kp2016

You know what will affect you and your co workers? The kind of ugliness that comes with this monitoring and reporting of each other for perceived violations of policy. If you have ever worked somewhere where "incident reports" were used as weapons by managers and staff against each other you will understand this isn't a trend you want to start. It spreads. Quickly. It makes for a very ugly work climate.

What is your facility policy? I would carefully document my assessment and then follow the facility policy and document that I did. My license would not be owning that one.

All of that for no on call pay and no minimum pay for calls. Wow. No. Just No!

I have never taken this exam but I have done some online "Learning" from my BON on effective communication and conflict resolution. Apparently I was in need of education as the "correct answers" were staggering to me. The emphasis was very much on being understanding/ accommodating towards under preforming staff NOT addressing or correcting their deficiencies. I would research if they sell any training or study guides and consider buying those to get insight into their thinking. Looking at the company goals may also help. I saw this after a quick search. I would say it is very geared to not hurting feelings. And your answers need to be mindful of that goal more than achieving a functional/ far work place situation. Google search, Prophecy interpersonal competence Situational assessment. Key Components: The assessment likely covers areas like: Communication: Active listening, clear expression, non-verbal cues. Empathy: Understanding and responding to others' emotions. Conflict Resolution: Handling disagreements and finding solutions. Relationship Management: Building and maintaining positive connections. Social Awareness: Adapting behavior to different contexts and individuals. Self-Reflection: The assessment encourages individuals to analyze their own behavior and identify areas for growth.

Whatever you decide to do don't lie to the BON but I would absolutely consult a lawyer familiar with RN BON cases in your state before you do anything.

https://apple.news/ArM3NF6vPQi-LmvJMplUYlg About time. It is disgraceful that even with the mounting evidence and international outrage that the courts and hospital itself refuse to acknowledge that Lucy was a scape goat for an understaffed, poorly equipped unit with grossly negligent medical supervision.

Be careful of the fine print! The last hospital I worked at that had that deal allowed for a maximum of 3 call outs in a set period for any reason AT ALL. You couldn't schedule annual leave on a weekend or call out sick. Once you hit 3 you still had the same schedule but without the extra pay!

It's normal to have on call as part of your role.... when you are offered the job. It's a little shady to add it onto an established role without any staff agreement. Also on top of the pay per phone call and 2 hour minimum for any call that requires coming into the office it is also standard to be paid and hourly on call allowance. If you need to be carrying a phone, and professionally available to answer calls then that is a situation that requires pay. I suspect your management is hoping to get your time for free. That should be a flat no! I would do some research into what average the hourly on call allowance is in your city. Even in low paying cities I have never been paid less than $2 per hour for being on call.

I am not accusing you of anything but you will get the best answers to a question like this in the Recovery group. They have experience with navigating this kind of situation. I imagine getting an immediate drug screening including a follicle test and retaining a lawyer would be a good start.

Sigh. It is a shame that you didn't head the advice that mentioning this after the fact or saying anything other than you thought you smelled smoke if it happened again was not a good idea. I hate to say I told you so... but here we are. I am going to take one more run at this. Your leadership called you into a meeting with your CNO, Unit Manager and ADON and changed your schedule in response to whatever you said and their perception of how it was said. In my experience these meetings are not intended to clear the air or resolve a simple miscommunication they tend to lead to nurses being disciplined then fired. It is clear you care deeply about your residents but you will be in no position to provide them great care if you are fired or have your schedule changed / shifts dropped repeatedly until you are forced to resign. You need to strongly consider keeping your head down and do not confront the RNs with your perceptions of the failings in their care. I do not say that to minimize the valuable role of LPNs in the care of our patients. I say it because you already have a very clear target on your back. Best of luck.

I would not be reporting this more than 24 hours after it occurred or demanding wide spread drug testing if I were you. You are convinced you smelled marijuana in an elevator space, this doesn't make it a fact that this was the case. The other person in the lift with you commented they smelled smoke. Now it could be that they don't know the smell and therefore didn't recognize it but it could also be that you were mistaken. I worked with someone once who's dog was sprayed by a skunk a few hours prior to their shift. Even after many showers and new clothes... they smelled. Awful. Strangely the locker room that contained the clothes and tote bag they walked in with also smelled for weeks, it actually smelled like marijuana at first then settled into a more general nasty smell. Just a thought. The smell could have been something else entirely. Given the other person with you thought they smelled smoke the thing to do at the time this all occurred would have been to notify the facility Night Supervisor/ Charge about the possible smell of smoke / potential facility safety hazard and allow them to handle it.

Sadly for Lucy I think there will be a lot of pressure to not further review this case or her conviction. The alternative to her guilt is that the unit was dangerously understaffed, under equipped for the acuity of the patients and inadequately supervised by doctors with an appropriate level of experience and expertise.

Let me flip it just a little. I've worked in PACUs where we had lazy RNs!! I've never had techs in a PACU. Normally we just take turns taking the pts as they come out. It isn't always even as you may end up with back to back major cases while someone else gets minor (easy) cases all shift . Where the lazy comes in is some nurses would do unnecessarily long recoveries on the basic cases that were awake and totally stable on arrival, others would discharge there pt, sit chatting and when they were next up to take a pt go on break as soon as a OR called they were on their way. The interesting (to me anyway) part was how reluctant our unit managers were to actually address this, even when it was so obvious the CRNAs and Dr's were asking why do only A, B & C ever take patients? It seems to me lazy is a human trait and not tied to any one job role. In the places (yes more than one place I work) I saw it happen. I kept my eyes open, applied for and happily took other jobs when they came along. I had more than one manager beg me not to leave "it will take 2 people to replace you". Funny, that's a huge part of why I'm leaving. Bye!

https://www.the-independent.com/news/uk/crime/lucy-letby-trial-new-evidence-guilty-nurse-b2691730.html https://uk.news.Yahoo.com/lucy-letby-conviction-evidence-case-appeal-experts-173551527.html? 2 high lights from an article published today in the UK and USA. Lucy Letby did not murder seven babies at Countess of Chester Hospital, claim experts, who say fresh medical evidence shows natural causes and bad medical care were to blame Dr Lee said the Countess of Chester would have been shut down if it was in his homeland of Canada.

