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jalvino1's Latest Activity

  1. jalvino1

    Nursing, the field of medicine or customer service?

    Yea I'm ashamed to admit that not only am I fully aware of this, but have frequently given the same speech when asked "you're so smart, why didn't you become a doctor?" We can create a whole other thread venting about people confusing the two. In the meantime, I haven't been back to this site in months, possibly years, and I'm trying to get back into it to find another outlet. I was nervous that I wouldn't get any responses so i was just trying to find a catchy title. So I am a little embarrased to flame my own pet peeve, but hey, you responded... so it worked. But back to subject, I did very politely explain to the rep the reason as to why the pt. can't have a milkshake, but it took me longer than I thought to have the rep (still not understand but) accept this fact, and at the end of the conversation she looked at me as if I were purposely torturing this pt. I felt guilty enough telling the pt, and pt's family, and now I have to explain it to the hospital staff who's suppose to be on my side. I'm just annoyed because I'm trying to do my job, and do it well, but if the pt's not happy, does that make me a bad nurse? When pt. safety and pt. satisfaction contradict, how could people choose satisfaction over safety?
  2. I'm sorry, but I didn't realize I signed up to please the customer. While the nurses go around reminding the patients this is a hospital, not a hotel, we get notices that we SHOULD make these people feel like they're in a hotel. Or "even if you know they're wrong, you should apologize and let them know that they're right" THIS IS AN ACTUAL MEMO THAT APPEARED IN MY MAILBOX. ... oh but it gets worse. I got tapped on the shoulder by the "hospital customer service rep" telling me this patient (customer) really really wants a milkshake and would really make her day if she could have a milkshake. And I tell this rep this patient just had a bowel resection yesterday and not only can she NOT have a milkshake, but she probably can't even have water, even ice, for the next couple days. I spend all day listening to this patient whine and complain, and now the hospital has provided her a rep to follow me out in the hallway to whine and complain. And neither of them can admit that although a milkshake would make the patient really happy for about 15 mins, going back to surgery and prolonging the recovery would not. I know there's a lot of things in the medical field that seem downright cruel. But if we go by "the customer is always right" keep the patient/customer happy, there will be consequences. Should customer service be #1 priority? Or am I just being delusional believing that patient safety is more important than patient satisfaction?
  3. jalvino1

    Nurse's Aid acting as a Nurse

    Wow, You've all given such great input. I know there's a mixture of agreements and disagreements, but you've all made a great point. I wanted to clarify on a few things and update the situation as well. First: I absolutely agree CNA's are great resources which is exactly why i've postponed the situation for so long. She is a GREAT CNA, extremely thorough, and extremely caring. In fact, I was greatful to work with her... at first. But that mindset is why I've let a few things slide, and how i got myself in this mess to begin with. Second: I confronted her first instead of my charge nurse or nurse manager because I respect her, and didn't want to make a fuss if she listened to me... which she didn't, so I decided to go to my charge nurse in a round-about way. Without mentioning names I asked my charge nurse if it was ok for CNA's to ambulate patients 1st time post op, change peripads and chart their assesment. To my surprise, she said all of that was fine. With that said, I've let go of the ambulation part. I am lucky to have a CNA so willing to ambulate patients. However, that still does not excuse her extremely rude response of "I don't have time to blah blah blah". As for the peripad and the "serosanginous" I still do not agree, and still prefer to see it for myself for the following reason: What if the next day the patient hemorrhaged, got into severe trouble, and sued. When I get called into court, and they ask me "so what did the drainage look like the day before she hemorrhaged, what was your assessment of her status?" My response would be "I never saw it." Whether the CNA is aloud to do it or not, that is my liscense and my responsibility. Fine, she's aloud to chart, BUT every assessment that she makes is an assessment that I don't. And when it comes down to it, it will be my license on the line. Please give me your opinion. Wouldn't you be scared of that situation? or do you believe you'd be o.k. in court? Or am I still overreacting. Third: I wasn't upset she spoke to the Dr. or the Dr. spoke to her. I was upset she didn't correct him. Instead of saying "oh I'm not the nurse" she said "can you write that down for me ." It's not just me or the Dr. I overheard the physical therapist refer to Martha as the nurse TO the pt. When a patient who's not mine asks me a question and I ask her who her nurse is they say Martha. So yes, she's an incredible CNA, the unit is lucky to have her, I'll be the first to admit that. But it gets me nervous that patients, Doctors, staff mistake her as the nurse, and she does NOT correct them.
  4. jalvino1

