I just read this article & am shocked that we are paying for this murderer to receive what he's receiving...am I the only one that thinks this is absolutely ridiculous???
I just read this article & am shocked that we are paying for this murderer to receive what he's receiving...am I the only one that thinks this is absolutely ridiculous???
Ahhh, so much to share with y'all. First off...my nephew's baseball team...ahhhh...it wasn't a pretty ending. In the state semi-final game, they got their butts whooped like NEVER before. They lost 10-0, game ended in the 5th ending due to the "mercy" rule. I can't even say that the other team was the reason they lost. Yes, they were good, but our guys just did not play like they usually do (obviously). There was no momentum to be found. It's too bad...this group of seniors over the last 3 years compiled a record of 84 wins & 11 losses. Pretty darn good! Too bad they couldn't also claim a state title.
My nephew's graduation party was on Sunday. I still can't believe he's all grown up & moving on to college. He was supposed to go to The Citadel, but he has changed his mind & will more than likely go somewhere local or not too, too far away...unless he gets an offer to get drafted. I'll know more in June.
Now for the title of my entry. I called in sick to work on Monday. I followed procedure...called in to the appropriate person & way before 5 pm (the cutoff to calling in as a nurse is usually at least 2 hours before the time you are due at work). I ended up on the phone with the VP of nursing at my hospital pretty much threatening me that if I don't come in, I will be written up. My reaction was "W-w-what???????" Since when are we "not allowed" to call in sick? She ranted & raved, basically told me it's my responsibility to take better care of myself & proceeded to word for word say "If you do not come in, consider yourself written up." Which of course I politely told her I would NOT be in. It's not like I have excessive call-ins....in fact, it's been over 9 months since the last time I called in sick. I thought her behavior was ridiculous. I understand we are short-staffed (her fault), but do not take that stress out on me. Perhaps if administration was doing a better job with staffing, she wouldn't flip out like this, but that's not in my hands & I'm not going to be bullied or harassed into working if I'm not feeling well. Am I wrong on this?
I did end up working on Tuesday & Wednesday. I don't know if or when I will be written up. I don't see under what basis she can write me up. I haven't done anything wrong. It's so aggravating working with people that don't appreciate all that you do...I mean I have picked up many, many shifts when they are short-staffed or when they rather have staff working than agency. No "thanks" or "job well done" when I volunteer for that...just an angry administrator when I call-in sick one time. I'm wondering if it's a sign to move on...to throw myself out there in the world of agency &/or travel nursing. I know there is more money to be made outside of the hospital I am at. The ONLY things keeping me there are the staff (outside of administration). They are so wonderful & helpful & easy to get along with. There are a few I don't like, but for the most part...we all help one another out, even without asking. The other reason is that it's so close to my house & I don't really care for driving long distances (anything over 20 min is a long distance in my book...lol). Wouldn't you know it...I've had 3 different agencies call me within the last 48 hours asking if I wanted to work for them. So I don't know. Am I ready for major changes? I'm so comfortable where I'm at, but I am getting fed up with being short-staffed. Not that I expect any other hospital not to be short-staffed also, but I can reason better with a lack of staffing when I'm getting paid twice as much as what I'm making now.
Tuesday night wasn't a bad night for me. I only had 3 patients the entire night....and all of them were alert & oriented. Well, scratch that, I started out with one patient that was confused & restrained. I heard he had quite a mouth on him, but he was being fine with me...very cooperative. My clinical leader informed me that there was another confused male on another wing (still PCU) & they wanted to combine these 2 guys into one room in order to free up the room for alert & oriented patients. Soooo, she asked "Do we have the other confused male come down here to us or do we send your confused male to the other wing?" I spoke up & said "Well, the other wing has a patient care tech & we don't. That's an extra set of hands to take care of these confused patients." She agreed with me & we ended up moving my confused guy down to the other wing. Wouldn't you know it...about 15 min after we moved him, we somehow ended up with a patient care tech...lol. Rarely does it work out that way, but I was glad we had some extra help.
