Irish_Mist

Do not take these two classes together. You are setting yourself up to be overwhelmed and to fail.

OMG I was just talking about this yesterday. I can't stand it when nurses act like this. I find myself just rolling my eyes. As if they nevvvverrrrrr get annoyed when a patient acts like a horse's behind. ?

It sounds like your anxiety about making a med error is what might have led you to missing this lasix dose. Take a deep breath and relax. Going over the MAR multiple times every hour is not necessary. All this will do is make you anxious. This is a very minor event, the patient is fine, you are fine, and all is well. Move on and forgive yourself. You are just as much of a human as any other nurse and you will make mistakes but the important thing is to learn from them. My suggestion to you is to find some sort of way to get past the anxiety you have. I have dealt with depression and anxiety all of my life. I take medicine for it and I see a counselor. Both of the aforementioned have made my personal and professional life SO much easier. Maybe you could do one or both of those if you can't find a way to establish your own healthy coping mechanisms. No nurse wants to make a mistake but if you are constantly living in fear of making a mistake, it will probably make you more likely to actually make a mistake.

You don't. You find another job where there is safe staffing. Might not be the most helpful answer but it is the best one I've got.

My first thought as well. In fact, I wonder if the patient herself would even test positive for opiates. There a so many situations of caregivers or family members taking or selling narcotics intended for the elderly patient that it makes my head spin. Narcotics are destroying this country.

What in the everlasting hell is wrong with that teacher? My GOD!

I have always been opposed to bringing young children to the ICU unless it's an end of life situation. Even then, I'm not so sure it is a good idea. In addition to potentially getting sick, it has to be horrifying for a small child to see an environment like the ICU with alarms going off in every direction and their loved one with tubed and vented with several machines next to him.

ETA: saw your recent response to Fiona and see where you're coming from. I'm glad to know you agree that it's wrong to film the staff without asking. I personally don't see anything wrong with writing down interactions throughout the day or taking notes about the care/plan of care. But literally writing down times and what the nurse/ staff did in the room for the patient or said, that is excessive and tells me the family member is either incredibly distrustful of the staff or looking for a pay day via litigation. If you have that much trouble trusting the staff at your local hospital, perhaps it's time to go somewhere else for your/your family's medical care or pursue mental health services. Again, as I stated before, I have the right to my privacy. The patient expects their privacy honored, so do I. I refuse to be recorded doing my job unless my permission was asked and approved by my me as well as my nurse manager and upper management in the hospital including (but not limited to) risk management, HR, nursing administration, etc. I have no problem with someone having me be recorded for wound care, wound vacs, or some sort of detailed procedure that a family member is going to be doing for my patient once discharged. However, I want to be ASKED. If I find out that I am being recorded without my knowledge or consent, I will get the charge nurse/house supervisor/nurse manager involved immediately. As far as your last paragraph, you will be hard pressed to find a hospital that will allow their staff to "honor the requests" of patient who want to film their care in the OR, pre-op, etc. It's a major conflict of interest and sets everyone up for a hipaa violation. It's a potential state and federal legal issue. Not to mention, everyone these days wants to whip out their phone, hit record and the post on social media. I have no desire to have myself recorded and plastered on Facebook.

Is your son 55 and does he need you to be the one who talks to the doctor and not him? Break has been given.

I have the right to not be recorded without my consent at my place of employment. Patient's have an expectation of privacy and so do I. It's a two way street. It is totally possible for patients to advocate for evidenced based care without recording the nurse or writing down every single interaction. That's excessive and way over the top. Recording every interaction with the staff smells of "I'm looking for a reason to sue". Encouraging people to record interactions almost translates to "you can't trust these people to do their job or do it well therefore you need to record in case you need proof against them."

At this point in your life, do you really want to incur more debt and work a physically/mentally/emotionally demanding job?How much longer do you plan on working? If you want to work for another 15 years, sure, go back to nursing school. What kind of shape are you in physically? Do you think you can handle being on your feet all day and working 12 hour shifts? It's a bad idea and if people looked at this more realistically instead of with rainbows and unicorn dust, they would say exactly what I just said. I doubt you'll want to be at the bedside for 15 years and retire at 76 with student loan debt. ultimately, the choice is yours but you'd better think long and hard and have an exit plan in place if nursing doesn't work out.

I cannot stand families with the unhealthy dynamic between adult children and parents. It's usually between a son and mom and half the time, mom answers questions for the son as he looks to her for some sort of guidance when he's asked a simple question. If you're 55 years old, it's beyond time to quit acting like a toddler and cut the cord.

