4th clinical

First of all I would like to talk about the swine flu .My step daughter had it and was she ever sick. 104 temp for 3 days ,we were so excited with 101 after giving here tylenol and motrin .She got better but, I must admit I put on a brave face while asking her "are you feeling short of breath at all"? Yesterday I went to my 4th clinical I arrived at 6am and stayed until 6:42 and I left before my preceptor. Does she ever put in the hours .She refered several times during the day to when I left Sunday around 8(pm) such and such happened. Okay now to the meat of the day .Rita my preceptor did everything that I expected from a manager . She put out fires .First thing in the morning before she even put down her purse down .A suporvisor came in and was concerned about a tech being late she was on her final warning and even though she was taking care of her sick father it did not mater "because this is a chronic problem" .My preceptor asked the suporviser if she thought changeing the tech 's hour would help the situation but the sup .said "she did not agree with this because then she would have to change everyones hours " My precetor than asked if it were so and so(a secretary) would you give them an extra 15 min. The sup.than said "that is compareing apples to oranges because they do two different jobs " Nothing was really resolved at that time.I can see both sides of the coin Rita wants to keep staff see if thier are any choices besides terminatin,the sup is thinking about how one persons behavior effects the group . The big issue woven in and out of the day was admissions .On a bone marrow transplant unit they schedule admissions for transplant of bone marrow. A pt .comes in has chemo than donates his own bone marrow to be frozen, finishes chemo to wipe out all cancer cells than recieve his own cells back .Pt also come in receive chemo wipe out CA cells than receive donor cells from another person this all has to timed.Any way 5 admission were comming Tuesday and all the beds were full .To move patient they had Rita had to speak to several MD 's one in particular that is known for being an a## and had the reputation for chewing on people.To make a long story short lots and lots of politics .Rita my preceptor said "well at least this week he likes me" .I also was privey to a can't tell you what it was about meeting with a Hosp V.P. but I could stay because Yes I had signed those confidentuality papers . After being in the meeting I felt like there is so much politics involved in running a hospital and you wonder if the powers at be really have a grasp of the day to day grind.Rita stayed calm cool collected to every bump in the road but you could see the wheels turning in here head .We also looked at a med error that was not reported to the MD untill 3 days later . someone was reviewing a"midus report" and asked the MD if she was aware. It was passed on in report by 3 shifts and a suporvisor because it effected the pt outcome in a poor way but no shared it with a MD.One of the nurses was on a warning for pt saftey issues .We went through the ivestigation process and some options of disapline including termination .At the end of the day mostly what I noticed is that Rita thinks before she ever speaks .She says few words ,it's almost like she speaks in code every word measured .I have been in several meetings now with the VP and she seems the same listen, listen, listen,than speak . Lots to think about and very interesting .