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Nurse_Advocate 2,417 Views

Joined: Mar 21, '08; Posts: 31 (58% Liked) ; Likes: 122

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  • Dec 12 '08

    I work on a very busy L & d floor that had a long history of making life very hard on new nurses. It was brutal and many wonderful nurses were lost to blatant bullying. Finally an ingenious nurse created a Mentor program which has proved to be fabulously successful in shifting our culture to one of nurturing our new nurses instead of isolating/picking on new nurses. Each new nurse is assigned an experienced nurse as her "Mentor" once out of orientation. That nurse checks in regularly with the new nurse and acts as a "sounding board" if there are difficulties. The mentor can also act as mediator if there are issues with another nurse. After 6 months working on her own with the support of the Mentor, the new nurse has a "shower" thrown for her where she is bestowed with words of support and encouragement, "cut" from the support of her Mentor (long red licorice cords--what can I say, we're OB nurses) It brings everyone together in a culture consciously choosing to be gentle and supportive with our newbies. It has made a world of difference to retention. Makes us old nurses feel pretty good, too!

  • Dec 9 '08

    i have this pt that is in renal failure and elected not to do dialysis. last night i cut her toenails for her. they had grown so long the literally curled almost back into her toes. while cutting them i noticed she had the remnants of polish on her toes. she told me she'd always wore toenail polish until she got this sick. i took some polish to work with me today and tonight i suprised her with a pedicure. i filed her toenails, massaged her feet and legs with lotion and then painted her toenails a pretty christmas color. Pretty toes for christmas! it's going to be her last christmas ever and i wanted to make her smile.

    her daughter and son walked in tonight while i was doing the pedicure.

    it was the smile on my pt's face and the hugs i got from her children that added an extra bounce to my step this evening.

    making a difference in people's lives...even small what i love about nursing!!!

  • Apr 30 '08

    Dear Friend:
    I God, I know. Any PICU nurse who has spent more than a few years will echo your experiences with empathy. I appreciate your candid admission about substance abuse. Let me assure you, we are all abusers of something- food, alcohol, shopping, drugs. They all serve the same purpose, to make us forget for just a little while that our jobs really suck at times. We remember the victories, which are our salvation. But we are haunted by the tragedies. I have flashbacks of the 4 year old meningicoc meningitis who was dead within 2 hours of admission. The indescribable color of his skin, purpuric and bloated from fluid. The permanent indentation of his sternum from endless compressions. The bloody oozing from every stick and every orifice. And worse of all, the wrenching cries from the mother and father who had to see the futility of our work and the violence left behind. That I could forget those moments forever.
    I also have the memory of promising an anxious mother who accompained her chronically ill child in respiratory distress that once we assisted her breathing with a vent, that "everything will be just fine- I promise." Little did I know that her daughter would be successfully and uneventfully intubated and 2 minutes later be in full arrest- and die, after 2 hours of desperate interventions. We did everything right, and she still died. I sedated an awake, talking child who was terrified and hypoxic (she had an extensive cardiac hx) telling her I would take care of her and she died under my watch. Walking in with my most respected and competent attending MD to tell this family their child was dead was the pinnacle of horrific anguish, clinging to the mother, sobbing I was so sorry- I had broken a promise. Everything was supposed to be okay and.. it was not. From that day on, I never make promises to my patients. The feeling of responsibility haunts me to this day.
    Friend, if those things don't do damage to our hearts and souls, I don't know what will. It is by the grace of God we persevere. Only through sharing our stories will we realize we are not alone. Silence is deadly. I realize I have not shared that story with anyone, the shame still is so near and real for me.
    You will have my prayers. Please do the same for me.

  • Apr 21 '08

    Kind of like the day I went into work and found my young resident (40+ yrs) sitting up in bed rocking. She doesn't really talk, so I asked her to lay down and what do you know, she looked 4-5 months pregnant with urine. Her bladder was so distended it was awful. She had a foley in, but for some reason noone had notice little to no output for appx. 24 hours. Her BP was 210/140 something, her pulse was 160+ and she was as pale as could be. I immediately pulled her Foley and straight cathed her and got 1700cc's out and her B/P and pulse went down within about 15 minutes. She has neurogenic bladder so she has to be either straight cathed or have a foley in or you know what happens. I guess noone wanted to deal with it for 24 hours prior to my shift. I know we all make mistakes and miss little things, but if I do something like that I give the nurse who catches my neglectfulness permission to kick my butt.

