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Lad345

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  1. Lad345 posted a topic in Nurses Recovery
    I've lurked on this board for about a year now, pretty much since I got caught diverting and fired from my job at a hospital. I just wanted to post my story for anyone that might be searching for hope, understanding, and solidarity. I know that reading about a "light at the end of the tunnel" got me through some of my sleepless nights over this last hellacious year of unemployment, drug screens I couldn't afford, waiting on the Board, hating myself for getting into this situation, and dealing with legal issues. Much like others on here, I'm in my state's monitoring program, turned myself in for a felony arrest (which was expunged as of two months ago, yay!), did outpatient therapy, and I attend AA/NA/impaired nurse meetings. I've applied to a bunch of jobs, interviewed a lot, and had almost given up hope because I met a lot of dead-ends. I was even hired by Fresenius back in October, but corporate shut the hire down due to my consent agreement. Everyone at the clinic knew everything from my first interview, and they were okay with my probationary status. But three days away from the start date, a stranger in CT decided they wouldn't allow them to hire me after all. However! I did end up getting a job not long after, one that I'm really, really enjoying at a not-for-profit dialysis clinic. I just wanted to say to anyone that might also be dealing with losing a job offer due to corporate nonsense, don't give up and keep pushing forward. I called absolute bulls**t on the whole "it gets better" spiel after I lost my first job offer, since I felt like it had taken so much to even GET a job offer that things must be impossible for me. But it did, indeed, get better. ❤
  2. Any nurse/person that spends their time talking down about another specialty and how they're "not real nurses" can kick rocks. Honestly, get a hobby. This sort of thing, the "nurses eat their young" trope, or "new nurses disrespect veterans" stereotype all boil down to one thing to me: insecurity. Take people on a case by case basis. Of course psych nurses are real nurses; I'd imagine that the specialty requires extremely quick critical thinking and fortitude to handle behavioral crises. My hats off to psych nurses, and all other nurses in areas different than mine.
  3. I know right now it feels terrible, but just know the onus is not on you entirely. I don't know your specific policies, but where I am the lab draws are done at 0400, so that they are available for MD review when the medical teams arrive between 0600-0800. In all honesty, the act of paging labs is not done to inform MDs about the *existence* of lab results, it's moreso a small *reminder* to them that an abnormal lab is out there. Just as nurses are ultimately responsible for ensuring that a tech's verbal report of a blood sugar matches the machine report in the chart; MDs are accountable for looking at labs to confirm verbal nurse reports. I mean, if your tech forgets to call and report a FSBG result to you, that doesn't excuse you from checking the FSBG and giving insulin coverage if needed. Yes, you should have glanced through labs and FYI paged it to them at some point during your shift. But ultimately I would think that they should have looked at the pt's labs on their rounds? Or when they wrote the pt's daily progress note? In the line of accountability you noticing and reminding them is important, but unless it's a true critical reported directly to you from a lab tech, its not really the nurse's true "responsibility" to remind MDs to look at their labs. Labs are a medical diagnostic tool that only physicians can officially interpret. We're advocates and liaisons between patients and all the different disciplines, but we can't always check behind everyone. It's definitely something we should TRY to do, but that comes with time I think. You can't sit and actively look for issues in the entire EHR, but you'll gradually find yourself checking certain things to be sure they are done. If those were the last labs the patient had had done, and none were ordered for the night before the planned discharge, then the MD inadvertently articulated "labs no longer needed". Logically, that'd should occur if they were reviewed and determined to be acceptable. The night nurse also should have looked at the labs, and he or she could have paged as well to jog their memory, and see if they wanted to replace the K. But again, while it's helpful and things get missed less when several team members are compelled to check the labs, the MD was the one truly responsible. If you're going to give certain medicine that directly correlate labs, like bumex or lasix, yes you should definitely be checking them first thing in your shift. But, in my opinion, it's rather poor-planning on the part of that MD to not have checked their labs from the day before until the day of actual discharge. At the core of healthcare, your responsibility is providing safe, effective patient care through ongoing assessment and carrying out orders; it is the MD who should be ensuring that ongoing diagnoses are accurate, electrolytes and blood components are at acceptable levels, the POC is progressing, orders are up to date, and meds are still appropriate with current pt status. I say all this because I would personally take issue if I overheard a veteran charge guilt-tripping a new nurse over something like that. I guarantee she or he has done something similar when they first started out. Habits like consistently checking behind labs, having the confidence and intuition to question orders, and getting a feel for radiology comes with time. It's always helpful to find a mentor to go to help point you in the right direction and help you grow. If that charge is continually overly-critical, I'd pull her aside and remind her you're new, you're committed to learning, and ask if she has any suggestions to improve your work flow. If extending deference to her doesn't help and she starts making a habit of guilting you like that, maybe distance yourself from her and find another, more empathetic veteran to assist you. I can't stand nurses that treat new nurses poorly and pretend like they just started out in nursing as knowledgeable as they are today. Your mistake still happens to nurses with years of experience, because on extremely busy days we may only get a quick glance and it's universally expected that MDs will perform all of their responsibilities during their rounds and notes. Just let it roll off your back and learn from it. You'll find your method for getting everything you need from the chart quickly, don't worry it just takes try time. From the sound of it, you got chided by your charge because things unfortunately roll down hill. But just know, you aren't the most culpable, and you are not really the reason discharge was delayed.
