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kp2016

kp2016

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kp2016 has 20 years experience.

kp2016's Latest Activity

  1. CGFNS can be very slow, they also require all documents to be resent for every new endorsement, they apparently can't use the ones you already paid to have sent to them. If I were you I would start by planning to renew your Virginia License. You mentioned you have a multi state license. Virginia and Florida are compact states. Could you keep VA as your home state and just do travel nursing in Florida which would allow you to use your current license while you get this sorted out - even with out covid, that would take a lot more than 3 months. I would not run the risk of ending up with an expired Virginia license and no Florida License.
  2. kp2016

    Alone in the PACU

    According to the managers I've asked; - Give any /all medications yourself and then take them with you when you discharge the patient to a unit so the receiving RN can waste with you. - Press the code bell on the wall in PACU, it only rings inside the OR because we don't need additional staff for a code...during the day when fully staff... so I never got an answer on, what the heck will happen alone in the middle of the night, other than "it's really very unlikely to happen". - Problems, concerns, safety issues, urgently need help or medications from pharmacy, call the Hospital Charge Nurse and ask them to come help you.... What if they are busy in the ER, ICU, L&D??? This was always the point where I was told to stop being deliberately difficult, so I don't have the answer to that one. In real life I quit this job and took a pay cut to work somewhere with much lower acuity patients and no on-call. Problem solved, for me anyway. At the point where your job feels more like an abusive relationship with the threat being to your license and having to live with knowing your patients are receiving care that is defined as unsafe by nationally recognized professional associations (ASPAN) it is time to find something else. Less money and "losing your skills" are not a reasons to put up with situations this dangerous. The sooner more nurses start making this clear to hospitals the sooner they will stop demanding we do it.
  3. kp2016

    PICC dressing change with 3M Tegaderm with CHG

    Working outpatient infusions in a very hot state one Summer I noticed the first time we changed the dressing on the newly placed PICC lines the dressing's were incredibly sticky and hard to remove. Most of PICCs were placed by a mobile PICC team who drove around between multiple small hospitals in our area. It was my guess that the kits were left in hot cars during lunch breaks or maybe overnight and the high heat in the car affected the dressings. I was told by the PICC nurses and management that I was wrong and imagining this issue. Strangely the dressings from our supply cupboard that we used for our weekly dressing changes did not seem to have this problem. We took to having two staff to do the dressing change (many of my fellow RNs also imagined the same issue), one to hold the PICC and insure it didn't migrate in or out and the other to get the old dressing off and place the new one.
  4. kp2016

    Alone in the PACU

    Sadly it's very common. ASPAN has a very clear policy statements that it is dangerous and not acceptable but I've noticed a lot of smaller hospitals do it anyway. I normally put my concerns in writing with a copy of the published ASPAN standards.
  5. kp2016

    PACU recovering patients in the ICU?

    I've done this before, it was a nightmare. Part of the problem with it is that the PACU nurse is now recovering the patient in a completely unfamiliar environment which makes if hard to function safely. The other factor is you are often alone in an ICU room instead of in the main PACU where you have other staff you can pull to give you a quick hand. Other problems I ran into was the ICU nurse took their break as soon as I started the recovery as "it's a PACU patient and I won't be able to take my break once I take the patient". Thanks, now I'm recovering alone in an ICU room. To be clear this wasn't exactly the ICU nurses choice, they had been assigned to cover everyone else's breaks while waiting for their patient. Anesthesia provider refused to write any additional orders that were needed as it was an ICU patient, the intensivist refused to write orders as it was a still a PACU patient. This is one of those idea's managers love as they can use staff across two units in the same shift. The reality from the perspective of the PACU and ICU nurse is that it forces us into unsafe working conditions, reduces our ability to swiftly get orders from over covering doctors for a critical patient and just basically puts the onus for shorting out the fighting between Anesthesia / ICU providers onto the shoulders on the nurses. In general just a horrible idea. It should be either a PACU patient and comes to the PACU and is recovered by a PACU nurse or it's a direct admit to ICU and is taken directly from OR to ICU.
  6. kp2016

    Working On Expired License

    The facility will most likely report this to the state BON. BON will probably give a fine and probation. I have no idea if the facility will fire your friend for this but I think it is likely.
  7. kp2016

    The golden first year?

    I absolutely hated my first year of nursing. I fantasized almost daily of walking out and never coming back. I made myself a timeline on my calendar for how many months, weeks and working days I had to get through. For some reason telling myself it's only X more weeks and then I'm done and will be walking away from here like my tail is on fire helped me. I also spend the last few months of my first year (It was a one year contract- and I have not for any amount of money ever considered signing a commitment contract again) looking at the job boards for every hospital I'd ever heard of looking to see what jobs they had. I hope you find something that works for you, maybe try a completely different area, infusions, dialysis, OR, PACU, IR, education you don't necessarily have to spend another small fortune and years of your life on a NP qualification to get a job that is 100% different from the work you to death floor nursing.
  8. kp2016

    The Honeymoon That Never Came

    If that is an actual picture of you and your real first name you might want to change the picture and choose a non identifying name. We live in a very small world and HR/ managers can be vindictive.... and let's face it given that yours are OK with blocking nurses from using their earned time off.....I think you get the point.
  9. kp2016

