youngvil 1,472 Views
Joined Feb 15, '09.
Posts: 17 (24% Liked)
This is in reply to the nasal airway in the mouth: I do use this and have seen it done. They are softer and it works with less irritation of the gag reflex. I have had one CRNA that does it and it works . "Is my surgery all done? Did it go OK?
What time is it? Can I have a drink? Can I eat? "
This is asked in a Q 5 min LOOP I wish I could play back my same answers on a loop.
Okay, I may be comparing apples to oranges. I currently work out patient surgery (I have worked main OR PACU and ICU.)
99% of our patients come out from OR easy to arouse. I know out patient surgeries are "lighter" than a main OR but my gut feeling is a good anesthesiologist can control the sedation/anesthesia effect to coincide with the surgeries start and finish.
If a patient comes out with an airway the anesthesiologists stays with the patient. We used to have a great, nice, "older" anesthesiologists who's patients almost always came out with an airway. The "young" newer generation of anesthesiologists rarely have that happen.
A Nurses Christmas
T'was the night before Christmas
& all through the floor,
The Lasix was filling the foley's galore.
Stockings were worn, to prevent emboli,
They came in two sizes: knee, and thigh-high.
The patients were nestled half-assed in their beds,
While visions of stool softeners danced in their heads.
We in our scrubs, and they in their gowns,
Fashions created to hide extra pounds.
When down in E.R. it became such a zoo,
They called with admissions, for me and for you.
They're coming, they're going, they're looking the same,
My patience for patients is starting to wane.
Another call light is ringing, the patient expounds,
"I have not had my peri-care, please send someone down."
About now delegation seems a good plan,
We pass onto others, the needs of this man.
When what to my wondering eyes should appear,
But Santa himself, and 8 tiny reindeer.
He states that he came from Central Supply,
To bring us LR, NS, and D5.
The doctor then scribbles what no one could read,
Orders instruct us to measure their pee.
As we try to decipher illegible words,
We find a new order to guaiac their turds.
The next shift arrives; our day is now through,
Only to discover emesis inside of our shoe!
We give them report and pass on the facts,
And tell them of duoderm lining the cracks.
And the Nurses exclaimed as they drove out of site,
Let there be Ambien for all, and to all a good night!
It's wise to ask as many questions as you need to in the preop consult before you sign the consent.
My grandmother just shared this list with me, and I thought it was wicked cute!! Feel free to add your own
You Know You Are a Nurse When...
As I prepare for another eight hour shift with the "old folks," I look in the mirror and ponder..."Oh my, it is a good day...no more wrinkles have formed and nothing new is sagging. At least nothing that is within my visual range." For that reason, you will not find any full length mirrors in my home!
Reflecting back to a conversation I had yesterday about age with one of my young C.N.A's who is from an African country, it makes me smile. It is an endearing and respectful thing to be called "MaMa" and this is a usual greeting from some of my favorites. She told me that at my age if I was in her country, I would not have to work anymore and would be taken care of.
Well, do not underestimate my 34 years of nursing experience. This white haired old nurse limps on occasion, after an accident where and l,800 pound horse knocked me down and ran over the top of my right leg. I can still see the perfect souvenir hoof print.
Granted, I cannot run to an emergency unless they want me to arrive red faced, out of breathe and speechless. My gait is brisk, but upon my arrival, my sharp mind guides the nurses through emergency measures so that when 911 Emergency arrives, the EMT's are not trite and there is no doubt about our true emergency situation. As they scoop and run, taking the resident to the ER, compliments are spoken "Good job" to my staff.
Time has marched on leaving my fingertips numb with neuropathy, causing limitations for my IV skills. I look for the perfect vein, anything bigger than a toothpick, for my young nurse to insert a line with my guidance, and profound instructions. Yes...
positive results with a resident being happy, infusion started, and first time good luck.
My eyesight is enhanced by my blue reading glasses that are always ready, as they hang around my neck on a chain. Now, I have to ask the pharmacy manufacturers why they make the print on medication vials so small? This causes a ritual where one has to outstretch your arms to the proper distance, and squint one eye to assist in being able to read the directions. For safety sakes I go find a young nurse who has good eyesight for clarification. Most of the time they just smile and humor me by reading the directions, because they realize some day they may be in the same situation.
