would want a second person, or to go in a taxi so I could concentrate on one thing at a time.

I agree. Ask your charge or supervisor to make the calls while you get the tasks done they are requesting. You aren't a damned octopus.

If you are 9months into your very first job as a nurse and you feel confident, you'd be an idiot. Feeling like you need years more of research and practice is appropriate, because it's true. No one should put you down for that, you aren't supposed to be perfect. I'm more than thirty years in and still finding things every damn day that I should know, but have to look up. It took me two years from graduation to feel like I could make it through a shift without killing anyone, and that was in a very supportive environment. If you have coworkers nitpicking, its hard to get that confidence, During my first two years nursing I was hospitalized for mental health issues six times...you are not weird for struggling. It's OK to choose something different, but struggling does NOT mean you are going to fail.

Good! They wanted me to take the English exam too, that was when they first started, but I pointed out my degree had been taught in English. A coworker, who was born in Britain, had a hissy fit when they told her she'd have to take an ENGLISH exam. "That's MY country, MY language!" she said. I had a feeling that if they corrected her grammar she'd go back to the Queen and get a royal decree to declare them wrong.

It seems like if there is a PRN order you should be able to use it.

I'm sorry to say you might not have completed your nursing tests. If/when you leave the country immigration may demand CGFNS certification. I'm working in the USA from Canada, and started working with a TN visa in 1997, then two years later I was told I'd have to go through the CGFNS process AFTER I'd already been working as a nurse for two years. It takes about a year to get all the testing and paperwork done, so wise to start sooner than you need it.

I was there for the last one, but I doubt I'd stay for another round. I'll pump gas before doing that again.

I believe I would choose the same as you, why torture yourself. I sure hope you have people around you that make you feel loved as things get harder, and an old crotchety nurse that is liberal with the pain meds. Make your bucket list and dive right in my friend.

Seriously? someone is still asking this? I'm making less than I was as a new grad, and I'm 35 years in when you take into account inflation. I'm working double time every shift. I resigned from a job with proper notice and good evaluations because the environment was unsafe for patients and they reported me to the nursing board three times in the next six months....but after all those reports my license is still completely clean because my offense was advocating for better care. Quit spending time and money whitewashing the hospital to make it look good and keep up the PR. Pay your nurses double what you do now and you won't need travellers. Keep supplies stocked and equipment working. Give us enough space and staff to take the patient load- no more hallway beds, or holding more patients than a unit is designed for. And stop asking stupid questions when you already know whats wrong.

If you make a mistake the lawyers will check your background and your other jobs. They will find out how many consecutive hours you worked and it will not show appropriate concern for your patients welfare. Staffing and sick calls are not your responsibility. Sick calls are a predictable part of doing business, so much so that administration should have a better way to deal with them than mandating a double shift. did they offer more money or time off to anyone before talking to you? Maybe they should make it a policy to give double time to critical needs. That said, they will call it insubordination, and abandonment, and whatever else they can think of so no one else thinks they can get away with saying "no." They might report you to the Board, which is a stress in itself, but no one there is going to fault you for refusing to work 24h straight because they are mandated to protect the public.

I'm working a travel position. An intoxicated woman came in requesting detox, and staff told her they don't provide that service, but XXX hospital in YYY city does, you should go there. Patient left because she was told we couldn't help. Sounds like a violation to me...

I suggest describing the practice to your board of nursing and getting the official interpretation as to it being legal or illegal, and passing that information to nursing administration, and your colleagues.

That makes sense to me. they get their results slightly sooner than if they waited for the phone call, and you get your prioritized work done before you look up their chart. I'd add "It could be hours, but you are welcome to wait" to that spiel.

Cats are little ***. I've had a lot of them, and called in because they were sick too.

Id inform the patient that unless they give permission for you to inform your supervisor, no one will know who they don't want caring for them. You don't have the power to rearrange staffing without a reason. You can let your boss know the patient has issues, and encourage the patient to talk to them, but after that, bow out. Not worth the stress or bad feelings on all sides.