babynurse4u

I also wonder if your quietness is being interpreted incorrectly by your patients or their families. Maybe you di not seem confident? That is one of the first things I teach my students-always appear confident. If you need assistance, seek it out but do not let the patient see your indecision. Not being talkative could also be interpreted as being aloof or non-caring. I think the others are correct: approach your unit manager and ask for feedback-you need to know what the real issue is so you can begin working on a plan of correction. Good luck, and hang in there!

It sounds to me like a combination of reality shock and trying to adapt to night shift. I was a slow one to adapt, as another poster referred to in an earlier post-you may be as well. Having acknowledged that, night shift may not be for you. I worked nights for over a year and finally had to transfer to another unit to work days. I could not sleep, eat or function normally. My digestive system was shot, as were my nerves. I tried all of the tricks: altering my sleep schedule even when I was off; black out curtains, white noise, etc. but nothing worked. While day shift has its own problems, it worked better for my natural body rhythm. I also think you should address the depression-been there as well. If you can work on that first then perhaps find a day time position maybe it will work for you. Either way, I feel your pain and am sending heaping helpings of hugs!

I'm on retainer for Judge Judy!

That is a great idea! Many nurses love to teach and /or mentor so buddy up with one or two and get some experience! You will also confirm that you truly want to work in pediatrics.

What a beautiful account! It only reinforces the knowledge that there is no explaining the human soul. It is comforting to know you were able to help him pass over, and I believe that everyone has an angel that helps them cross over when it is time to go. It makes death less frightening and confirms that there is something or someone waiting on the other side.

Tami, I was a clinical manager for several pediatric HH agencies for over 16 years. This is my pet peeve: sending out nurses who have no pediatric experience on cases with no training (you did not indicate that they are training you). My former agency has a pediatric training class we put nurses new to peds in. We also did an all day orientation to the paperwork, documentation, etc. and we checked off on skills prior to the nurses even meeting the family or accepting an assignment. We had a clinical supervisor or a preceptor to train the nurses bedside in the homes as well. You should not accept an assignment if you have not been properly prepared, and have every right and obligation to request assistance and training. Peds is an awesome specialty and if you are properly trained and prepared you will love the kids!

My mom passed away unexpectedly 4 years ago. I was sitting in the ICU waiting room for a week-I actually went back to work while she was hospitalized, thinking she was on the upswing only to be called back home . We took her off the vent and she went home. I went back to week almost immediately, because of the same reasons you did. Give yourself time, and going back to work was not selfish-it may save your life in the long run. When you need a break you will know and then you should take some time off. The grief hits you later after the numbness wears off. Not a day goes by that I do not think about her and miss her presence, but having the love and support of my co-workers was what got me through the rough times. Let them be there for you, and please accept my deepest condolences. You are a strong lady!

I think maybe there is a larger issue here, if the entire administrative team has turned over. It sounds maybe like inappropriate behaviors have been an issue in the past (ie the late days) and perhaps this new team is trying to "clean things up" and follow policy or create policies to address concerns. This usually does not go over well when established staff are suddenly being held to policies that were previously ignored or not enforced, or non-existent. Many times staff will see how far they can push a new employee and you need to establish boundaries. They will usually respect someone who stands up for themselves-it doesn't matter if they like you or not, but they need to treat you as a respected fellow employee. In the end, patient care is what matters. Have confidence in your abilities and project that confidence in a pleasant but firm manner.

freckles23, you did the right thing. Your feelings of guilt and and violation are normal, because you care about how you perform your duties. In my opinion, they lost the opportunity to have a compassionate and caring nurses at their side during what has to be the worst moment of their lives. Don't change a thing-keep on providing wonderful and compassionate care, and realize that anger is often misplaced when a loved one is ill or dying and unfortunately health care workers are in the line of fire. I have had families express anger towards caregivers that were with them for months or even years upon the death of their child, it helps to have someone to blame. More often than not, these parents would eventually reach back out to us and apologize, and thank the nurses for caring for their child. So stay the course!

I worked as an office nurse with two pediatricians and loved it! It was very rewarding to form those bonds with the parents and children as they came in regularly for check ups and then also sick visits. I always hoped I took away some of the fear for the children by being patient and kind with them when they expressed reluctance to come and see the physician. We gave stickers at the end of the visit and that was a popular practice.

In the world of Medicaid and Medicare, there is legislation that requires that if a nurse (or other healthcare worker) has ANY knowledge of fraudulent or unethical activities they MUST report. This is a case of guilty by association-if you do not report and it is discovered at a future date (and it most likely will be) you can also be held accountable for not reporting. And this is NOT secondhand information, hearsay, etc. it is a matter of knowledge of potential wrongdoing. There will be an investigation, so if someone's license is affected or if they go to jail, it is on THEIR OWN head not yours. And what about the patient??????????? Aren't we supposed to protect and advocate for them?

What mistake was made???????????????? The nurse did not follow physician's orders! The deterioration of the wound has nothing to do with whether a mistake was made. It has everything to do with consequences of the actions and proving injury should there actually be a lawsuit (assuming it wasn't changed, etc.) And this absolutely is reportable to the board if an investigation (which should occur) shows that the dressing wasn't changed and the documentation that is was changed was falsified. Also, Medicare and Medicaid consider falsification of documentation to be a very serious issue.

I think many people are missing something important here: the licensure of the home care agency. I worked home care for many years and while it is always POSSIBLE that a patient is self injurious or being non-truthful, why would one assume this is true before believing that another nurse could have made a mistake or covered up one? It is a requirement that any incident such as this (especially when a patient complaint is involved) is reported to management asap and an incident form completed. Next the incident must be investigated thoroughly (again, regulations) by the agency. It will be a sorry day when you advise someone not to report and the patient contacts the state with a complaint. Then the entire agency is in jeopardy (especially if there really were past indiscretions). The state can come in on a complaint survey and examine all of your records, not just that patient's -in fact they never investigate just one patient in an effort to protect their identity (patients fear recriminations). At the very least it will be a very uncomfortable several days for the office staff and at the most the agency could be shut down (of course that is the extreme, but believe me I have seen it happen). it is unfortunate, but the state almost always finds citations when they survey, even of they are unrelated to the patient in question the agency will still have a plan of correction to file.You absolutely cannot approach another nurse with any patient complaint as a "courtesy". If the other nurse did nothing wrong, then he/she has nothing to fear from an investigation that will exonerate them if they are indeed in the right. You on the other hand, are guilty by association-if you do not report you can be held liable as well. I am only attempting to answer the original question-falsifying documentation is prohibited by most state nurse practice acts, and can lead to being reported to the board, a fine and even jail time. If Medicaid or Medicare is involved and documents are found to be falsified, the agency can be fined and placed on conditional probation, or shut down if other violations are present. As a former regional director, I can say that once you have reported to the proper people, you are out of it. You have to trust that they will do their jobs appropriately. if you do not trust them, then perhaps this place of employment is not a good match for you.