So I was down to 2 patients & eventually got a new admit. An older woman in her 80's that was alert & oriented, had no problems with her.......until last night.
I went into work Wednesday night knowing we were short-staffed (big shock!) & there were only 3 nurses & no tech...which lately is the norm. I had 5 patients last night...one of them being my new admit from the night before. Who went from being alert & oriented, to still quite alert...but confused. Not a good mixture! She kept trying to get out of bed, so I finally put a posey vest on her. I was worried if she got out of bed, she'd fall & break a hip or something. She got fed up with the vest & resorted to pulling out her IV...blood everywhere. Ugh! But like I said...the other 2 nurses & my clinical leader were in there before I could even get there & they were taking care of it all. One was cleaning up the blood, another was starting a new IV & the third was getting supplies. Talk about teamwork! I ended up putting soft wrist restraints on so that she wouldn't be able to pull out the new IV. She wasn't happy & she did not sleep for a single minute last night. I don't know what was going on with her, but it was very time consuming...not that I mind it, but when you have 5 patients & no patient care tech...you just don't have time to spare between the patient's needs & the paperwork.
Add on top of that I had another confused patient that was also in restraints that was able to repeatedly pull herself to the end of the bed...she was like a regular Whodini. I put a call in to the doctor in hopes of getting her a sleeping pill or something to relax her & got an order for Ativan. That did stop the squirming to the end of the bed, but she didn't sleep all that much either. Just kept picking at the sheets & laughing. At least she was pleasantly confused!
My third patient was in with c-diff. Normally I would cringe at hearing the word "c-diff", but when I heard he was alert & oriented & able to get himself up to the bedside commode without any assistance...it stopped me from cringing. C-diff is just literally nasty diarrhea. It has this icky odor to it & you usually have to go to the bathroom a lot. Most patients we get with c-diff aren't even able to get out of bed, much less be able to make it to a bedside commode & clean themselves up. So he was easy to care for.
My fourth patient I had the night before. He was in need of a blood transfusion...so that was my priority. He had received 1 unit during the day, then was given lasix & I was to start the 2nd unit at night. Lasix...a blessing only if you have a foley catheter. This gentleman did not....so he was having the urge to urinate quite often....not fun at nighttime when all you want to do is sleep. He was for the most part able to stand up on his own to use the urinal, but a few times he missed & got the floor instead....can we all say "ughhhh" together??? I didn't have time to think about it...I thru some towels on top & went about my business. I know, sounds gross...but when you don't have time to spare, you don't have time to spare.
My fifth patient probably thinks I'm a dumb blonde nurse...because he would ask for something & I would tell him "Ok, I'll be back shortly"...only to find it would take at least 20 or 30 minutes to get back to him. And of course it was never anything quick with him....it wasn't his fault though. For instance...he needed pain medicine...Demerol 50 mg IM...so I would draw that up. Then he also had IV meds...one of which was Lopressor...which you have to push slowly. His dose was 10 mg IV...Lopressor scares me a little...you have to watch that heart monitor closely to make sure they are tolerating it ok as well as checking the blood pressure. He also had an IV piggyback that needed to be hung and an accucheck which required me hunting down someone whose badge would actually work because for some reason mine & nearly everyone else that works at the hospital...our badges don't work - even though we've done all that we are supposed to do in order for them to work. Anyways, it's time consuming all of these things & it would seem like I'd always forget something & his room was like the absolute farthest away from everything. He was ok though, he said he understood...but I still felt like I just wasn't meeting his needs the way I would have liked "if" we weren't so short-staffed.
Just an addendum...we aren't short-staffed because of a lack of resources, we are short-staffed because admin. is cutting back on their budget. So much for patient & staff satisfaction. Saving $$$ is where it's at I suppose. I always wondered in the past why our hospital is unable to meet any of the criteria standards when it comes to interviewing our patients after they have gone home. We always get lower than average ratings...but I can see now that perhaps if we did have the right amount of staff, our gallop scores would go up. If I can figure that out, you'd think admin. could also. <sigh>
So that was basically my night....6+ hours of running around meeting patient needs, another 4+ hours of paperwork & finally something like 10 minutes to myself to recover. I will enjoy my time off this week for sure.
