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Hygiene Queen, RN Guide 25,171 Views

Joined Sep 13, '07. Posts: 2,372 (73% Liked) Likes: 8,072

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  • Mar 23

    I don't know anything about clinics -- I'm just responding to the "losing my skills" concern. If you change jobs, you will lose some skills, but you're going to develop others. When the time comes that you need the skills you've "lost", they'll come back to you pretty darned quickly.

  • Mar 21

    Quote from cocoa_puff
    As I was reading your post, it sounds like the patient is blaming the pharmacist for his own problem. Why would the patient not "remember" that he had a penicillin allergy when asked if he has any allergies at the office, but then tell the pharmacist when picking up the prescription? The "you probably outgrew the allergy" is what the patient believed, but then once the rash appeared, the patient knew that he had made a mistake, and shifted the blame to the pharmacist to appear to be the victim in this situation.
    Pharmacists are my closest colleagues at my current job and I don't believe for a second that a Pharmacist really told the patient "oh I'm sure you outgrew that allergy" and wouldn't call the MD to clarify the prescription/allergies. Patients aren't always accurate historians. I think it's fine to call the Pharmacy and say "Mr Smith was prescribed Augmentin from our office. He didn't report any allergies. He came back with a rash on day 10 of his course and states that when he picked up the prescription, he mentioned an allergy to Penicillin and was told that he had probably outgrown it and it was fine to take the med as prescribed" and get the Pharmacist's account of what happened. But to YELL at the Pharmacist? Just based on the report from a patient who "forgot" about is allergies then didn't call about a rash for 10 days? No.

  • Mar 19

    Been an LPN for decades. This has been a survival job. Raised kids and kept a house, but unable to progress due to health issues (shift work exacerbated migraines, caused other health issues). Earning a four year degree was easy in comparison to the hurdles of going from LPN to RN - never did cross those hurdles. Still an LPN, still getting treated like an overpaid CNA, still can't leave as pay is just high enough to be above minimum wages. Hurdles to pursuing RN included scheduling for clinicals vs need to work availability (bills keep coming), the insane prerequisite to redo A & P courses after less than a decade of completion of college level work and continued practice. Still keep training new RN's who either lack spatial intelligence or truly cannot disconnect from tech long enough to be plugged into real life. After decades as an LPN, even with a life science BA, earning $2/hr more than 20 years ago. Still finding myself needing to 'dumb down' to meet current job expectations. People who have worked with me, including RN's, are dumbfounded that I am still working the LPN license. I can't even begin to imagine a retirement - yet my cohorts are able to choose that luxury either by proximity to partner or long term planning. I am now forced to either find a way to reinvent myself and create a new career after age 60 as (finally) the kids are grown & on their own, I left my ex after giving him most of our assets - but I am free. Poor, with a new mortgage, but free.

    So, do I like being a nurse?

    Yes, I love being a nurse. I like helping people. I like being proficient at planning their care and being able to improv when the plans fall off track - and still reach goals. I like the knowing of the differences between flesh and bone and spirit. I have been privileged to be in the presence of many intimate and powerful moments that only a nurse would have access to witness. It is in that world I remain strong and capable and useful and valued.

    On the other hand, when I leave that world to try on new job descriptions in the corporate world, I become like roadkill. I have never been able to explain to their satisfaction why I continue to work as an LPN even though I have all this experience and education. There is surely something I am not revealing, something dark and onerous, perhaps I am just a waste of time. Plus I am now old and time has not been kind. Nursing is a great career - but only if you are an RN with a plan.

  • Mar 17

    Quote from Rayrayma
    This is what the nurse told me about the patient

    "He's a terrible person, very evil and you should ignore him, also redirect him" I wasn't informed he was suicidal AT ALL or that he had an IV in....

    Uh, I was taken back because it seems out of line to be calling a patient evil. However when I came near the door there was slew of nurses by the door watching him scream at them. He was in restraints yelling at the nurses, calling them things and they laughed it off....

    They recommended I sit outside so I did just that, and it resulted in this dude almost dying...

    Tbh, I learned a lot from that experience, I just wasn't prepared for handling a patient of this caliber five days in....
    Come on now. I think you are blowing this out of proportion. The nurse should have told you he was suicidal. You complained to your company and got an apology.

    Patients pull out their IVs all the time. I have never seen a patient bleed to death from a dislodged IV.

    I think you are new to nursing. One of the things you will learn is that stuff happens. Just be cool and do your job.

    Best of Luck going forward.

