Guest02/04/2016

yeah... i started to slow down. DON wonders why i am spiking in OT. i told her they can't dump on me the type of patients they do and expect me to finish on time. patient safety and my license is my priority. sorry boss... apparently, this error happens more than none. it will again... and i hope nobody dies this time. hospital won't order the correct bags and pharmacy will not create a prompt for it. i had a 30 year old RN made a different mistake the other day, but she didn't get written up because she retired that weekend. mistakes happen people... only trying to see if anybody has any ideas... besides what my username was ... and clearly (i should've read that order, properly) :) thanks all. i didn't make this post trying to shift blame. i made the mistake and own up to it. seems like somebody/somewhere on AN is trying to find an angle to **** on anybody.

different patient... the patient that expired, i did EXACTLY what the MD ordered. it was 1 of those instances where a procedure can potentially kill the person or keep them alive for another month or 2... the patient was do not resuscitate status. guess that's why nobody gives an F. i was only task running that shift. come to think of it, that's all i ever do nowadays. i am always dumped on with unsafe assignments. i reported it this time. looking for a new job, also. the other person wasn't harmed, MD said don't worry about it, and was discharged.

please don't think this is 1 of those "hey... i'm a new graduate, i'm more knowledgeable than the charge... etc..." i'm still too new at this to feel that competent. i'm in the process of looking for a new position because it scares me knowing i do not have an experienced resource on the floor with me. i work at a s***hole. 75+% of us are new graduates. i want to keep my patients safe... and alive. after a hand full of incidents, i decided to share with the few trusted veterans and the person who precepted me (a year ago...) they tell me... keep that particular person/charge out of your care. she doesn't give an F about anybody/anything. i'm not going to share details, but i heard "interesting" stories. thanks for the responses/time. i'll go straight to the MD, moving forward.

thanks for your time/response.

i wasn't oriented properly and there are issues with my facility i will not go into details about. it is to my understanding, i must have a discussion with my charge about patient status and they ultimately make the call. i do not utilize my charge for any other reasons, other than discussing my patients change of status. all i need to know is if there is a chain of command i need to follow...? if can completely bypass my charge nurse, great~! that is my only question. - when i write my preceptor, i meant my preceptor from a year ago. i voiced my concerns about transferring a patient. my charge nurse refused to transfer because it will add to her workload. my preceptor (from a year ago... i am off orientation) walked into the room and told me... "you should get this patient off this floor, stat." the patient was transferred to a monitored unit, and they transferred the patient to the ICU, the next day. sit there and absorb this for a moment. this isn't the first time this has happened to me. i only wrote of 2 instances, however.

i am not on orientation... sorry. the person who precepted me, i meant.

i am not sure what quantifies/qualifies an excellent charge nurse... but i think there is an issue with mine. i work on a medical/surgical unit. i felt a patient admitted should've been on a monitored floor. change of shift arrives, charge nurse from oncoming shift blasted me for not transferring pt elsewhere. another instance, i discussed with my charge. the charge was contemplating on keeping the pt on floor (while the patient declines). coincidentally, my preceptor was working and emphasized we should transfer the patient. the patient was moved to the Intensive Care Unit the following day. i also experienced other instances where i needed my charge to brainstorm possible critical patients with me, but she was too busy jotting down vacation days. charge would tell me to give multiple narcotics and synergist, but never do themselves. (for instance, when i am on break.) to avoid confrontation with a patient, my will falsely redirect their tension towards me. like lying to a patient and telling them we had the MD order hours ago. speaking off... my charge would rather have me execute and order WITHOUT MD approval, to get a patient off the call light. unfortunately, i am not the only person on my unit who experienced the like. i'm not sure what the duties of a charge nurse is, but mine never assists me when i need it. hat do they do?

i wouldn't worry about the pt ratio. i work in CA and i have 1:7 sometimes (i cover 2 for an LVN/LPN). your issue is acuity. my 3 can require more nursing care than your 7. i've been a year on, but the veterans cringe when they have to get report from me. they tend to switch assignments IF it's ever a 1:1 exchange. and i have no aids. they constantly/consistently bombard me with these assignments. my only advice is for you to remember this: you can/will lose your job over time mgmt issues... jobs are a dime a dozen, even in my CA market. but you WILL LOSE YOUR LICENSE over patient safety. never rush, cut corners to get out on time.

-always recheck your medication before you administer. because it scans and matches the patients armband doesn't mean it's correct. -it doesn't matter who you talk to or tell about the dumping-ground you become. the director doesn't give a ****. wait until you see how many hours of OT i have. i am constantly/consistently caring for patients who other/veteran nurses refuse. or the "difficultly/needy". -i need to slow down... i'm becoming an unsafe nurse.

i had to complete peritoneal dialysis for a patient twice a shift. order stated 2000cc from a 2500cc bag. normally, a prompt would show up if it was for a pill. for example: --"READ THIS: only administer 12.5 mg of 25 mg"-- the offgoing nurse told me what the pt likes to watch, eat, favorite hobbies, etc... BUT failed to mention "only give 2000 of the 2500 bag". keep in mind, we do have a 2000cc bag and they BOTH can be scanned interchangeably. i have no idea why/how? so i figured, IF IT SCANS... nothing more to it. i didn't notice the order, as i never experienced this. my fault... for not reading the order. but how do i go about resolving this? as so it would NEVER happen again. i had to file a "risk" report... i called the MD and no orders were given. they told me the order was because the pt was retaining fluids. i input 2500 and received 2300, twice. other times, i had patients retain more than this and no such order was given... so i didn't even bother second guessing. i am going back again... hope i didn't injure the person.

finish my first year on the Med/Surg floor... should i stay for another 2 years? or transfer to the telemetry unit? what else? i want to be prepared for the ER. classes, etc... thanks in advance.