faithkindness

I am glad you asked. Of the first few male nurses I met in school, 1 was gay, the rest clearly hetero (you describe yourself as clearly hetero too). Most women have no trouble sensing the difference. Going out on a limb here, I think most men recognize who is gay as well. I really enjoy working with male nurses, of both sexual orientations; men bring great balance to the units. The extreme macho-types who gay bash are also the ones who "cat call" and harass women as they walk by. We're trying to figure out how to deal with them too. But they do not define the kind of women we are. Don't let their perceptions and ignorance rob you of your peace.

Very helpful! And I am motivated to help change the process. Thank you so very much for your supportive comments and recommendations. Kind Regards.

Thank you. Hope you are wrong about the toast prediction.

I empathise with you and the punitive way your mistakes were handled by management. Having worked as a nurse for 2 years, I see this strategy is used frequently and many coworkers and members on this site accept the status quo. People say things like: "You must accept blame/responsibility." "There is no excuse." The reality that begs to be recognized is that our healthcare environment is conducive to mistakes and punishing people for their mistakes is not the best way to help people learn and improve. Healthcare needs objective process improvements plus support systems for workers. Continue striving to be the best nurse you can be, knowing that all nurses make mistakes, and focus on your positives to help build up your confidence. Ask for legal advice on breaking your contract vs. getting fired. Perhaps a local university has a free service or an attorney's office provides a free consultation to advise you. Also I recommend investing in insurance for nurses. It is reasonably priced, provides some good benefits, and they may offer legal counseling on your circumstances. You may try to reduce interruptions to help you work more calmly which helps us attend to details. Hang in there.

Your article is very helpful and your kind tone is so encouraging to me. I wish I could learn from you how to get all of this detail done. I like to do it; I know it's important. I don't want to do lose a patient. However, I am still struggling with having enough time to get the data and interpret it and act on it. Sometimes I spend a good deal of time with a patient whose vitals are slightly off or who looks sicker to me, and they turn out to be fine. Which is good except my instincts were off and I have lost time to give to another patient whose vs don't get done. Any advice?

Yes, that is true. There was so much going on. I was also concentrating on getting all meds and treatments passed and communicating patient specific issues to direct care staff. Starting this week, I am writing every little detailed discrepancy down on paper (we are not electronic yet) and delivering to manager q shift. I have to figure out a way to keep a copy without patient identifiers. I wonder if it's legal to keep copies in a locker at facility?

Thank you for your time and your thoughtful comments. I am struggling with the hard line reasoning of 1) med errors warranting punishment; 2) pulling a med error out of the context of all the factors at play when that error occurred. Recognizing the context of an error is not excusing it. It is an effort to learn from the mistake. People seem to use hammers in nursing when they talk about med errors. Hammers hurt people. Fixing a broken process helps people do better. It is not possible, for most humans, to accurately check details in a chaotic environment. There's a lot of research to support this, but I don't see it being applied in nursing. I agree we have to get Pharmacy labels to match eye drop ingredients exactly. I wish it were possible to have pharmacy verify meds brought in from home, and will ask the administrator. Maybe she'll surprise me.

Anonymous does an excellent job of describing many broken and dangerous aspects of our health care system. Thank you for inspiring this discussion and motivating change. I would like to add an analogy that may help patients and healthy employees recognize how current healthcare working conditions and economic pressures increase everyone's risk of being injured or killed the moment they become a patient. We all pay some portion of our medical benefits therefore everyone deserves to receive safe products and services.

Patient rec'd correct drops but MAR was never corrected and large group of nurses and medtechs were all issued a written warnings for failing to maintain 5 Rights. I would like to challenge this action as inappropriate and have all write-ups expunged based on "the right med was given" and all 5 Rights were maintained. Am I on strong ground? In addition, there are so many process issues associated with this error and other eye drop errors, that I would like to insist the company implement it's own procedure by conducting a "Learning from Defects" (which is a tool developed by Univ of Chicago) to address the process issues that exist at this facility and that precipitated the MAR error and contributed reasons why the error was not corrected sooner. Without listing multiple poor processes here, do you think it would be reasonable to request this review be done to address the huge process issues that need to be fixed before HR/management issues written warnings? Thank you to anyone who is able to make the time to read this long scenario and share their experience.

I agree and I would add that citizens and lawmakers along with patients and their families would benefit from improvements to many healthcare environments. I think budgets are tight because many processes are broke and poor conditions feed higher costs. I hope everyday, each one of us can do one thing to try to make this topic of national interest.

As a fairly new nurse, 2 years experience in SNF/Indep. Living, I see what you describe in the SNF setting. I would add to your thoughts, my belief that we must organize patients, families, nurses, lawmakers, lawyers, and others at the state level to define and mandate quality and safety improvements. The owners, directors, board members have demonstrated that they will not sacrifice their salaries and profits to improve processes that lead to quality patient outcomes and working conditions. How can we create an effective oversight system?

There are several skills that I have very little experience with since graduation (RN). I would like to ask a co-worker or manager to accompany me the next time I have to perform these skills. What is a good way to ask for this kind of assistance?