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Because you have an expanded education base you have a broader perspective from which you can provide for your patients.

In my hospital, even middle management has to have our be matriculating to a master's degree.

When you are in an RN to BSN program there is not going to be a focus on clinical education. You already learned that in your Associates program. The BSN program is going to focus on what you missed out on in your Associates program including Theory, informatics, and yes, Public Health and Social Work. I think it's a shame that you don't recognize how much Social Work you do do at the bedside every day. That's what helps you communicate with your patients, and assess their needs. And as far as the writing goes, what if you want to make changes in clinical practice, run a quality improvement project, approach your manager or director of nursing to appeal for staff increases, or write a grant? A broader education in writing, theory, communication, and social services will help you in all these areas. Informatics is the future of health care and improves the safety of your patients. I think you need to open your mind to the possibilities that the power of this education has, to help you make changes and improvements in the area you are so passionate about, bedside nursing.

T-spot is a blood test that replaces need for PPD and is (I believe) more accurate.

Hi Nurse Beth, First, I would like to say, there is not a nurse in practice who hasn't been "fired" once or twice. Don't stress too much over it, or take it too personally. Sometimes patient/nurse chemistry just doesn't mix, and EVERY patient isn't going to like you. You say that "most often" you get positive feedback from your patient base, but then say you are "frequently dismissed from patient care by patient request." It seems to me that both of these things cannot be correct. So to you, how frequent is frequent? If this is happening once or twice a year, I wouldn't worry, but if it is happening on a weekly basis, there might be a problem on your end. I think everyone has given you really good feedback. If you're close enough to a co-worker to ask what's up, I would. Or if this has already gone to the supervisor, look for feedback there. I think both Kooky Korky (#10) and pmabraham, ADN, RN (#11) gave you great advice. Patients want a personal touch, that's why nurses have not been replaced by machines, make a connection, make them feel they can trust you and that you can relate to them. Go a little out of your comfort zone, and beyond their hospital stay, let them know you want to know who they are, and not just a diagnosis in a bed. The most important thing is that you care about this and as long as you strive to improve, you will do fine. Good luck!

You did the right thing. There is too high potential for risk/problems, which I detailed in response to another readers comment. I think your supervisor must have been having a bad day and was reacting to the stress of her own job and the added responsibility of having to find a way to change your assignment.

I disagree with the person who said it wouldn't matter if she took care of the ex's lover. Even if the patient does not recognize/know who the nurse is, the nurse knows who the patient is, which could effect her judgement, even subconsciously, in a number of different ways. She could jeopardize or neglect other patients due to stress/anxiety, or from trying too hard to take GOOD care of the "lover/mistress." She might also, intentionally or unintentionally avoid the patient, thereby neglecting her care. Additionally, the ex will undoubtedly be present as a visitor, which would likely cause the nurse anxiety, potentially causing her to make errors with this or other patients. Finally, if she was seen by the ex or recognized by the patient, she is opening herself up to liability because even if she never walked in the room, he has an abusive history and could make any number of false accusations including something as simple as a HIPAA violation, such as telling family or friends that they were in the hospital, which is a terminable offence.

In your initial post I did not see information about you getting sick over the weekend, that is a different story. If you have been ill, and without sleep, and not fit for duty, then you have to call out for the safety of your patients. You do not have to give a reason for calling out. You simply call out and say " I cannot come in to work today, I have to call out." Your employer is not supposed to ask why. If they do, you just say, I can't make it in, I am not able to work today" It is personal time, an unplanned event, NOT "sick" time, or calling out sick, which it is usually mistakenly called, but simply "calling out for an unplanned event that prevents you from coming to work."

Nurses are ethically required to be fit for duty, and that includes being responsible to make sure you are fit for duty. If this happens once, you're ok, but it is your responsibility as a nurse to make sure you get the sleep you need before your shift starts.