Lvuv

Okay to hang pt home TPN. no other orders no mar order Pharmacy was not involved even.

tough one!!! I would want to know why I was being recorded and if the answer is benign. I would cover myself by being sure to say something like, "This is discharge instructions or (blah blah whatever your teaching) for you and you alone and it is one piece of a bigger picture. If you have questions or concerns you need to talk to your PCP or if you think you are in a medical emergency go to the ER. IN no way is this recording suppose to negate common sense in an future event. I am not able to tell you everything you need to know but here is what we will go over today. You should continue to seek out information about your own health care after discharge ..." UNLESS your institution has a policy about recording, in which case you can stand behind that and elevate to your manger or customer service agents as appropriate.

My guess is the CNO is using an acuity tool. I would love to hear which tool since none are evidence based --YET!

mine have never faded! They are my favs. they never wrinkle... go ahead abuse and use them,they are built tough! :)

I am interested to hear any stories about providers placing an epic nursing communication for something that should be a nursing order. Like a pts TPN. Does institutional policy trump a provider nursing communication? What was the order? How did you handle it? Thanks!

No! But yea I stayed very objective in my fall note a happened then b, despite c, I called x,y,z.... We did... E,f,g.... We will do x for c. Etc.... however, in my hospt event reporting still I didn't say p the it fell on purpose but I strongly suggested it.... Again not in the chart! So glad to hear these responses. I did suggest a psych eval in my care plan for escalating emotional responses r/t emotional support interventions set forth in care plan that previously worked well but seemed to fall apart this shift. I felt bad for suggesting that but feel it is the problem. All safety things I charted also but in hind site could have added much more! in my fall note also. Thing is I don't work on a psych floor and this pt could use one for histrionic's. This worse part is I work on am intermediate floor and did have 3 others with legitimate illness. One of whom I was anxious to give care to despite all the darn charting. OMG THANKS for the responses is totally helpful specially the story about the fall Roman! Love the fainting couches idea... If I ever make it up the ladder I am totally pushing for this! Thanks!

Just curious about people's thoughts about patients who seem to intentionally fall. As the RN are we even allowed to think that? Or are thoughts like this off limits like the pain perception variety? I had a patient whom is very young emotional and liable. Always attention seeking. Complaing, crying, moaning or profusely apologizing for nothing... Whom my gut tells me the fall was intentional! It was assisted as I was there. BUT, and it's a big butt... I am 1/3 the pt size so it was not as controlled as I wished it could have been. How do I know this would happen... Rhetorical question! Don't answer that.... Answer these though... Am I evil for thinking this? Am I burnt? Or just feeling bad for knowing I am right? I don't want to think the worst but it feels true. I am not a RN who can't put 2 and 2 together. This could have been mechanical in nature. There are some things we could blame here... Point is my gutt says "nah... this was just another peg in the long list of attention seeking behavior". I know I need to let it go... ! I am stirring on this... because it's my first fall and also because I feel like I have NO tools to prevent this. So perhaps this is cathartic. Please tell me your thoughts and stories! And one more time before I go... Son of a puppy!

Oops I mean HouTx! thanks!

pHEW oh I feel for you. I think you should stick it out while you look for other jobs. AS LONG as nothing illegal is going on. IF that then quit, report and move on. I suggest an exercise 1. Make a list of all the things you want to change, big and small. 2. go through them and put them in two piles "things YOU can do/ control" and things "not in your control" 3. THEN, try and let those things you can not control go. Lend your focus on the things you can change. Like others said you must work within the constrains of the system. Every new RN goes through a period of harsh self-reflection when we realize what nursing school said "nursing was like" and "what nursing should be like" and we realize that it is really sometimes no where near that ideal. The point is it can be with good leadership and dedication to excellence which is out there! That said, 16 months into my career and I am still working on giving up control on the things that I can not change. For me IDing those situations I CAN change and turning my attention helps a lot! It makes for a much more positive and rewarding experience. Also step two is to get a fun hobby outside of work and DO it not obsessing about work. Sounds silly perhaps but this is my advice. I am sorry you feel how you do sounds like you are a great asset to your job since you care! I wish all the best luck in the world and hope you find your way to the sunnyside of the street.

Thanks Sliver 2 that is brilliant advice! Thank you!

Hello, I recently moved to a new state and I have a burning question I would love to know peoples thoughts on. I am an experienced med/sur RN with active license, BLS and ACLS and I am looking to transition from acute care to critical care. I would work on another acute care floor as well thou so I am not too picky. I have applied profusely to the hospital that I am most interested in in both jobs I am very qualified for and jobs that I would like to transition to and have the minimal requirements. I have heard from the recruiter at this hospital but not had an interview or second step yet and its been 2 weeks. My question is should I sign on with a staffing agency to do per diem work or could this hurt my chances of full time employment in a long term placement? My goal is long term placement but I have very limited contacts here, just one very hands off direct recruiter from an area hospital and a girl I met in my ACLS class. ADVICE appreciated. Thanks!