queenjean 10,458 Views
Joined: Mar 23, '07;
Posts: 997 (34% Liked)
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I've started doing a class 1-2 x a week that is a combo yoga/pilates/thaichi class, and I have noticed how WEAK my feet are. They HURT during class, and are sore afterwards. Now that I've been doing the class a few weeks, they are much stronger and aren't nearly as sore post-workout.
I also have a goal of working up to some running (for me it's a half marathon), and this time around I haven't had any problems with shin splints. What I have done differently: the combo class that has stretched strengthened my lower legs and feet; walking way more than I feel like doing (as opposed to starting the running right off the bat); running slower than I feel like I want to; doing at least half my workouts on a nice treadmill; only devoting 20-30 minutes to the run, with the rest of the exercise time different aerobics classes, elliptical trainer, rowing machine, and a stationary bike.
Hope that helps! Shin splints are so painful, and I seem to get them every dang time I start the running again. Captain Obvious would say that I just need to NOT QUIT THE RUNNING; and captain obvious is right. Maybe this time, I'll keep it up....
Adults have poorer circulation than infants and children. With lower extremity sticks the risks for clots and infection is much greater, and if it infiltrates, the complications are more severe due to the circulation issues.
Think about it--walk down the typical med/surg hallway. The vast majority of the pts are over 60, have multiple health problems, and every one of them has PVD, diabetes, or artherosclerosis (or all three). That's why you can't do a stick in the lower extremities without an order from an MD. In ER, ICU, and in nursery and peds, this rule does not usually apply (though in my hospital, tICU hast to get an order from the MD, too).
Where I work, we have plenty of nurses (and supervisors) with visible tats. There is no policy to cover them.
In nursing school, we were supposed to cover them. Mine were covered by my lab coat (we couldn't wear long sleeves under our scrubs, either). I guess you could put a bandaid on it if they really didn't want it visible.
I've known a couple of people who have attempted to have laser removal of facial tattoos; it has not been very successful. There will always be a faded area--might as well keep it, get it touched up when necessary to keep it looking sharp, and wear it proudly!
I was staying at a snazzy hotel this weekend, and noticed in the pool area that the tattooed nearly outnumbered the "blank slates". Tattoos are becoming so common in our society, I think this issue of visible tattoos hindering employment is less of an issue than it once was.
I used to work peds and nursery, and here are my two thoughts that helped me with this.
One, this child needs taken care of. If I can't pull it together and take care of this child, the child won't get good care. I'm doing a huge disservice to him/her by allowing my heartstrings to somehow control my entire being.
Two, if this were my baby sick and screaming in the ER or the ped unit, who would I want to take care of her? A nurse who isn't bothered by a crying baby, or one who *is*, who is sympathetic, who really feels for my baby, and cares that she hurts?
It's okay to care and even to shed a tear, but it's not okay *for the pt* to let those things get in the way of taking care of the wee ones.
If you can't get past it, maybe the ER really isn't the place for you. I suspect, though, you will find it is more difficult to NOT take care of these babies than it is to take care of them. When I float down to the ER, I would rather take the babies and kids. At least, if I'm taking care of them, I know that I'm taking care of everything I possibly can. If I'm *not* taking care of them and I can hear them cry, I'm wondering "Did the nurse offer a popcicle? Did she explain everything in simple, basic terms before hand? Did she give her an extra bandaid for her babydoll?"
Once you take care of a couple of kids, you might find it isn't nearly so traumatic for you as it is right now, when you are still learning.
Amybeth, I would like to point you to this:
A gentle reminder:
Folks, please try to be polite to one another and please, please, please stay on topic. This is a vent thread.
In a vent thread, criticism of the post and side comments to the poster are considered inappropriate and off-topic.
Further off-topic posts may be removed at the discretion of the mods.
Angie O'Plasty, RN
All in town employees are expected to be there; they are more flexible with employees who live in rural areas, which seems fair to me.
I'm in the midwest, and the only time I called in for weather was during an ice storm when a tree fell on my car. They told me if they were short, they would send the police or fire/medical for me. I told them not to bother, fire and medical were at my house because the tree also took down a bunch of live wires. After the repair guys from the electric company took care of business, the fire truck drove me to work.
And that's the plan. If we can't get out but live in town, the police or fire and medical will come and get us.