    Advice on what to say during performance review

    I would say it depends a little on the attitude of your manager. I had two different managers for the same unit at the same hospital (1st one got fired) Manager A was a PITA, grilled me about my future goals, when would I be starting my Masters (that they don't pay extra wages for...so never) what extra committees was I looking to volunteer on (in my own unpaid time..none) Manager B was great. Here is your eval, you are doing great, thank you. This is the max annual raise I'm allowed to give you, do you wish to discuss this or contest the annual raise, in writing to HR. Nope? great, sign it and we are done. Honestly I would never announce that I am looking to switch units to further my career. While it may certainly be true I can't see how it would benefit you and I can see it being quietly held against you if announce you are planning to leave. If you have a type A Manager I normally prepare to say I would love to start a Masters but it's not financially possible for me right now, but I am committed to continued learning through CEUs and In-house education (I love this one as they are required to pay for the course and my time) For type B. All you need is a smile and your pen.
  10. kp2016

    I don't know if I can do this...

    That sounds like a shift that would have been difficult for any nurse, let alone a beginner. If you have a medicated patient in restraints your charge nurse really should have stepped up to help you, it's impossible to do all the extra checks and documentation and carry a full patient load. As for the miss counted drug, forget about it, it happens all the time. A pharmacy at one small hospital I worked at actually made the charge nurses do a count every day and rectify any miscounts. It really isn't that hard and doesn't take very long. She should not have gotten upset with you and frankly I feel like this is partly on her anyway for leaving you with such a tough assignment. Hang in there, it gets easier.
  11. kp2016

    Personal Life Affecting Work Life

    You seem to be very focused on your job / hours as the problem here. I'm sorry to say it, but you asked. I think the breakdown of communication, trust and just generally having different priorities to your husband is the larger issue here. You could quit your great job which is close to home and has supportive and kind co workers and role the dice on a new day shift job but that won't necessarily change your husband's behavior or the health of your marriage. I would try and have a really honest conversation with your husband about the state of your marriage and his current level of commitment before I quit a great job. The fact that he was texting someone else may be a one off because he was lonely and bored or it could be a very serious sign that the marriage you thought you had is gone. You might want to consider talking to someone just by yourself. This isn't just about your husbands behavior, it's about how it made and continues to make you feel.
  12. kp2016

    New Grad Needs Advice - Hostile Work Environment

    I realize it doesn't help your situation, but these two answers are for anyone considering taking a sign on bonus or accepting an incharge position as a brand new nurse. Just Don't! There is a good reason hospitals offer a sign on bonus tied to a time commitment and trust me it is normally very bad for the nurse! Hospitals even large ones are like small towns, everyone knows who the bullies are and which units are awful to work on. Management is also well aware how difficult this person is as are most of the people on your unit. The people who asked you if you really said the "n" word were probably more expressing their disbelief in her allegation than a belief you did say it. People are distancing themselves from you purely for self protection. They don't want to be on the receiving end of the treatment they see you being subjected too. I'm really sorry you are going through this but your manager who advised you to keep your head down and mouth shut wasn't wrong. It's either that and hope this person decides at some point to leave you alone (most likely pick on someone else) or ask to transfer units. Best of luck.
  13. kp2016

    Lost med

    Go and read the Nurses/ Recovery board. I'm not in anyway suggesting you have a problem or have done anything wrong, I am suggesting you need to see exactly how seriously you need to be treating this. Get a lawyer immediately!
  14. My opinion on this has evolved a lot over the years. I've gone from perfect attendance, dragging myself to work no matter what to realizing that I am important in my own right and have every bit as much right to be "sick" as my patients do. If I am sick I should stay home, if my back hurts it's fine to stay home, if I just need a day at home in my PJs because it's Monday that is fine too! The staffing of the Unit Is Not My Responsibility! Taking care of myself physically and mentally is.
  15. The problem with using your PACU on call staff to cover ICU overflow is that they are then not available to do emergency surgery cases. It depends on the hospital but a lot of smaller hospitals expect the PACU nurses to collect the patient, bring them to the OR and check them in while the OR staff open up for the case. The management answer to that is always, well "it probably won't happen", the ward / ER/ ICU staff can bring the patient to the PACU/ come get them, the Supervisor will come and help....blah blah blah Trust me it does happen and "everyone" is always too busy to "do your job for you". Having a clear written policy on the role of your on call staff and the exact criteria for calling them in saves lots of middle of the night drama.
  16. This is a policy issue. I've had plenty of on-call jobs and there was normally some written or at least informal policy on when on call staff were to be called in. Having said that we were not called because certain staff "didn't feel like working". In fact one time a co-worker had the audacity to actually tell me she didn't feel like working the rest of her shift and I should call in the on-call person so they could go home, our supervisor told her "No, you will finish your own shift". Probably because I told the supervisor that she had told me she wasn't actually sick. In your case if Susi called you Saturday night to basically tell you she plans to be sick Monday, I would be passing that information onto your manager so they can deal with it. Lots of hospitals actually having disciplinary policies for staff who abuse sick leave.