quazar

On my floor it's the opposite problem. The nurse's station and hallways feel like the frozen tundra, and the thermostat is dominated by the ones who are sweating. Our patient rooms have individual thermostats for control, so their comfort is not considered when setting the unit thermostat.

Nothing WAS wrong, actually. You weren't there. I was. Medicaid is relevant to this conversation because another poster mentioned that medicaid would never tolerate or allow such a situation.

This is excellent advice. Please take it.

As an L&D nurse who has delivered quite a few babies on the fly over the years, I can honestly and fervently say it is not only barbaric and against all practice guidelines to "hold in" a baby, but my God....if we're talking path of least resistance here, why on earth would I ever prevent a baby from coming? If you've ever pushed with a patient for over 3 hours, you know that having a baby just pop out with little to no work is absolutely fan-freaking-tastic. I'll take it any day of the week over a marathon pushing session.

I had a patient refuse to go home for 4 days. She insisted SOMETHING was wrong. We did every test under the sun on her, most of them ungodly expensive. Nothing was wrong. She was medicaid. *shrug* It happens.

. It can, sure, but most CNA jobs that are plentiful and available are the ones that require extreme physical labor and endurance. It might not be what you want to hear, but it's the truth. CNA work is very physically demanding, very sweaty, very hard work. Bottom line. I've done it. It's hard. No other way around it.

I love learning new things if they hold my interest. For example, I love learning about life sciences. However if you try to teach me something new about math or computers, my eyes will glaze over and I will be asleep in 5 minutes. The thing is, I have to pay out of pocket for any conference I attend, so I want to make it worth my while. OB conferences are a no brainer, I love that stuff. Med surg conferences and cardiac conferences are what spark my non-OB interest the most.

I think you handled it as well as could be expected. Had I been confronted with this as a student on my first day of clinical, I have no idea if I would have had the stones to speak up. Sad but true. It has taken me years to grow the cajones and backbone that I have now. You are on your way to a good start.

I get email alerts for professional nursing conferences, and frequently get brochures as well. Not all of them are strictly OB related, either. Some of them pique my curiosity, and sometimes I think about attending conferences on topics that have nothing to do with OB, just to keep my knowledge base well rounded. Would I be bored out of my gourd? Confused and lost? In over my head? Have any of you who've worked primarily OB ever attended, say, a med surg type conference and enjoyed it?

So proud of you. You may "only" have 2 years of nursing under your belt, but your spine is already rock solid. You did GREAT.

Thank you, you took the words right out of my mouth. What knocked me over was that was followed by this:

If only I was a travel nurse......I have the biggest fangirl crush on him.

Yes, thank you, that post was completely out of order. "Tattle tail?" Really? What is this, the 3rd grade?

One of the many sacrifices I voluntarily make by taking per diem status. I'm not sure if the full timers get it paid for or not, but still, one day I'll go. After all, even though it's expensive up front, it's tax deductible.

This is where that boring part of orientation and the yearly mandatory education about corporate compliance kicks in and is actually beneficial. Report her, there is a way to do so confidentially/anonymously within your system. Don't falsify, report, and I agree with the pp it's not worth your job to stay at this place if the higher ups support this kind of nonsense. I'd walk if it wasn't addressed and corrected immediately.

Smart. Good suggestions.

Oh, so jealous. I want to go to an AWHONN conference one of these days, but the stars and my budget never seem to align.

I would be interested to know what led to the rapid response as well. I have had "that" frequent flyer patient who was a drug user who turned tricks to get her fix who would sign out AMA frequently only to return when her situation was dire. I have discharged patients to rehab instead of home, only to have them bounce back again, using. I work OB. Let that thought settle in a little bit and think about the implications. It is hard. It wears on you. Yes, I get that. Addiction is a brutal disease, and in the acute care setting it gets really complicated. HOWEVER....that doesn't change the fact that addicts have pain, that their pain is real, and that yes, they do a lot of the time have a lower threshold for pain and need more medication than their non-addict counterparts. You still have to treat their pain, not for patient satisfaction, but because there is actual documented research out there that shows that poor pain control post op leads to slower recovery time which in turn can lead to greater post op complications. You can't control their behavior outside of the hospital. You can only treat the after effects when they come to you for treatment. It's all you can do. I made my peace with that a long time ago, and am so thankful for people like Social Workers and Psych who can an do come in and do what I consider to be the "tough stuff" and confront the issues of the addiction, poverty, prostitution, etc., head on. Thank God for the multidisciplinary approach. You don't have to do it all. The others made a great suggestion about asking for continuous o2 sat monitoring if you're worried about her respiratory status. Put the patient closer to the nurse's station so she can be observed closely. When you're burned out and feel you can't go into that patient's room one more time without screaming (it happens), ask a colleague to check the patient for you, just so you can take a quick mental health break. I get that she was a challenging (understatement) patient. I still assert that drug user or not, her pain needs to be treated based on what she is reporting, as long as her vital signs and assessment are WNL.

