unhappy nurses?

[guetzow]

What about RNs who don't use restraints because they don't want to do the restraint notes?

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[justmanda]

What about RNs who don't use restraints because they don't want to do the restraint notes?

We can't use restraints without a doctor's order. The restraint notes, for soft wrist restraints, consist of checking boxes every two hours. It takes very little time to do. We just make sure there is no skin breakdown, make sure the patient is toileted and given water, turned..etc. and we check a box. Nurses would rather restrain a patient then have them fall. The four-point leather restraints have to be charted every ten minutes and a doctor has to do an in-person assessment q 4 hours to maintain them (only used for violent/confused patients) Of course, these are rarely used (even when needed) because the doctor doesn't want to come in every four hours through the night, especially when he has to work the next day. I have, however, seen situations where nurses just tried to handle the situation (retraint-free) because they didn't want to wake the doctor at 2am for the order. Contrary to popular belief, we don't like to wake you guys up if we don't have to. I'm sure it sucks to be on call. But, I have never seen a situation where a nurse just didn't want to do the paperwork so, didn't call the doctor for restraints. With all the paperwork we have to do, this is minimal. Look up the cases on the internet where nurses have gotten sued because their patient fell a broke a hip -- we would much rather spend a few extra minutes with a pen then go to court.

 

[guetzow]

...............

 

[fab4fan]

Perhaps you should read up on the limitations that JCAHO and the state DOH puts on facilities with regard to restraint use. In many SNFs, you can't even use psychotropics like Haldol because they're considered "chemical restraints."

You can have your personal observations; it would be nice if you were actually informed about the topic, first.

 

[justmanda]

Perhaps you should read up on the limitations that JCAHO and the state DOH puts on facilities with regard to restraint use. In many SNFs, you can't even use psychotropics like Haldol because they're considered "chemical restraints."

You can have your personal observations; it would be nice if you were actually informed about the topic, first.

'
From what I've heard about nursing homes, you are correct. No restraints...ever. What is their rationale for that with regard to patient safety? Are they concerned that a patient will spend the rest of his life tied up or drugged? I guess I can see their point. However, a posey vest restraint at bedtime, to me, doesn't seem excessive. So the bottom line is: we get sued/arrested if we use restraints AND we get sued if the patient falls and is injured. Nice.

 

[TucsonDDS]

What about RNs who don't use restraints because they don't want to do the restraint notes?

If I feel that a patient needs retraints I would much rather use them and click the copy button on the retraint flowsheet than fight with a patient all day. However, if a patient doesn't need then they come right off. I think that once you actually start to work you will see that your comment is really stupid. I also think that you will find more people using them and filling in the flowsheet for people that don't need them than nurses who won't use them because they are too lazy to fill in a flowsheet.

 

[fab4fan]

'
From what I've heard about nursing homes, you are correct. No restraints...ever. What is their rationale for that with regard to patient safety? Are they concerned that a patient will spend the rest of his life tied up or drugged? I guess I can see their point. However, a posey vest restraint at bedtime, to me, doesn't seem excessive. So the bottom line is: we get sued/arrested if we use restraints AND we get sued if the patient falls and is injured. Nice.

It's ridiculous...I work in hospice, and we can't even use Haldol for terminal agitation if the pt is in an LTC/SNF. One of the best things to use for terminal agit., ABHR suppositories (Ativan, Benadryl, Haldol, Reglan) is an absolute "no-no" because of the Haldol component.

In some of the LTCs in my area, you can't even get a bed w/ siderails, because siderails are considered a restraint. So you have to get these ridiculous beds that sit really low to the ground, so if the pt tries to get out of bed, he won't fall on the floor.

I've never, in 20 years of nursing, seen nurses who were "too lazy" to initiate restraints because of the paperwork. It takes way more paperwork to fill out an incident report because the pt fell. I'm not saying it doesn't ever happen, but I doubt it's as rampant as guetzow suggests.

Are you even in med school, guetzow? You sure don't seem to have a clue about what goes on in hospitals. If you're not in med school yet, it's not too late to consider a career writing fiction; you're already off to a good start, judging from some your posts that I've read.

 

[caroladybelle]

What about RNs who don't use restraints because they don't want to do the restraint notes?

Oh, you must be high.........

Do you know the amount of crap we have to do to "legally" restrain someone. The notes are an extremely minor detail.

Do you know how many times I have had infected scratches, glasses broken, clothing torn, been cursed and spit at because an MD thought a patient "didn't need" restraints?

One of our pregnant nurses had her fingers broken, from trying to hold a demented patient in place for an LP. Do you think the MD did anything to stop him? Do you think that he ordered restraints? Of course not!

He also neglected to tell anyone that the patient was a rule out meningitis.

