Wuzzie

Bliadhna ùr mhath!

I too am finding myself here less and less. Some of the changes have bummed me out and I agree , the fun gets shut down far too often. But I will miss interacting with you guys that's for sure.

I'm going to agree with my colleagues Akula and Mike. Although I work in a cushy clinic job as retirement nears, I am a senior National Ski Patroller, EMT-P and worked decades in CCT, Flight and ED. Without scene safety and management training, without even basic first aid education and certainly without the equipment we are used to having stopping at accident scenes is a risk I would not recommend to take especially for new grads. Answering the call on a plane? Sure. There's only so much you can do. MVC? Not so much. Even with my experience I think twice about stopping. If I can do so safely I'll stop sometimes. If I can't, I make the 911 call. Honestly if any of you want to be helpful in the community I would highly recommend you take a first aid course. You'd be surprised what you didn't learn in nursing school.

The tele position will get you a strong foot in the door for the ED as well as the hospital. HH is not a great place for new grads and rehab, while a terrific specialty, will not have the same weight as the tele position.

So let me get this straight...you had 6 weeks to orient to 3 disparate, complicated specialties, were given vague explanations of your "deficiencies", were not offered any assistance/education to improve but instead were left on your own to try to figure it out AND didn't get the full 30 days? Girl, they did you a favor. Pick that chin up and move on. You'll find your place. ?

The problem I have with the phrase "nurses eat their young" is that workplace bullying is not unique to nursing nor is it perpetrated only by senior nurses. I agree with Tweety that the statement needs to go away and instead of pointing the finger at one particular group recognize that this is an issue that impacts all humans in all walks of life and somehow we need to figure out how to make it stop.

This 100%. "Some humans eat other humans" is much more accurate but just as vile of a concept. I wish people would stop propagating the wildly inaccurate idea that only older nurses are running around abusing younger nurses. Bad humans are bad humans and they come in all shapes, ages and sizes. They are also present in every single workplace. Nursing does not have a corner on this market.

I'm sorry Matt but per our TOS we cannot give medical advice. Sending positive thoughts your way.

https://www.aol.com/radonda-vaught-bid-reinstate-nursing-224400266.html

Politely demand this in writing. This will call her bluff without risking your employment. If what she is stating is against written policy she will not want you to have proof of it and will back down. If she persists you might want to contact your state's labor board.

"Patient advocate" ?

I am seriously shocked and massively impressed that these physicians have gone to this length to support Lucy and are working so hard to right what I have come to believe is an egregious wrong.

I get what you're saying and I did not mean to imply a lack of critical thinking or inability to adjust care to a situation, but care by protocol is, by nature, "cookbookish". FTR: I was on an extremely high level peds/neo team and one thing is certain....kids don't like to follow the rules. Regardless, applying this to in-patient care with no physician or other provider type on site is a recipe for disaster.

That's why I appreciated your sage advice to for them to remain quiet and let the chips fall where they may. I've learned if you point out the issues prior to implementation when those issues arise, and you know they will, they somehow manage to make it your fault they happened. It's maddening.

Not disagreeing and given the ridiculous plan this place has come up with so far they can't be trusted to make any good decisions. However, this is very much the reason the role of the NP came up in the first place.