    Nurse's Aid acting as a Nurse

    So here's the deal. I'm a new grad RN, 22y.o. often mistaken for 17y.o. and even 12y.o. by one patient. The CNA is probably in her 60's and has worked on the unit for a very long time. When I first met her, I too, thought she was a nurse, I don't know why, it's just the way she presents herself. Then when I started working with her, some patients thought she was their nurse and I was the CNA or nursing student. I would always correct the patient, and assumed their mistake was because I look so young, and she so old. But then one day I walked in while the CNA (who's name will be changed) was introducing herself to a patient and she said "Good morning. My name is Martha, I'm one of your nurses today." Mystery solved! So some time passed, and I've been brushing it off my shoulder and just correcting people because I figured she was otherwise harmless... until this recent event: I work on the surgical unit, and my patient had a hysterectomy. Martha comes up to me and says "so you're patients peripad was saturated so I changed it." I asked her if she saved it so I can see it. And she said "oh it was just a moderate amount of serosanguinous fluid." I thought to myself, I hate she did that because now I can't document it. But I didn't let it bother me, I figured I'd chart that the CNA disposed of it and so on. As I go to chart I see that she's already charted HER ASSESSMENT. Then there was a new order to ambulate the patient. It would be her first time up since post-op, I always prefer to be with the patient first time. But Martha comes up to me an hour later and says "I walked the patient, and she started feeling dizzy and nauseated so I returned her to bed" (Great, another assessment, I missed). Those offenses were almost excusable, but the next one absolutely is not. The same patient tells me that "the doctor told the nurse that he wants her to change my dressing." :angryfire As politely as I could, I told the patient "Martha is not your nurse, she is your nurse's aid. I am your nurse, and I will be doing your dressing change." That was my last straw with her. There is NO reason why she should be talking to the doctor about patient treatment. And I finally decided to confront her. I told her I had a few things I was concerned about. #1 the peripad and documentation to which she said "the other nurses don't mind that I do that" and I told her, well for me, my preference is that I see it and I document it. #2 ambulating the patient to which she had the nerve to say "I don't have time to wait around for the nurse to come around and ambulate the patient." I was speechless to that one. So I moved on to #3 and said "you spoke to the doctor..." to which she cut me off and said "no, the doctor spoke to me, and I told him to write it all down. I've been here so long, all the doctors think I'm a nurse here." I said fine, then what did the doctor say, and she ran down a list of orders. Which by the way I still find strange, that a Doctor would tell a nurse's aid a list of orders... unless she introduced herself as the nurse. It's also strange that she didn't tell me she spoke to the doctor, that I only found out through the patient. Anyway, I go to the chart, and the doctor forgot to write an order to change the dressing, and I spend the rest of the day trying to get a hold of the doctor so I can get a telephone order. In the meantime, the patient's all mad at me for the hold up. And all I can think is, if the doctor told me instead of Martha, I could have written a verbal order. Am I crazy? would all of this get you angry? Are nurse's aids aloud to document? I thought ASSESSMENT is a nurse's job. Any similar events out there? Please give me your opinion, I'm too new on the field to know if I'm overreacting or if she's oversteping her boundaries.
  5. jalvino1

