Content That Chaya Likes

Content That Chaya Likes

Chaya 7,100 Views

Joined Mar 5, '03 - from 'Bosstown metro area'. He has '15' year(s) of experience and specializes in 'Rehab, Med Surg, Home Care'. Posts: 1,119 (19% Liked) Likes: 487

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  • Sep 19

    How about the two of you go in together, work as a team and clean it up,
    mess is gone.

  • Sep 19

    Why not quickly clean it up together? We do bedside reporting or at the very least introduce the pt to the oncoming nurse and do line tracing. It should be at this time when the mess is discovered. Personally I would hope both RNs would help to quickly tidy up the room- both are on the same team. If the mess was made by the off-going RN that would be a totally different story, but it's still not something I would make a big deal out of (unless it was a habit).

  • Sep 19

    This is the kind of nit-picking issue that leads to unecesary shift wars. On-coming nurse just needs to pick up and move on, not waste time and energy chasing off-going nurse around and nagging her about it. It would be different if off-going nurse made the mess herself or if she was sitting around making small talk at the change of shift, but that wasn't the scenario.

    The person responsible for the mess is the one who made it. As a lifelong night nurse, I've picked up after a busy previous shift more times than I can count. Got no time for kid stuff.

  • Sep 15

    Hi Nurse Beth,
    I really got terminated during the probationary period with 4 months of OR nursing experience (both scrubbing and circulating). My preceptor hated me and gave me a bad evaluation. Can I list my working experience with new job application? I heard OR nursing is very high in demand and most places would hire one without much interview process. Is this true?

    __________________________________________________ __________________

    Dear Got Termed,

    I’m sorry to hear that. It’s a devastating experience to get fired, and more so when it’s unfair. Situations are not always black and white, but mixed, and so do take some time to consider the performance aspects of your bad evaluation that may have a shred of truth in them.

    It could be that your preceptor both “hated you” and also used some areas for improvement against you. I just want to set you up to have a successful experience next time, friend.

    Your job application will most likely instruct you to list previous work experience. If so, you should list it and then plan how you will speak to a short tenure when asked.

    It’s best to be brief and segue positively to the future “It wasn’t a good fit and I look forward to using my skills in an organization that better matches my values”. Avoid saying anything negative about the preceptor or organization.

    Experienced OR nurses are in high demand, yes, more so in some areas than others. A hiring manager may well see 4 months of training as a benefit, especially if you make a good impression during your interview.

    It’s not necessarily a good thing to be hired “without much interview process” because a good employer will want to select the best applicants to join the team- and you want to work for a good employer.

    Don’t be afraid of the interview, or feel “less-than”. You have marketable skills, and you may thrive in your next position. Let’s hope you do!

    Warmly,

    Nurse Beth

  • Sep 14

    Wait until you get a job before you buy more scrubs. Some require a specific color, some let you wear anything. I got a few scrubs tops at uniformadvantage.com for less than $10 in the clearance section. I'm sure other scrub shops have similar deals. Walmart carries scrubs too. You could try goodwill or resale shops too. Good luck!

  • Sep 14

    Quote from Emergent
    Do you have solid evidence to support that statement?
    Took the words out of my mouth.

    I shower before work (nights). After work, leave the shoes by the door, get in PJs, wash face, brush, & hop in bed.

    I keep up good hand hygeine & standard precautions at the hospital and honestly don't feel any more "dirty" or "infectious" after work than after, say, a day with my kids at the mall.

    Of course there are exceptions, such as any major splashing of body fluids or such like.

    By the way, I call the sink-wash-up a "bird-bath" or "pits and bits".

  • Sep 14

    Quote from TheCommuter
    In the morning I lather up the 'hot spots' with a quick PTA wash (pits, tits & @&#) for some cursory hygiene, then I take a full shower or bath at night.
    FACES & FANNIES, PERIs & PITS.

  • Sep 14

    Quote from JBudd
    Oh Evastone, I can't do names for the life of me. I have a hard time recognizing people I've worked with for years outside of work. Been that way my whole life, I stuggle with faces and names. I love badges! but ours are so often flipped over, not intentionally, that I just wing it. Not with madeup names but simply don't use them. Makes it hard to complement or complain about someone, when you can't come up with their name.

    So my peeve is at myself and those darn badges that won't stay face up!
    Our badges are doubled so that if it flips over our name is still facing out. Mine would forever be flipped the wrong way of we didn't have them like this!

  • Sep 14

    I would just say "I want to maintain professionalism and prefer to keep my work and personal life separate." Seems kinda odd. Was this patient long term enough to want to get to know you on a personal level?

