Fleur deLirious

@SaltySarcasticSally -- You may not be fully into the vein. When you see the blood flashback, continue advancing just a smidge to make sure that the plastic cannula, and not just the needle tip, has entered the vein lumen.You should be more successful.

I've experienced this "cover-your-butt-by-throwing-the-innocent-nurse-under-the-bus" behavior before. I received a patient to the Rehab unit, where we normally would change them from IV/IM to p.o. pain management. This patient's orders still had them on IM Demerol. I called the MD to review the transfer orders and got an order to change the patient to p.o. pain meds. Later that night, after having received said p.o. pain meds, the patient sustained a fall. I came to work the next day to hear that this MD subsequently denied giving me the order. What? I get orders for LESS intense pain management, and you're trying to shift blame? I was incensed. We admitted a lot of patients with telephone order approval on transfer from acute care. I had been a nurse for about 15 years at that time, and had never experienced this before. I was not about to remain silent. I wrote a very professional, detailed letter to administration, outlining the events and stating that I would no longer take phone or verbal orders from this physician without another nurse witnessing the order (as with phone consents). The first couple of times after that when I called for orders, I'd have a nurse next to me listening to me repeating the orders to him, and when I said "I just need you to confirm these orders with nurse Jane", he would say something like "I don't have time for that" and hang up. I persisted, and called back until the orders could be obtained. He never did that to me again, nor has any other physician over my nearly 30 year career at the bedside. About 5 years ago, I started seeing him as a consultant on occasion on the Tele unit where I worked -- he was very respectful to me. My advice: Insist. Persist. Resist. You have to protect yourself.

The secretary on our unit says this (sarcastically) whenever we experience "managerspeak" from someone in the upper echelons.Makes me laugh every time.

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I have 29 years of bedside experience. Over the years, I've been the designated charge nurse (but keopt a second job at the bedside. I've been offered management positions, and always turned them down. In the end, I'd rather be on the front lines, taking care of my patients. Yes, it's hard. Yes, sometimes I wonder why I stay on such a busy, high-acuity unit. But seeing a patient go home doing well or getting them to critical care before their condition has deteriorated to the point of no return is gratifying. Having patients and their families express sincere thanks for the care they received is the best gift I could receive for all the hard work I put in each day.

You'd be a fool to risk your career to get high. Even if it were legal, until there's a test that can determine current intoxication levels, I don't think healthcare professionals should be allowed to smoke or ingest marijuana, even in their off time, as a positive test can occur for weeks after use. Would you want to be facing a life-or-death situation with a stoned nurse or doctor standing over you as your treatment provider?

I graduated in 1988, and worked as a nurse tech for a year prior to that. In those days, many people still smoked, and smoking was allowed in hospitals. Only doctors were allowed to smoke at the nurses' station or in public areas; nurses smoked in the break room/report room. The room was filled with smoke as we all listened to taped shift report, and nurses would go to the break room to smoke and chart. Patients were allowed to smoke as long as they weren't on oxygen. It's comical to think back on it. Although we collaborated with physicians and felt comfortable with approaching most of them, nurses were still expected to give up their chair at the nurses station if a doctor approached. Some of the older MDs treated us like the hired help, expecting us to step'n'fetch for them. Unfortunately, some of the old-school MDs also would rather give up their license than take a suggestion from a nurse seriously; this really only hurt their patients in the end. We've come a long way, baby!

