Nurse Jen, RN

Hi everyone. I work on an acute care unit in a large hospital. In the past six months two of our staff have been injured to the point of needing to take leave, both by young adult males with autism. Both patients were at least minimally able to communicate basic needs, but definitely not able to verbalize feelings, etc. Those of us who have requested it have been able to take MOAB, but I feel that those deescalation techniques are more directed to those without the kind of communication difficulties that those with higher levels of autism experience. Plus, one of these assaults appeared to come out of nowhere. Do any of you know of any training or education focused on patients with autism? Some of our staff are really afraid to take care of these patients now, mostly because of the level of unpredictability that they associate with them, but I think more familiarity and a better understanding may go a long way toward relieving some of these fears. Ideas?

Deaconess is not represented by a union, and the nurse-to-patient ratios are higher than some other area hospitals.

They can ask, you don't have to share. There are so, so many health professionals with depression, anxiety, and the like. As long as you have healthy coping mechanisms and patient care isn't affected, it shouldn't be a problem. If you were on a controlled substance, like benzos, you would probably have to disclose that, however.

I've been a nurse for two and a half years now and I still occasionally forget to unclamp the IV and to hook the BP machine to the BP cuff before starting to inflate it. On Saturday I tried to help a coworker out by flushing a possibly clogged NG tube. Turns out it was clogged, enough that when I flushed the tip of the syringe popped out just enough to spray the water back all over my face. The family member was horrified and asking if I was ok, my first reaction was to burst out laughing. It happens, you laugh it off because none of these things hurt the patient. NGs and the like leak, you'll learn fast to put a washcloth or something under it to prevent things from getting too messy. These are nice little tips for your preceptor to be helping you out with. Which brings me to your preceptor problem. I agree that you should try another shift with her. Realize that if you go in with high anxiety your performance will not be as strong. If you can, ask before the shift if you two can go over goals for you to work on that day and what suggestions she has. This should all be constructive. If she is still behaving inappropriately I would tell whoever is in charge of preceptor assignments that you just don't think her style of precepting coincides with your learning style. It's not a lie, and that way you stand less chance of stepping on toes (if that's a concern). Anyone who has precepted knows that some people respond better to others. I wonder if she has behaved like this with other preceptees?

I had the same thing happen. I was promised by the NM that they would give me an answer no matter their decision by that Friday. Never heard from them, even after leaving a follow up message for the NM. There had been some warning signs before that that had me a little hesitant, the no call was my confirmation that I'd dodged a bullet. It sounds to me like you might have some reservations as well. If you were correct in interpreting the "underlying mockery," do you really want to be employed there??? I walked out of my next interview (different facility) feeling like the NM and I really clicked. No warning signs, much more organized process. Been there for over 2 years now, and I am SO grateful that I did not get that first job!

If med/surg is your ultimate goal (or next step), the rehab position will be a better experience. Most acute care positions are going to say "experience preferred," but apply anyway. Med/surg is often a starting ground for many new nurses, and depending on the size of the unit and number of potential hires, hiring experienced nurses may not even be an option.

I would assume that if they haven't called yet, the answer is that you need to move on to other opportunities. Especially if there were only three interviewees for the position. If, for some reason, they are late in getting back to you, it doesn't hurt to look elsewhere in the meantime.