  • Mar 14

    Quote from calivianya
    Recently, we had a new admit who ended up buying himself a ventilator really quickly because he was not breathing well at all. All during the intubation, and while the physician was dropping a central line, everyone was commenting on how huge and weirdly shaped the patient's nose was. After everyone else left the room, I decided to investigate further and squeezed it. What I found was never-ending whiteheads that smelled like rotting fecal matter, so I deduced pretty quickly that the size of the nose was probably due to a cyst or something right under the surface. No matter how much I squeezed, more pus-like material came out. By the end of the shift, I'd had at least five coworkers in the room squeezing on the patient's nose, because we are all freaks like that on my unit.
    "Each was squirming slightly, and had a number of large, shiny swellings upon it, which appeared to be full of liquid.
    'Bubotubers,' Professor Sprout told them briskly. 'They need squeezing. You will collect the pus... ...Wear your dragon-hide gloves..."
    [...]
    "Squeezing the Bubotubers was disgusting, but oddly satisfying. As each swelling popped, a large amount of thick yellowish green liquid burst forth, which smelled strongly of petrol. They caught it in the bottles as Professor Sprout had indicated, and by the end of the lesson collected several pints..."

    Harry Potter and the Goblet of Fire

  • Mar 11

    I am so sorry you are going through this....I am sure it is difficult for you. ((HUGS))

    I am concerned, however, that you are focusing on your friends dismissal and readmission instead of researching an action plan and developing your own plan on what you are going to do different as you go forward to improve your academic performance. I can see why the Dean refused to consider you for readmission if you called complaining about your friends readmission and you are being treated unfairly.

    You know as well as I do that they are not going to discuss his meeting with them as that is private and none of your business. I am positive that you would be outraged if the circumstances were reversed. The university can do exactly as they wish and essentially you have very little control. I would however do some research about the schools academic dismissal/grievance procedure and follow it to the letter. I also strongly encourage you to develop your own performance improvement plan and present it at your meeting.

    1. Appeal in Person

    If you have the option of making a written or in-person appeal, choose the latter. The members of the appeals committee will think you are more committed to being readmitted if you take the trouble to travel back to college to make your case. Even if the thought of appearing in front of the committee terrifies you, it is usually a good idea. In fact, nervousness and tears can sometimes make the committee more sympathetic to you. These articles can help you prepare for an in-person appeal:


    If you need to appeal in writing, check out these sample appeal letters. Both present the students' reasons for poor academic performance and their plans for improving their grades:






    2. Don't let your parents appeal your case

    The appeal committee members want to see that you, not your parents, are committed to your college success. If it looks like your parents are more interested in the dismissal appeal than you are, your chances for success are slim. Don't have your parents write a letter of appeal for you, and don't let them show up at your appeal with you. The committee wants to see you taking responsibility for your bad grades, and they want to see you advocating for yourself.


    3. Be Painfully Honest

    The underlying reasons for an academic dismissal vary widely and are often embarrassing. Some students suffer from depression; some tried to go off their meds; some got messed up with drugs or alcohol; some stayed up every night playing video games; some got overwhelmed pledging a Greek.
    Whatever the reason for your bad grades, be honest with the appeals committee. Colleges believe in second chances -- it's why they allow you to appeal. If you don't own up to your mistakes, you're showing the committee that you lack the maturity, self-awareness, and integrity that you'll need to succeed in college. The committee will be happy to see you trying to overcome a personal failing; they will be unimpressed if you try to hide your problems.

    4. Don't Blame Other People

    It's easy to get embarrassed and defensive when you fail some classes. Still, no matter how tempting it is to point at others and blame them for your bad grades, the appeals committee will want to see you taking responsibility for your academic performance. The committee will not be impressed if you try to blame those bad professors, your psycho roommate, or your unsupportive parents. The grades are your own, and it will be up to you to improve your grades. See Brett's appeal letter for an example of what not to do.
    This doesn't mean you shouldn't explain any extenuating circumstances that contributed to your poor academic performance. But in the end, you are the one who failed those exams and papers. You need to convince the appeals committee that you won't let external forces lead you astray.

    5. Have a Plan

    Identifying and owning up to the reasons for your poor academic performance are the first steps to a successful appeal. The equally important next step is presenting a plan for the future. If you were dismissed because of alcohol abuse, are you now seeking treatment for your problem? If you were suffering from depression, are you working with a counselor to try to address the issue? Going forward, are you planning to take advantage of the academic services offered by your college?
    The most convincing appeals show that the student has identified the problem and come up with a strategy for addressing the problem. If you don't present a plan for the future, the appeals committee is likely to think you will end up repeating the same mistakes.