Aaaaaaaaaaaaaaaaaand that's where I stop reading this thread. OMG. *heave*

I will just say this. I had an IV drug user post op once (okay, I've had more than one IVDU patient, but this one in particular was severe), and she required massive doses of pain medication to keep her levels stable. From a clinical standpoint, I knew that she would require much more medication than a non drug using patient, and thankfully her physicians understood this as well and prescribed accordingly. My job was not to judge her drug use habits outside of the hospital. My job was to manage her post operative course safely, and that included appropriate pain control, which meant giving much higher doses at much more frequent intervals because to do otherwise would have left her in pain and suffering. You were not in your patient's body, you don't know how much pain she was in. To withhold pain medication when there is no clinical evidence that doing so would be detrimental to the patient from a physiologic standpoint (e.g., their vitals go in the tank) is cruel. You cannot judge another human being's pain without being in their actual body. You simply can't. Maybe she was drug seeking, or maybe she just really had a lot of pain because she had *spine surgery,* which I hear is pretty brutal, and she NEEDED pain control. Maybe she threw a fit because she was hurting. People lash out when they are in pain. In the future, I would recommend that you try your best to leave your personal opinions and judgments aside where pain control is concerned, particularly for patients who struggle with addiction.

Will ZDoggMD be there? 'Cause if so, I will somehow find a reason and the funds/time to attend. Haha.

THIS. YES. Exactly. She is deriving perverse pleasure out of making people suffer, and in very vulgar, embarrassing, dehumanizing ways.Sorry to keep responding, but this issue is so close to my heart. I just keep thinking of my parent, and it really really REALLY rubs me the wrong way here. I have taken care of elderly people who were violent and belligerent, and I never treated them like this. Never. The whole abuse aspect aside, yes, she is putting those people at risk for real health complications, and if you want to get down to the nitty gritty and things that will get the attention of the administration, talk to them about reimbursements. Medicare and medicaid don't reimburse for things like CAUTIs or bedsores due to neglect. Speak to the people up top in terms they understand if you can't appeal to their sense of basic human decency: money. This woman will end up costing them money in the long run as well. That ought to get somebody's attention.

*I* was young when I was a CNA, I was only 19-22. I still had the ability to have compassion for those who could not do for themselves. This woman is displaying a basic lack of empathy, something that is quite unsettling (to put it mildly) for someone in a position of power over a vulnerable person. She needs to be put in check, and right away, before she hurts someone.

I have been surprised on a number of occasions by the most innocuous looking patients giving the most shocking answers to screening questions. Had the questions not been there, I likely wouldn't have asked, and never would have known the (in some cases very large and dangerous) risk was there. Yes, the screening questions are annoying, but I think of them like a giant sieve: they are useful filters that catch small things that would otherwise be missed. You never know.

Please report their behavior. Your post made my blood run cold. I have a parent with advanced dementia and Parkinson's, and the thought of my parent being "cared" for by these people is horrifying. If they treated my parent this way and I knew about it, I would be in the administrator's office raising Cain. My parent is difficult to care for, and I myself have worked as a CNA for very difficult total care patients in a nursing home AND in a residential facility. I got frustrated on the job. I STILL didn't treat my patients like that OR talk about them like that. What you're describing tiptoes around the edges of verbal abuse and elder abuse. Those CNAs are abusing their position of power over the residents, and in a disgusting manner. Report them. Leave out no detail.