update on steppping on senior nurses toes

[b eyes]

Hi all! and thank you for the replys. Helped alot. However, now I have a addendum to that issue.

here goes, It seems that the senior nurse I was talking about has been trying to set me up for failure. The other day, she set alarms on a patient who was in RAF to go off whenever the hr dropped below 100. Being new, I did not know how to turn these alarms off, and frankly didn't need them on as I was sitting bedside with the patient monitoring him while giving diltiazem. Anyway, monitor ran out of memory because it records every time an alarm sounds, which was numerous, as trying to get this pts hr to decrease was my ultimate goal! Needles to say, all my data was lost for the last 2 hours of this patients stay in the ER. (I have since found out that I need to turn the monitor off and back on to get rid of the alarms! )

Then yesterday, before she left at 3:30 am, she came out to med-surg where I was because there weren't any patients in the ER and said there was nothing to report on. So I stayed out on med-surg and helped the other nurses. well, at 7:30 I received a phone call from the OR tech telling me there is a syringe of morphine laying on the counter and alot of staff walking through the ER. So I go and get it and return it to pharmacy.

Maybe I am just paranoid, I don't want to think these things were done intentionally, but this is all in 4 days. Just want to know if you think I am being paranoid or If you think the first incident was jsut what she said for patients safety and the second incident an error, after all, we are all human, right?! Trying to be oprimistic, but this very difficult.

b eyes

[GardenDove]

She sounds like a sociopath, if all of this is true. Scary.

[b eyes]

I swear to the heavens this is all true. and you are right I am scared!

b eyes

[caliotter3]

The situations you described are quite possibly deliberate. Never let your guard down. But on the other hand, don't get so paranoid that you go around talking about how she is out to get you all the time. You will develop the reputation for not being stable, even if everything she does is obvious. There are people who will stand back and watch her behavior without batting an eye, but they will watch your reactions. So temper your reactions.

I could write encyclopedia entries on the things a few of my co-workers used to do on purpose. The more they rattled the intended victim(s), the happier they were. Sooner or later, it was the victim(s) who left their jobs, not the instigators.

[suzanne4, RN]

First, suggest that you have a talk with your clinical educator. Monitors usually just have a reset button, not that you need to turn it off to erase the alarms that were saved. You also need to know how to adjust the parameters for the alarms. That is legally your responsibilty to know. And yes, you need those alarms even if you are sitting at the bedside with the patient. And if there were any legal issues ever to come from anything, first question that they are going to ask is what were the alarms set at. And if you do not know, and what the default settings are for that monitor, then you could be in big trouble.

The other issue what would you do if that patient was discharged or transferred and then the next patient came in that has a different rhythim, what would you do? You are pushing drugs that cause issues, but you do not have control over your area. Sorry, but now a good thing. You are now legally responsible for everything that is being done to that patient, even if someone changes something, you are the one that is caring for that patient and are legally responsible for them. Not the senior nurse. You are not under your license and no one elses.

Who signed that syringe out in the first place? And when the final nurse went home, who counted narcotics? Sounds like that you are at a smallere facility, and do not think that you have a Pyxis, or something similar there. Who ever signed out that syringe, it is their responsibility for that drug. And just htink, if that syringe were just picked up by someone, but was signed out for a patient and was never given, who is going to be at fault and liable for that narcotic? Missing syringes can cost a nurse a license, especially if there is an audit done.

And then for you....what type of training have you actually had? Were you actually given adequate training to be pushing a drug like that? Have you been trained in working in the ER, or was it med-surg and you float there?

Sorry, if this sounds tough, but you can lose your license much quicker than it took for you to get it. And it does not look like anyone is being tough on you, are are responsible for patients lives.

[suzanne4, RN]

Have no idea of the other thread that you wrote about, but you have stated in your profile that you have 5 years of experience in med-surg and ER. Then you should not be having these issues. You should have been thoroughly trained on the use of the monitor and long ago. And who signed out that syringe of narcotic? They are the one that is responsible for it, no one else. And legally responsible for it.

[SmilingBluEyes]

Suzanne makes some good points. I wish you well.

[TazziRN, RN]

Suzanne, she has 5 years' nursing experience but is new to this ER.

I do agree with you, she is responsible for her pt even the equipment was messed with by someone else. At the same time it sure does sound to me like the senior nurse is trying to sink her. Methinks it's time to have a talk with her with a manager mediating.

[b eyes]

I have been floating in the ER for 1 year and recently accepted a full time postion there in November. I have been ACLS, ENPC, CALS, TNCC certified and am comfortable giving diltiazem. If I am uncomfortable giving a med, I look it up, talk to the icu nurse, and watch my patient very closely. With the monitor, I asked the patient care manager who is also an ER nurse and our nurse educator and she is the one who told me I had to turn the monitor off after printing a code summary to reset the the parameters. I understand that I am the one who is responsible for my patient, and I should have asked her before she left how to reset the parameters.

I work in a small facility, one nurse and one doc. the other nurse is the one who took out the narcotic.

you are not being hard on me, this is how it is and I realize that and thank you for your frankness. I will definitely look at the manual to see if there is in fact a way to reset parameters without turning off the monitor. The monitor is always set for v-fib, v-tach, and hr greater than 160 and less than 50, unless we change it.

b eyes

[SmilingBluEyes]

The things she brings up, however, tend to be standard knowledge in most, if not all, hospitals, Tazzi. And while policies vary, standards of practice and CYA tend to follow no matter where you go.

[TazziRN, RN]

true.......I was focusing on her not knowing how to reset the pump alarms

[b eyes]

And suzanne, you are right with assuming that I had a short orientation.. That is why I am always taking classes to learn whatever I can about emergency medicine. I was not very accepted in tehER as most staff have been there quite long 15+ years, each of them, and were not very receptive to me coming along excited and eager to see and learn whatever i can. When I ask questions, I rarely get an adequate answer. I take it upon myself to learn and do as much as I can by asking nurses, doctors, and radiologists, anyone when I have question. I am the first one to ask for help in a scary situation and have had many.. Yes, cardiac is the most frequent visitor to our ER and scares me the most. It sends my heart a pumping! But I have learned to take deep breaths ans focus on the situation at hand. But I still think that we all rely on co-workers to help, guide, and teach us. As not everything can be learned by a book.

b eyes