  4. I use a few different things, depending on the severity of the belligerence. If I'm delayed by something serious and the floor is too busy for a coworker to help me out, I'll go in quickly, apologize for the delay using an even and uninflected tone, then launch into my pain assessment and scanning the band/med. If they snark off, I'll again apologize and ask if there's anything in addition to the med that I can do for them. If they STILL continue to grumble, I'll tell them that while I'm sorry that circumstances beyond my control prevented a swifter response, I understand and acknowledge that they are frustrated. I then tell them that in order to improve our night, let's talk about how I can provide them with better care moving forward. Then I'll just keep changing the subject: Do they want the next dose as soon as it's available? Need ice/heat pack? Thirsty? Comfortable position? Need to go to the bathroom? Until they give up trying to get a rise out of me, and let it go. I get that sometimes they just need to vent and smart off initially, but let's move on after. I don't operate in the past, and you're not roping me into an argument so you can report me. It happened, I've apologized, I've made amends, and I've encouraged their input on how they'd like the rest of the shift to go. I'm not going to use a soft, shamed voice and fall all over myself showering patients with apologies and play into their anger. I try to stay even-keeled and objective. If they're cursing and yelling at me, I'll calmly and quietly scan them and the medicine and attempt to do a pain assessment. If they won't answer, I'll chart they endorse pain but refuse focused assessment at the time. After I've medicated them I'll tell them that their language is inappropriate, apologize again for the delay, and inform that I will be bringing another staff member along each time I return until we can speak to one another calmly and with mutual respect. Last of all-- if they're yelling, carrying on, AND threatening me or using aggressive body language, I tell them from the doorway that I will not be entering the room until we can talk calmly. If they keep on threatening and yelling, despite my warning that escalating and violent behavior won't be tolerated, then I'm calling security. Then, they're not getting a thing from me nor are they getting within arm's length of me until someone formidable from security has arrived to support me. I'll take my charge in too if they're available. To me, the prioritization of the nurse-patient duty takes a backseat the second a pt starts hurling threats towards me. My safety will always trump everything else to me. Once i have support and three people are looking them in the face, they'll usually start feeling foolish and downplay it as though I'm overreacting. They may even make up some elaborate lie about me and "report" me. But, remaining in the doorway has more than one advantage: everyone at the nursing station will be witnesses to hearing them call me a stupid b**** and say they want to "show me what pain is". Cute, but no cigar, bud. .
