®Nurse, MSN, RN 13,242 Views
Joined Feb 26, '08.
Posts: 1,140 (63% Liked)
Eating is a hobby...
Valium and Ativan were not counted in the drug count
Glass IV bottles were the norm.
Reyes Syndrome was new.
You actually had time to feed a patient.
Heat lamps were used on decubs
Treatment and med pass 1"X1" cards were color coded per shift so you would know what was due and when.
Shift report was given by the head nurse who read through the patient names on the kardex along with their whole life history in a nutshell.
The patients hairdresser could walk in and inquire about the patient and no one would bat an eye.
You could score a breakfast tray a lot easier if you were hungry.
The hospital provided coffee, toast, butter and jelly for the break room.
Central processing would try and resterilize anything they could get their hands on.
They would Not tell you the sex of the baby if you had an ultrasound. (Just a bunch of Killjoys)
It cost around $3000 dollars total to have a baby!!
We all just take turns. We are a level 1 PACU, so we have a Primary and a Secondary RN per patient. We function in teams for the day, so both nurses will take turns being primary and secondary RN. As far as the CNA goes; we do not have a CNA in the PACU. No one is really deciding who is getting the next patient coming out from the OR except the nurse-teams. It’s really hard to hide the fact that you’re sitting there picking your nose while another RN team is taking patient after patient.
I think that people develop different coping skills as well as technical skills at their own unique pace. Sans a rigorous rubric/scoring tool that evaluates a person for the daily grind of the floor, the whole definition of “fit” is dependent upon the sole observer.
My hospital requires an interview for every single position change - be it from nights to days, part time to full time, unit to unit, or floor to management. With each opportunity, the interviewee is evaluated based upon a hiring panel as to whether or not they are a certain caliber or not.
It just doesn’t seem right for one single, solitary person to decide whether or not a person is a “fit” for that particular specialty. Something like that should require more than a few people to weigh in and give merit to the observations that are being seen.
How does an RN working at home minimize the profession?
Personally, I’ve found that I can only tolerate a month or two of the undesirable behavior before I start to catch myself falling into the same cattiness that I abhor (hence, taking a long break), or finding myself being appalled at what is stated and condoned on this site. I think it is a form of a defense mechanism that spreads like the norovirus among posters once you reach a certain exposure of postings.
Hoping that all people can conduct themselves in a manner that the profession of nursing SHOULD be elevated to is a noble endeavour. However, human nature is not going to allow perfect behaviour as much as it is so desperately needed to be demonstrated.
I just heard my Mother’s voice in my head finishing up this post with the saying “If you can’t stand the heat, get out of the kitchen”. lol.
1. Mathematically Challenged Family. The notice over the phone that you called to get access into the ICU says "Two Visitors at a time" for a reason. Do you REALLY a think I won't notice TEN of you at the patients bedside? I can't see the vent, nor the patient because I can only see You all.
2. Bondage Averse Family.
Yes, I really DO need you to STOP taking Dad's wrist restraints off because this is the Second time that he's needed to be re-intubated because he pulled his ETT out, and don't even get me started on how many OG's I've had to reinsert because of you.....
3. Sedation Vacation Family.
Please, for the love of God ~ stop trying to get my patient to wake up. As I've explained numerous times, I am trying to Sedate you loved one. The fact that you are shaking him and yelling in his ear is only going to hasten kidney failure from the ever-increasing doses of sedation that I'm having to give him because of you.
If it helps; In California, the mandatory ratio of RN to Stepdown patient is 1:3. In the past, I've worked in an ICU stepdown unit with post cardiac, level II trauma, and your obligatory sepsis, DKA and ETOH'rs that were supposed to be more "stable" vents and what-have-you.
A vented patient's alarms cannot be put off like a call light for the bathroom. If you add hourly blood sugar checks and insulin drip titration, a delicate drip titration on a gorked-out ETOH'r, a need to address a CVP of 1 in a septic patient, a sheath-pull on a post-op heart cath and the vent alarming in the other room...... Things can get hairy very quickly.