 

[guetzow]

Sorry, it was just my "PERSONAL OBSERVATION"

 

[MedicRN]

Sorry, it was just my "PERSONAL OBSERVATION"

If this is all you have observed, then you need to get out and observe some more. This time, open your eyes and pay attention!

 

[fab4fan]

Yeah, your "personal observation" as a frequent flyer on the local psych unit.

 

[guetzow]

Denial of bad behavior and bashing do not serve you well

 

[fab4fan]

I wasn't bashing...it was just a "personal observation."

You're a fine one to talk about bad behavior:

"Hello, Pot? This is Kettle...you're black!"

 

[guetzow]

Is perpetuated by bad behavior

 

[fab4fan]

You're right...I have no respect for people here whose stock in trade is to write antagonistic posts about nurses.

Interesting how you never answered if you're actually in med school.

 

[justmanda]

You're right...I have no respect for people here whose stock in trade is to write antagonistic posts about nurses.

Interesting how you never answered if you're actually in med school.

He's just trying to get your feathers ruffled.

 

[justmanda]

Is perpetuated by bad behavior

Stop already about the respect thing. To my fellow nurses: Somebody out there thinks you're a crappy nurse. Somebody out there thinks you are a *****. It is irrelevant! The nurses are worse to one another than the doctors are to us. Forget to look up a bad lab and your oncoming shift will call you stupid. Any misdeed, no matter how minor, will be instantly written up rather than discussed and corrected. If I worried about every person who thinks I'm an idiot, I'd go nuts...especially from some doctor who I don't know and who doesn't know me. Why would I care if he "respected" me as a vital member of the healthcare team blah blah blah. He gives me an order, I take my little two year degree and give the f-ing pill. I couldn't give a rat's a$$ what he thinks of me while I'm doing it.

 

[BSN]

Stop already about the respect thing. To my fellow nurses: Somebody out there thinks you're a crappy nurse. Somebody out there thinks you are a *****. It is irrelevant! The nurses are worse to one another than the doctors are to us. Forget to look up a bad lab and your oncoming shift will call you stupid. Any misdeed, no matter how minor, will be instantly written up rather than discussed and corrected. If I worried about every person who thinks I'm an idiot, I'd go nuts...especially from some doctor who I don't know and who doesn't know me. Why would I care if he "respected" me as a vital member of the healthcare team blah blah blah. He gives me an order, I take my little two year degree and give the f-ing pill. I couldn't give a rat's a$$ what he thinks of me while I'm doing it.

Nursing as a profession is changing and more and more nurses are getting higher degrees. Not just the “two years” as spoke of before. Regardless of the number so years ones been in school they deserve to be respected. One must ask for and demand respect to get it. Putting nursing and yourself down by calling yourself, “pill pusher” and “two year degree” is not good for the profession or yourself.

 

[justmanda]

Nursing as a profession is changing and more and more nurses are getting higher degrees. Not just the “two years” as spoke of before. Regardless of the number so years ones been in school they deserve to be respected. One must ask for and demand respect to get it. Putting nursing and yourself down by calling yourself, “pill pusher” and “two year degree” is not good for the profession or yourself.

I wasn't implying that my two year degree had anything to do with the amount of respect I deserved from the doctors/fellow nurses. I was actually referring to an earlier post about nursing salaries when I said my little two year degree yields me 100,000$ a year. That's all the respect from my job that I need. I was being flip about the pill remark. Obviously we do more than give out pills. My point was, I don't need the "respect" from a stranger or a group of people about what I do for a living to feel good about myself. I will not be one of those nurses who seems to need to be validated by those higher ups in the medical profession and, as a result, is always whining about not getting any respect. It is a silly thing to worry about. If a doctor thinks nurses are idiots, but he is not verbally abusive...why do you care? I want respect from my family, from my friends. A job is a job. If I do it well, I go home satisfied.

 

[BSN]

I wasn't implying that my two year degree had anything to do with the amount of respect I deserved from the doctors/fellow nurses. I was actually referring to an earlier post about nursing salaries when I said my little two year degree yields me 100,000$ a year. That's all the respect from my job that I need. I was being flip about the pill remark. Obviously we do more than give out pills. My point was, I don't need the "respect" from a stranger or a group of people about what I do for a living to feel good about myself. I will not be one of those nurses who seems to need to be validated by those higher ups in the medical profession and, as a result, is always whining about not getting any respect. It is a silly thing to worry about. If a doctor thinks nurses are idiots, but he is not verbally abusive...why do you care? I want respect from my family, from my friends. A job is a job. If I do it well, I go home satisfied.

yes, i can see your point.

