Content That adpiRN Likes

Content That adpiRN Likes

adpiRN, BSN, RN 8,824 Views

Joined Nov 2, '08 - from 'South Carolina'. She has '3' year(s) of experience and specializes in 'L&D'. Posts: 359 (27% Liked) Likes: 188

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  • Apr 3

    Do you understand that FNP scope includes pediatrics?

  • Feb 21

    Adult Med-Surg has nothing in common with NICU. In fact, I think starting in med-surg is only going to make things more difficult for me as I have to practically erase everything I have learned in my first job.

    Two years or even one year wouldn't have helped me in the slightest in NICU and just about every single NICU nurse I know who has made the transition from adult med-surg to NICU agrees with me.

    Quote from Ruby Vee
    A solid two years -- or even one year -- in Med/Surg would have been better.

    I took the "Princess attitude" comment to be reference to new grads who don't want to put in one to two years at the floor which first gave them their chance to show what they were capable of. Those who want to get the "dream job" without having to put in their time learning the basics. People who were sure they were being victimized if someone else got the job they were convinced they "deserved". We see a lot of that here on AN.

  • Feb 21

    I've worked as an RN for 17 years. Not once have I had to write a nursing diagnosis.

  • Oct 30 '15

    If you are going to have an asthma attack, what better place to be around (hospital) or people to be surrounded by (nurses and doctors)??

  • Oct 30 '15

    I rarely sit, but I do pee every 15 minutes because I live in constant fear that **** is ABOUT TO GO DOWN and this very well may be my last chance for the rest of the shift lol. Truth.

  • Oct 29 '15
  • Oct 29 '15

    I daydream about my upcoming vacation when I don't feel like going to work.

    Or I tell myself, "It's only 8 hours. You can do anything for 8 hours."

  • Oct 27 '15

    There's an awesome documentary called "Little Man" that I would recommend. It's probably about 10-11 years old.

  • Oct 27 '15

    People who come into large sums of money suddenly have a bad habit of ending up broke. The prevailing wisdom is that the stock market has about a 7% return on investment per year over long periods of time... so I'd turn it over to a firm like Vanguard and give myself a $70,000/year allowance (paid weekly, naturally) and supplement that with a part-time job. Just to keep the old neurons firing.

    I'd hire a housekeeper. And I'd travel ​everywhere.

  • Oct 27 '15

    My family income is far from the millions, but I have to option not to work if I don't want to and I still work. I work per diem and get the benefits that working as a nurse gives, but avoid the wear and tear of full-time hours.
    Even if I did get the millions, I doubt I would give up my job.
    After the thrill of winning the lottery wears off and giving away lots of money and helping your family out with your winnings, and dodging those who would scam you, without some kind of direction or purpose in life, life feels empty.
    Working in a job, (even the most part-time) gives a person a purpose, a feeling of competence, a feeling of independence that comes from being able to support yourself. Working with the public keeps you from living in a bubble, cut of from reality.

  • Oct 25 '15

    NP, my dear. It's NP you want. And it is a fantastic career choice.

  • Oct 25 '15

    Nursing school before PA school is not "working your way up". They are two completely unrelated fields and one does not lead to the other.

  • Oct 18 '15

    Quote from SimplisticRnx
    Hi OP. Just wanna follow up with you on any luck with finding your dream job?
    Hi, yes I did finally get a PP job! I just started orientation sept 30th. It's going great and so far I love it!

  • Oct 17 '15

    OP, you have some really good advice above. As an L&D nurse, I deal with everything from miscarriage to fetal demise to neonatal death fairly often. The points below are a few things I have gleamed over time.

    (Please note that as previously discussed, these measures should be gauged based on the response of the parents and/or their expressed wishes for how they want to be approached. With little exception, however, parents will appreciate it if you take the steps below).

    1. Refer to baby by sex if possible. Use the appropriate pronouns (he/she) and try to avoid calling baby "it" as this dehumanizes baby and also reinforces that baby is deceased (most people would never call a live baby "it"!). If the sex is ambiguous or undetermined and you feel comfortable doing this, ask mom if she thinks baby was a boy or girl. Sometimes, mom and dad will already have been referring to baby as one sex or the other. See if you can get onboard with that trend.

    2. Refer to the baby by name if possible. Some parents will choose not to name their baby, so keep this in mind if you inquire as to baby's name. Be ready to turn on your heel and validate the parents' decision not to name the baby if this is their choice.