The trick is to know what management expects of the nursing staff. If you find out that they make every attempt possible to prevent the scenario that I gave above, then 5:1 can be do-able. If they cannot state what their parameters are for acuity purposes, then do not put yourself in that environment.
It is so critical to be able to see....then understand....then act with increasingly quicker response times as a new grad. If you are constantly drowning, you're really not cementing the lesson for further use like you could otherwise.
This is my second time to post on this thread.
Having been an LPN (and an LVN) for numerous years before bridging to RN. Then having been an RN for about as many years while working in critical care, and then going on to get my MSN, I think I can speak to both sides.
What I found, is that if you put an RN and an LPN/LVN side by side and gave them the same tasks, they could each state that they did the same thing. The perception is that the scope of practice is the either the same, or extremely similar.
As you get more and more in to critical care, trauma, etcetera, the tasks that can be performed by both become more and more dissimilar. The perception is that the scope of practice is vastly different.
Depending upon where you stand within the spectrum of same-versus-different as noted above, you may have a different perception of RN versus LPN/LVN.
Just because you might know how to fly an airplane, does not mean that you can legally fly one. The whole purpose of having a license is to demonstrate competency to show that you’re capable. If you have an RN license, then you’ve passed a competency in order to call yourself an RN. If you have an LPN/LVN license, then you’ve passed a competency in order to call yourself an LPN/LVN.
I think the RN versus LPN/LVN debate centers around flying the airplane. (I’m talking in metaphors here.....) You can talk all day long about how you can fly one in this State, or that State without a pilots license, or that you can fly one at certain hours of the day, or under special weather conditions, or that you’re perfectly happy where you’re at with learning how to fly the airplane, or that someone just gave you a lot of money to learn how to fly an airplane. However, until you have demonstrated competency that you can pass the exam, there-in lies the rub; you are merely talking, and have not put your money where your mouth is. Not only that, but you snub your nose at those who have went through the effort to GET the pilots license to begin with.
Worst of all: You put yourself down, because there is nothing wrong with being an LPN/LVN.
Again, I have spent numerous years as an LPN, and then some more as an LVN. I speak from experience. I’ve endured years of hearing ALL of the disparaging comments that ignorant, rude, and hateful RN’s could think of to say to me. I’ve left work in tears at the end of the day, from the mean things that were said because I was not one of them.
Physicians, and ONLY Physicians have earned the right to call themselves Physicians. That is the title that they can legally lay claim to. Anyone who earns a Doctorate, be in PharmD, DNP, DNSc, PhD, etc, can call themselves a Doctor.
I dont like med surg. I like taking care if patients medically too. I hate being at a job and can't even use the bathroom. How do you enjoy a career like that. Thats why Im doing a year in med surg, then going to different department, either ER, OR, L and D.
I've been on numerous interview panels for ICU positions.
Be prepared to discuss how you handled a critical patient and what was wrong with them.
Talk about how you used your critical thinking to address your patients issues.
Good luck to you
I'll never be able to look at my laundry room linoleum floor the same way again. To think it was once a roll of cold linoleum.
Kaiser compiles the latest EBP into an algorithm that the RN uses, along with the nursing process and a heavy dose of critical thinking to work through the patient phone assessment in order to arrive at the safest outcome.
Even with all of the safe guards built in, if an RN doesn't explore the right symptoms, or has a lapse in "active listening skills", the algorithm will fail.
You utilize a combination of both to guide your advice.
You are forbidden from giving advice that is not listed within the established parameters. You cannot "go maverick" with a personal tried-and-true method of addressing an ill. You must only utilize the established evidence based practice methods. (i.e. honey for a continual cough, versus standing on one leg and holding your head back while jumping up and down).
There is precious little room for creativity, and it gets old, very quickly, taking call after call after call, while regurgitating a rote fix for someone's ills.
.....and then, there's the special little snowflakes (I don't want to go there....)
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