It's a slow week at work for me...our patient census has dropped. Not sure if this is something that happens nationwide or if it's more location specific. Florida is known for having plenty of "snowbirds"...senior citizens that spend the winters in Fl & the summers up north. As a result, our hospitals are packed in the winter & way below census in the summer. Therefore, I got called off last night because we had too many nurses & not enough patients. I don't mind, just hope this isn't gonna happen a lot. Perhaps it's time I started looking for a per diem or agency job at another hospital. I'll think about that next week.
Because as most of you know that have been reading my journal on a regular basis...my nephew's baseball team is in the state championship tournament this weekend. They play Friday at 1 pm. I hope they play well enough to win. This team has been to the state championship tournament the last 3 years in a row...but they have been unable to bring home the 1st place trophy. The competition is really, really tough this year...but then it's so easy to overlook just how good they are too. I hope this is their year to take it all home.
I did work Monday night. I felt like I was babysitting...not because it was easy this time, but because each of my patients were a little on the needy side & kept using their call bells all night. I felt like I was juggling trying to meet their needs. It was simple stuff...too hot in the room, too cold (in the same room), need assistance getting to the bathroom, need the bedpan, need a blood transfusion, need medications, need someone to talk to, need help with my covers, need something to drink...nothing life threatening, just time consuming.
I'll be back by Sunday to update you on the state tournament. Wish us luck!!!
Let me list the # of things that are all Gina's fault...lol...
1) Gina's the reason I had no breaks after 1 am this morning
2) Gina's the reason my feet are sore & my body is physically exhausted & my mind is emotionally worn out
3) Gina's the reason my hand hurts from all of the DAR note writing I had to do this morning
4) Gina's the reason I did not leave work until after 8 am this morning
5) Gina's the reason I am not making $500 in overtime tonight
Lol...told ya Gina that I'd be writing about you today!!! Do you feel honored? I'm just kidding about this being Gina's fault, but don't let her know that. What I'm referring to is last night at work. We each had 3 patients & had a pretty decent night going until we were told we would each be getting an admission. Gina got to hand pick hers...a male in his late 20's in with "pseudoseizures." We prepared his bed with seizure precautions & Gina was ready to give him great nursing care. My patient was a 90 yr old female with chest pain & anemia....I'm talking about a hemoglobin of 8.6, hematocrit of 26 I think. Needless to say, this lady needed a blood transfusion sooner than later.
So there we were...with our new admits...me thinking Gina got the easier end of the spectrum with her hand-picked patient. It couldn't be any farther from the truth. My patient arrived first....very pleasant woman. Did not appear to be 90 whatsoever. Her son was in the waiting room. I went & retrieved him so he could spend some time with her until I got the first unit of blood hanging. Then it would be time for her to get some sleep & give him the option of taking a nap in the waiting room as we are not allowed to let guests spend the night in semi-private rooms. I completedthe admission assessment, got my patient comfortable & ventured back to the nursing station only to find a lot of commotion.
