NM nurse to be 3,892 Views
Joined: Sep 22, '08;
Posts: 174 (51% Liked)
; Likes: 204
Just before everyone started taking a treat she said "I hope you will like the brownies. I used some of the milk from the breast pump"
how about when a patient calls to ask to be repositioned/made more comfy in bed.... you spend 15 minutes fluffing their pillows and placing them in JUST the right spot, wrapping warm blankets around them, scooting them up in the bed, getting the HOB just right.... and then you hear the dreaded words... "You know, I think I have to go to the bathroom!"
it is sooo hard to keep a smile on my face and say, alright let's go... *sigh*
Hehehe. When I read this post I immediately thought of Chris Rock saying "there is NO sex in the Champaign Room!"
All joking aside, In the LTC setting, you're basically working in their home. Sex is healthy, and if they are able to give consent I say let them have fun. It will save you having to give them anxiety medications later on in the shift. You may have to give them something for pain, though!
It's best just to turn around, walk out, and shut the door. The good thing about LTC is you'll know the residents well after awhile, and you'll know who is capable of giving consent.
When I give my notice they are going to be angry, but not suprised. I know they wont have me finish my two weeks, but I plan to give it. The last two people that gave notice left the directors office crying after she screamed at them. I will not be crying. I will probably smile all the way home and then have the best sleep of my life. I am trying to hold out as long as I can, I have an interview next week. I feel like it is easier to find a new job while you have a job.
Chances are a poorly run facility is known for just that and a reference from such a facility doesn't exactly unlock doors. Sounds like just the thought of it makes you feel ill.
Although I do LOVE that my post is sparking such interest and getting people talking, remember that in my case, I need to be able to find evidence-based nursing journal articles and write a paper on the subject. I don't mind if you continue to discuss all of the various questionable actions you've seen, but if you're trying to answer my question, it needs to be something that somebody might have actually researched and written about, and I can write a 6-page paper on.
Thanks guys! Keep up the discussion!
"Will this clueless nursing student feeling ever go away?"
Yep, it will. But then you will have the clueless new grad RN or LPN feeling.
I'm a new grad about three months into my new job. My advice is to don't worry about what you don't know. You would never be able to see everything in school that you might run across on the floor. And, once you are working, it is luck of the draw (also depends on what kind of unit you are on) of what you might see. You might see ostomies right away, or be like me and still have not had one to care for. I'm on a unit with high acuity and getting valuable experience. However, there are very few things I am proficient at. Counting school and my job so far, there are even some basic things I have only done a handful of times, including starting IV's and foley's.
School gives you exposure to things, but doesn't teach you to be an expert at anything. The most important thing you should learn in school is how to be safe a safe nurse. The technical skills will develop over time.
Realize you won't be able to do everything right off the bat, and you'll be slow at some tasks. Don't beat yourself up for it. I agree, the mentor and/or preceptor can really make the transition easier (or harder, if they are not a good preceptor!). Remember your school training gave you a way to think, and you'll always have that, no matter what the task. Remember, basics really are important! Take your time and think things through. Smile as much as possible, even when you are nervous inside. Every day, I think to myself, "I am going to learn something great today". That gives me a mental framework for starting my day, and I've been surprised how much that little saying can influence my ability to be calm and take things as they come. As others have said, ask questions. Lots of them! If you find a nurse who doesn't like your questions or sighs, move on and find someone who can answer them in a patient way. Never pretend you know something you don't; your patients depend on you to do the right thing for them.
P.S. Every once in a while, look down at your ID badge, see the "RN" after your name, take a deep breath and smile. You made it!
Take advantage of your preceptor every chance you get when you start working. Watch, listen and learn. Ask lots of questions. Don't expect to know everything...ah heck, don't expect to know even 1/2 of what you will learn. Remember your basics and don't sacrafice your principles. Keep out of the negativism and stay positive. Recognize who you can trust to answer your questions correctly and who will be there to help you when you need it. Its a scarey thought when you walk onto the floor the first time and you realize that you ARE the nurse. When that patient yells "can you please send my nurse"..thats YOU, its scarey. You CAN do this, you were educated to do this, you are good at this. If you doubt yourself, surround yourself with those you can trust.
We never stop learning, I think that is the biggest and best advice I can give. Every day we learn something new. At the end of every day, while walking to your car, think "what did I do well today?" "what can I do better tomorrow?". We are always evolving. Enjoy the first steps of your next journey!!
It really bothers me, as a student, that there seems to be a mass opinion that all nursing students don't care, don't want to be there, and don't want to learn. I work my tush off and really don't appreciate the generalization. I don't judge all nurses on the bad ones I've encountered, so I wish people wouldn't judge me because of the bad apples.
I like students. I attribute their standing around and looking lost to their being, well, lost. And terrified.
I have one for nurses--
When we show up eager to learn (I'm a student), and before we have a chance to prove we are serious about wanting to learn and help, we get eye rolling, sighing, and muttering under breaths of "Ugh! we have students today!". It is the worst part of my day, to show up knowing that someone does not want to work with me. I've had nurses who try to ditch me, who don't believe my assessments-- for example when I saw that a client's IV had infiltrated his hand, who send me to do some task and then passes all the meds or does some interesting procedure while I'm gone even though I verbalized that I wanted to help/observe.
Usually I end up winning them over by showing how I am willing to work hard alongside them, do a lot of the CNA work, the dirty work, and treat the patients like human beings. I have always been a hard worker and an eager learner, and act professionally, but when I am given the signal loud and clear that I am not wanted, it's very very hard to do *my* work as a student. I only have a precious few hours to learn in that department. I learn best by watching and doing, not from books, so if you get a student, just realize they may be a good one if you give them half a chance. :-)
I know we slow you down, get in your way, ask dumb questions, but we have waited a long time to get into nursing school. I know that my patients' lives depend on me. Train me well, make me feel relaxed enough to learn.
One piece of equipment I use when cathing females is a miner's/camper's flashlight; the one that sits on your forehead with a strap. It looks like I am going mining. I am! I can point the light exactly where I need it.
One thing I do that allows me to get it on the first try nearly everytime:
I have a second person hold a flashlight in there. I know it sounds ridiculous but it makes everything sooooo much easier. I pull the labia apart, get my helper to shine the flashlight in and then have my pt. cough. You can see the meatus wink at you every time
I've done more than my share of caths on large women during my time in the ER and have found a few things that seem to help. Like the other poster said, take help. The other nurse can help spread the labia and help spread the legs further apart. Put the patient in Trendelenburg position so the abdominal "apron" falls back towards her head and out of your way. Be aggressive with your swabs. I've found if I apply a little more pressure when cleaning, sometimes the meatus seems to react to the cold and pressure and shows itself. And lastly, don't be afraid to really get in there. I've worked with many new nurses who were very tentative about moving the tissues around. On us larger ladies, the labia get fat just like the rest of us, and the meatus can be much deeper. Don't be afraid to get your hand in there and spead til you find it. You aren't going to hurt her. And lastly, PRAY!
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