Working for the last 17 years in a supervisory capacity, one of my favorite sayings when a page comes overhead on the intercom for assistance, and of course I am on the opposite unit three hallways away, is "Patience is a Virtue." Often a "new
nurse" has a question or concern, sometimes legitimate and other times mundane. Keeping my caring mentor nurse voice, I always try to "reply/teach" keeping in mind they may be taking care of me some day. As I walk away after the problem is resolved, I reinforce my other old saying "There is no such thing as a dumb question!"
One aggravation that is intolerable to me is a nurse with a cocky, "know-it-all" attitude. As experienced as I am, many a time there has been a situation where a group decision has been made because my memory bank fails me and a young mind right out of school is badly needed. Anyone who does not listen to solid advice from their peers, or a nurse who is older than dirt-gets my comment "Go ahead-be all you can be-but I made it 34 years without ending up in a court of law with my right hand in the air stating "Yes, I swear to tell the truth, the whole truth!" Amazing what kind of attitude adjustment this comment will bring on occasion.
Yes, I am an old white haired nurse and on occasion can be overheard stating that "When I am ready to retire I can just change roles from being head nurse and check into this nursing home." Joking of course...my retirement plan is to move back out west, buy a small ranch, have friends, horses and a variety of pets to fill my idle hours with pleasure. Aptly, it will be be named the "OBR"
which stands for (Old Broad Ranch.)
Jackie I had to create my own policy and procedures for the pain clinic I work in now. I wasn't fun and very time consuming even with prior years experience in different pain clinic. I would be glad to help you out any way that I can. Just let me know what you need and I would be glad to email you what I have. :typing I also have discharge teaching sheets and other patient education if you need them. Just let me know, Maggie
My supervisor told me tonight that HR was getting complaints from patients stating, "The BSN nurse gave better care than the non-BSN nurse." End result, only RN will go on namebadge.
I do not want to debate whether BSN nurses are better or worse. What I would like feedback on is:
1.) Can a hospital legally take away your title of RN, BSN or RN MSN, etc.?
2.) I personally feel that is a "slap" in the face and demoralizes nursing and education! Am I the only one who feels like this?
Well, you all know that's not really possible. You either pass on the first time, or you don't. But I sure feel like that's how it was.
My boyfriend and me met 4 years ago, through my brother. What are the chances that we were both busy doing nursing pre-reqs? He finished his, and applied at the local Community College. They lost his application. He waited 6 more months and applied again. He didn't get in. Finally the following January he was accepted for the LPN program. Seeing his frustration, I finished my pre-requisites and applied directly to a private school. We both started at separate schools at the same time. He considered the content challenging, the instructors unmotivated and their enthusiasm underwhelming. Nevertheless, he still managed to get straight A's. I had a program that felt like home; a close-knit group of students and instructors, hands on and flexible clinicals and even field trips. I managed A's and B's as well. He graduated in December and got his Authorization to Test in February. We were both confident in his abilities. I mean, Straight-A's... he had this in the bag. We studied here and there but assumed that his year of hard work would be all he needed. The day came, we held hands in the car and talked about how this was finally all going to pay off for him. I sat in the car trying not to worry while he tested. I had heard through the grapevine that 85 questions is a good indication of passing, so when he walked out with a smile on his face and said "I stopped at 85!" I was thrilled. We went to get something to eat and he then hung out with his friends. The next day he came over and we saw Quick-Results were available! Awesome! We paid the $7 and clicked the button:
He put his head in his hands and didn't budge for nearly an hour. He didn't want to talk about it, and I could tell he was crushed. He said he didn't want to take it again, he wasn't meant to be a nurse, he was stupid, you name it. I felt like I failed too. I talked about the test like it was going to be a piece of cake and how he didn't need to worry too much about studying. It took until the next day for me to be able to talk sense into him. He agreed that he hadn't studied like he should have and that the format of the questions was kind of confusing to him.
I graduated from school the next week.
