1. 30 year critical care
2. honesty is my personal philosophy. it builds a sense of trust between pt. and nurse and family and nurse. i also hold on the the things i learned in fundamentals. there is a person under all those tubes and wires and must be treated as i would like my own mom and dad treated. if i do it for myself in the morning (brush teeth,brush hair etc) i will do it for my patients despite being on the vent. turning q 2 hours is also what my patients can expect, whether they want to or not, it's in their best interest. do no harm is a good motto to keep.
3. nursing school
was a loooong time ago for me. it was skill oriented as well as basic knowledge based. as graduation approached, i was alreay doing full shift clinicals 3 days a week with several patients as my primary ones. i had experienced being med nurse for an entire floor, charge nurse for a unit. that is NOT what i'm seeing in today's graduates. many of the students today have NEVER been on the floor for an entire shift, have no concept of what it's like to be on from start to finish of a day. that is MOST UNFORTUNATE. being on the floor as a student all day provided opportunity to actually evaluate how the new orders influenced the patient's condition. it gave the student opportunity to be a nurse under the guidance of the instructor and the staff nurse, having all the responsibilities they would encounter as a staff person. upon graduation, i only had to learn the routines of the particular unit. the rest of the nursing process was quite routine for me by then.
4. not sure what you mean by that one. we talk about the patient, the goals of the day and how they can be accomplished, whether it's with PT, OT, Lab, radiology etc. the nurse is the co-ordinator of everything and ultimately responsible for seeing that things get done. i talk with rounding docs about concerns or problems and together we trouble shoot how to fix things. chatting among ourselves is still the best way to gain knowledge and experience from other staff members. i am on hospital committees to keep informed of the whole picture.
5. sarcasm usually. humor mostly. i work with a good bunch of people and sharing and laughing is a good way of coping and surviving even the most horrendous days. ultimately, it's your party, your responsibility to get the job done. if other departments bail, it's still you that needs to make it happen. it can be daunting at times, but you get use to it.
6. yes i do. i have done high school student observations where they have followed me around for several shifts so they can see what a nurse really does before committing to nursing school. i have done nursing school student internship kids where they shadowed me for a summer, assising in care and begin to apply what they are learning in school to the real world. i am a preceptor to new people in the unit, responsible for their clinical orientation, confiring with the unit manager and educator as their readiness to act on their own as a full staff member.
7. work ethic is a biggie here. there are some "needy" nurses that feel they can't do anything by themselves. i'm not one of them. i assume i can manage the patient or the task alone FIRST. try it and only after i have failed will i ask for help. i have been schooled in being independant and providing the opportunity for the patient to maintain as much independance as possible. i also take advantage of the tools at my disposal.
8. i stay positive......no matter what. i try to find the humor in all situations. when there is a crisis and the patient is crashing through the gates of hell, i step back and don't get caught up in the panic of it all. this allows me to stay with the tasks required to keep the patient alive, evaluate current conditions and decide what the next step might be. i always have plan A, B and C in my head. having a plan is better than no plan at all, might not work, but it's a plan. my external behavior exhibits confidence and i ALWAYS keep a game face on even when i'm shaking or scared inside. that comes from experience. never let them see you sweat! getting caught up in the panic of the situation robs the nurse of her ability to think, act and sucks the energy from you which can better serve your patient. that's not to say i don't complain sometimes, i'm human, i do, but i keep my hands busy doing, which eventually helps any situation.
9. being in critical care i am exposed to most of the current clinical advances in my daily practice. i'm on the education committee of the icu so i'm responsible for putting out monthly ed. articles for the staff. the hospital provides several articles with continuing ed credits monthly which i do. as a ccrn, i am required to get 100 ceu's in 3 years for recertification, mostly through articles. going to conferences is almost unheard of. staffing does not allow for that.
10. in the short term, staffing is the biggest challenge we face. i have to believe that if staffing, nurse
atient ratios, was done by accuity vs number, we'd be able to deliver the care most of us wish we could and limit 'burn-out'. in the long term, the quality of today's graduates. they are ill prepared for nursing in today's world. while i find they may be able to parrot the nursing process, they are unable to demonstrate that right out of nursing school due to the limited experience they actually obtain. the push is for degree nurses. in my opinion, this should be reevaluated. degree nurses do not possess the skills required to be effective at the bedside. it is those bedside skills that will save a life, not their ability to regurgitate the words learned during course work. schools
today bet on the seasoned nurses to teach grads the skills they need to function. the emphasis should be on clinical practice. this is where the student can couple the concepts they learn during the course to the real world. this will save a life.