Apparently, Gina's patient was giving her a very difficult time. He didn't want her assessing him, all he wanted was his pain meds & for us to leave him alone. When she informed him that she had to assess him prior to giving him meds, he started calling her some very nasty names & literally told her to get the "f" out of his room. Classy, isn't he? The clinical leader went in to speak with him & his wife, meanwhile, Gina & the other nurses are telling me that I have to trade patients with her. Huh??? I already did all the work & I like my new patient! Doesn't matter, this guy doesn't want Gina back in his room. The charge nurse & supervisor were also given an update as to what was going on. The supervisor also spoke with the patient & his wife because the patient wanted to leave the floor in a wheelchair because he was "nervous." Do they think we're dumb? It's obvious that when a patient insists on leaving the floor, that they are going outside to smoke a cigarette or whatever else they may be addicted to. So they left, we can't hold him hostage. We even tried to get him to sign out AMA. He refused. They come back about 20 min later & I'm handed a bottle of Ativan....one of his medications that he's requesting. The supervisor & I go into his room to give him some good news & some bad news. The good news is...here's your Ativan that you were requesting. The bad news....he listed Codeine as one of his allergies, yet the pain medicine he claims to take at home on a regular basis has codeine in it. Thus...we can't give it to him even though it's ordered. Let's just say he was not a happy camper. I'm silently praying that the Ativan will be enough (2 mg IV) to quiet him down & get some rest because I have paperwork to do. Along with that, we inform his wife once again, that she cannot spend the night in his room...she is welcome to stay in the waiting room. They pitched a fit. She wanted me to sit at bedside just in case he had another seizure. Ummm, hello, I'm not his private nurse. I have other patients to tend to & plenty of paperwork that needs to be completed in the next 3 hours. I am not going to sit & watch a grown man sleep. Especially one that has been acting like a total jerk since he arrived. Let me add also...that in the ER, he claimed to be having a seizure...went through the motions, but when the ER doc told him to stop it....he stopped it. Is that truly a seizure? I think not. He just wanted his pain meds. I have a real low tolerance for drug seekers. I have an even lower tolerance for doctors that admit drug seekers at 1 in the morning. Thanks Dr!
The Ativan is not enough to make him happy...he threatens me that he's going to have a seizure right now if he doesn't get his pain meds. He wasn't being rude to me though...I think he learned quickly that he was close to being thrown out of the hospital with the way he treated Gina. He was calling me sweetie & sweetheart...constantly saying my first name & being very kind. At this point, the lab girl goes in to draw blood. He refused to let her. Just reinforces my belief that he is here for drugs & not for real treatment. Why else come to the hospital & do everything you can to not get help? The rest of the staff was tired of his behavior...time to call the doctor. Remember how my first few posts in my journal related to the topic of how I didn't like calling doctors in the middle of the night? Ha...boy has that attitude changed. Now it's "if I have to suffer, than the doctor should be suffering too." :)
Luckily it was one of the nicer doctors who actually took the time to listen. I felt like I was talking to my dad & tattling on my brother with all of the things he's doing wrong. Anyways...the doctor advises me to inform the patient of his right to sign out AMA. I told him I tried that, the patient refuses to leave. I let him know about the allergy/pain med problem. So he orders Dilaudid IV 1 mg, which is what Mr. Pseudoseizure was requesting in the first place. Gotta love the patients that are so familiar with pain meds that they not only request the name, but the dose also. This is not to knock those that truly suffer from pain. In fact, I believe this guy suffers from pain also & has reached the point of being addicted to pain meds. But going to hospital after hospital in hopes of getting a quick fix rather than having a regular primary doctor irritates me. Did I mention they had tried going to our sister hospital earlier in the day which refused to treat him & instead advised him to see his neurologist...and they got mad at that request? This was directly told to me from the wife.
Ok, time is ticking away....I get him his pain med so now I'm like his best friend as far as he's concerned. He's offering me money not to clock out at 7 am, he wants me to be his nurse all day. Ha! It's now about 5:35 & I have soooo much paperwork to do as well as checking on my other patients, doing I&O's, passing meds & whatever else needed to be done. AND having to document as much as possible on the whole situation with the pain med seeker.
