A message to new grads: NEVER.... - page 7
* un-spike the old IVF's with 100 mls left in the bag while it's still hanging * say the word "quiet" in reference to your hopes for the shift * say you've never had a patient ________ before... Read More
Feb 7, '05never brag to the next shift that you were so bored you never got out of your chair all night!
never leave the bedside cart unstocked, the ivs dry or the meds not ordered.
never lie about what you did or didn't do, gave or didn't give. patients can survive a lot of mistakes, but only of you own up to it and then work at fixing the problem you caused.
never leave the messy dressing change, bath, whatever for the next shift.
if you drew the labs, check for the results and deal with them yourself.
never forget to take care of yourself first!
Feb 7, '05Always take time to get to know your pt's family or visitors. You never know you might find out valuable info.
Always be an advocate for sedation on ventilated pt's. This means something for pain AND something for agitation. Dr's hate this topic for some reason.!!!!!!
Always talk to your "intubated and sedated" pt's OR "brain Dead" pt's YOU NEVER KNOW! Tell them what you are doing to their bodies.
Feb 7, '05Always:
- do your own assessment, don't count on someone elses. Things can change or be missed by previous shift
-check your equipment. make sure your suction is ready, your ambu bag and resuss. stuff is available. It never fails that the one room that is improperly stocked is the one that will have the code/seizure/unresponsive pt.
- make friends with the housekeeper- you would be amazed at the resources they have!!!
- give your best.
- find a mentor on your shift that is willing to be there as a resource for backup. Have had some new grads in the ER and I am more than happy to back them up or be there for a question. We encourage our new grads to approach a resource nurse each shift and say "Will you be my resource person for tonight"
- chart any change in pt condition and what you did to address it. I am amazed at simple things like "pt. c/o slight dyspnea" but never charting that you informed the doc/gave a med/ check a pulse ox. You always need to be aware that your charting reflects your care and trying to explain 5 years later that "Yes, I checked a pulse ox" in court when you have no recollection and no evidence of a recorded pulse ox is an eye opening experience. Always chart like you are on the stand and always make sure that whoever reading it can see the full picture.
- delagate a nasty job just because you can
- dump on your CNA/PCA/ floor tech while you sit on the phone (see this done all the time)
- say the word "QUIET" in any form or sentence- you will be smacked!
- sit on your butt while your co-workers are drowning and try and make yourself look busy with nothing
- be a lazy nurse.
- put down the floor, other nurses, the hospital. if you are unhappy do your best to make it better, if you can't find another job. Nothing is worse than working with a nurse who is miserable and complains all the time but continues to stay and make others miserable with her constant banter and bad attitude.
- put down a policy/procedure without following it with a solution to fix it. You will be respected by your nurse manager/director if you offer to help fix it.
- talk behind a co-workers back, they will find out eventually. don't get sucked into gossip by chiming in.
- accept rude/condesending behavior from a doctor. they are no better than you. You are both professionals and you deseve to be treated as such.
- apoligize for calling a doctor with a change in pt. condition- it is your duty to act.
- stop learning. keep up to date with lectures and obtain certifications in you area of specility.
Feb 7, '05Quote from earle58This one sounds familliar :chuckle!!!and as a new grad, NEVER act like a know-it-all.
i've seen too many new grads that challlenge the seasoned nurses, thinking they know it all from their recent education.
I am a self confessed smart-guy but I would actually encourage new staff to challange the practices of more experienced staff... How else will outdated practices change or new staff learn?
Now in my case, even though ive only been qualified since September 04, I know a great deal more about a great many subjects than a lot of the other staff I work with (it's what comes of having a 1.5hour commute each way to my hospital and using the time constructivley in my 'commuti-versity' ) so I have often found that when i ask questions, i often need to supply an answer.
I would point out its not the challange that often irk's the more experienced staff... its the way they get challanged... Telling them "Well i was show to do it this way..." or "Your doing it wrong..." Is a surefire way to annoy the heck out of them... Asking questions about WHY they do something this way is much better
Feb 7, '05Quote from maireWhat is a "seasoned" nurse???What a great thread!
And I dunno, but I figured marinated meant seasoned, been in it awhile, etc.
Like... one with pepper on her/him?
Feb 7, '05As a new nurse, what you have to hear is a whole lot more important than what you have to say.
Don't talk when you should be listening.
Feb 7, '05Quote from acutecarenpI would agree that you shouldn't "...talk when you should be listening,"..As a new nurse, what you have to hear is a whole lot more important than what you have to say.