 

[oldManDO2009]

Stop already about the respect thing. To my fellow nurses: Somebody out there thinks you're a crappy nurse. Somebody out there thinks you are a *****. It is irrelevant! The nurses are worse to one another than the doctors are to us. Forget to look up a bad lab and your oncoming shift will call you stupid. Any misdeed, no matter how minor, will be instantly written up rather than discussed and corrected. If I worried about every person who thinks I'm an idiot, I'd go nuts...especially from some doctor who I don't know and who doesn't know me. Why would I care if he "respected" me as a vital member of the healthcare team blah blah blah. He gives me an order, I take my little two year degree and give the f-ing pill. I couldn't give a rat's a$$ what he thinks of me while I'm doing it.

ahmen!!!!

 

[guetzow]

I concur. It's that personality disorders running rampant that give all the other RNs a bad rap. Gotta clean house, ladies

 

[justmanda]

Many nurses make more in units at specialty hospitals than primary care PA's. "That", is disgusting....

That's the result of supply and demand...Nursing Shortage = $$$$. If we were a dime a dozen, we definitely wouldn't make as much as we do.

 

[Mr.Nurse]

I concur. It's that personality disorders running rampant that give all the other RNs a bad rap. Gotta clean house, ladies

Dude, you're an idiot!! You have no clue what nursing is about and you're just pissed that we (RNs) often make more than your dumb azz ever will.
You make all PAs look like a bunch of jack azzes. You don't give a flyin sh@t about patients or working with a team. You're on a bad ego trip man!!
You need some help real fast before you get pulled outside the hospital one fine day and have your azz kicked by one of us RNs (me being the first volunteer)!!!

You better watch yourself "boy"!

 

[justmanda]

Dude, you're an idiot!! You have no clue what nursing is about and you're just pissed that we (RNs) often make more than your dumb azz ever will.
You make all PAs look like a bunch of jack azzes. You don't give a flyin sh@t about patients or working with a team. You're on a bad ego trip man!!
You need some help real fast before you get pulled outside the hospital one fine day and have your azz kicked by one of us RNs (me being the first volunteer)!!!

You better watch yourself "boy"!

You have to agree, Mr. Nurse, that there is a lot of petty back-biting among nurses, huh? More often than not, a seasoned nurse will destroy a newbie just for the fun of it. I see it at my hospital all the time. They will go behind their backs and tell us what idiots they are. And the inferiority complexes are REAL! Why else would someone try to burn someone else just to make themselves look good? I haven't read any of guestow's previous posts so I don't know if he has disdain for us as a whole, but the post to which you replied was accurate. I don't know if it is just because it is a career with a majority of women or not...but, I find that most male nurses are not petty. They do their jobs, are very laid back and don't back-stab.

 

[guetzow]

Thanks for the honesty. I respect that

 

[oldManDO2009]

Stop already about the respect thing. To my fellow nurses: Somebody out there thinks you're a crappy nurse. Somebody out there thinks you are a *****. It is irrelevant! The nurses are worse to one another than the doctors are to us. Forget to look up a bad lab and your oncoming shift will call you stupid. Any misdeed, no matter how minor, will be instantly written up rather than discussed and corrected. If I worried about every person who thinks I'm an idiot, I'd go nuts...especially from some doctor who I don't know and who doesn't know me. Why would I care if he "respected" me as a vital member of the healthcare team blah blah blah. He gives me an order, I take my little two year degree and give the f-ing pill. I couldn't give a rat's a$$ what he thinks of me while I'm doing it.

Justmanda I so like your perspective - you are right on! I get so tired of listening to people ruminate about people and management blowing sun shine up my a$$ about how important my opinion is. isn't it amazing they pay some one for that!!!!

edit

guetzow - what is your deal? why do you need to go on about nurses and how horrible they are? You have his warped attitude towards nurses - were you spanked during your clinical rotation and hold a grudge? I think the same could be said about any profession including PA's!

 

[caroladybelle]

You have to agree, Mr. Nurse, that there is a lot of petty back-biting among nurses, huh? More often than not, a seasoned nurse will destroy a newbie just for the fun of it. I see it at my hospital all the time. They will go behind their backs and tell us what idiots they are.

I don't know if it is just because it is a career with a majority of women or not...but, I find that most male nurses are not petty. They do their jobs, are very laid back and don't back-stab.

It is regrettable that you work at such a place. I wouldn't.

Please note that what you are describing does not occur everywhere. And men can get just as down and dirty as the women can. Just look around this BB.

 

[justmanda]

It is regrettable that you work at such a place. I wouldn't.

Please note that what you are describing does not occur everywhere. And men can get just as down and dirty as the women can. Just look around this BB.

