limerick1913 (1,831 Views)
Joined Apr 5, '09.
Posts: 57 (26% Liked)
We never discharge straight from PACU. All patients go to our short stay observation unit, where those who are ready to be discharged are sent home and those who are felt not ready for discharge can spend the night without having spent most of the day in PACU, where visitors aren't allowed. Also frees up PACU slots for fresh post-op patients.
It does get easier, thats the good news but it does take time.. just remember you are never alone even when off orientation.
That was nice to hear. It is a nice reminder that we all need to remember to thank those around us.... Even for the smallest things they do, because it all matters. Everyone on the team matters.
Yesterday was a busy day and I had two patients who took a lot of my time and I needed a lot of orders for both of them. A young doctor I didn't know well was covering for one of the docs, and after he listened to me describe each problem, ask for orders, and then put in the orders, he walked away down the hall and I called out "thank you!" because he had been very helpful to me. He turned around in the middle of the hall and called back (in front of a lot of other nurses) "No, thank YOU because I know that you nurses are the ones WHO DO ALL OF THE WORK. I come in for 5 minutes a day, but you are here all day. So thank YOU!"
We all applauded.
He's my new favorite doctor
"Are the nurses who complain just plain lazy..." ROFL....
Excuse me while I go make some freshly-popped popcorn and hunker down to watch the self-hanging continue...
After you've been through school, passed the NCLEX, received your registration, AND worked for at least 6 months, then you'll have a better idea what a nurse deals with. Nursing wouldn't be as demanding, except most places are understaffed with too many redundant forms. So yes, nursing is that hard.
What if you're awesome?
Which do you prefer...
1. High patient satisfaction scores OR semi-private rooms?
2. Staff clocking out on time OR bedside report?
3. Quiet at night initiative OR filling the unit with admissions all night long?
Because when you change "OR" to "AND", it doesn't work. You can't have it all. Thank you.
Night Shift Floor Nurse Who Works Her Butt Off But It Never Seems Good Enough.
One way to organize your report is to go through your information by systems (neuro, resp, cardiac, etc) making sure to include lines/drains/tubes where important. Then you can add any important events that happened that shift (Xrays/extra labs/procedures/changes in condition)
You can have an outline that you follow when giving report that reminds you what system/category to talk about next, until you become more comfortable giving an organized report!
Nursing is still the most admired profession in public polls. Folks generally see nurses as overworked, underpaid, and selfless in their devotion to patient care. As a 30-year veteran, I have seen nursing make many transitions, mostly for the good. What disturbs me now is the overmarketing of the profession by schools who see nursing programs as a cash cow. I see many men and women entering the profession because they see it as a steady job with good money. Nursing is still a calling.... folks who think they are getting an easy ride to quick success need to stay out of nursing. I'm tired of hearing students say that they have chosen nursing for the job market or money (let's face it- where else can you come out of a 2-yr college program and enter the market making $50K to start?) We need to leave nursing to the folks who are ready to accept it as it is: hard work, poor working conditions, long hours, and underappreciation from management. The nurses who can't take the heat are dragging us all down...
There is no nursing shortage.
My 2 cents. I was a new grad back in August 2011 and landed in an ICU setting as a Staff RN 2 months after graduation. Also received MANY offers from other hospitals to work for them (this was not happening to my friends). What did I do different? First, I made sure my resume was written by a PROFESSIONAL resume writer, I also had f/u letters and thank you notes written professionally. After that i submitted applications online BUT what really worked for me was going to hospitals and knocking doors down.....yes...you read right! I went to hospitals and presented myself to prospective employers, I worked 24 hours for those two months after graduation and finally landed MANY interviews and my dream job. Recently I got accepted to start the Acute Care NP at NYU in the Fall 2012. Moral of the story. Be pro-active, don't do what everybody does (online submissions, they write their own horrible resumes....blah....blah...blah). Be creative, but among all, stop spending too much time on boards complaining and take that precious time to take action. BTW, i'm not saying that you guys are complaining, I mean it in general, it's a saying . God luck!
Hind sight is always 20/20. Depending on the amount total of amiodarone and metoprolol given po previously I would have clarified with the MD about the 2200 metoprolol and gotten parameters at the time of the bolus or, I would have called a the time of the 2200 dose..."Dr. Backstabber? I am calling with an update on Mrs Syncope....the ED admit with the rapid AF that required the bolus for hypotension earlier. I see she is due for another dose of metoprolol.......Her vitals are blah, blah, blah. Her rhythm remains blah. She seemed to respond to the fluid bolus and has been doing alright so far....I was wondering if there were any parameters on the metoprolol."
I am big on calling the MD. Especially ones that prove they aren't worthy of my trust. They can yell and scream to their little hearts content about being called. They know they should give parameters. That two faced MD threw you under the bus because she is an incompetent........&%&%$ person. I can't be sued for calling the MD and making sure they are the scapegoat but I can be sued for not calling. I don't give a rats bah two tee whether or not they get upset....WHATEVER.....do your job "DOCTOR".
I cover my own butt. I'm too smart to be anyone's jackass.
Never trust this MD again...you see what her tactics are.....you are her whipping post for her incompetence. She is probably accustom to being spoon fed by competent nurses and can't think for herself. How many times I would call with stuff like this and get the "'Uh Yes sure that's a good idea.....I forgot to write it?"
Forgot my foot...idiots.
I Don't think it was your dose of metoprolol that initially dropped the B/P but I do think it prevented her responding to the bolus. Live and learn. When patients are being dosed heavily po like that it is worth a bit of caution. Technically you did just fine. The vitals were perfectly OK at the time to administer the meds....the caution to me would be that she had already bottomed her pressure and was going to prove to be fragile in this department. The MD was being a jerk.
I'm sorry there are jerk idiots for MD's. Well, done but always CYA and for my usual lecture behaviour like this is the exact reason I say to get and carry your own malpractice insurance. To give you piece of mind. I'm done now....
Talk, Discuss, and Share your experience at your favorite Nursing School.
Advertise With Us