  • Apr 21 '08

    wonderful message.. i'm pretty sure u really got a big heart. you are truly a nurse by heart

  • Apr 21 '08

    I retired from the VA hospital after 34 year of nursing care to our Vets. and can say that we as Nurses are in the best position to carry out GOD"S will of helping others.
    I was able to treat many CA. pt. with iv chemo drugs and saw many pts. call upon their higher power and the nurse for confort and guidence.
    We were put on this earth to reach out and help others in need and in that process GOD is blessing us. Stress can be reduced when you know that you are doing GOD"S will in our lives.:bowingpur

  • Apr 17 '08

    I hate to say it but I would probably from there on out be somewhat judgemental of that last nurse - you know, going over EVERYTHING with a fine-tooth comb after getting report from her b/c you know things have not gotten done.

    Nurses like that are the reason I love the concept of walking report - you have the chance to at least get a cursory glance of the patient and get to hold that nurse responsible for at least the immediately obvious things that need to be taken care of (empty IV bags, pain needs, etc.).

    One thing I do wonder about is, why did the MD not just go ahead and order for the NGT to be placed (non-elective) when he saw her on his rounds. A patient does not just suddenly develop massive abdominal distension. Did he not do a patient assessment? Sadly, I have seen docs come in and write a progress note without ever even laying a hand on their patient. Heck, I've even seen one write a note and not even go in to talk with the patient!

    Nurses like that give the term "nursing judgement" a bad rap. I guess that MD had more confidence than he should have in those nurses.

  • Apr 15 '08

    Quote from ms kylee
    i got tattled on one morning. i was working my side of the unit, and a student nurse came to me and asked if i could help her walk her patient to the bathroom. patient was an assist x2. since i can't say no, i went to help. when we got there, the patient had an accident and messed up the bed. student went to get a bed change and stuff to clean the patient up. i started cleaning the patient up with what i had available in the room. turned out to be a half hour, 25 washcloth cleanup, bed and gown change for the patient. when i got back on my side of the floor, all of the nurses and the unit director were standing around the nurse's station. someone had tattled that i couldn't be found and i wasn't giving my patients baths. of course, nobody came to me and asked me where i was, but right away went running and tattling.

    i learned a lesson that day... that my unit has no teamwork and you get your butt in trouble for helping out.

    you know....i have noticed that too. when i would do the same thing and after being in a room for a half an hour or more - sometimes the patient had a meltdown and you couldn't walk out on them. sometimes they had questions so teaching began right then and there regardless of what was waiting for you and sometimes it was what you described. then when i walked to the unit another rn that is a total alcholic and stressed about her deadbeat husband and thieving step son at home would say....."where were you?"

    i can't spend the rest of my life saying "i didn't do that" or "i didn't say that" and i can't keep trying to answer to or defend myself to miserable people that need to look at themselves. they are the reason that i will quit trying to do bedside care. they can figure out what to do with the nursing shortage. i am not going back to work in that environment. period. i will never shut up about what it is like but i won't be a part of that any more.

  • Apr 15 '08

    Quote from violet888
    Dear BrokenRNheart, please review why you are an RN. Self-esteem positive. You made your choice to work as an RN and do not let others dictate your career, even the bullies.
    Maybe somewhere else. All I know is the thought of working in that atmosphere again makes me want to puke. I am so done with it. Over it. Never want it ever again. Won't kid myself. I have seen way too many people in that area of nursing that are the reason for the shortage. They will continue to work there and chase people off and the shortage will continue. Period. Until they change the dynamics it is going to keep going on and wearing people down.

    Wore down.....moving on.

  • Apr 9 '08

    ability to share my knowlege with others so can help decrease someone's pain, suffering or prevent complications...
    helping to arrange services so a person can remain in their castle: HOME rather than hospital ....
    networking with others......
    learning somthing new everyday so never ever bored!

  • Apr 7 '08

    good writing you guys


  • Apr 7 '08

    Quote from Nurse_Advocate

    Nurses, if you do nothing else, start living outloud!
    My excuse for shutting down and shutting out was always, "But I have to talk to and be around people ALL DAY LONG! in the most intimate ways imaginable! YUCK!"

    I do a lot better now by some of the ways you described. I'm glad you wrote the article, you write very well!

  • Apr 6 '08

    Ya know, if it was worded a little differently, say something like "Handwashing saves LIVES" or something along those lines, I could get on board with it. The "Ask me if I've washed my hands" kinda leaves a bad taste in my mouth; it's along the lines of "Ask me if I coughed on these pills I'm giving you ( I mean, if you've gotta ask, what are the chances of getting a straight answer?)

  • Apr 5 '08

    This makes me feel better when I write with solutions...

    Thank you,

  • Apr 5 '08

    Fantastic article on a needed subject! Thanks so much!