24 years after having switched from BSN to ASN programs due to financial constraints and graduating with an ASN, I returned to school and graduated with my BSN from the University of Texas at Arlington in 2012. I had always felt like a failure for not having earned a Bachelor's degree, and it weighed on me until I just had to go for it. I also saw the writing on the wall, with many hospitals hiring BSN-prepared nurses over ASN/Diploma RNs. I looked at many programs, and eventually chose UTA for several reasons: 1. I wanted a program that was fully accredited, with a solid reputation. 2. I wanted a school that had a brick-and-mortar component, not an "online-only" school with no solid foundation and extensive history. UTA is a state institution, and has been around for well over 100 years. They are also renowned as a research institution. 3. UTA's online nursing program was very highly rated. 4. UTA accepted ALL of my college credits (from 1984-1988). Not some of them. ALL of them. They also allowed me to use my specialty certification to count for one of my 3-hour elective courses. There are several colleges that will accept all of your prior college credits, with no limit on how recent they are. You worked hard for those credits; you shouldn't have to spend your time and money taking those courses again! 5. At the time of my enrollment, UTA had one of the best price packages going; and your cost was locked in as long as you took at least one course per year (I completed my degree in less than 2 years, though). Please note that the price lock did NOT pertain to the non-nursing courses, so if you enroll and need electives, I would suggest taking those early on to avoid price hikes. I believe they still offer the same "Academic Partnership" program, though the price has increased over the last few years. OK. All that said, my opinion of online education was drastically changed by the time I graduated. I really didn't think online courses would be very difficult, but if you think it's a "pay your fees, get your B's" environment, think again. It was pretty much as hard as brick-and-mortar education, though some of the methods had to be adapted for the online format. I worked my tail off to graduate Summa Cum Laude, and I'm very proud of it. It's not a store-bought degree; it's hard-earned. Working full time, I found it hard to take more than one course at a time. I honestly don't know how my classmates with young children survived at all. For me, the only thing that I HATED about the program (and they all have this component) was the group projects, designed to help you learn collaboration skills. I collaborate every day at work. Mostly what I learned from these group projects was that there are still people in this world (even RNs, the most respected profession) who are content and even determined to ride your coattails and graciously accept a grade they did not earn. I just had to give up my anger and leave it to Karma to reward them for their lack of effort at some point. Do your homework. Compare the schools. Demand credit for your college courses, no matter how old they are. Look at the national reputation of the schools you are considering, and make sure their nursing program is fully accredited. And finally, congratulations for making a decision that, though you feel pressured into it, will give you a great sense of fulfillment and pride once you have that degree!

Perhaps the first correction we should make is changing the title to Correcting Others' Mistakes...

I had the same beef when I returned to school for my BSN. There were a few motivated people in each group, and everyone else just rode their coattails for a grade with no consequence for their inaction. One project, we had a student who was MIA for the first full 2 weeks of a 3 week project, then showed up on the forum to say, "OK, what do you need me to do?" When the leader replied that we had sent numerous emails and messages without response and had moved on without them assuming they had dropped the course, the student contacted the professor and we were all strongly chastised and told we had no right to try to exclude the student, no matter the circumstance. So they got a grade for doing NOTHING, since we were at the end of the project by that time. The only positive was one of my last classes, where we were allowed to join the group we wanted to be in, rather than being assigned a group. When the group reached capacity, it was closed to further members. Therefore, all the motivated people ended up in the same group because we got in early, and we were pleased to see all the hangers-on having to try and get it together in a group with each other. All I can tell you is like the others... just have faith that the world is round, and it will come back to them at some point. Know that YOUR degree was EARNED, and that your grade has integrity.

I've experienced "dumping syndrome" as both a PRN nurse and an agency nurse. It's quite frustrating. The justification I have often heard charge nurses use is that "they're making the big bucks, let them take care of the tough patients." This is ridiculous... For one thing, I made less money at my PRN job than I would have working overtime at my full-time job (I just liked having a backup plan when census was low at one facility, and a change of scenery is nice, too). Agency earned me only slightly more than that. Plus, I'm filling a hole in the staffing that would otherwise leave everyone on the unit overworked. Once you explain this to the people who perpetuate the "big money" myth, they often are more considerate when making assignments. I certainly try to be fair when making assignments, whether the nurse is staff, prn, float or agency.

EXCELLENT article; I would love to put it in the newsletter that I do for my telemetry unit (with proper credit to the author and a link to your website). Would that be okay with you?