dmrodri

So I am leaving the clinic. Got 2 job offers for pool pacu positions which work great with 2 young children. Thanks for the advice though :)

Oh and when a patient has a reaction or vasovaguls while starting the IV, I basically was told to get the NP and see what they wanted to do. Problem was I didn't agree with what they told me to do (keep infusion going, try sticking the person again).

Thanks. I knew we needed them, but wanted to make sure I wasn't crazy. I am transferring out of the clinic and back to the hospital. I have tried bringing up the need for p&p to multiple people. They kept telling me we "are a grey area and don't need them". After that the NP started giving me a hard time and pulling me into meetings with mgmt. hopefully the next nurse realizes what's going on.

Hi everyone. I have a dilemma. I currently work in a headache clinic. I am currently on maternity leave and have been doing everything in my power not to go back. While on leave they got a new PA and Neurologist. I have been getting texts from the MA asking about infusions and medications. From what I've been told the neurologist wants to start giving a lot of different infusions and the other nurses in the building have been starting the IV's but refusing to give the medications. I am a former ER nurse who had policy and procedures for everything. Well coming to the clinic they have none. I was told by my old supervisor (who is a RN and currently left) that the clinic does not need any policies or procedures. So heres my concern. 1. i have no policy for starting an IV, monitoring, or even what to do if a reaction should occur. IV's are considered invasive. I have been starting IV's in the clinic (because I feared I would be fired for saying no) and had the NP (who doesn't trust me because I question her on a lot of things) tell me to keep a IV running that looked like the patient had either had a reaction to the medications I had given (NS, Toradol, decadron, and zofran) or had phlebitis. I refused to keep the infusion going and d/c'd the IV. This situation scares me, as I don't want anything to happen to the patient but also would like to keep my license. Also, what happens if they do get phlebitis? What happens if they faint while getting an IV in? How many attempts do I do for an IV? 2. I found out they want to start doing depakote infusions, DHE infusions, Mag infusion among others. I currently work in a stand alone clinic with no code team, code cart, cardiac monitoring. I have no way to monitor these patients. They do not do urine pregnancy test on patients that they are bringing in for these treatments (who are of child bearing age). Some of these meds can have serious side effects. Bottom line I don't feel comfortable giving them. Am i justified? Can I refuse to give these medications? Can they fire me if I do refuse to give them. I have talked to a couple of friends and they say the wouldn't give them and that they have policies in there clinics. I have also attempted to write policies in the past and the provider at the time (the NP) refused to sign them. Now that my old supervisor left, I have non medical personnel over me. Help!!!!!

We have an aed, oxygen, and an emergency bag (which contains no meds). I am acls and pals certified, from my previous jobs. We just have no policies or procedures in place. Also the other mds will not cover our patient if something were to happen if something were to go wrong and I had no provider in the office.

I tried to bring these concerns up and was told that because we are a clinic we do not need policies. My supervisor told me that I could make whatever policy I wanted and it would get signed, but one of the providers dosent trust me (I have given her no reason not to) with protocols. I'm currently 20 weeks pregnant and don't plan on coming back after my maternity leave. I asked for a code cart multiple time (I am acls and pals certified) and was told there is no need to have one. We don't even have Epi in our clinic. I have so far had 1 patient almost pass out on me from inserting an iv (I was told to try agian anyways) and one patient had what looked like phlebitis (was told to keep the infusion going but I refused to do it). I just feel like things are unsafe and I'm unsure how to go about talking to the right people to make policies etc. the reason I want a provider here is because there are no protocols. I would be up a creek if something happend. Our clinic dosent have over head paging, so it would be hard to get help. Ugh.

I work in a headache clinic. When i joined a year ago they had lost their md, nurse, and one of the ma's. I basically had to train myself. I came from a very busy er. I have had many concerns since starting my position. My job title is nurse educator even though i do nothing besides triage and the occasional iv treatment. I currently work under 2 np's and 1 md (who comes on wednesday from another clinic to oversee the np's). When i started they were not doing iv treatments. I was asked if i was comfortable doing iv treatments (we give ns, toradol, zofran, compazine, benadryl, iv tylenol, and decadron). I said yes. But after seeing some of the patients they were bringing in (pt who has extensive cardiac hx or new type of headache with stroke sypmtoms) and no code cart in the building (building is separate from the hospital) i started to voice my unease. My supervisor basically told us that i needed to do more treatments to get comfortable doing them and that i was paranoid from my er experience. Well today they brought in a patient who i was in the middle of giving an iv treatment to (with medications she has never gotten) when both of my providers left. I called my supervisor and he stated because we had mds in the building (mds that do not cover my providers) it was fine. Am i the only one who finds something wrong with this? I don't know if i am being paranoid, but if they are going to say i can do iv treatments without a provider being there then i can do it on days they are on vacation. It just seems wrong. I would love any advise.