1. I currently work telemetry/oncology; I have done med-surg, peds, ortho, and acute rehab as an agency nurse; I worked geropsych for almost two years fresh out of nursing school. (I got my license in 2000.)
2. That's an interesting question... I think that to be a great nurse, you have to be able to work within the confines of restrictions to your practice (whether it be from facility or regulatory agency) whlie still delivering compassionate, respectful, individualized care to each patient and family to the best of your abilities. Also, noone knows everything, so there is no shame in asking for advice or opinions when it's in the best interest of your patient to do so!
3. What I learned in nursing school was the foundation of where I am now. The one thing that I think all the care plans, projects, etc. that at the time drove me nuts did to make it all worth while was to train my mode of processing information to really bring out those critical thinking skills. I do have to say that the time management skills taught in nursing school are nothing compared to what you'll have to learn out on the floor!
4. On the floor that I work on, we frequently go to each other for advice and validation on the big issues with patients, it is a very team oriented shift. As an example, if you have a patient going bad, it's pretty much expected that you'd approach another nurse (or two or three) and explain the situation, what you've done, and ask for advice about anything that you might have missed. I think that working nights really contributes to this, as we are more autonomous than day shift is...you have to be sure that you've done XYZ for ABC before calling a doc at two in the morning!
Additionally, I truly believe that respect begets respect. We have two docs who are in practice together and are notorious for being pains on the other floors; on our floor, we pretty much all get along well with them b/c we treat them respectfully, even when we have conflicts with them. I also try to have a smile and hello for everyone, and greet the docs by name..."Good morning, Dr. Jones, how are you doing today? Is there anything I can do to help you this morning?"
Keep in mind that everyone at the facility is vital to it running as smoothly as possible, from the guy who mops the floor to the medical director. All are deserving of your respect and time.
5. Honestly, alot of venting. To a select few coworkers, to my husband, to my family members who are in health care. And sometimes you just gotta go in the med room for a few minutes, bang your head against the wall, and do some deep breathing.
6. I don't officially mentor/precept, but I like to be sure that new hires know that I'm there for any questions they may have, and to step up and offer assistance when it looks like anyone is struggling. Although I'm an LPN and therefore not eligible to charge or precept, many of the RN's will come to me for advice when they are fill-in charge or precepting, and often tell their orientees to come to me with questions. I like to think it's because I'm approachable, I've been on the same floor for five years now, and have a pretty good memory, plus I love to help educate others and learn new things.
7. One of the most important things to be able to recognize as a nurse is when you need help. Anytime you start to wonder if what you did was enough, or if you start to second guess yourself, it's perfectly fine to ask another nurse to validate your decision/actions. Everyone needs help sometimes, just make sure to make yourself available when it's your turn to be asked for help.
8. I love to read, and find that taking five minutes with a "fluff" reading (like a romance novel, People magazine, etc.) where I don't have to think allows me to recharge. At home, I love to play with the kids and watch comedies.
9. I have to keep up my certifications for work, and I have a folder where I keep printouts on any interesting disorders that my patients have. My state does not require CEU's, so I often don't take the time off to obtain them for financial reasons. I am back in school to bridge to my RN and don't plan on stopping my degrees until my oldest starts college (hopefully I'll have my MSN by then).
10. There are several issues which are of vital import to the way we practice...in no particular order, the two I think are most important...
a. Money. The current state of Medicaid/Medicare and reimbursement is causing alot of issues with how much money facilities get, which in turn is causing alot of issues with how well they are able to update to attract new patients, pay current staff, and afford to staff safer. The lack of adequate staffing leads to patient safety and regulatory compliance issues and burnout of staff.
b. The current atmosphere of customer satisfaction trumping patient needs can turn patient care into a nightmare balancing act of trying to ensure good Press Gainey scores while adhering to care which will ensure optimum patient outcomes. For example, patients who are fluid restricted may be very irritated about the fact that you won't "sneak" them extra fluids, despite the fact that doing so is detrimental to their outcome. This is also leading to management expecting near impossible performance from their staff, often putting middle management in a precarious position and causing rapid turnover of these positions, which in turn leads to a revolving door of leadership and lack of stability which trickles down to floor nurses and further contributes to the burnout issue.
Honestly, I'm not really sure what we can do to address these issues. I think that alot of people who couldn't care two bits about nurses in general are going to get their heads outta their butts before we see any significant changes. Maybe if we can manage to get some real nurses into politically important positions we'll see some changes, but who in their right mind would want those jobs?
Hope this helped you out some