It's a hospital. It can't run without staff. We're essential employees, like the police and fire/medical. My vehicle is appropriate for my geographical area, it's in good condition, I have experience driving in snow and ice, and like I said, I've only called in once, but still managed to get there. If your area routinely gets large amounts of snow, you (and your facility) should have a plan in the event of terrible weather. You should make every reasonable attempt to get there, and the facility should make every reasonable attempt to call off employees who live farther away, and/or offer reasonable lodging for those who can stay (or who can't leave!).
Think persistence. Fax, mail, or hand deliver your resume not only to HR but also to the head of EVERY major department (ICU, Med/Surg, ER, etc). I find that many HR departments don't communicate well at all with the departments and have no real idea about what's going on on a floor. HR may be telling you they only want someone with experience--meanwhile a director is tired of paying time and a half and having a short schedule, and would be MORE than willing to have a new grad.
Follow up at 1 and 2 weeks and then monthly after you sent your resume. Again, follow up not only with HR but also with the directors of the departments. Following up means a phone call or email (I personally think a phone call is best, but email's not bad), expressing your interest in a position and inviting them to contact you with any questions.
If you get an interview, look good. Don't wear perfume. Smile, sit forward and nod attentively. Look up information on the facility, (go through recent articles about the facility in the newspaper, check out the facility's webside, ask former or current nurses, etc) and prepare in advance a few general and specific questions. While questions re: pay, schedule, etc are acceptable, questions that show a long term, general interest are better. Something like "I read recently in the paper that the hospital is trying to attain magnet status. Where are you at in that process?" "A friend of mine who works here says there are many different council and committee positions open to floor nurses. What sort of involvement do you recommend for your new nurses?" "I see on the hospital website that this hospital has a growing, successful hospitalist program. I've never worked in a facility with hospitalist; what is the impact of a hospitalist program on the role of the floor nurse?"
After the interview, even if it is a phone or email interview, send a thank you. Thank them for their time, let them know *again* how interested you are in the position, and how good of an impression the facility made on you.
If you flat out get turned down for a position, thank them graciously for their time and their consideration, and *again* express how interested you are in a position. Request that your resume be kept on file so that you might be considered for future positions. Ask them if they have any suggestions for you in terms of interviewing or marketing yourself better--for example, would you be a more desirable candidate if you had ACLS certification?
Finally, volunteer somewhere. If you are wanting a position at a specific facility, volunteer there. You will establish a positive relationship with the facility, prove your reliability and professionalism, and will be gaining at least some sort of experience. Some facilities (mine included) even have "nurse volunteers". These are mainly retired nurses, and they don't actually take pts, but they do perform more duties than the regular volunteers--such as doing some of the admission history.
If you can't volunteer at the facility, volunteer at a place that will get you nursing experience. Free clinics take nurse volunteers. You will get to use some of your nursing knowledge, and you'll gain experience.
Volunteering will also show that you weren't letting your skills go, that you really wanted a job and were willing to put in unreimbursed time to get it. It shows responsibility and maturity.
Have someone go over your resume professionally, while you are at it. Practice interviewing, ideally with someone who has interviewed people in the past (sometimes your school's guidance counselors will offer this service); they can provide you with some constructive criticism.
Good luck! It's such a tough market right now, especially in certain geographical areas. Anything you can do to stand out positively will help you.
Sometimes the error comes in the pt's listing of the reaction of the allergy. For example, in our facility, we would give a med the pt lists as an allergy if the allergy isn't a true allergy, but rather a side effect. Like GI upset, which is oftentimes the result of the route. I would definitely talk to the pt, though, and let them know why we are giving it and why the pharmacist and doc feel it is safe to give.
I've given things that people claim to be allergic to, with no ill effect. Like the allergies "I'm allergic to all abx because they give me a yeast infection" or "nitro gives me a headache". Rashes are not always indications of allergy, and a lot of people do not take appropriate abx because they "got a rash" once, maybe, when they were 3, but actually they can't really remember what the reaction was, maybe they threw up? They don't know, and their mom is not around to tell them.
I'm not saying this was the case in the OP's situation; I agree that there were many at fault in that situation.
However, I would like to point out the importance of a COMPLETE documentation of allergy. Not just asking the pt "Do you have an allergy to any food or medication?" but also following up with "When did this occur?" and "What sort of reaction did you have?" Every nurse needs to do this with every pt when updating allergies.