Don't talk when you should be listening.
But having said that it does depend on what the more experienced nurse has to say on whether or not you really need to be paying attention...
Just the other day I was questioned over using an alginate linen bag for a bed sheet that was covered in urine... the more 'experienced' nurse was of the belief that they should only be used for patient's under isolation and not for any linen that had been exposed to body fluids...
Similar thing when one of the other long serving nurses on my ward criticised me for not rubbing an injection site after giving IM cyclizine.
Still... I am apparently good listener (as far as I can judge it)... Though I know some of the girls I work with have said that, "...for a guy, I listened like a girl..."
Im sure that was a compliment
Feb 7, '05Quote from joecalifaHere's one for you and all the other new/potential OB nurses:HI, Thanks for your messages guys, great topics, it helps a lot all of us nursing students. I am a second semester RN student going to OB/GYn Peds, and very excited to learn. It's a a very new field to me, especially OB , I am a male but so far everything is going well, just trying to do my job professionally and learn what has to be done correctly. I heard many things about men going to OB and having a hard time,it can be understandable in some cases. Unfortunately there is still this dilema in nursing , it's getting better slowly, which is very good for everyone and the profession.
Take care guys and thanks a lot.
Never ignore the patient who says "I have to push". Even if you JUST checked her and she was only 3cms., check again. Otherwise you will end up having to explain how the patient preciped in the bed!
And as most parents know as well, don't leave that baby boy uncovered for a minute!
Feb 7, '05Never Crush Pills And Dump Them In An Enteral Feeding Bag With Ensure/glucerna Etc.. It May Save You Time But It Sure Doesn't Save Your Fellow Nurses Time When They Have To Change Out The Whole Bag Because The Tubing Gets Clogged Up!!!!!!!!!
Feb 7, '05Quote from LPNtoRNOk, I have never heard of anyone doing that before. Why would they crush up the meds and put them in the bag with their enteral nutrition instead of administering them directly into the GT?Never Crush Pills And Dump Them In An Enteral Feeding Bag With Ensure/glucerna Etc.. It May Save You Time But It Sure Doesn't Save Your Fellow Nurses Time When They Have To Change Out The Whole Bag Because The Tubing Gets Clogged Up!!!!!!!!!
I can't even say that's poor nursing practice (although it is). Its just... stupid.
Feb 7, '05And one of my own: never ignore it when a patient says they're going to die.
They're usually correct.
Feb 7, '05We recently did this at my place of employment, and had a lot of fun at it, here were my contributions...
* Keep up with research, and share it! Also implement it on your unit. Insist on change of things that are potentially harmful to patients and yourself. If you can't get others to change, at least change yourself.
* Don't be afraid to challenge things you believe are wrong.
* Bed baths are great ways to assess your patients, and educate them.
* If you don't like the way something is done, don't complain, do something to change it.
* When death is imminent, turning the patient on their left side may hasten it.
* Sometimes patients just need to be told that it's ok to go.
* Be sure to mark organ donor on your driver's license.
Feb 7, '05Quote from bonemarrowrni do agree that na's and unit sec's cannot do the same tasks as licensed personell, but having worked my way through as a cna...i will tell you that those nurses who became my 'friend' and bent over backwards to make sure that i wasn't up to my elbows in feces alone were the very nurses that never had to worry where a na was when she needed one (even if i wasn't assigned to her patient).while i don't disagree with these, i urge you do them with caution. i don't mean to sound disgruntled (but i am :chuckle ). don't let them take advantage of you! they will sit there and watch you change every wet/soiled pt. if you let them. they are also well aware of the fact that you are 'new', and want to do everything you can to help your patients. many nurses told me this as a new nurse. depending on where you work, you need to make a choice- either be their friend, or keep it professional (so they will do their job). it is very hard, once you've established that 'friendly' relationship, to change that.
please remember this: you can do the cna's job (and the unit sec as well), but they cannot do your job!!! i'm just a little sick of hunting them down, and doing everything for my patients, while they sit on the phone.
those nurses who left patients sitting in vomit, feces, and urine until i was able to leave another patient room were reported to the nursing supervisor (for the hospital...not just the floor) by the patients as well as the staff. so having said that...to all of the new nurses/students...what kind of nurse do you want to be??
never, under any circumstances, is it okay to leave your patient sitting in bm, urine, emesis, or any other body fluids.