sle9403RN

I own my mistakes. I learn and try to make it 100% better. Trust me this will never ever be an issue for me again. When I wrote this I was just wanting advice on how I could show interviewers that I have learned from my mistakes and want to prove it. I think that the comments got me defensive and I felt I needed to show where my mind was at the time. That may have come off as an excuse. For that Im sorry. Putting myself out there for all this open criticism is extremely hard and something I've never done before.

This is exactly the case with this facility. However, we did not have a snack between breakfast and lunch. I went against the rules and let the co-worker give him his breakfast so there was no need to call the dr for an order because he had eaten. And as I previously stated the Dr and dietitian always were aware when pts missed meals.

Thank you for your response. I feel that I need to clarify the reason that incontinence with this pt was an issue because with other patients at that facility is was not. I'm not sure if any of you have ever worked with a conversion pt? These pts typically have some kind of emotional issue caused by outside factors that leads them to believe they can't do certain activities (walking, seeing, taking care of themselves) when in reality they can. If it goes on for too long they can lose some of they ability due to lose of muscles in the leg for example. I've a had 4 of these pts in my time the facility, all of who were w/c bound. When this patient came in I argued that he needed to go to the acute unit to get accustomed to how things worked there but I was told no because he was conversion that he needed to be pushed to do things and we were to give him minimum assist (10%) with all activities. He had incentives to do things we asked, he loved Gameboy and we had one he could use if he moved himself and did as much on his own as possible. That particular morning he was awake in bed at 7 but between 7-8 he never once told any staff he needed to use the restroom. The issue was that if he needed a new game for the Gameboy he would ask peers to tell staff but he would not do so when he need the restroom. I went in at 8 to get him out of bed and realized what had happened. Going by the 10% assist we were to give him I reminded him that he needed to be up out of bed by 9 several times so we could get his breakfast. He refused to assist me at all. I kept letting him know how close we were to 9 and he still did as little as he could so when we finally got him out of bed it was almost 930. I didn't refuse his meal due to being angry for any reason. Why would I be angry? I've cleaned butts, bodies and ostomies. It's nothing new. If it had been my child I would have followed the rules just as I had done with all the kids. I think the facility needed to check in on the units more often, then they would have realized what was going on and could have changed it. But even in the rules book the facility gave the units to give the kids it said kitchen closes at 9, didn't say we will give snack if you miss a meal. If anyone involved had said anything about him not eating I would have been more than willing to give him whatever food was allowed. The Dr stated we just had to wait him out when I told him that the pt was missing breakfast. I can't take it away and go back, all I can do is take it as a lesson learned and move on. I will always check with the facilities on policies and rules on issues such as these with these type of patients. I also will try to find a substitute to cursing if only we could chew gum on the floor lol.

Hmmmm. you learn something new everyday!

Yes the only units that were not done like this was the acute and the autistic units. An never with the eating disorder pts. I always made sure the Drs knew when a patient missed a meal and why.

I read somewhere on here that saying it wasn't a good fit might lead into questioning how it wasn't a good fit. What if they call the facility and they tell them what happened? Then I won't get the job due to being a liar. What a tangled web I've weaved. I love being a nurse and the patients I've worked with. Thank for your feedback, it really helps.

Thank you for your response. Yes cursing is not acceptable in any professional setting, healthcare or not and I can admit this. However, its a very common occurance. I've heard so much fly at the nurses station. I am working hard at changing my bad habit. It has improved. The patients were not the issue it was my co-workers who in my opinion acted "holier than thou". But it definitely a lesson learned for me. As for the meals, yes everyone got a chance to eat. However, based upon the way I was trained at that particular facility, it was kind of like we gave them the choice of either get up and get stuff down so you can eat breakfast and go to your school and therapy sessions on time or lay in bed that extra time and skip the meals. We wouldn't let this go on for an extreme amount of time, the Dr and MD were always aware of what was going on. Its like if they were at home and had to get up to go to school on the bus. If they didn't get up in time for breakfast and didn't make it to school for their breakfast then they would go without until lunch. School doesn't say well your running late because you slept in so here is some crackers. I often tried to give extra time when I could but these patients had strict schedules. If they missed one meal I always tried to make sure they ate the next one. upon admission I always made sure to explain. I felt horrible to have to make that decision but with 18 patients if I let one lay in bed until 9 then get up and to get stuff done and eat breakfast late then they would all choose to do so. They had to go to school and therapies that started at 9am and we would get in trouble if they were late.