Do your pumps have a pediatric setting? If so, make sure you use this all the time. If not; maybe this is something your hospital needs to invest in.
So, what have you learned? Will it happen again? Will you let an IV go more than an hour on a child without checking it?
Unfortunately, in our profession, when we make a mistake, it can harm someone. You got lucky. I've gotten lucky before, too. Now you have a decision to make. Will you learn from this mistake? Or will you just beat yourself up over this, and never move forward?
I completely mis-programmed a PCA pump, and the nurse who double checked it didn't do so thoroughly. I got lucky, in that the person I overdosed was a drug seeker and had such a high tolerance, it didn't even phase her. For a day or two, I wasn't sure I could go back to work. Ever. And then I just decided--everyone makes mistakes. I can either learn from it, or I can go to work at a coffee shop. I will never.ever. program a pump while distracted, and I will always double check someone else's pump extremely carefully.
Evaluate what you did wrong, what you can improve, and become a better nurse. This is what it means to be an experienced nurse.
Here's an actual conversation I got to have last noc (and it felt good!):
Pt, after we've discussed her plan of care for the noc: Thank god you're my nurse tonight. I had a real ****** of a nurse last noc who wouldn't let me eat and just lectured me about what I was eating and was like "blah blah blah" all noc, she was a real pain in my a$$.
Me: Well, I'm sorry that teaching wasn't effective. I must confess that *I* was that ******, and when I was lecturing you, I was trying to explain a little concept called cause and effect. You eat, you throw up. You are here for nausea and vomiting, and I was trying to help you. I *tried* to explain to you that your GI tract needs rest, and that I can't just give you meds to fix your problem. Instead of blaming others or calling people who clean up your vomit and stay up all night trying to help you nasty names, you need to take some personal responsibility for your health.
Pt: Uh. Sorry. I, uh. Yeah. Uh, so I can't have a hamburger?
Me: You can when you leave. And you can leave whenever you want.
Pt: Uh, if I stay, will you still take care of me?
Me: Of course. But taking care of you means you don't get a hamburger.
Pt: Uh, okay. Sorry.
Geez, people! If you have gastroenteritis and you puke every time you eat, STOP EATING! It's NOT rocket science, for crying out loud! How did you survive for 38 years with such complete lack of common sense? You are pathetic!!!!
I was soooo sad when I missed my oldest child's first day of kindergarten. What sort of horrible mom was I? I was in school, had clinicals, and absolutely could not miss to attend. My mom came to visit and took her to school instead.
Years later, the topic somehow came up and I mentioned how badly I had felt. My oldest (a wonderful, well-adjusted, delightful 13 year old) looked at me quizzically and said "You didn't take me on my first day? I don't even remember that."
Sometimes I think *we* as parents put too much on the importance of certain events. Yes, I've missed some things. I've also attended a lot of things, and because I'm home during the day, I'm able to do more in their classrooms. They have also benefitted from having a nurse as a mother, during the times they have been ill or injured.
They have a mother who is the primary breadwinner in the household, who went to school when her children were babies, they watched their parents balance school, work and family to make it work for everyone. They've been more involved with their father, and their father has always taken on more then his fair share of household chores because of my school and career. They are able to take music lessons, attend camps, and go on vacations domestically and abroad on a regular basis because I earn enough money for us to be able to do these things.
Overall, nursing has been a wonderful career for me, in terms of how it has affected my family.
I don't know; just like there are general crazies running around out there, there are a few docs I've met who have such horrible temper problems. I'd honestly be afraid of them if they were armed.
I'd only want our docs to carry guns if the NURSES each got one, too. Frankly, though, in the end I'd probably kill two doctors in particular...or at least shoot their car windows out in the morning.
This thread has been an interesting read. Lots of good questions and information. Thanks!
Of course, my nose itched the entire time I was reading...
Obviously the medical community still has a ways to go in educating the general public about organ donation. I don't know when or how it should be done, but if people still believe that we just let them die, or that we charge them for the donation, or other completely untrue myths, we need to be somehow be doing a better job. It's completely amazing to me that these myths are still out there.
I've felt for a long time that it should be the primary care providers' jobs to make sure that all of their pts understand the need for living wills and DPOAs, and that this discussion should take place every year with the annual health exam. Perhaps a little information on organ donation (as simple as a flyer about myths and realities) would also be helpful. Would people actually read it, though?
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