  5. What you're experiencing does happen often, to a lot of nurses. Don't give up on nursing if you really want this, over one job. I think it's a bit unfair to write you off and say you don't belong, or that you're not cut out for it. Healthcare has its social quirks you adapt to over time. It's a culture shock, and wondering what you've gotten yourself into is normal. Not one person has thick skin on day one; some people ignore rudeness, some meet it with returned rudeness, others call people out for being unprofessional, and some just remove themselves from the situation. While it's usually in your best interest to try a job out longer than you did, I understand fully. Some places are giant red flags, and it's better to get out before they start writing your name with pen instead of pencil. I honestly almost walked away from nursing myself about a year ago because an LTC was crushing my spirit and wreaking havoc on my body/mind. I came out of school and took a Unit Manager position at a SNF (which, lessidea earned, if somewhere will hire. someone for a "higher" rung position like that as a new grad, you should probably run far, far away fast). My passion is in geriatrics, and I was wide-eyed and excited to have my very own unit and residents. While I truly enjoyed getting to know and love my residents and the place in my heart for the geriatric pt population only grew bigger, I also stubbornly tried to fight something much bigger than me and threw myself into that position full-force. I pushed and pulled for better staffing, I relentlessly tried to motivate/reward staff for how burdened they were while still coming down hard on abuse/neglect, I lobbied to be properly supplied and outfitted with equipment, I created inservices and streamlined work flow, I squared up when needed with the handful of MDs that rounded weekly if they werent acknowledging issues, and I talked myself blue in the face arguing for our right to better resources/attention/treatment from our mother hospital system. I kept it up a long time before I started becoming really jaded to healthcare, and even in some ways: human nature itself. It was as though I was a figurehead leader of a glorified health insurance-money farm. They made a killing off my SNF while providing borderline inhuman conditions, because, hey, the checks clear and most of my residents weren't cognizant enough to understand how they were being disgustingly shortchanged. Nothing I said/did helped and I was advocating into a vacuum. And I was there almost every day of the week, upwards of 60 hr a week, for what was about 21/hr with no overtime pay, so my checks only showed 42 hr if I was lucky. Honestly, through and through, I got to be truly miserable and exhausted to my very core. Not sleeping well, poor appetite, always lethargic and sad. I didn't think it healthy for me to remain in nursing. But instead of leaving outright, I applied around and fielded some different possibilities before I accepted my current position where I'm now practicing patient care that I'm excited about, at a facility I enjoy, with teamwork and good people. Just to give you an example of how another nursing job could be totally night-and-day different from your last one: I now work on an ICU stepdown surgical floor. I work with a 1:3 ratio for appx $37 an hour before diff, and I get to self-schedule. My fellow nurses and our techs are really amazing and proud of what they do and where they are. The high job satisfaction leads to everyone consistently helping everyone else. No one sits and lollygags at the desk while another nurse/tech is drowning and running around wide open. We toliet each others pts, medicate if needed, help each other with invasives, and look out for one another. Additionally, my facility does quarterly, organization-wide nursing forums to field concerns/needs/issues of the bedside nurses, and then *actually* follows through with change rollouts and work flow improvement projects that we on the floor *actually* petitioned to have. I'm also constantly getting to learn new things. I take care of some involved sxs like Islets, CABGs, TAVRS, Whipple's, etc. I'm given pay incentive to increase my skill set, and take part in innovation and new training in pt care. And to top it all off, my facility is providing me with a full-ride from BSN to MSN, with option to bridge to DNP down the road. It also has the framework, resources, and infrastructure in place that's allowed me to join the research team of an ANP, with the ability to form my own team down the road to conduct my own research. I suggest, like others have above, that you perhaps consider clinic work and go do the last bit of school to get your RN. Now, when I say that I honestly don't mean it to sound as though it'll make you any "better". I've met many an LPN that's more savvy and adept than BSNs with the same work experience. It's just the nature of how nursing is progressing--you almost have to get the RN to get on in acute care, the extra bit of school opens up a lot more doors. I know this was an extremely wordy reply, but I feel like I can kind of relate to what you've said. I really wanted to stress that there's better things out there for you. LTC is almost universally deplorable, it seems. But there *are* good companies out there, and different roles you could fill as a nurse. I came from the science research sector myself, and rudeness was no acceptable there either. I was taken aback by how nurses/CNAs spoke in residents' rooms, talking about them like they're objects. Not explaining care before the touch them. Just rough stuff for me to stomach. No matter where you go though, you'll sometimes have heavy shifts and deal with rudeness. The real litmus test is if those instances are not commonplace. Some MDs you'll have to work alongside will be like pod-people, lacking any social manners. Patients and family will also occasionally be rude and mean. You develop a thick skin, and a begrudging empathy towards a-hole pts. It's not personal, and being sick/anxious/scared in a hospital can bring out the worst in people. But it's rewarding to watch people progress and get better each shift, because you helped them do that. I think you ought to give yourself at least one more chance to find your place in nursing, and I hope you find a better position.