Ok, I can still get done on time...no problem. Umm, nope. I notice his wife is sleeping in his room. I wake her up & walk her to the waiting room which is just down the hall...not very far. She manages to fall asleep...she looked exhausted anyways. About a 1/2 hr later, he's using his call bell...he needs his wife or he'll have a seizure. My patience was wearing thin. I was in the middle of hanging Heparin so he had to wait. Two minutes later, he has his heart monitor off & he's out of bed...getting in a wheelchair & rolling out of his room. I stop him & ask him what he's doing. He said he's going to the waiting room. He looks beyond drugged up...amazing he didn't fall on the floor. I told him he had to get back in bed, that until the doctor sees him...he's on seizure precautions & fall precautions as well as bedrest only. Amazingly he complied, but then tells me "In the morning, I WILL BE GOING OUTSIDE TO SMOKE." I told him that it wasn't a good idea, that they may not allow him to come back into the hospital if he does that. He says "That's ok, I'll just call my attorney." Ok, no problem...I'm not going to argue with him. I wake up his wife & tell her she's welcome to sit in there with him. At this point, if she was willing to babysit him, then have at it. Even after telling them earlier in the night that she was not allowed to lay in bed with him....she does it anyways. At that point, it was about 6:30 am & soon to be dayshift's problem, not mine. It took me about an hour & a half to catch up on paperwork & to end my work night.
I was mentally exhausted when I came home! All Gina's fault...lol. I told her I want an I.O.U. in writing! I really did want to go back & work tonight for the overtime, but the floor was full of time consuming patients...which is fine, when you are properly staffed. But we have been short on patient care techs 2 out of the 3 nights I worked. It just gets to be too much...both physically & time-wise. I'm still debating about whether to pick up a shift on Fri or Sat night.
My other exciting entry for this week happened early on Tuesday morning. I had a new admit earlier that night...an elderly woman that had a stroke 2 months previous & as a result, has uncontrolled hypertension. Upon admission, her BP was 209/90. They gave her something in the ER that brought it to the 160's...which is fine for a stroke patient. Don't want it too low. Her son was with her & she seemed to really be with it....no deficits from the stroke other than short-term memory loss at times. Got her settled into bed & went about my night. Around 2:30 am, my tech & I decide to give the other patient in her room a bath as she needed her brief to be changed anyways. This patient screamed all during the bath so I looked over at my new admit to see if she was sleeping through this or if she was awake. She was awake, she looked really mad...as if all the noise was annoying her. I asked her if she was alright. She replied back "I feel like I'm going to faint." I wasn't expecting that answer, so I ask her if she would like a cool washcloth & at the same time I'm sitting her up so she can breathe a little easier. I get the washcloth & Gina tells me this patient's heart rate just went from the mid-70's to the low-40's. I ask Gina to get me a nasal cannula...something wasn't right with this patient. We get the oxygen flowing, wash cloth to the forehead, asking her how she feels...call for the dynamap to check her blood pressure. We can't get a blood pressure reading & she is getting more pale by the second. I pull in my clinical leader, who puts a call out to the charge nurse & I have Gina placing a call to the doctor. My patient is starting to not follow commands, eyes are closing, speech is becoming garbled...something is definitely wrong. Gina gets a direct number to the doctor..I call......and get his answering machine. Lovely! The charge nurse decides we don't have time to wait for the doctor to order ICU transfer, we move her over because she is starting to fade. I am told to call any doctor on her case since the primary is unreachable...the only other doctor is the neuro doc on consult who has yet to see the patient since she is a new admit. Needless to say, he wasn't happy that I was calling him at 3 am & didn't hesitate in telling me so. I just wanted some orders...especially for a CT of the brain to see if she was having another stroke or to figure out what was going on. He wouldn't order a damn thing! Advised me to continue to try getting a hold of the primary doctor. Gina finally gets him on the line, I take the call...the doctor is half asleep & whispering his orders. He orders the CT of the brain & then adds in "if it is negative for a bleed, start her on aspirin 325 mg PO." I'm thinking....did he not hear me say that she is somewhat unresponsive. How in the world are we supposed to get her to take PO meds if I can't even get her to open her eyes??? I figured we could deal with that later. He ordered some lab work & kept asking me "What else do we need to do?" I was partly in shock that this was even happening & partly in shock that the doctor was asking ME what we need to do. I write up the orders, talk to the ICU nurse who received my patient & I go to check on my patient. She's a little more alert, blood pressure was ok...in the low 160's, she's following commands...then says to be "Please don't let me die." I didn't know exactly what to say because I didn't know what the heck was even going on with her. The ICU nurse told her she was going to be ok, that we wouldn't let her die. I just don't feel comfortable saying that to a patient because I don't know that I can truly fulfill that promise, you know? I'm all for giving them hope, but I'm not going to lie to them either. Instead I told her the facts...that she was doing better, that we were running tests to see what was going on & that right now she is doing ok. Turns out they don't know what happened....all her tests came back absolutely normal. Luckily I have witnesses that saw with their own eyes that something was not right...it wasn't just my imagination. She was only in ICU for less than 20 hours before being moved back to PCU. I'm glad she was ok.
