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!

I find it an odd trait in myself that I always try to justify bad behavior in others, perhaps it is my own short comings surfacing. Putting myself in your place I can see myself trying to give this instructor the benefit of the doubt, but also looking at this objectively from the outside my brain screams this was wrong. Had you been hurt then what? Mistakes happen, and we don't always get to pick when or where they occur by the virtue that they are outside of our control. Sometimes as humans we have to acknowledge that and move on. Having a fit of unbridled anger and physically lashing out is not a mistake, it is a decisive action of choice. Where to go from here is something I find I am at a loss to advise you on, because some really good advice has already been put forth - but I do want to say that no matter how bad of a day we have, or what is going on in our lives at any given moment there is a certain level of professionalism expected of us as nurses on the job, which your instructor was. Perhaps doubly so in regard to what is acceptable behavior for adults to adhere to in civilized society. Striking another person is outside of orthodox conduct no matter the circumstances, or who you are.

It shouldn't matter what we look like, but sadly in nursing you most certainly are judged by appearances. It's not like a hair stylist, clothing designer, or actor who are free to creatively express themselves through appearance - nursing's cornerstone is Florence Nightingale, no matter how outdated it may be. I guess we should be thankful we don't have to wear hats any more.

You don't have xray vision, so there was no way for you to know for certain a Fx exists. The teacher should have alerted you in a way that not only maintained your dignity, but was far less pompous. What purpose is served by making you feel ashamed, or incompetent - especially in front of a student? Professionalism would have been nice in this case, even if this particular teacher is perfect and exempt from errors. Lot's of times we are forced to go by what evidence suggests - in this case the child was weight bearing, playing, and not crying - when we lack diagnostic equipment on the job. It sounds like mom missed it too, and asking your thoughts is no substitute for responsibility on her part to get an evaluation after an injury at home (although again, evidence suggested no Fx). I get what you are saying and how you are feeling (I am harder on myself than nearly anyone else when I make a mistake) but sometimes we just miss things. No matter how much we strive for perfection we'll never attain this lofty goal (because we are human - therefore prone to err from time to time). Some Fx's are easy to miss: my old PCP's MA is tiny, and her husband must be nearly 1.5 ft taller than she is - one day he accidentally stepped on her foot. She limped around for over a week C/O pain, and subjectively had ecchymosis and swelling - but the xray said no Fx. She was miserable, but weight bearing. Finally she demanded further imaging: an MRI showed 3 Fx's the xray missed. She was in a boot for nearly 2 months. If a radiologist with imaging studies can miss a Fx, then you certainly get a pass for not having xray vision super powers.

As a Rx pharmaceutical I think there is a place for it ... Recreation for a nurse? It will never happen without much to lose. In my state it's still illegal, which is like asking do I enjoy a little illegal activity in my free time. Do I wish it was legal? Well, yes. Do it use it? No.

OP are you a nurse? The things you mentioned don't seem like nursing type assistance, rather CNA help (the reason I ask is these are things I hate doing at home anyway, and I would enjoy doing it even less on the job). Your profile doesn't say.

I had never heard of a serial bully before. That is a lot of good information.

Mistakes happen. Things get busy, and you are new to the job. We can't be perfect, although we all try to be. Cut yourself some slack.

Probably not legal so much, but it's a question of politeness. Imagine your office was right next to the bathroom in question? Now imagine smelling other people's turds all day long? {Retch} My son (and cats) can unload some whoppers, requiring window opening, door shutting, and ample spraying of air freshener (all while gagging). My son laughs it up, and says, "You're a nurse!" (as if I have no sense of smell ... dear God in heaven Boy, what did you eat!?!). Tell your friend to have some courtesy for everyone else and poop in the requested bathroom. Even better, lite a match.

It's amazing how free MD's feel with their unvarnished opinions, screaming it from the rooftops, while we nurses are cowed enough to apologize to avoid a verbal brawl. I've noticed men (although not exempt from getting reamed) are on the receiving end far less than women. Hmmm ... I've often wondered if manners are stripped away in medical school (How To Be An orifice 101). I guess you've never had to pleasure of witnessing a MD throw objects yet (charts, chairs, telephones, etc)? I'm sorry this happened to you - it won't be the last time, sadly.

If I like what is said then I "like" the post. Sometimes a lot of good stuff is put out there. But do I drone-like hit every single "like"? Heck no, I'm way too lazy for that!