SentimentalGeek, RN 3,220 Views
Joined May 6, '09.
Posts: 84 (24% Liked)
Just curious about the staff's experience on day shift- is it all experienced nurses? Is there a way to provide an incentive for experienced nurses to work the more "undesirable" shifts? Skill mix is important to patient safety, and I can only see adverse safety events if an entire shift is made up of new nurses (I personally do not like the term "baby nurses" as it can seem derogatory- in fact, I at first thought this was about an ICU whose new manager had only mother/baby experience).
Nope, I am an A/B student. I do not have straight A's. Grades do not matter as much in the real world. I have seen people stress out about their A, but when you give them a patient they just freak. Life isn't a multiple choice test. Do not stress about the letter, rather you should learn to apply theory to the real world.
This is what I think about when I start to over stress about a letter grade. 85% of my family are BSNs, many of them were average C students. But they have been working in their specialty like ICU for over 20 years. Their experience and skill is what defines them, not the letter grade they got back at University.
Last I checked, 18 is an adult, and I disagree that it is unfair to have the 18 year old looking after their younger siblings, if said 18 year old is still living under your roof. Yes, I think your husband is being unreasonable.
I work in one of those hospitals that took in many of those emergency transfers from NYU Langone; let me tell you, that if people think those nurses deserve praise for transporting those patient out, many may be surprised to realize that it didn't just stop there. Upon arrival with those patients into the new hospitals, many of these RNs resumed their care despite being in completely new surroundings. The hospital took their names and was able to ascertain licensure status from the state, and allowed them to continue working as full RNs.
It seems to me that the more one digs into this story about dedication to duty, the more one finds that is worthy of laudatory adjectives. IMHO, that's just the nature of the nurse, humbly and quietly going about their business while conducting themselves with the best of human character; it's a shame that it takes a disaster for the public to notice.
Kudos to those in NYU Langone for showing the world what nurses really are.
Look who was in NYU hospital and evacuated with the rest of the patients!
"Kenneth Langone, the billionaire chairman of New York University Hospital, said he was a patient at the NYU Langone Medical Center when it lost power duringHurricane Sandy and had to be evacuated. "
“The backup generators failed, it’s that simple, but the story here is the magnificence of the effort of all of our people and what they did,” Langone, 77, today said in a telephone interview from his Fifth Avenue apartment. “Just think of the effort to bring down 200 and some patients and they did it and they did it all night long.”
“I saw it all happen, and I watched these wonderful nurses and nurse’s aides, I saw humans at their best, at their very best, and you say thank god there’s people on earth like this,”he said. “This impromptu command center that was set up, I sat there and I watched it and I marveled.”
congrats! I remember when a fellow nursing student and i landed the same job and after orientation we found ourselves suddenly in charge. she looked at me and said, "OMG it's just us! everybody else went home and now its just us. They think we are real nurses" I said, "Well I guess we are" and we laughed and laughed and laughed. Was a sudden wake up call for us.
Not your fault. It was HER patient. If she noticed the call light, then she should have answered it and taken care of it! Especially if it was going for 10 minutes. She knew it was going off, but chose to ignore it. What if her patient had a real emergency? Fault would have been on her, if there was a poor outcome from ignoring the call light.
You were doing your job. She was out of line both for berating you in the first place and in public. Mention it to the charge nurse if it happens again.
This is the nature of working in a teaching hospital.
For your own sanity, you'll have to make peace with this fact, and incorporate it into a team approach to patient care. Otherwise you'll continually feel resentful.
Look at it this way: at the end of a 3 or 4 or 5 year residency, you will have helped to shape a good doctor, who will go out and provide great patient care. And s/he will more than likely have taught you a thing or two along the way, as well. Everybody wins.
Ok, I'll play devil's advocate. After all, it's a debate!
A doctor is not obligated to take on any patient who walks through the door. If a doctor decides a policy of not accepting obese patients/morbidly obese patients is a comfortable practice for them (or taking on such patients puts a strain on them in some way), then so be it.
The patient has no "right" to receive treatment from the doctor of his or her choice, no questions asked. The doctor DOES have the right to refuse a patient he/she thinks will be non-compliant or in some other way will put his/her practice at risk. The liability for treating such patients is, as we are all aware, extreme.
Heck, treating patients we think of as 'run of the mill' can be pretty risky--ask any malpractice carrier.
So, limiting liability is just good business sense. After all, can't risk having some patients take you out of being able to care for others. Picking and choosing might be offensive to some, but I say don't judge until YOU have to be the one in their shoes.
The concept maps that you do as a student are not meant to be used at the bedside -- just like the 15 page care plans that my generation had to do in school have never been considered practical for bedside use. Those types of concept maps (and/or care plans) are used to help students improve their thinking processes -- not to help experienced nurses give care on a daily basis. Concept maps help students to see (literally "see") how different pieces of the puzzle fit together when everything is not linear. Traditional care plans force everything into a linear format that doesn't always reflect reality and may involve a lot of duplication as details overlap and involve multiple relationships. Care maps seem "messier" because they better reflect real-world conditions -- that are rarely need and tidy.
Concept maps can be very useful in the real world when you are designing and/or evaluating programs -- mapping out how multiple services will be delivered to patients, how multiple topics will be delivered within an educational program, etc. Nurses responsible for such things "sketch out" their ideas all the time.
They are very helpful for some brains. I had my kid (IQ >140, brilliant at science and math, could explain anything to anyone, but couldn't write a comprehensive paragraph to save his soul) eval'd by a learning specialist, and she taught him how to do concept mapping and said MIT is full of kids like him. Now he's a nuclear engineer. Really.
I've seen some crazy looking care maps....yes they have the same information. I don't like them because they appear disorganized to my OCD anal retentive brain.
You may find this resource helpful. Concept Mapping
Whether or not it's "mess of boxes & circles" depends on how your instructor requires you to do the concept map. The ones required by my instructors are not as crazy looking as some that I've seen. Ours have the reason for visit/care in the center, then nursing diagnosis in surrounding boxes. As part of the nursing diagnosis box, we have to include all that stuff that other instructors have you put in even more boxes/circles within the SAME diagnosis box (and in a particular order). The concept maps as we're required to do them, don't seem at all like the visual "big picture" aid that they were intended (and often fail) to be for other students/programs.
IMHO concept maps seem very unprofessional. And correct me if I am wrong, will never be used in the real world. Its a mess of boxes and circles.. it felt so unorganized. The only benefit of a concept map to me is that it can have more than one diagnosis versus having separate care plans for each diagnosis. As a nurse I would NOT want to look at a concept map that another nurse wrote. Its a waste of time deciphering it.
I'm new to this as well, but have gotten good marks on my concept maps. We put the main diagnosis or reason for visit in the center, then nursing diagnosis in branching boxes. Off the nursing diagnosis comes interventions and then goals off that.
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