  • Aug 31

    Quote from blondy2061h
    Adrenaclick is available in the US for around $100, too. Your doctor just needs to prescribe that one instead of "epipen." I think suggesting people try and draw up 0.3 mg of epinephrine in a syringe from a 1mg vial with almost no practice while in distress due to an emergency is asking for trouble.
    I've seen complaints about Adrenaclick because it leaves the needle exposed after injection. Seems like a minor concern given the context of the use of the device, but still, it's a concern.

    If they went with the vial/syringe route, couldn't people draw up the correct dosage ahead of time and just carry a loaded syringe around with them in a pen case or something? They could make a new one every week, if contamination was a concern, and still come out way ahead in terms of cost.

  • Aug 31

    Adrenaclick is available in the US for around $100, too. Your doctor just needs to prescribe that one instead of "epipen." I think suggesting people try and draw up 0.3 mg of epinephrine in a syringe from a 1mg vial with almost no practice while in distress due to an emergency is asking for trouble.

  • Aug 11

    Well no duh!!! Of course if your patient looks horrid and the monitor doesn't reflect that you should most definitely perk up and do some investigating.

    Im regretting this post!

    Your assessment skills can fail you just as badly as a monitor can, we have to use ALL THE DATA at our disposal.

  • Aug 11

    "Look at the patient, not the monitor" doesn't work for me either. I've seen plenty of patients that look fine chatting away with a CI of 1.8 or an SBP around 200. So...as long as my equipment is calibrated correctly and not being assessed by someone who doesn't know how to properly use the devices, more often than not, I believe what my monitor tells me 100%.

    Your story is interesting and it sounds like it made for a terribly stressful day. Seems to me there may have been a failure in protocols. Did anyone check a pulse or responsiveness? Even if a monitor shows a shockable rhythm you still follow the BLS survey first. It also seems odd that the monitor in room A (which was presumably hooked directly up to the patient in room A) would show data from a different room. I'm no IT guy for sure, just seems very odd.

    I'd say my point of view only works if you know what you are doing. It doesn't work if you put the wrong size BP cuff on a patient, or if you have bubbles in your pressure lines, or if you don't check your patient's pulse and responsiveness when you have some strange artifact that often does look fib-ish.

    I just find this old expression to be only mildly useful. Of course you use your intuition and assessment skills, but the notion that you should treat based on what you see over data drawn from high-tech equipment seems a little over the top.

    I think treating the patient and the monitor should be on an equal plane....use all the data you can get.

  • Aug 11

    Quote from jk2185
    This is my least favorite "go-to" that I hear all to often. Why even have monitoring in the first place? I trust the monitors more than my own ability to intuitively know a patient's condition based on my limited assessment skills; and just to ward off evil comments spawning from this notion I want to remind everyone that we all have limited assessment skills, our senses can only do so much. And of course, if your monitor screams asystole or vfib and your patient is smiling at you politely asking for more apple juice, I do hope that we all know to check lead placement or something.

    We didn't have numbers 100 years ago and look what kind of healthcare we had...not the greatest.

    I just wish we could flush this saying out or maybe change it.
    Numbers have been around far longer than a century. Just saying.

    I'm sorry you dislike the expression. Does "look at the patient, not the monitor" appeal to you instead?

    Years ago -- decades ago, actually -- I worked in an old, decrepit hospital. A brand new hospital was built, and many new nurses were hired to staff the additional beds the new hospital afforded. Moving day came, and we moved into the MICU with it's bright, shiny new, state-of-the-art monitors. The first patient was moved in and hooked up to the monitor with a lot of fumbling because the monitors were new and unfamiliar. The second patient was moved in and also hooked up to the monitor . . . And so forth. Not long afterward, the nurses were gathered around the nurse's station when the monitor alarm went off. Patient 1 was in ventricular tachycardia. Everyone went rushing into his room with the code cart and code drugs, following accepted ACLS protocol. The rhythm deteriorated from ventricular tachycardia to ventricular fibrillation to asystole, despite the interventions. Then a wondrous thing happened . . . The patient began to strenuously object to defibrillation and chest compressions despite the asystole on the monitor.

    During the construction process, somehow the monitoring wires in the two adjoining rooms was crossed. Patient 1 wasn't in asystole; Patient 2 was. And because all those brand new nurses and former medical students (did I mention this was July?) were treating the monitor instead of the patient, a patient died. And the patient they were treating had some pretty bad burns and broken ribs.

    Use your judgement. Sometimes, the monitor can alert you to the beginnings of badness before anything else will alert you. Other times, the monitor's malfunction will send you careening down the wrong path. According to Samuel Shem in "House of God," the first pulse to check in a code is your own. Maybe you like that expression better.

  • Aug 4

    Not allowed to ask employer if you were terminated; they get around that by asking"would you rehire this person" That answer kind of tells the story


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