Content That JBMmom Likes

Content That JBMmom Likes

JBMmom, RN 5,024 Views

Joined Jun 24, '09 - from 'CT'. JBMmom is a Scientist, Nurse. He has '2' year(s) of experience and specializes in 'Long term care'. Posts: 364 (34% Liked) Likes: 429

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  • 5:30 pm

    Overuse of these medications can lead to CDiff. We get almost 100% of patients from the hospital on a PPI. Unless they have an active diagnosis of GI bleed, we ask the PCP to discontinue the med. People take far too many medications as it is.

  • Jun 2 '15

    Quote from HelloRN00
    I felt like it was my fault and that I did something wrong.=(
    Since my conscience is not terribly active, I generally do not blame myself for things that go wrong in the workplace. Guilt is not a part of my emotional repertoire, and it is less stressful living this way.

  • Apr 26 '14

    Nola...I designed the orientation myself. I think it's part of my job to assure my new nurses, especially the new grads, have a positive experience. We don't give 3 days and send them off on their own. Most of the new grads have orientations that last at least 6 weeks. They learn the med pass first, then we add on the treatments...they are never alone while they are learning. They then spend time with the desk nurse so they learn the procedures for writing orders, ordering labs...and that is never done on the busy sub-acute unit even if they are eventually going to work there. It's too frantic an environment for someone new to long term care to try to absorb everything.
    They then get an orientation on the shift they'll be working. Either the SDC, the ADON, or I check in with them almost daily to make sure they are getting what they need. So yes, I'm SURE the orientation is good.
    I've called around to other facilities...our pay is more than most are offering. Our benefit package is better, and we are better staffed.

  • Sep 4 '13

    HAHAHA! Yeah....I never wear make-up. My philosophy is just to keep expectations low!!

  • Aug 21 '13

    I attended a lecture a few years ago who touched on the interesting fact that when we ask people who they are, something like 98% of them will answer with their names and their occupation in the same breath.

    Long and short of it: people introduce themselves based upon what they call their "active role".

    So it is not unheard of or strange for your identity to be associated with your job. And as one who, due to a physical malady, has had to bow out of a role that was not only something I loved dearly, but was how I identified myself, I can appreciate where you are in your grief and anger.

    Because remember, that is all part of this process of changing and assimilating identities, limitations, and goals. Before one can move on, one must first grieve. So take your moment and make your peace all in due time.

    As far as fulfillment and job ideas, I know that many here have had suggestions. You could always check into doing pre-admissions screening for a hospital OR or perhaps work in a central scheduling office. As far as fulfillment goes: Volunteering works wonders on the soul for that one. There are so many places where you can go, from nursing homes to hospitals to veteran's centers, and truly make an impact.

    Quote from VivaLasViejas
    We'd gotten the great news from the university hospital about hubby's stage IV pancreatic cancer being treatable after all.
    This, Marla. This.

    In spite of everything that is going on, I really wish that this one little fact would eclipse all others.

    Perhaps it is time to rest the mantle of asskickin' nurse and instead become immersed in the life that exists outside the doors of the hospital. It is time to rewrite your active role.

    I don't have to ramble to you about the frailty of life or the downright insanely amazing news that you have been given in regards to your husband's condition. I know you know.

    Rather than wondering where you go from where you are now, I think the more fitting question is the following:

    You, yourself, stated that you have just been given a new lease on life (such a rare and precious opportunity)--

    How do you plan to make the most of it?

    With kindest regards and sincerest belief you will find your way,

    ~~CP~~

  • Aug 16 '13

    We sent two of our chronic babes to children's rehab today! Best feeling in the world when you have former 24 weekers who have had every single complication known to man, end up trached and with GT's and with a gloomy outlook , who end up very appropriate 8 month old babes! My co-workers and I have empty nest now! Good luck out little sweeties!!!

  • May 7 '13

    When it comes to nursing, I respect the profession for what it is, what it has been, and where it is headed. Am I proud to be part of the profession? Sure, in a subtle, I'm proud my hair is long kind of way.

    I own no nursing paraphernalia. I do not announce what I do readily at meet n' greets or reunions. I prefer to refer to myself as a Frustrated Carpenter or a Confused Ninja.

    Ever since stepping foot into the profession, Nurse's Week has always been a tough pill for me to swallow.

    You see, I'm used to flying under the radar. I do what I do because it needs to be done. And that's the truth. I am here because I choose to be. I could be pastry chef or a crotchety stay at home couch warmer content to spend her days writing scathing letters to the editor while snorting Cheeto powder.

    But no. In my professional life, I'm a nurse.

    And for the record, I'm not a hero. Never have been one, never will be one, don't want to be one. That is way too much pressure. I look at what I do as getting paid to do the right thing. Hey look, you're not breathing. How 'bout some oxygen?

    It's nothing special. It's just the right thing to do.

    My patients know I exist because when they wake up, their IV sites have mysteriously migrated, the gaping holes in the abdomen are miraculously closed, and, if you are a peds patient, you may have a new stuffed bear friend dressed in scrubs to keep you company.