My school paid for the NCLEX and filed the paperwork for us, so my ATT was there before I knew it. His re-take application was approved also. The plan was to focus on him and I would take mine after his re-take. But that wasn't meant to be. The only afternoon openings were both on the same day, a month away. We made the decision to just take it on the same day. I thought of this as setting ourselves up for heartbreak. Unless we BOTH pass, there wont be a celebration. So I decided to turn drill-sergeant and get serious. 100 NCLEX questions a day, as well as 6 chapters in the book. We took turns reading to each other. We argued over the questions and rationales. Once we got closer to the date, we did some software my school supplied me and made pharmacology flashcards. By the time the test date came up, we had gone through a 70 chapter-nursing book, did 3,000+ questions and memorized endings of drugs. And I was about to see how he felt when he sat in that testing center.
It felt as though none of these questions made sense, and I felt like I didn't know any of it. How could I have read ALL THE WRONG things!? I rested my head on the desk at one point because I just couldn't believe it. My test stopped at 85. I was so unsure of myself. I sat outside the testing center for three unbearable hours waiting. My boyfriend finally walked out, grimacing. "I got all 205 questions," he said. My stomach dropped. I had read that chances are you failed if you got all 205 questions. I hid my anxiety and told him "I'm sure you did fine!" I felt that he had failed, again. I knew he would not try a third time-- he would be too upset. It was going to be a long night. We went to Applebee's and got margaritas. That helped for about an hour. We stayed up all night talking.
The next day I looked at the Board of Nursing site. He was napping so I paid and got my results without telling him. OMG! I passed! I was thrilled. However, who cares if I passed if he didn't?! I really wanted to check his results behind his back, but the form required a Social Security number. I leaned down next to him and whispered "What's your Social Security number?" he said, "Oh god Kelly, not now, please" I said "I checked mine, I passed" He sat up and said "Okay, lets get it over with" I thought this was the walk of doom. But I smiled and said, "Whatever happens, happens". He put in his information and I told him to turn around. I clicked enter.
I could not believe it. I told him and we jumped up hugged. His face lit up like a kid on Christmas morning. Hard work does pay off. We earned it, and now we could really celebrate.
I just think it's funny how things work out. We joke now about how he failed when most people pass, and passed when most people fail. I can't think of anything that felt as gratifying as May 17th, 2010
Facebook, hands up who doesnt have an account??? It appears our new life is now being controlled by this new phenomenon which had dragged many people into the 21st Century it can be fun, exciting and enables us to catch up with friends and family we may have lost touch with over the years. If you havent been exposed to Facebook then you are probably dead or deep in a coma, and everbody has an opinion on it.
Businesses are thriving from advertising on facebooks, hundreds of jobs are being generated from it,
On the other hand it can be a very dangerous tool which is causing world wide discussions, new policies are being written and developed daily by companies to protect their workplace. Everyday we hear about problems being caused by this seemingly innocent pastime.
Employees are being fired for discussing work, or playing on there when they are off sick and somebody has seen the time and date you were on line.
Nurses are often in the spotlight because of confidentiality and the vunerable nature of their job. Some people/patients believe that we 'the nurse' are their friends because of the care we give them during their sickness, they always remember our names when they meet us outside the hospital but how many of us remember our patients names?
In reality we are not their friends, it is our job to be kind and caring and to know everything about that patient in order to decide how best to serve them. We know their name, their age, their family members, their illnesses past and present, their job and job status, who lives with them, how many kids they have the list is endless. They share so much information with us, and to show we are interested and care we remember during their hospital stay to ask after their spouses and children each new day we look after them. So it is no wonder the line between us becomes smudged, of course we are just in the process of making the patient feel at home, to relax so that the quality of care is excellent and as we move on from room to room we hope we are doing a good job, but for some patients it must be difficult to understand or comprehend that once we leave work and go home, we leave the pts behind us, and we go on with 'normal' life.
Now we have a new concern patients want to befriend us on facebook. I for one couldnt count how many patients I have looked after in 20yrs, imagine if every other pt wanted to be my friend on Facebook-well I am just laughing out loud at the thought of it. Over the years I have met many wonderful people/patients, some who will be embedded in my memory forever, a lot who I thrust out of my mind as soon as possible and some whom I love to dread should I ever see again in my lifetime.
Here on allnurses there are heated debates concerned with such topics as "Facebook at work" "Do you add patients as your Facebook Friend"
It is an ethical and moral dilemma that should be easy to answer 'NO' you should never add a patient as a friend on facebook but like most ethical and moral dilemma;s there is never an easy answer is there?