The last little bit of this long, long post is of course focused on my nephew & his baseball team. They played the best game I've ever seen Tuesday night. It was so exciting...first they were winning, then they were losing, then they came back at the end to win 6 to 5! It was so crowded there...standing room only. So many people cheering, it felt great. They are the Regional Champs & will be playing in the State Tournament next week in Sarasota. I can't wait. Last year they placed 2nd in the state....I really hope they win it all this year. The bad thing about it though...they are supposed to graduate from high school the same day as the state tournament. Why the school picked that day when this exact team has been in the state tournament the last 3 years straight, I'll never know. I'll let ya know how they do...wish us luck!
Nurses are #1 in Honesty and Ethics Poll
According to a survey by the Gallop Poll, nurses are considered the most honest and ethical of a wide variety of occupations. Nurses were considered by the respondents to be significantly more ethical and honest than physicians, policemen, and even clergy.
I've been having a nice week...why does time off go by so quickly? I was able to spend time with friends & family, exercise & of course...my nephew's baseball game last night. It was a close one...they were losing 5-1, but they do know how to rally & came back to win 7 to 5. My nephew was hitting very well last night...even got a homerun!!! So they move onto the Regional Championship game Tuesday night.
I'm heading out shortly to take my niece to a movie..."Stick It"...some type of gymnastics movie. Then we'll watch the Nascar race. A nice relaxing day before returning to work tomorrow night. I'm going to try to put in 4 or 5 nights this week to make up for slacking this past week. Wish me luck...lol.
I worked this past Monday night...it felt more like babysitting than actual nursing. I started out with 4 patients...all males, all walkie talkies. Other than meds & snacks...they really didn't need anything. I like nights like that...calm & cool. I got a new admit around 1 a.m. She had fallen the previous day & come to find out...fractured her left tibia. On top of that, while doing the bilateral ultrasound, they discovered she had a DVT (blood clot) in her right leg. Needless to say, she wasn't gonna be getting out of bed anytime soon. She was in a lot of pain & the only meds ordered were Demerol & Phenergan IM. I don't particularly enjoy giving IM injections to people that are in pain. I feel like I'm adding to their pain as opposed to giving them an IV med. She brought out my maternal instinct even though she was more than twice my age. I made sure she was comfortable so she could get some much needed rest.
That was it...a very uneventful night. I've had quite a few of those the past couple of months. I did get to see Narcan administered for the first time. I don't know what I was really expecting. The patient had received 1 mg of Dilaudid IV. His respirations dropped to about 7. So the nurse got the order for Narcan. I didn't see much of a difference after the patient received it. He'd wake up, fall asleep, wake up, fall asleep. That got old quick & since he wasn't my patient, back to the repetitive paperwork that I needed to finish.
I went to my nephew's baseball game last night...it's the quarterfinals of Regionals. The team they were playing looked like they belonged in little league rather than high school. Anyways, after watching my nephew hit a homerun (go Eric go)...before we knew it, the score was 12-2 by the 5th inning & they called the game due to the "mercy" rule. When you're ahead by 10 in the 5th inning...they will end the game. No need to make the losing team suffer anymore. The next game is on Friday in some small town about 90 min or so away. Ugh! I don't like long drives & 90 min is a long drive to me...but I will be there! Did I mention they are ranked #3 in the nation according to Sports Illustrated? Oh yeahhhh, they are really, really good & it's not just "me" saying that...lol.
Time for lunch!