Well, yes and no. I think it's more nuanced than that. Having spent a substantial amount of time doing that particular type of nursing I feel like I have the street cred to chime in. While, it's true CCT/Flight nurses work from protocols, assess and make treatment decisions based on their assessments the big difference is time. That is the amount of time the patient is in the sole care of those nurses without being evaluated by a physician. Transport is a stop-gap. It's a means of bringing an arguably higher level of care (specially trained nurses and medics) to a patient while at the same time bringing the patient to an even higher level of care (physicians and tertiary centers). And that's one patient at a time with a 2:1 level of care limited to <1->4 or more hours if the proverbial poop hits the fan. Also, there's a much narrower disease process focus mostly limited to issues that have a high rate of going sideways quickly. Not to mention it's "cookbook" medicine. You follow a protocol and hope the patient responds in the expected manner. If they don't, you put as much Jet A into the equation as you can muster while doing the best you can with what you have on board and get the heck back to the hospital. Now, I'm not saying that nurses can't assess, can't follow a protocol, can't recognize when things aren't going right and respond appropriately. But to do so for a long period of time is asking for trouble and for an entire admission is borderline, not to put too fine of a point on it, malpractice. We all know that video visits can be problematic. Then there's the sheer number of protocols that will need to be written to cover everything a critical access hospital has to deal with. This cannot be accomplished in a week's time. Heck, I doubt a year would be long enough to get this plan up and running. I think this hospital's plan is short-sighted and full of holes. It smacks of "bottom lining" and perhaps a little desperation. I don't see how any ethical physician would think this is a great idea. I wonder if they lost their physician coverage group and can't get another to work at what is probably considered a B-list hospital. So this is what they came up with. I'd also like to point out that this is exactly the type of situation that the role of the NP was first envisioned and I'm mystified why they haven't considered that route.

It was actually a shift I worked (well 5pm-3:30am). It was staffed that way because the bulk of ED patients are seen in those hours. It wasn't really as bad as you seem to think and I'm a single female.

In re-reading the first post I also don't think she was forced to work over. That would have been a 20hr shift. She said she was scheduled to work until 0330. Everyone assumed she was working 7a-7p but I think it was more likely 3p-3a. Some units do schedule like that (EDs come to mind) I don't think her schedule had anything to do with her problem. I think the real issue was she was salty about having her Friday shift eat into her weekend (which does suck) and came here with a bad hospital/abused nurse story looking for support and justification for calling off. Which she got...at first, until people figured out the math wasn't mathing. Then the story changed to having a GI issue preventing her from sleeping which is a totally legit reason to call off. Heck the GI issue alone was enough to call off. But why not say that in the first place? I'm guessing it's because she was beginning to get called out so she switched tactics and it worked. I'm skeptical about the GI thing because most people don't come here for justification for calling off due to legitimate illness. They come here when there's something sketchy going on and they know it. Also, she wouldn't answer clarification questions and then got prickly. But I wasn't there so, for all I know, she was sicker than a dog. I think the bottom line here is if someone has to go to the internet to get justification for their actions from total strangers then maybe they should reconsider their plan. It probably isn't a good one. Just to be clear. Yes, I think people should call off when they are too tired to function for any reason but along with that there is also a certain responsibility to make good decisions about protecting your sleep, circumstances beyond your control not withstanding. Yes, staffing is a management problem and not the employees responsibility. Unfortunately most hospitals don't see it that way which is wrong on so many levels. Regardless, this thread is also over 8 years old and the OP hasn't returned since May 2016 so whatever happened has happened. I do have to congratulate her/him on an excellent "rage bait" in absentia. ?

Maybe I read it differently but I don't believe that's how it was scheduled. She worked over on Friday night but had both Saturday and Sunday night to sleep prior to going back to work on Monday morning. She added details later about a GI illness that caused her to not be able to sleep. Big difference. Sure, staying over sucks but I'm not seeing how the hospital scheduled her was at fault.

Agreed. Success at IV placement is 50% skill and 50% vein selection. You can have all the mad IV skills in the world but if you pick a crap vein your chance at success drops dramatically and visa versa.

If the vein is visible try no tourniquet and drop the angle of approach to nearly flat.

When you say "missed" do you mean you didn't get in, back-walled it or it blew?

You think this is bad? Wait until you have kids. ?

Each facility will have different rules. Certain units within facilities will have even stricter rules (think ICUs, OR, NICU, Oncology). I don't see a ton of nurses with super long nails but I wouldn't call it rare. I, personally, wouldn't have them because of the ick factor plus they can tear the gloves we use. Other people's MMV.

I think the reason why no other CNA wants to help this person has become abundantly clear. ?