First up, I don't do home care and never have. But.... this seems very concerning to me. You know Mother complains a lot to you about the other nurses. I am willing to bet she also complains about you to the other nurses. She has made complaints about you to your agency. The fact that she never spoke to you about the concerns thereby not giving you any chance to discuss or rectify any issues or misunderstandings is a huge red flag. Those complaints are almost certainly in you personnel file. The bottom line is, the patient and the mother are not family. They are clients. The mother is clearly showing you she has no problem damaging your professional reputation and potentially your job. If I were you I would be looking for a new client asap while it is still your decision to make.

I don't need to. This isn't my license or my homework. I sincerely hope that this is homework. Abuse, neglect and abandonment in my opinion all apply to the described behavior, but thats just my opinion, I'm not going to the Arkansas State BON to find that for you. I'm sure if you email or call them they will be able to clarify it for you.

I think they did answer your question. But I will attempt to be clearer. Leaving in the middle of your shift without handing your patients over to a qualified person is abandonment. I think it is almost certain you will be reported to your board of nursing.

I was cleaning recently and found old copies of evaluations from my clinical's. As I read through them they were all very positive except for one. One was extremely critical and basically said I "would likely struggle in a clinical role" I was shocked as I don't remember doing badly on any clinical and I've been an RN for decades. Basically I thought I was going to faint while observing a procedure so excused myself, stepped out of the patient room and got some water/ sat down to ensure I didn't faint at the bedside mid procedure. With hindsight the only person who acted inappropriately was the instructor who choose to write such an unfounded comment. She was completely wrong and at this point in my life I can easily see that writing such a negative comment about a student based on one encounter where I actually made the right decision says a lot more about her than it did me. A therapist is likely a good idea. They can help you process this and hopefully put it into an appropriate perspective and move past it. Best of Luck

I would personally print the form. Fill in all information that is in the chart and from the recent well child visit. Attach a flag sticker to any boxes where the information is not available and at the sign here box and place it in the providers To Do Box.

That is absolutely ridiculous and your co-workers need a proverbial kick in the tail. If we were talking about 4-6 year olds then sure but 14-16 year olds in an out patient setting so presumably not exactly critical care, they are just picking and choosing which patients they prefer to care for and that is never acceptable!! BTW if your unit does routinely does pediatric cases all your staff need to be PALS certified, I guess my real question is why on earth is your manager allowing this nonsense?

It would be very tempting to choose option 2 and save that $14,000.... but I think that up front dollar saving could be significantly less by the time you are all done. The cost of flights, hotels, ubers or hire cars and meals while traveling for your placements is going to add up. I'm not a NP but I understand obtaining appropriate clinical placements and preceptors can be a significant challenge. I imagine this may be even more of a challenge if you don't have any local contacts from working in the area. I would probably choose option 1 that includes the required placements and preceptors and comes with the bonus of being in your local area which allows the potential to network in what is I assume you future job market.

"being mean" I would smile and ignore this, it is just argumentative. I have had patients that requested the IV in their hand, others that said anywhere you want but NOT the hand and others that didn't offer an opinion. I always consider any expressed wishes, any requirements due to the location of the surgery/ positioning and then go with the most appropriate distal location that I am confident I can get in 1 go.

Patients are often dehydrated after the bowel prep for the colonoscopy. When you add versed and propofol or versed and fentanyl you have patients prone to hypotension. For safety it is essential that you are able to quickly deliver a fluid bolus, atropin or reversal agents if needed. The main problem I had with pre op placing 22g IV access is that it was often "positional" and basically barely functional. While I do agree with not placing unnecessarily large bore IVs, safety requires that you have a functional IV that will allow you to quickly give a fluid bolus. While problems are rare they can and do happen. 20g for colonoscopy / EGD.

In all honestly I don't think focusing on the actions of the staff members is the best way to help your friend in this particular situation. The bottom line is you friend is an addict. Your friend had a relapse after leaving treatment. They need to work on their sobriety which includes owning their actions and doing their best to make the best possible choices they can going forward. You shifting blame onto others is unlikely to help that.

I would say you need to ask to make a time to speak with your manager in regards to your orientation and schedule as soon as possible. I'm sure she is very busy but you need a dedicated 10 minutes to discuss this. This is either a scheduling mistake or a very clear sign that this unit is a very very bad idea. 6 preceptors on one presumably 1 or even 2 month schedule for a new graduate is a terrible idea. You are going to spend every shift being shown "a different way" to do things. The runs of shifts 6 x 12 hours is either that they have somehow scheduled you twice or they are wildly understaffed. Regardless. This is just not a functional plan. I get that you like know and like the co-workers and want to work on an ICU unit but if this really is their orientation plan for you it is very unlikely to turn out well. I would say this either needs to be corrected to the regular number of shifts with no extra's and 1 or 2 preceptors not 6 or you need to to be talking to HR about other units.