    6. Show Humility and Be Polite

    It's easy to be angry when you've been academically dismissed. It's easy to feel a sense of entitlement when you've given a college thousands and thousands of dollars. These feelings, however, shouldn't be part of your appeal.
    An appeal is a second chance. It is a favor being offered to you. The staff and faculty members on the appeals committee spend a lot of time (often vacation time) to consider appeals. The committee members are not the enemy--they are your allies. As such, any appeal needs to be presented with the appropriate "thank yous" and apologies.
    Even if your appeal is denied, send an appropriate note of thanks to the committee for considering your appeal. It's possible you'll be applying for readmission in the future.
    How to Appeal an Academic Dismissal

  • Mar 10

    I think an anonymous call to the health department is in order.

  • Mar 9

    I finally left nursing 4 years ago after experiencing severe burnout. I was only a nurse for around 8 years, but in that short space of time went from loving it (5 patients with a tech to help) to loathing it (7-8 acute care patients with no tech and the hospital giving the charge nurse a full load of patients so that they couldn't help either). 90% of our patients were either detoxing alcoholics (with associated hepatic encephalopathy, GI bleeds, end-stage cirrhosis), Uncontrolled hyperglycemia with insulin drips, other GI bleeds and related blood/platelet transfusions and preps for colonoscopy, suicide attempts/psych patients or dementia, not to mention at least 20% of our floor would be isolation. First my hospital started to increase patient loads, but they added video monitoring...then they got rid of the video montoring, increased patient loads more, then got rid of the unit secretaries and then sitters (unless for suicide watch), and then decided that 1 tech was sufficient for a floor of over 35 patients of extremely high acuity. Often we had no tech, or we would have to pull the tech we had to be a sitter, or float as a sitter to another unit. The hospital also decided to cut down on supplies so that every night we would have to scour other units for basic items like clean sheets, chucks and depends...that is if they were available...I often had to make my own chucks from an isolation gown with a couple of towels on top.
    I went from being able to really care for my patients...washing a homeless guys socks and underwear by hand, so they were clean for discharge...holding anxious patients hands and really listening to their fears instead of pretending to listen while worrying about how I was going to get the rest of my charting done...being able to clean up a patient and make them comfortable straight away, rather than having to have them lie in their own mess for 30 minutes while I ran to other floors looking for clean sheets and waiting desperately for someone to have the time to help me lift and turn safely...making sure that my end of life patients never died alone...to running around in and out of patients rooms making promises that I could never keep. Bed Alarms going off 30 seconds after I left my patients room to get them pain meds, or my phone going off to tell me that a bed alarm was going off...in fact, bed alarms were going off at a rate of 20-40 times AN HOUR because almost every one of our patients were confused, detoxing or on Golytely prep and that was just the rate for my 7-8 patients, let alone the rest of the floor. And every other nurse on the unit was running at the same pace...no-one could either ask for or expect help from anyone else because we were all living the same hell.
    So what did my hospital do? Falls were of course increasing...it is not physically possible to run to every one of those bed alarms and still do any actual nursing tasks. Patients were complaining because help was not available for turning, toileting...pain meds were late...heck ALL meds were late because a bed alarm going off is only secondary to a code blue in urgency. And forget about bed baths or showers or brushing teeth. So my hospital, in it's wisdom decided to start punishing the nurses. First "If a bed alarm goes off you MUST stop what you are doing and run to it". That of course conflicted with the "No interruptions are to be allowed when getting or giving medications", Then "Any falls will be followed up with a hearing and disciplinary action", and finally...because by now we were all staying behind at least 2 hours after the end of shift to START our charting (not just catch up) "If you clock out more than 10 minutes after the end of your shift you will be subject to disciplinary action", so we started clocking out and then doing our charting unpaid..."That is against the law and you cannot do that"
    Anyway, like you I was crying, having nightmares, deep depression, taking pills to stay awake, pills to sleep, living off chocolate bars because no-one had time for a lunch break...One day I quit. Just quit, no notice at all. It was terrifying and guilt-ridden, but it was the best decision I have ever made. When my nursing license expired 18 months later I opened a bottle of Champagne and celebrated. I feel human again, I feel positivity and joy again, I have love and time to give to my family and others again. I actually have a life again, and boy did I miss that! No regrets.

  • Mar 8

    This little gem stood out to me. That the administrator's first idea was that the nurses drugged their own popcorn is pathetic.

    The administrator, who came to the ICU to check on the progress of our investigation, was surprised to see the bag of popcorn on a desk where there should be no food. He then found, to his surprise, a popcorn maker in the ICU nurses' lounge.
    That led him to speculate that the popcorn was the culprit and perhaps even that these free-spirited nurses (as he viewed them) had put some kind of drug in there, and that that had made them sick. I proceeded to provide a more evidence-based explanation from what I found in radiology.

