tish666

I think you did the right thing. The patient ALWAYS has to come first, and pain control is a big issue in both the facilities I work in (hospital and LTC). I feel the nurse going off shift should have addressed the issue. You are not off duty until relieved.

My hospital recently opened a new patient bed tower and moved my floor (Medical/Oncology). We know have tele and all the "fun stuff" that the others units have had, and that we are not used to. I was assigned to a 78 year old man who was admitted with chest pain, ischemic changes. He put on his light to tell me that he was going to die if I didn't spend the night in his room. After explaining that I couldn't because my other patients wouldn't appreciate it, he put the call light on every 15 minutes "so you know I'm not dead yet." I finally told him that I could see his monitor (ours are in the hall, attached to the wall). and I knew he was fine. He wanted me to move it in the room, because he didn't think I could watch it constantly. When I explained that wasn't possible he called his wife who showed up at 2:30 A.M. "to watch the monitor" because I was too busy.

I was an LPN and became an RN this year. I think that the only patients who really cared if I was an RN/LPN? NI were a couple of retired nurses we have had admitted to our floor several times in the last 4 1/2 years. If you weren't an RN you knew the shift was going to be bad; on the call light constantly, if you didn't answer it they would demand to know why, nothing was ever right, water to cold, then too warm, etc. But if an RN was assigned to them they hardly ever put on the call light. When I asked one of them why the difference she told me that "everybody knows LPNS are just play nurses and have nothing better to do." Maybe we need to educate the public better.

My facility has started writing us up for clocking in early or staying over without a "good reason" . The reason? Nursing is $1,000,000. over budget for the year. Of course all the extra help we had for JCAHO and Magnet were counted. Our old staffing levels were 5:1, once in a while 6:1, team leaders had 2 patients. Now we subtract 4, (Team leaders each get 2) then divide the remaining patients by 5. if you have 23 you get 4 floor nurses, 3 of whom have 6 patients. But , we have also been warned that Patient Satisfaction scores are not supposed to fall. I work a Medical/Oncology floor. As hard as we try I just don't see this working.

In the hospital I work in LPN's are not allowed to take orders, but we are working changing the hospital policy. Other hospitals in Ohio let LPN's take orders. When I answer the phone and the doc tries to give me an order I always explain that per hospital policy I cannot take an order from them. It has gotten alot of the docs on our side to help us change the policy.