Axgrinder

Sadly you can't chant your own rhyme in response to his juvenile antics - but doesn't mean you can't think one up and say it in your own head. Then smile (let him wonder about what that is about). Why hasn't he just had a chat with the doctor about changing the Rx Synthroid dose time? Seems he could have fixed this the 2nd day of admission. My guess is he is bored and enjoys playing with you. You could try to joke back with him and see if he unbends a little?

I left working in a certain ICU 18 years ago for the same reason - an open bed does not always mean we have enough nurses to take that admit (sometimes with no warning at all). I usually got stuck being charge (with 2 of my own very sick patients) because most nurses refused to agree to do it. The last straw was a night when PACU was wheeling in a fresh AAA at one end of the unit, and ER was wheeling in an unstable cardiac patient whom they had just floated in a transvenous pacemaker from the other end. Neither one could give any warning? I remember standing in the middle watching both with my vision telescoping down thinking, "OMG! Now what???". We had already called in our on call nurse - there was no one left to call. The stress from that job made my hair white long before it's time (but it wasn't the only one).

Under different circumstances this could have happened to any one of us. Not to say I wouldn't read a label or a box, but being stressed due to extreme pressure to hurry because tasks are piling up makes it more likely that mistakes will happen. In a hectic work environment with more patients than is safe, or coming into brief contact with patient's you are unfamiliar with, I most definitely can imagine a situation where you thought you had one drug but it turned out instead to be one that was very different than the one you intended. I've never done float nursing where I roamed all over a facility helping out where needed, but a position such as that would seem to require a vast amount of experience in very different types of nursing to competently be qualified for that type of job. It would take a very special nurse to do that job well. My heart breaks for the patient who thought she was in safe hands, and for the nurse who made such a grave error. I can't even imagine what she or he is going through.

No I don't think you were wrong. This wasn't an antibiotic or some other routine medication that must be given as ordered. It's not like you missed a scheduled routine med - a PRN med is just that, and from the scenario you described the patient had not asked for it, or even indicated a need for it at that time. You are not obligated to administer a narcotic to a patient just because the incoming nurse wants you to. She is not your supervisor, and you are not beholden to her orders. You act under your own nursing license as you see fit.

That depends on what type of MRSA infection the patient had. Was it wound, respiratory, urine, or just a past positive carrier? When I was a brand new grad in 1994 we freaked out about every MRSA case that hit the unit. We all went down to employee health for nasal swabs. Eventually we were told not to bother. A few years later a pulmonologist I worked with a lot at a hole in the wall long term ventilator ICU facility said, "All you nurses will probably succumb to MRSA when you are old and immunosuppressed". Do I believe that? Then I did - when I was young and being old was a million years away. Now that I am old and crusty? Nope. I think you're fine. There are plenty of people you encounter in a daily basis - in the grocery store, restaurants, work place, schools and hotels who have tested positive for MRSA in the past. They aren't isolated forever you know, right? They are typically only a problem to other immunosuppressed patients in a acute care setting. Like patient's with a super low WBC count, cancer, active HIV, or other immunosuppressive illness. Don't worry unless you develop acute symptoms of an infection that doesn't respond to usual antibiotic treatment. Until then I am getting the farm you are okay my friend. Beware more of pulling back bed clothes ungloved - there you will encounter snot, urine, feces and semen regularly.

Love your avatar pic! That seems to be 99.9% of the people I personally know.

I routinely call in telephone order Rx's for the on call provider when they're too busy (and it's not a controlled substance) - on several occasions when calling in a Rx antibiotic eye gtt the pharmacist has stated that the eye gtt version of that particular medication was not available/in stock, but the antibiotic ear gtt version could substituted instead. I always ask what the difference is between the eye and ear gtt preparations? The pharmacist so far has always stated "None". I could be wrong (it wouldn't be the first or last time) but unless it specifically states "Not for use in eye" then this may not even have been a Rx med error at all. I bet if you called the inpatient pharmacy and discussed this specific situation with a pharmacist you may find that this is the case, and you have been worrying and beating yourself up for nothing. I'm so sorry for the anxiety and distress you've suffered over this. It can be frightening to think you've made a medication error, but very few nurses will retire with a spotless medication error record under their belt.

I would imagine that an offer of increased float pay would go a long way to make one happy to float.

I have to wonder if we all have moments of thinking, "What have I gotten myself into? Can I do this?". Perhaps the question to consider is if we never did, would we be human? After all, we are only mortal - nurses, doctors, advanced practice, respiratory therapy - often assisting Those on a higher level to grant more time in a bad time. We intervene, we try - we save some, we lose some, and we grieve all those in a bad place. We are after all only human.

Hey Dr. Fever - if two trains leave Chicago loaded with cargo, one headed for the West coast, and one for Canada ... what is the name of the engineer's?

In theory I totally agree, but real life situations (at least mine) tend to get messy with all kinds of complicated details and extenuating circumstances. I've made some mistakes - will I make them again? Sure, but hopefully not the same ones.

Yes ... still scraping the bottom of my shoes off.

An uneasy truce exists at the moment, with far less contact than previously. After a 2 week silence she has since been on her best behavior, but I remain wary. I don't think all the chips have finished falling yet.

Dad's (and mom's) know best - but Mick Jagger said, "What a drag it is getting old".

I don't want to falsely get your hopes up, but I have been surprised how long the wheels of motion take in matters of hiring. In terms of reasonable time frames, I have personally seen things take entirely too long - so long in fact that once or twice I thought they either forgot about me, or changed their mind. This aspect of the hiring process can be frustrating, but HR can move like a glacier: slow and methodical. Something like this just happened to my husband, he himself still a fairly new grad: he worried and moped and stressed, and once he had nearly given up he received a text message from HR. Gah! Chare may be right - it may be likely that she has moved on to another applicant, but if you wanted to make one last attempt to reach out to her waiting a week to do it is way too long. If it were me, I would write her a short letter reiterating that you are very much interested in the position, and would like the opportunity to discuss it with her at her earliest convenience. Short, sweet and politely professional. A letter says you took the time the show how much you really want to work there, and to be considered for the job. It also shows you are persistent, and serious. Another thing to consider is a letter also stands out more in someone's mind than a voicemail. Even if she filled that position already, others open up all the time - you may get lucky with your timing if that is the case. Show that recruiter you mean business. Good luck!