  • Mar 5

    Quote from elizandajd
    do you think it's beneficial or not beneficial to go out with coworkers?
    Familiarity breeds contempt. The more one becomes acquainted with a person, the more one knows about his or her shortcomings and, hence, the easier it is to dislike that person. The lines between professional and personal relationships become muddled and can lead to putting personalities before principles, a mortal sin in a professional relationship.

    But hey- if you like drama in your professional life, go for it!

  • Mar 2

    Inserting a pre-op foley into my Nursing Supervisor who I had been assigned as her nurse. Humming 'Getting to Know you', she caught it and we both were laughing so hard I compromised the proceedure and had to build a new set-up.

  • Mar 2

    I was thinking about this really awkward situation that happened to me a couple years ago and I thought it'd be funny if you all shared your most awkward moments in your nursing career.

    Without a doubt, here's mine:


    I'm a male CNA at a long term care facility, and I walked in at around 8 o'clock one evening, to a woman's room who we will call Betty. Her call light was on, and as I shut it off, she explained to me that she was ready to get in bed, however, she didn't want me (because I'm a man) to help her, she wanted her female CNA, Stephen.

    (Right now you're probably having the same reaction I did).

    Not quite understanding what she meant, I asked her again who her CNA was for the night.

    "You know," she says, "Stephen. She's that large, black woman who comes in and sings to me every night."

    Now, we did have a CNA named Stephen, and he was working that night. And yes... he is larger... and yeah... I do believe he likes to sing... buuuuuut... he is most definitely not a she. Now in hindsight, I can think of about a thousand ways in which I could've handled this situation better. In hindsight. I however went with the knee-jerk.

    "Betty... Stephen is a man."

    (long pause)

    "No no, you're not thinking of the right person. Stephen is a woman. She takes care of me every night"

    "Betty, when was the last time you heard of a woman being named 'Stephen'?"

    (longer pause)

    "This can't be right. Do you mean Stephen? The CNA who takes care of me?"

    She's not getting it. And at this point, she's so darn convinced that he's a she that I'm starting to rack my brain like, "Do we really have a woman named Stephen working here!?!" So after re-convincing myself that I'm not crazy, I must have said something that finally got through to Betty that Stephen was a man. IMMEDIATELY however, I regretted the entire conversation I just had with her. I still remember...

    "Are you kidding me?!" she says. Betty's got this look of sadness and disgust all over her face. This little old woman who was so modest and private that she never would let a male worker see her naked, and who loved this 'woman' CNA so much, just had these things dashed before her, by me. And at this crescendo of opinion reorientation and awkward silence, guess who walks in?

    "HI Betty!!!!" Stephen bounds in with his eccentric voice and noticeably feminine mannerisms.

    I squeak from the corner, "Oh hey Stephen! uh.. hehe.. uh..."

    Stephen, noticing something in the aura of the room is a little off, inquires what's up.

    I look down at Betty. She has this unsure, confused look on her face. I watch in horrid, awkward silence as she looks up at Stephen... then looks at me... then looks back at Stephen. Suddenly, a slight smile peels across her face.

    As she looks at Stephen, she references me and says, "He's been pulling my leg!" and starts laughing.



    Stephen, unaware of what's going on, politely joins in with her laughter. Like a compliment of the Grinch (who thought up a lie and thought it up quick), I saw my salvation in a way to omit the truth... and omit it up quick! I released that pent up awkward energy into a big laugh, patted Betty on the back, said something like, "Oh Betty, you're fun to joke with," and walked my butt out of that room so fast I left smoke.

    Honestly it could have been a lot worse.

    So what's your awkward story?

  • Mar 1

    Hello all!!

    Haven't been around in awhile, lots of things happening at school that are keeping me busy, busy. And now I have some sort of stomach virus and the kicker, I have no subs!! I don't know if this is a private school thing or not but we have no back up. And they usually want me to find the sub which is ridiculous. At least it is an early dismissal today. Wish me luck. =(

  • Feb 24

    Intervention is a must...KY jelly on the palms, stick a phone receiver in their scrub pocket - wake em up and tell there's a call for them, tape a sign on their back, or cotton balls, or a kerlix tail. Let your imagination be your guide.

  • Feb 24

    Quote from Sour Lemon
    A few weeks ago, the AN facebook page posted a meme of a nurse telling a patient, "Trust me. I can tell the pharmacist more about the medications he is giving you than he can."
    This is the type of social media nurse bragging thing that I cannot stand. I see stuff like "I know more than doctors," too, and it's like... nope. No you don't. Absolutely not. Doctors and nurses (and pharmacists, for that matter) have totally different knowledge bases and while there may be some things you're more equipped to handle than a doctor is, it's very unlikely that you actually know more about treating complex disease processes than a doctor does. UGH. And you don't know more than a pharmacist does, either. Period.


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