I looked after a pt back in England for a year he had 'locked in syndrome' and eventually learned to communicate by computer he was a young patient in his early 40's. When I moved to the USA he asked me to email him which I did and still do 5 years on. It has been a very innocent relationship, he is housebound, wheelchair bound and socially isolated by his illness, his only pleasure is his computer and I have noticed recently that the emails are few and far between. I would probably not kept in touch had I lived back in the UK but felt safe being 3000 miles away and knowing his condition. I will never regret this relationship but I doubt I would have him as a facebook friend as to enjoy the site you have to have total freedom in what you communicate as it is totally open to the world.
I read on a thread today that a nurse communicated with her friend on Fb and a pt she had recently looked after was also friendly with the same friend, this pt then made a comment back to the nurse via the mutual friends page! I found this to be a little scary, we do not realise what a small world we live in.
Another friend of mine a Doctor back in the UK recently told me of something which happened to him on FB his great grandfather translated passages from the Koran and he photographed the pages to show how beautiful the writing was. This was accessed by somebody via a friend via another friend and he was subjected to racial abuse. I then went on and checked my privacy status and found my photo albums were open to everybody on facebook and I had to go in and edit each and every photo-it was not obvious by just checking the privacy you had to go into the albums themselves.
I dont know about you but I dont want my patients or my employers to view my photo's on facebook most of them are of myself, my family and friends enjoying themselves, some with drink in hand LOL. A lot of photo's are not work suitable, especially when you do education re dieting, alcohol use, smoking cessasion, limitation of exposure to sun. A lot of photos contain pictures of people indulging themselves in activites you frown on in your professional life but it real life these are the photo's you love to share.
I have hundreds of fun in the sun photo's, beer in the bbq, funny photos of people falling over and everybody laughing the list is endless isnt it. But we wouldn't want our pts to disrespect us because of our home life, would we.
I think facebook is fun but it is about my personal life I want to keep it that way and I dont want to share it with my patients.
As a nurse of some years' duration, I've often been accused of harboring a rather warped sense of humor. I'm not sure what happened, or when I devolved from a normal person who laughs at knock-knock jokes and funny animal videos to a degenerate who cackles madly at bodily functions and the infinite variety of stupid people tricks. All I know is, I've seen some crazy stuff since I've been in this field........and every single one of these stories is 100% true.
........Some years ago when I was still working Med/Surg, I had a patient who could be described diplomatically only as "fluffy". In actuality, she was a diabetic who weighed more than 400 lbs. A pleasant sort, she struck up conversation with me as I performed her PM assessment; when the aide brought her supper tray in, she mentioned that she'd lost her lower dentures at breakfast and asked if I'd seen them. Of course, I hadn't---at least, not until I turned her onto her side so I could listen to her lungs.
There, firmly implanted in her left buttock, were the teeth. They'd made such an indentation that I literally had to pry them off her cheek with a gloved finger..........whereupon she whisked them out of my hand, said "Ahhh, thanks, honey", and popped them into her mouth before I even had a chance to wash them!
........Same hospital: we had this little old man from a nursing home; naturally, he was terribly confused, and much to the dismay of the entire floor yelled incoherently for hours and tried repeatedly to climb out of bed. Finally, after several complaints from other patients and a couple of Ativan tablets that did nothing but wind him up even more, his nurse found a geri-chair and brought him out to the nurses' station so we could keep an eye on him. In exasperation, she told the man, "Now you be quiet---I don't want to hear so much as a squeak out of you."
That was when we found out he wasn't quite as demented as we'd assumed. With a sly grin on his face and an unmistakable twinkle in his faded blue eyes, he said "SQUEAK!" and promptly subsided, content to watch the corridor and nibble on graham crackers.
........Another time, an aide and I were cleaning up after a patient who'd been incontinent of a rather impressive river of loose stool..........in fact, it was pouring off the bed and splattering on the floor (not to mention our shoes). Why I was reminded just then of the need to pick up some chocolate fudge cake mix on the way home, I'll never know, but when I said as much, the aide turned a funny shade of green and fled the room!
.........Here's a patient I'm sure many of us have met: the nineteen-year-old primigravida with tattoos all over her upper body who screeched like a frightened toddler when I tried to start an IV because she "didn't like needles"...........