    families with clipboards/notebooks

    Haha, call me naive, but when I have patients or family members taking notes, it never occurred to me that "they're preparing for a law suit." I was always glad that they were participating in their care. ex #1. One patient was very particular in getting his pain meds every three hours, but he had a horrible memory, so he would write down everything he took and at what time. How could I complain? Instead of him ringing his call bell every 5 minutes asking when his next dose was (which does happen with some patients) he knew when he was due. ex #2. On discharge instructions I always go into more detail than what is written down, so the family member started writting down what I was saying. It made me kind of nervous, but I knew it was good information, so there's no reason to be nervous. In my experience, the stuff they write has more to do with the meds their taking and things they have to do, not opinions. But honestly, if it makes you nervous DOCUMENT DOCUMENT DOCUMENT. You're documentation is a LOT more credible than there's.
  6. jalvino1

    Nursing Salary...

    "bling bling" doesn't say anything about how much a person makes. Everytime somebody buys a boat or go on vacation they are sacraficing something else. For example. My mom is a nurse, I have one sister and we grew up in a 3 bedroom townhouse, we each have a car, we do not wear designer clothes, we rarely go on vacation,. But because we do not own more than necessary, my mom was able to put both me and my sister through a reputable university, with a reputable nursing program. And most importantly she is not in debt. On the other hand, I also know a family that lives in a 1.5 million dollar house, with an Audi and BMW. They go to europe for a month every summer, a cruise for a week every christmas, they own enough clothes to clothe a small country, eat out at fancy restaurants many nights... and they are in debt up to their ears. Their daughters are still paying for their student loans, their oldest daughter had a very small wedding because her parents couldn't help pay for it. They spend their money as it comes. Priorities. "Bling Bling" is a lot of peoples priorities, and I'm not judging bc they earned that money, they can spend it however they want. But my mom grew up very poor. And she says she never wants me or my sister to have to struggle the way she did growing up. Now she makes just as much as that nurse with the "bling bling" lifestyle... it's just that her daughters are a bigger priority to her than a fancy car.
  7. jalvino1

    Nursing Salary...

    Anybody who says money's not important has never been poor. My mom became a nurse because it meant a plane ticket to America. On that note, the whole money issue makes me tremendously uncomfortable. Anything my family of nurses can say to me is "oh congrats for graduating. Now you can make the big bucks!" I hate it, because that's not why I went into nursing, but that's what everybody thinks.
  8. jalvino1

    1,000 days for nurse strike

    I admit, I don't know much about unions and strikes, and it's very difficult to judge this specific situation becuase there is no detail. Just that they have been on strike for 1000 days. but given the information I have been all I can think is: 1000 days?! Isn't that a bit excessive. Don't they think it's time to change tactics. Advertise for community support, get the governer involved, lobby the white house. I don't know what these protestors are currently doing but 1000 days, or even 365 days, their tactic is not working!
  9. ...Somebody calls your friend an SOB and you start assessing his respiratory status. ok. so that one's a joke, but everybody's gotta have one of those stories when, for example: I instant messaged my friend "you need to have some patients. Oh, uh, I mean patience! so what's your story? :)
  10. jalvino1

    What's your story? Why did you take up nursing?

    I'M A FILIPINO... need i say more? o.k. I will. A lot of Filipinos become nurses because it means a plane ticket to America. However, that's not my story, that's my mom's story. That's right- a filipino family of nurses. It's about as rare as grass. Well, i was predestined to be a nurse whether I liked it or not. I Remember being 5 years old and thinking "I'm gonna be a nurse just like my mommy!" And as the years past I decided I wasn't so sure about nursing, and as more years past and the time to apply for college rolled around, nursing was the only thing I could think of. I had doubts in my head about nursing everyday, and I was surrounded by nursing fanatics. Then one day (you know that day when you haven't slept in days, you've spent hours studying for that exam right after finishing that project and getting dressed to go to clinical and had your morning cry) I thought to myself: "Damn! I love this profession!"