Yes, it must be JUST in my hospital. That's why "nurses eat their young" is the phrase heard 'round the world. And this BB is supposed to be for doctors, not nurses. We infiltrated it so we could whine about how much respect we need and are not getting. All you doctors out there...please say you respect these poor souls already so they can puff up, smile, and go on emptying their bedpans with the dignity they deserve! After all, your respect will get us better pay...wait, no it won't. Your respect will get us better staffing...umm, it won't do that either. If you respect us, we'll be able to sleep at night...hummm, nope. Oh, whatever.... I'm sure I'll eventually think of a good reason.

 

[caroladybelle]

Yes, it must be JUST in my hospital. That's why "nurses eat their young" is the phrase heard 'round the world. And this BB is supposed to be for doctors, not nurses. We infiltrated it so we could whine about how much respect we need and are not getting. All you doctors out there...please say you respect these poor souls already so they can puff up, smile, and go on emptying their bedpans with the dignity they deserve! After all, your respect will get us better pay...wait, no it won't. Your respect will get us better staffing...umm, it won't do that either. If you respect us, we'll be able to sleep at night...hummm, nope. Oh, whatever.... I'm sure I'll eventually think of a good reason.

Excuse me!!!!!!

I am here in to add information, to gain perspective, and eliminate misconceptions about nursing and nursing care. Not to whine about how poor little me, how bad nurses are to other nurses and perpetuate other myths started by people that want to keep lousy working environments dysfunctional, because it suits them.

You, on the hand, seem to be doing much more whining than anything else without a great deal to substantiate it. Or any reasonable way to solve what you whine loudly and eternally about.

If you work in a lousy environment, guess what, it continues to be lousy because it has no reason to change. If you work with nasty health care professionals, of all degrees, and put up with it, they have no reason to change. On the other hand, if you refuse to put up with bad behavior and confront those with problematic behavior...they will have to change or get out.

As far as you perhaps working around "nurses that eat their own", well maybe you should look to yourself for the reason why. I choose not to work with such people. And I have more than enough job offers to choose from.

 

[justmanda]

Excuse me!!!!!!

I am here in to add information, to gain perspective, and eliminate misconceptions about nursing and nursing care. Not to whine about how poor little me, how bad nurses are to other nurses

How noble of you. I am just here for entertainment purposes. And you are right. Nurses are just wonderful to one another. I just made it all up...for fun.

You, on the hand, seem to be doing much more whining than anything else without a great deal to substantiate it. Or any reasonable way to solve what you whine loudly and eternally about

Yes, I'm whining about whiners...funny, huh.

On the other hand, if you refuse to put up with bad behavior and confront those with problematic behavior...they will have to change or get out

Confrontations in the workplace always work well. Especially when one is dealing with someone with "problematic behavior" Actually, I find the antics of problematic humans to be quite entertaining at times.

As far as you perhaps working around "nurses that eat their own", well maybe you should look to yourself for the reason why

The term was "nurses eat their young" and yes, I am the reason for that.

 

[guetzow]

This honest debate is uplifting; an honorable change from the usual denial

 

[Mike MacKinnon]

Guetzow.... All you do is dig a deeper hole of ignorance with every post. It is entertaining.


Justmanda:

I agree with basically everything you have said. However, i have experienced none of it as a male nurse. I have been lucky and it is totally based on gender. I have seen how female nurses have problems amoung each other as well as within the system. It is unfortunate.

As far as the "Nurses eat their young". this was actually quoted in a journal article a collegue of mine helped write a few years ago. Its a common saying. However, i will also say i have seen a similar issue in other professions. Watch an attending with a resident when the resident dosent have an answer, scary.

I think that any profession is only as good as you make it yourself. Much of the problem with nursing is due to the typical person who becomes an RN. A mom with a family who dosent have time with home expectations to further their education and increase their knowledge base. Typically these nurses stay in one area for 30 years and often retire early or go parttime as they are the second income earners. This isnt a profession for them, its a JOB. They come to work and scoff at anyone who takes an interest, furthers their education or asks good questions. These individuals do as little as possible to get by. Its a sad thing.

I would estimate that is well over 70% of the nursing population (personal guess). I would also say that where you find A type personalities (and the most educated) in Nursing is the ICU, ER and flight. These are the types that seek out a challenge and when they beat it, move on to the next one. This might be 20% of nurses (thats a liberal estimate).

All that being said those 20% are often the nurses that drive education within hospitals, cause healthcare reform, persue advanced certifications, teach every class avaliable to teach and become the "goto" individuals in their departments for help.

I would guess that every profession has a similar make up. Is it gender related? Im not sure I have seen similar percentages in physicians. I hear from many nurses that other nurses are catty and they hate working with women. It hasent been a problem for me so i really cant say i can confirm it.

At the end of the day, the profession is what you make it.

 

[guetzow]

Don't be a hater

 

[Mike MacKinnon]

Don't be a hater

too true

I dont hate yah, but its fun to argue with you! I think we actually see much of this the same way, its all in presentation!