.........More fun from the OB unit: I've worked three-day stretches in postpartum without seeing even ONE married couple. Sent new parents home who couldn't even read the directions on the box their infant car seat came in. Caught a baby in my bare hands when the L&D nurse was on break and the doctor hadn't arrived yet because Mom was only at 6 cm and the contractions were still three minutes apart after eight hours of labor.
And I've spent nights in a hospital nursery with a baby in each arm, wondering what I'd done to deserve the privilege of actually getting paid to sit in a rocking chair, cradling downy heads and inhaling deeply of the scent of new life. Nope, you really CAN'T make this stuff up.
I am 49 - been in nursing for 30 1/2 years - from nursing assistant to LPN/LVN to RN - to FNP-- It's been a great ride
After reading so many threads here on allnurses.com about the hard times many new grads are having at getting jobs, I just wanted to share a few words of encouragement.
My feelings go out to all of you who are having a hard time finding jobs. I feel your pain and know what you are going through.
I graduated in '95, we all had the similar issues with new grads having a hard time finding a job. The market was saturated, hospitals only wanted 1-2 years experience. I found it very frustrating and scary. Months and months of applying, sending out my resumes and applications, and continually getting rejected. Eventually, I came to the realization that my dream of working in a hospital as a new grad was not going to happen.
I began applying at Long Term Care (LTC) facilities, something that did not interest me at the time, but I was wanting so bad to begin my nursing career that I was willing to take any job that I could find to begin getting some experience etc...
While my goal was to to work in a level one trauma center and ICU, or ER, I found myself in long term care, and once I accepted it, I really enjoyed long term care. I found myself learning a ton of nursing assessment knowledge and personal skills. It really forced you to become independent and autonomous, working on time management and so many skills that are essential to all nurses. I learned a ton from so many LVN's and RN's in LTC, they were amazing sources of experience and mentoring. I really felt that my experience in LTC was a wonderful asset to my future working in Critical Care. I eventually ended up working in CCU (Coronary Care Unit), and the vast majority of our patients where elderly, and I felt I had already been accustomed and educated on that clientele, and my experience with that population from LTC, it was a great source of confidence.
After a few years, I began re-applying to the hospitals and with my experience, and the nursing saturation cycle changing, I eventually moved into a long term acute care facility, got hospital experience, all while continuing to apply and followup with multiple hospitals, eventually was hired by a hospital in telemetry, then CCU and I finally moved into a job that I was wanting from a new grad. Also, during this time, I took every opportunity to get certificates in ACLS, EKG classes and other certificate classes to help make me more marketable and attractive to hospital mangers. But it was a long hard journey, but well worth it.
As you all know, the market and nursing shortage (or not so shortage) varies dramatically based on different geographic regions, cities, states, etc... I have no idea on the long term care employment marketplace where you live. But I would recommend you explore ALL employment opportunities, whether or not it's in your overall dream on how you thought you would start your career.
No one has a crystal ball on when things will turn around, but historically, they will eventually will. There are so many positive indicators that nursing is still a strong profession, and a wonderful career choice. The average age of nurses (upper 40's), the baby boomers creating more demand for health care, etc... all indicate that nursing will be a strong employment arena. I feel that the projected nursing shortage we've all been hearing about for years was and is a legitimate concern. However, the changes in the economy other industry job losses, has brought many existing nurses back into the workforce, kept nurses working later in their career than planned before retirement etc... All of these issues have skewed the projections and the nursing marketplace is not really hot for the time being.
My gut feeling and my hope is that in the next year or so, as our economy improves, more nurses will be retiring, more baby boomers putting more and more demand on the health system, the hiring freezes will lessen and that the nursing marketplace will eventually open up more and all you newer nurses will have many more opportunities.
No one has a crystal ball on when things will turn around, but by historical records, they eventually will. There are so many positive indicators that nursing is still a strong profession, and a wonderful career choice.
So my words of advice to all of you is try to remain as positive, do your best to get employment, open your boundaries to acceptable driving distances, possible relocation if that is an option for you. Take jobs that may not be your ideal job, gain any experience that you can, even if it's not what you want. Continue to educate yourselves, certificates and classes (ie. ACLS, PALS, EKG) that are related to the type of nursing you want to do. So when the time comes and the employment opportunities do open up, you are prepared and ready.
Best of Luck!
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