GM1928

I said above that the shift supervisor told me that I needed an order before that dressing could be changed. Shift supervisor said I needed an order before I changed that dressing. Policies and procedures were checked. Nothing pertaining to dressing changes for chest tubes.

The San Bernardino shootings were at a medical facility. It is, I fear, just a matter of time until hospitals join other gun-free zones in being sites for shooting rampages. The facility at which I work has mall cops on duty...they don't have guns. I formerly worked at a facility where security DID carry. I have considered carrying my .44 snubby at work, but yes, if discovered, I'd probably lose my job and my license. I think everyone in a hospital -- patients AND staff -- are sitting ducks. In the San Bernardino case, I disagree with those who say the killers had body armor so a handgun wouldn't have helped...you always have a better chance with a gun than without. In lieu of carrying at work, I would probably barricade myself in a pt's room and lock a bed into place in front of the door so that no one can get in.

Because it was a chest tube, I deferred changing it until we got actual instructions from the MD. If I'd changed it without an order, and something had gone wrong, I'd have been on the hook for doing something without an order. I discussed this very issue with shift supervisor and she agreed that we needed orders before changing it. She talked to the MD and got the orders for daily changes; he insisted that he'd put them in on admission, but shift supervisor and I both checked the order history and he had NOT put change orders in.

I'm an RN on an ortho unit at a large hospital. We recently admitted a patient with a chest tube. Several days went by without the dressing being changed. I cared for the patient on the 7th and 8th days after admission. The general surgeon, who was the admitting, did not include any orders for dressing changes. Pt's family got very upset, especially after I paged the MD for change orders, and he didn't call back. Because we're an ortho unit, we don't see a lot of chest tubes, but apparently on the respiratory unit, it is common knowledge that this MD likes daily dressing changes on chest tube pts, so he never puts in orders for changes. Family contacted the director of med/surg for the hospital about this, and the director contacted shift supervisor, who then contacted me. I did page the MD, and I also left a note in the electronic chart for him indicating that the family wanted to speak with him about care, and included a phone number. He didn't contact them until he found out that they were upset. He didn't respond to my page (he's notorious for this). I feel like I did my best, but this matter has gone all the way to the chief medical officer, my unit supervisor, and the med/surg director. In an email, it was stated that our ortho staff needs education on chest tube dressing changes. I feel like we're being thrown under the bus. The MD should have put in dressing change orders. The MD should have responded to my page. The patient shouldn't have been on an ortho unit for over a week when he could have been transferred to the respiratory floor. As I said, I cared for him on the 7th and 8th days after admission. Maybe one of our nurses who cared for him much earlier in the week should have asked the MD about change orders. As it turns out, the MD is pissed off at me, the family is pissed off at me, and administration is pissed off too. Sometimes, you do your best and it still doesn't work out.

Hello everyone. I work on a med/surg/ortho floor at a large hospital. One day recently, we started the shift with 3 RN's. Shift supervisor pulled one of us to another floor, which left us with two RN's for 12 patients. Granted, the census was low on our unit, but is it safe to have just two nurses working? If a patient codes, don't you need two nurses to handle the code and a third nurse to cover all of the other patients? I've expressed concern to our unit supervisor about this. Hospitals typically don't back nurses if a lawsuit is brought, and I have told her that I'm really uncomfortable jeopardizing my license. Thoughts? I know it's not my place to tell the facility how to staff, but it IS my business to protect my license. (The shift which followed us also had 2 RN's for 12 patients, and those two nurses were very upset. The facility has never staffed our floor with just 2 RN's) Anyone have input? Thanks.

I became an LPN in 2010, after 33 years in media. I was 48. I worked for a urologist for a couple of years and then went back to school to become an RN. I worked on a hospital ortho floor for a year after getting my RN -- and then briefly for a clinic, but was recently terminated ''because it just isn't working out'', according to my supervisor. So I'm 54 now, an RN, and pretty rattled by having been fired. Taking a little time off to regroup. I do like being a nurse, but it seems there's quite a bit of hormone-driven drama in most medical settings. A doctor I know calls it the ''hen-house mentality.''

Update: I asked for a few days off to tend to my ailing father...this on the heels of the incident with my co-worker. My boss called me to her office late today. She fired me. She said it just wasn't working out. Earlier in the week, she'd said I was doing great. I knew all day that she was ****** off at me--no eye contact, no verbal interaction. So, two hours after firing me, she sent me a text message: "I wish you all the best. You're a great person. I hope you have a good weekend and I hope your dad does well. Thanks.'' I did not and will not reply to her. She needs lithium. Very unpredictable, very unstable.

Thanks, everyone. I went to my supervisor and talked to her about it. She was sympathetic (or appeared to be). She called a meeting of the 3 of us, which was this morning. I told my co-worker that the micromanaging has to stop...she tried to justify it by saying that there's just a way ''we do things here.'' I said ''you don't need to tell me how or when to empty a garbage can, or a linen bag, and if you want more examples, I will give them to you.'' I told her that the impromptu meeting she called (reference my original post) came across as heavy-handed and extreme. ''You involved 6 other people in a situation that really was between you and me.'' She did apologize for having done so. She also said (with our supervisor sitting there) that instead of giving me direction, she would just give regular reports to our supervisor about me. I told her I would do the same about her. All in all, I think she got my point, and was more than a little ****** off that I called her out on the bullying, but hopefully she'll leave me alone and let me do my job. Our supervisor did say in the meeting that I am doing a very good job as a new employee. I don't take anything for granted and realize that I may have stirred up a hornet's nest, so I do have feelers out. But as a male RN, I have never taken **** from MD's and I certainly won't take it from other nurses. If speaking up gets me fired, so be it. If it improves my work environment, that's fine too.

I'm an RN and new to a outpatient procedure center. There's a co-worker who micromanages me. As I went to empty a wastecan, she told me not to, because it wasn't full enough. I started to haul soiled linens out of the recovery room; she told me the bag wasn't full enough. She ordered me to move paperwork on a counter 18 inches to the right ''because it doesn't belong where it is.'' I've been trained by several other coworkers to immediately get family members when a patient comes to recovery, rationale being that if the MD comes to talk to the family member, then the MD shouldn't have to wait. This woman jumped down my throat because a patient ''wasn't stable'' and that I had brought the family back too soon. She referred to me recently as her ''aide.'' I do not engage her in discussion about the micromanagement but she can tell it angers me. She called an impromptu meeting of all the nurses in recovery last week and stated that the ''new nurses'' are told to do things ''because we have a way of doing things here.'' She looked directly at me. She said that when ''new nurses are told to do things and they just walk away'' (as I have done a couple of times), ''that's just being passive - aggressive.'' (I would rather walk away than say or do something unprofessional) After this impromptu meeting, a couple of other nurses asked me if I was ok. I told one that I'm on the verge of quitting, and she strongly encouraged me to talk to my supervisor about the situation, and that I need to ''just let that person's words roll right off your back.'' The micromanager is very tight with our supervisor and I feel that talking with her as suggested will not accomplish anything. The impromptu meeting, in my opinion, was heavy-handed and intended to humiliate me in front of other people. That's mainly why I want to quit -- because I've been humiliated in front of other people. Those nurses did not need to brought into a discussion about tension between two people. She basically brought 5 other people into a situation that should have been handled between me, her and our manager. I'm 54 and I know bull**** when I see it. I guess I'm looking for advice on how to handle this with my supervisor.....should I just resign, or give her the chance to look into it?? I really feel that if this coworker would stoop to public humiliation of another person, that's not a place I want to be.