  6. You should have probably told him to hold that thought, went to wherever your supplies were, and came back with a fresh blanket, some warm milk, and a few Graham crackers. Then sit him down and ask him how being scheduled makes him feel. I'm from the southeastern U.S., and personally I think I'd have likely clicked my tongue, given him a great big smile, and told him, "Well, bless your heart, how unfortunate for you. I'm sorry to hear that". And then turned my back to him. Then to add insult to injury, I probably would have lightheartedly asked my coworker if he or she cared to accompany me for a stroll to go put the time request in, while I still had it fresh on the brain. I've found in my years of nursing that the best response to unsolicited, unprofessional, and uncouth aggression from notoriously grumpy MDs is to clap right back at them with your best good-natured, jovial demeanor and a jokingly sarcastic answer. Then just leave them be to fume and let the nearest know how important and angry they are like a petulant child. Going to your higher up may help, and you're certainly right to do so if you choose because no one should speak that way to anyone, but if he has a reputation he may have been reported before. He honestly may just not care.he could even take being reported as a sign that he's intimidating and feared, which might translate to "respected" to him, if he's the self-important type. MD personalities range the whole spectrum, just like they do in nurses and other HCPs. There's a few abrasive MDs with no comprehension of basic etiquette and zero social skills for every couple of ever-negative, sour-faced nurses that are always having the dreaded, apocalytic *WORST ASSIGNMENT EVER*. I think the most deflating thing you can do with an erratic, aggressive MD like that is to just casually brush them off, crack a joke, and walk away as though they aren't much more worthy of attention than a bratty, barking chihuahua. Sounds like he may have wanted to beat up on you just to blow off stream about what a sore loser he is, and to see you phased might make him feel justified and like he "put you in your place". Next time, don't give him the satisfaction. Keep your body language relaxed and smile. Let him work himself into a tizzy, until everyone's looking at him thinking how pitiful and pathetic it is to see a grown man having a temper tantrum. Nine times out of ten, they just sulk away in a huff. His bad vibes and attitude are his problem, don't allow him to shove them in your face and unnerve you. Let him sulk away with his black cloud feeling ashamed and looking silly. Maybe he'll be forced to do some introspection and work on self-regulating his emotions like an adult.
  7. If you do not like nurses, why are you on a website called AllNurses? We coordinate all interdisciplinary care and advocate for pts. We have to put out fires and make sure people are doing their part for the care plan. We are watching everything and tracking the patients overall physiological status. Reduce nursing involvement? Many issues are handled and serious harm is curtailed because we page the MDs to bedside. I mean, jeez, sure let's lower our vigilance of patient status. You're incredibly misguided about what we do , and needlessly hateful. I appreciate every aspect of the care team, but you seriously need to reevaluate how you approach others. I care immensely about what I do, as do many other nurses. It's ridiculous to be discriminatory towards an entire profession, like you are. Especially on a nursing website. I don't claim to know what your shift looks like, please don't suppose you have the faintest idea what mine looks like.
  8. A place where the people taking care of you appear greater than human, larger than life, infallible figures Have to stop you right there. That would not only be a blatant lie but a dangerous, creepy goal. We're NOT infallible. And, no, patients should not be directed towards considering us such, even if it's just for aesthetic sake. Patients should not just inherently agree with us and pedestal us like that. We are out of the age of healthcare coercion and "we know best", for good reason. Also, I see zero reason to doll myself for coming in contact with human bodily fluids and being on my feet 12 hrs. I'm in direct patient care, and I enjoy what I do--the good, bad, and ugly. I see no reason to put on airs. A lot of your complaints sounds petty and childish. I for one kinda dont want my hair "flowing" when I'm hands deep in human feces. And, uh, maybe brush up on your perception because I seriously doubt someone wears an eye patch to look like a pirate. She may have a medical condition, but it's none of your concern anyhow. And who cares about her haircut, it's not 1920. Women can do whatever they want with their hair. It's a very insecure and juvenile practice to spend your time looking around for people and things to judge. You might think it's good to dress up, feel free to do so. Take a book to work or something, and leave others alone.
  9. I don't know, I think allowing staff to treat the station as a reprieve as well as a central area to chart and monitor is something that depends on the floor. There's a culture of hyper-connectedness in healthcare now. That's great for patient outcomes, as turn around time on issues lessens; but at the same time, nurses may be in a constant state of keeping track of care plans that update constantly. We sometimes have shifts where we might not get to eat, revolving doors of admits/discharges because of clinical pathway adherence, not getting to listen to our body and rest a few minutes after settling medically heavy, total care patients , and we have ever-updating electronic charts and always ringing portable phones. Things are evolving, patients that used to be treated in ICU are on the floor now. I personally think it's okay to have some comic relief for the sake of staff camaraderie. Burnout can creep up on one quickly, sometimes you really need to stop and do something else for a few minutes.