No compassion??? Really? So when I have to wrap up wrists cut to the bone or Ng tube a patient who refuses to eat or cried with a patient who was having a hard time or spent the countless hours trying show them that they can't be angry all the time means I have no compassion? I lived at my job...not because they paid me to or because i had to, but because I loved my patients. Have you worked on a psych floor? Let alone a peds psych floor? If not then you have no idea what goes on and what I've dealt with how many times I didn't curse or cry or become emotional when i felt my life was threatened. Yes there were times I put myself in harms way to save my patients. So if that is having no compassion then maybe I didn't. I didn't baby my patients or pretend as if it was ok that they abused the people and caregivers who cared about them. I gave them real-life and a shoulder to lean on when they struggled. I'm sorry you feel the way you do.

Never! It just occasionally happens when I'm really frustrated or extremely stressed. I'm really trying to stop but it has been hard.

I put that facility on my applications and resume to show I have some expierence. Where it asks why I left I put personal reasons. I only tell them if they ask about it. The reason I put it on there at all (I did consider removing it) was just in case an employer did a background check and found it.

Yes it is technically recapping. However insulin pen needles are once and done. They lock after they are pulled out the skin so they are considered safety needles so they are safe. We taught the kids are my facility to put the caps back on to be on the safe side when out in the community.

Sorry this is sooo long!

This is very hard to be honest about but I know that I need to in order to move past it and to show that I know that what I did was wrong. So I'm a relatively new grad (got my RN in Jan 2012). I took my first nursing job at a pediatric dual diagnosis hospital where the patients have both a medical diagnosis and behavioral diagnosis. I worked there for just over a year. In that time I was written up a total of 3 times for cursing, but only 1 of which actually occurred. The first time, one of my co-workers wrote a letter to the DON stating that I had made a statement at the nurses station about "punching that ******* ***** in the face" and I was brought in and questioned, which I completely denied. The second time is the 1 time it actually did happen, I had a patient call me lazy because I refused to heat up her butter and I stated that I would be damned if anyone is going to call me lazy. I immediately apologized to the patient and when my supervisor questioned me, due to having been informed by a co-worker, I told her the complete truth. I also used this as a teaching moment for my patients to show them that even adults are not perfect and we all have stuff we have to work on (mine being cursing). The last time never happened. It started out with a co-worker being upset about the way I treated a patient and the co-worker lied and said I cursed at a another patient. I was working with a patient who had conversion disorder and he would attempt to get the staff to do everything for him. When he was admitted we were given instructions from the doctor and his PT that he was a minimum assist patient. I was trained that if our patients were not up by 8am then they would get cereal on the unit and if they were not up by 9am then the kitchen was closed, the whole time I was there this is how I ran the unit. I had gotten an order from the doctor that this patient be gotten up before 7am, since it took him extra time to get up and out of bed, which ment the night nurse would have to get him up and he would be out of bed when I got there (this never happened). So that day he was ready to get out of bed when I woke up the other 17 patients. He never said anything about having to go to the bathroom to anyone who went in his room. By the time I went in to get him up, he had gone in the bed. To make a long story short, he didn't get out of bed and to breakfast until after 915. Following the unit rules he wasn't going to get breakfast due not being ready before 9am. The other nurse got rude with me and stated if it were her she would give him the food because he had been awake. She was very upset and I told her that she could give it to him but I felt he should have been up earlier and the rules apply to everyone else. She went to the DON and complained and told them that I had cursed at another patient saying "stop your ********" which I deny because it didn't happen. I was called in and questioned about the patient's breakfast to which I replied that this was not the first meal he would have missed and I was not the only one who followed the kitchen rules. Also that I had told the Doctor and his Dietitian that he had been missing meals due to not assisting with his activities and such and not one person said anything about not giving him his food. The DON said we could not do that and we could not deny patients food, I stated then someone, anyone should have said something and that this needs to be told to everyone. They then questioned about the cursing and said that since I have a history that they were letting me go. I feel like I was targeted. I've tried to find another job but have had no luck and it seems that this issue is why. I have asked interviewers if their are any red flags during my interview and have been told the cursing. I have no idea what to do and how to show people that this was an isolated incident. I mean I worked in customer service for years and never had any issues like this. Any help would be great.