People who hound me about getting discharged the moment someone (usually a specialist who clears him/her) mentions possible discharge. Seriously, stalking me at the nurses' station or in the hallway will not speed it up. I once had to get very honest with this patient's daughter who literally asked me every five minutes when the doctor was coming. I explained to her that I paged to ask for a time estimate. Not two minutes after that encounter, she comes up and asks for an update. I said "ma'am, this doctor has a lot of patients. I have already sent her a page. She hasn't called me back as she is still seeing other patients. I am not going to send her another page as there is not an emergency going on. There is nothing else I can do at this time. As soon as I hear from her, I will come to your mom's room and let you know." I'm not sure what she expected me to do short of locating this doctor and dragging her in the room at gun point. People who have no clue what medications they take and then tell me "it's in the computer". If you are an A&O patient, the onus is on YOU to know what you take. Telling me "that little white pill" is not helpful at all. Patient family members who answer questions for the alert and oriented patient or even the non alert family member but still verbal. "Ma'am, I really need to hear your husband's description of his pain. But I thank you for your help." There's a few more but these are the main ones.

In general, I think it is a bad idea. If things go sour and the other party is bitter, they could throw some major accusations your way. It sounds like a great romance novel idea, but not a good idea for real life.

Maybe I'm in the minority here but I do not care at all how someone charts or doesn't chart. I am not in management so I am not paid to care. Now, when it comes to patient safety issues, I definitely care. Your license has nothing to do with her charting. As long as you document everything, you have nothing to worry about. My advice to you is to continue doing what you're doing and provide the best care possible for your patients. I work with a nurse that does similar things that you've described and it amazes me she hasn't been let go. She doesn't chart anything except hourly rounding. There's also been numerous safety concerns I could write a novel on. She frequently leaves figurative messes for day shift (she's a night nurse) but I just keep on going. No sense losing sleep over it as I do not have the authority to address things like this.

This doesn't sound like an assisted living facility to me. It sounds more like an understaffed nursing home. 5 total cares? Wound Vacs? Don't these people receive home health? I work in a telemetry unit at a hospital and if and when patients are discharged back to assisted living, they have to be able to do most ADLs on their own other than cooking, laundry, medications. Otherwise, they need a full time caregiver, home health nurse, PT/OT, etc. Absolutely no assisted living (outside of the memory care units) will accept the kind of people you are describing. These people need a higher level of care like a skilled nursing facility. You know that this working environment is unacceptable. It is dangerous. It is immoral. And it is setting not only the residents up for failure, but it is also setting you and your colleagues up for failure. This is all in the name of the almighty dollar. Absolutely despicable. The more us nurses REFUSE to accept these sort of conditions, the more likely facilities will quit operating like this. You seriously need to find another job because something bad will happen and this facility will point their finger at you or another nurse if/when it does. It is impossible to provide anything more than substandard care to these residents with the staff to patient ratio you have described. RUN FAR AWAY AND RUN NOW. Report this facility to every governing body you can think of. The State Board of Nursing and labor come to mind. It would also be helpful to contact your state's regulatory body for nursing homes. In Texas, it is called the Texas Department of Aging and Disability Services.

Mavrick! With all the delicious places to eat in Seattle, you had Taco Bell for lunch. I am truly shocked and almost a little offended .

There is no such thing as a student nurse med error. Think about that for a minute. When I precept nursing students who can give meds, we go over all meds together before proceeding. Your preceptor should have been watching you more closely.

You know what? Administration can kiss my ass. You were dealing with what sounds like an impossible situation. If administration doesn't want falls, how about they staff appropriately? How about we stop downgrading patients from ICU/PCU when they truly aren't ready? Stand your ground and do not let any of the higher ups point their slimy fingers at you. Truth is, even with every possible safe guard put in place, falls will happen. We are not magicians nor can we be everywhere at once.

You did the right thing. This person can go sit in a fire ant pile for being so unreasonable.

I actually agree with this physician. She should have kept quiet and spoken with him in private.

I've been there. It sucks so badly. I know how scared you feel. But, you'll be happy to know, it DOES get better. Push forward and continue to do the best you can. You've made it this far!

I like the science of my job and knowing that I am the eyes and ears of the physicians. It gives me a sense of pride when doctors ask for my opinion or how I think a patient is doing. Or catching something that someone has missed. I also like playing with drips. 😎 I enjoy my elderly patients. Especially the 90-100 year old a&o4 ones. I also like connecting with cool family members and filling in the gaps of the plan of care that may not be well understood. Or just sharing an interesting conversation or too. Teaching is one of my favorite things to do. I also enjoy the occasional patient who is close to my age (29-35). Most of these are chronically ill individuals and it's nice to do what I can to make them feel better emotionally and physically. Plus, it's nice to share some common ground since a lot of these patients will have similar interests in music, tv, movies, activities, etc. I guess it's safe to say I enjoy the connection aspect of my job.

So sad to read this. I really enjoyed this member's contributions to this site.