11.11.2008

A meeting

After being canceled on a couple of times, I finally had a sit-down with my boss about the pedi case. Flu season keeps everyone busy, it seems.

I was nervous going in, even though I had told myself that even being fired instead of switching assignments wouldn't be as bad as continuing to work on this case.

The boss, thankfully, is a pleasant guy. He's personally cared for my client in the past, and when I told him all the issues I was having, he nodded sympathetically and told me that that's more or less what the last thirty nurses said also.

Wait a minute, THIRTY?

The boss confirmed what I had suspected about receiving the case because of my gender, figuring that there would be less personality conflicts and I'd be less likely to strew makeup and feminine hygiene products all over their bathroom.

I tagged along as long as I did because I assumed that once the chart arrived I'd have doctors orders to back up the things I'm doing. Administering the lactulose via g-tube was a major thing. I'm not the one mixing it, the mom is, but I'm the one administering it. When she mentioned offhand that she had changed the dose, red flags started popping up everywhere.

Besides that, though, there was just too much about the situation that screamed at me to get out of it. The mom had no faith in what I was doing, when I assessed a new bruise I found (a common occurrence for this kid), she yelled at me for "pushing" on it when I was just lightly feeling it for warmth! She'd criticize me for being in a "rush", and then when we're late for the school van, guess who's fault that suddenly became!

I went over all of this with the boss, and he said he'd have to confer with higher-ups to see if this case is worth the liability risk. He told me he'd call me tomorrow and tell me what they've determined, and for now to plan on showing up for my next shift. I'm seriously considering refusing.

I offered a compromise, everything runs pretty smoothly at school, so I offered to work the hours in the school and just hand-off the kid afterward. I wanted to offer some kind of concession, but really that's just going to postpone the inevitable. During my meeting with the boss I actually used the words "time bomb".

I have a lot of sympathy for the family, they take really good care of the kid and work hard and lose sleep to keep everything going, but there's just too much stress, and too little communication. I suggested that if someone was going to be successful on this case, it's going to be someone with the experience and education to provide nursing care for the mother and boyfriend as well as the child. The problem is that a nurse with that kind of experience and education (probably a BSN, although I hate to say it) is unlikely to work for what a job like that pays.

My enthusiasm for the charge nurse position at the nursing home is still on the upswing, though. There's a lot to learn, but I have a lot of extra shifts scheduled to figure it out. I'm actually working two 7a-7p shifts this weekend!

1 comment:

Strong One said...

Errr..
Sounds like a sticky situation.
Best of luck