  10. Goodness, it sounds like you have a very specific chip on your shoulder. It's a bit dramatic to expand your individual experiences to make statements about the field of nursing as a whole. I know disengaged nurses that just punch the clock, and I know nurses invested in the health and course nursing is on. That's life. I absolutely love precepting students. I enjoy teaching, and I like seeing the pieces come together for students as they develop their nursing skills over the semester on my floor. The example of the SCDs is a joke. Maybe they meant have you used their brand yet. Maybe they were prompting you to show what you know. And, yes, maybe they just wanted to know if you knew how to use them. I don't think you should be offended by that. The nurse probably had no idea they'd have you, and they probably had no say about it anyway. You're ultimately unlicensed guests at the facility. The nurses are giving *their* time to watch you give medicine and do invasives. It's not simulation lab, real people are really sick and the nurses you encounter are responsible for them. Rounding your education is not a priority of the floor, nor should it be. You need to seek what you can from clinical, but understand no one owes you anything. You have no license and you are not their employee. Units that don't like having students exist, and they get students just like the welcoming ones. If nothing else, familiarize yourself with Mosby's, get an idea of what a unit layout is like, work with eMARs, study the facility policies, and learn how nursing work flow plays out. As student, you're honestly only guaranteed shadowing experience. You'll be put on orientation when you're hired somewhere, and then learning the ropes and doing nursing skills before a preceptor happens. Ultimately, the onus of your education is on you. Welcome to real life, man. You have to adapt and seek things or our for yourself in actual nursing. You will be solely responsible for the currentness of your clinical knowledge and skills, your license, and your practice. Consider the disengagement you're experiencing your first lesson. You can whine about it, or figure out how to make it work for you.
  11. Considering the assessment and the patient load you described, I would have done the same as you. I've worked in LTC also, and I've felt the conflict between doing things that are patient-centered and safety-driven vs what's "financially ideal". It seems to be an ongoing dilemma, and I think it's present to some degree in all settings. What I personally try to keep in mind is that, while I want to try to do what's best for my facility, my license is my own property and responsibility. The patient comes before the facility needs for these scenarios. If something happened to that resident, unfortunately culpability would have probably fallen on you. You saw a change in acuity and acted to give them more focused care. They were no longer medically stable in my opinion, and to me that means they're not LTC appropriate. An acute change in physiological status calls for an acute care consultation, in my book. You used your judgment to advocate for the resident's best interests and also protected the quality of your practice. It's much easier to be a Monday morning quarterback and predict the medical course AFTER diagnosis is made. Out would have been hubris for you to just take those two components of temperature and wheezing, and decide it was pneumonia. She hadnt even assessed the patient at the time of the occurrence, so she doesnt have any legitimate basis to say what should have been done before a diagnosis was even made. Where I work, a fever past 101.4 with wheezing/SOB warrants full workup. Blood cultures, xray, CT, BMP, CBC, EKG, trop, and ABGs. It sounds weird and dangerous to me that she'd even want to talk the MD out of their decision to get further evaluation. I mean, differential dx should be done. Even with a bedside CT, it's not definitive that just seeing infiltrates means only pneumonia. Is there a need to rule out cardiogenic, mechanical respiratory, or nephrological origins? Are they becoming alkalotic with that CO2 blow-off? There's a lot that could have been going on, and we nurses can't decide within our scope of practice that the problem just needs antibiotics, honestly, and you're right to want them moved to a higher level of care. It seems more like a "preferred" thing for her, but honestly I feel safety should trump preference. Good for you for deciding to go with your gut and stand by your assessment.
  12. Islet. It's not that the word disgusts me or anything, it's just that I cannot, for the life of me, say it correctly with any consistency. I -know- how to say it just fine; it's not even that it's difficult for me to pronounce from a phonetic standpoint. I mean come on: "eye-let", right? But alas--if I'm not actively wary of stopping myself, I'll say "Eyes-let" nine out of ten times. I'd say twenty percent of the patients my floor gets are Islet Tranplants, so the word comes up often enough that it's in my regular vocabulary. Honestly, you really would think I'd break the habit by now. But naaaah. Lol I'm also strangely perturbed by patients saying they need to "tinkle". For whatever reason, my skin crawls when one of my adult patients uses it while we're talking. It just hits my ear as eerily regressive and child-like.