    3. If you are physically handling baby, treat baby like you would any other infant. Talk to baby, hold baby like you would any other, comment on baby's clothing, etc. One of my coworkers lost her baby at 36 weeks and still remembers that the nurse caring for her patted her baby's butt while holding her--a small but almost unconscious reaction to holding a baby. This not only models healthy bonding for the parents, but it reinforces that even though baby is no longer living, baby is still a baby.

    4. If appropriate per the parents and you feel comfortable, I would argue that praying with the parents or making comments of a religious nature is completely acceptable. Again, take your cues from the parents. Let them initiate that kind of discussion or activity. But if they are looking for that kind of connection from you, that can make a huge impact not only in their care, but their overall experience. I still remember the people who were brave enough to look me straight in the eye in the midst of my grief and tell me, "I know this is horrible, but it's going to be OK. The Lord has your baby safe and sound." Those were some of the most powerful and positive experiences I had in the midst of my miscarriage.

    5. Try to support mom and dad in their decisions, but also help them see through their fear and into what they might someday want. As an example for this rather ambiguous suggestion, if mom and dad don't want to see the baby after baby is born, try to gently offer options such as pictures, clothing, and other mementos that they may want in the future. Sometimes, fear of the unknown and grief can keep parents from really understanding what they're giving up by declining to see/hold/interact with baby. In presenting this discussion to parents who don't want to see baby, make sure you explain your motivation--you're trying to make sure that they as parents don't miss out on something they might regret later. Some patients (especially if they are really bonded to their nurse) will do whatever the nurse tells them to do, even if they don't want to. Make sure you clarify--even if you have to outright say it--that you're looking out for them and you have no dog in this fight. Be respectful of course, but also make sure you leave the door open to seeing baby later as it's fairly common for parents who initially don't want to see baby to change their minds (at least in my experience).

    6. Springboarding off #5, if mom and dad are hesitant or nervous about seeing baby, be there with them to help them through. Understandably, some parents are really afraid of what they'll see, especially if baby isn't newly delivered. Help them to see baby as a little person. Point out those tiny hands, the little feet, the nose that looks like mom's, the eyes that look like dad's, etc. Sometimes, nursing plays a huge role in not only helping parents bond, but helping them to see their deceased child as one of their own.

    7. Ditto, ditto, ditto the advice about what not to do: don't say it wasn't meant to be, it's ok because they can have another, etc. Acknowledge the uniqueness of both baby and the loss thereof. I think losing a child in pregnancy is such a personal thing that other people sometimes have difficulty understanding it as losing an actual human being. There is something about being born and being a known entity that frees you from this misconception. After all, you'd never console someone who had just lost their 4-year-old by saying, "It's OK--you can have another one!"

    8. Make sure the parents know it isn't their fault. Many women will have serious identity questions to answer after a loss ("Who am I as a wife/girlfriend/woman if I can't have live children?"). It sounds a bit archaic in this feministic culture to ask those questions, but the bottom line is that the responsibilities of pregnancy and childbearing still belong solely to women, and even as much as we value our freedoms and our rights in this country and this era, the inability to perform what are considered basic functions of being female still has the great potential to cause a lot of confusion and distress.

    9. Keep in mind that addressing mom' s emotional distress can help assuage her physical pain, too. I've seen on many occasions where physical pain (which there's plenty of in a miscarriage or fetal demise) is amplified and compounded by the emotional distress of loss.

    10. Finally, if mom and dad are open to it, ask them if there is anything they want or don't want to have happen in their hospitalization. Ask if there's anything that hasn't been done that they want. Ask if there's anything that they don't want that they're concerned will happen anyway. As much as possible, just like in a live birth, tailor the experience to the desires and needs of the parents.

    11. If you do say something that was taken incorrectly or insensitive, be the first to apologize. Those parents will probably remember you the rest of their lives, but they will really, really remember you if you say something thoughtless and either refuse to own up to it or choose to ignore it. To this day, my husband and I still talk about the ultrasound tech and the midwife who were with us when we found out our baby had died. The midwife was a sweetheart and very nurturing. She was adept at not only empathizing with us in our grief, but guiding us gently through the reality of losing our child. On the other hand, my husband still refers to the ultrasound tech, who was cold, correcting and rude as "the *****".

    You have such an incredible opportunity to help these patients through something that, for many of them, will be one of the hardest experiences of their lives. All the best to you, OP. Thank you on a personal note for caring enough to ask for advice. You are already an asset to the patients who will come your way!

  • Sep 23 '15