  13. 1. Personality is definitely a big factor. I'm not a schmoozer myself, and I'm rather introverted by nature, but I can be pleasant and conversational. That's really the minimum I feel, just develop a few points of innocuous small talk. Unfortunately, just being reserved and harmlessly quiet can make you seem aloof. 2. It's always best to address issues with your coworker first. No one likes or trusts a tattletale. Unless it's a serious and dangerous issue, don't immediately go to the manager. I like most people, and personally don't have the mental energy or spite in me to try to get someone fired just because we don't click. What goes around comes around, too. To me, it's ridiculous to sabotage someone's livelihood because they're not your BFF. And eventually people notice and distance themselves from nasty people. 3. It really depends, I don't know if there's a concrete answer as to what is the best preceptor set-up. Depends on both you and your preceptors. A few things I can almost guarantee will be bonus points with any preceptor: ask deeper questions, research things for yourself (you might need to skim policy and protocol on days off, but it'll pay off once you've acquainted yourself with your facility's foundation), don't constantly whine "but, in nursing school..." because you've got to move past that to adapt to real life, take initiative and help others, and do not be a know-it-all. A particularly twitchy, nervous oriented recently chimed in during report in an attempt to inarticulately stutter-question me on an irrelevant CT from two weeks ago--her preceptor cut her right down at the knees for it. It was painful to see. She was trying to look smart, but came across as foolish. Honestly, a really big tip is don't try to outnurse others. It's silly, and you'll never win because this is a team effort. There are ways to prove that you're intelligent that don't involve coming across as a ridiculous kiss-a**. Lol. 4. I want you to show signs of developing your own process. There's many ways to do it, and I like to see orientees work out their method. Get into a habit of tracking the basics: vitals, intake/output, skin, labs, general survey, etc. Acquaint yourself with the medicine you see most. Train yourself to look for oxygen, IV access, and what drips are up when you enter a room. Don't chicken out and pass on every needle stick, and if you find you need it seek remediation on invasives. 5. Fit is very important. For example, do you like cardiac? Do you care to really dig in and learn more about your population's pathophys? When you're passionate, it shows. Even if it's not your ideal specialty, as long as you make some effort and aren't visibly miserable with it, you should do fine. 5. Last of all, even if the new hires do better than you, it's not fair for you to attribute that to them being better than you. You must have confidence. Don't be hard on yourself, and don't assume the worst. Brush it off and strive to do better next time.
  14. No, this is very different. She received the goods for the currency she spent in your scenario. The school isn't going to take her books from her because she failed. She had the ability to be in lecture and take tests. Those experiences/items were properly exchanged for her money. This reads as though they not only won't reimburse, they won't even GIVE her what she rightfully bought. They've essentially swindled $100 from her if "no reimbursement/failing forfeits ownership" wasn't made transparent to her at the time of sale. Without prior written agreement that she risked forfeiting the money, that's illegal.
  15. This just doesn't sound kosher to me. The fact that a donation of her pin is possible hints that buying one wasn't mandatory. I cannot imagine it's legal to withhold the property she bought, if no prior agreement was signed. These pins/caps usually come from a graduation company or uniform store. The school has rights to the emblem, sure, but they themselves didn't make the pins. They would have given the rights for the school's likeness to this third party during creation and distribution. It's absurd if they claim they maintain irrefutable ownership of the likeness in so much that they can TAKE the product from an individual. If she put it on and posted pictures online, they could make her cease-and-desist publicly showing their brand but they can't take her physical property unless they give her compensation. She can't possibly be obligated to both the school AND the company. That's impossibly unfair for the individual consumer, after all--she didn't pay them both. Sounds as though they're interfering with a business agreement made between her and the pin-creating company, and forcing her to pay for a product she bought, that they'll use. A football team can't decide to keep their memorabilia you bought from an atheletic outfitter without just reimbursement. All the ritualism of nursing school aside, without prior signed agreement this is just plain failure to render. Also, the idea that they shouldn't be on the hook for reimbursement just doesn't make sense to me. Someone using that pin certainly should. If there's a need for the pin, the owner deserves payment for her property or else her property should be given to her. I just can't see where, unless terms were made clear before payment and signing was done, this is legal or ethical? How can you be forced to donate something you purchased, unless you specifically signed something agreeing to do so? It's just bizarre to me. No other part of your schooling is taken from you. You can fail, that doesn't allow the school to commander ownership of your textbooks and uniforms. Even the classes you failed, you got what you got out of them with lectures/testing/etc. Where I schooled, I paid a separate fee after finishing for a physical degree. If nothing else, encourage her to use it as a tax write off?

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