    It took me a while to get used to the idea of never being seen let alone remembered. And now, my thanks comes daily in the form of self satisfaction and appreciation for the little things. When a tubed trauma patient gives me a thumbs up before going to surgery and a middle finger when I assess his pain as he wakes, I'm doing something right. When a surgeon saves an especially naughty joke just for me and tells it with an excited gleam to his eye like a kid on Christmas morning confronted with a gaggle of puppies, I know that my work has been noticed. And when my coworkers creep up to me mid case to bump shoulders, stand close and communicate with sidelong glances and hidden smirks, I know it's all fine.

    And those are the things that keep me going.

    Not the brunches offered by guilt obligated physicians or luke-warm lunches served by begrudging Nurse Managers. I don't need their approval. I don't need their recognition.

    And when the nation decides to herald nurses in random clips on the news, it causes a bitterness to surge unbidden to the fore.

    You want to thank me? You want to honor nursing?

    To management/corporate leaders: Then lower nurse to patient ratios so I and my brothers and sisters in healthcare can truly do the job to best of our abilities.

    To the Government: Offer clinics that can be accessed by all people in a way that makes sense and for once removes the terrible choice of food or healthcare. We send so many resources overseas, which is all fine, but what of our folks here at home? Research more than the Cancer "flavor of the day". For the love of all thing sacred, stop denying reimbursement funding based up on greater, more ridiculous parameters.

    To patients/families: Remember that time you called the Nursing Supervisor to complain because I sheered the britches off your child's shattered femur and then had the audacity not to escort you to the coffee shop before taking said kidlet to surgery? Yeah...not cool. Kindly learn what to truly complain about. Better yet, respect the fact I helped save his leg or something.

    To the fellow healthcare workers: Treat each other with dignity and respect. Thank each other. Recognize each other. Why do we need a week or a day at all?

    My feeling: if you truly need a day to give you a reason or remind you to show someone appreciation, be it your mother, your spouse, etc, then something is amiss, don't you think?

    I had a doc try to worm a thank you out of me for a lunch his group provided. My answer was simple, "One sandwich does not make up for a bunch of distressing conversations. You made my orientee cry last week, in case you forgot. Perhaps in the future you can treat us all decently as people and I will thank you. But for now yes, the sandwich was tasty. I appreciate the effort."

    He seemed affronted. Surprise.

    I let him mull it over as I waddled off, diet soda in hand, to go settle before having to scamper off to another case.

    Perhaps my refusal to kowtow and play nice in the sandbox makes me a bad person. I don't know. But I think I'm alright with that.

    But I suppose it's time to get to the point, isn't it? Tick-tock, CheesePotato, we don't have all night.

    In summation: Thank me as one person to another, for what I have done and not because of the letters at the end of my name. Thank me genuinely and at the moment it happens.

    And I shall be sure to return the favor.

    ~~CP~~

  • May 4 '13

    Read ANY of the posts on other forums and you'll see nurses dissatisfied no matter where they work. I've been in long term care for years....I wouldn't trade my career for anything ( ok...so I'd trade it to be a movie star, but...)

  • Mar 26 '13

    There are times though, when patients ARE on their lights too much. Their families tend to their every whim in day to day life, and now it's YOUR turn.

    "Oh, straighten the wrinkle out of the lower corner of the pillow. Nooo ... the other side!"

    "Okay, wait, don't go away .... give me a minute to see if that's okay."

    NO!

    Here's your Percocet, it's time for you go for a walk in the hall. When you get back, brush your teeth and sit in the chair for a FULL HOUR to do your coughing and deep breathing.

    I know, that's not the case every time, but there are times when you need to lay down the law. It's your job to help them get better, and if it's a kick in the a** they need ... then that's what you give them.

    When they've done their part, then I'll give them a back rub. Not before.

  • Jan 4 '13

    My facility requires that I wear a certain shade of blue. Not navy, not ciel, but a bright blue. They give every new employee two sets of scrubs. Cherokee is what they stock. So far, I like them. I don't know about being scratchy or anything as I wear a long-sleeve compression shirt underneath. But I also like Landau. I know that I need cargo pants as the pants they gave me only have regular pockets. I don't like carrying my BP cuff in my shirt pocket, but in a cargo pocket would be fine.

    I recently found out that Carhartt is making scrubs. I would love to get a set, but they don't come in a color I can get away with at work. They do, however, come in black, which is what I'll need for nursing school, so I may end up with some.

  • May 16 '12

    I am as anti-fat as I am anti-anorexia/bulimia, anti-smoking and anti-riding a donorcycle without a helmut, anti-unprotected sex, anti-failing to wash your hands, etc. I counsel all my patients that smoke, I counsel all my patients that have high BP, high cholesterol, and too high or too low BMI, etc. It is my professional responsibility to discuss the risks associated with unhealthy behaviors. I have probably lost patients over it. I don't care. They don't get tacit approval for ignoring risk factors just because they are embarrassed about it.

    People need to separate the emotional component from the facts. As BMI increases over 25, risks go up. As pack years smoking history increases, risk increase. I have a cardiologist friend who will not treat smokers. You either quit, or find a new cardio. He sees them as just wasting his time. I think that's extreme, but I do get frustrated hearing "my knees hurt, gimme medicine" from people with BMIs over 35. "I smoke 2 packs a day and I'm SOB, gimme medicine, FIX IT!" It gets tiresome.

  • Oct 22 '11

    twelve leads are an advanced skill that i wouldn't expect a new grad to be familiar with. what i want my new grads to know:


    • professional conduct: be at work on time, correctly dressed and ready to work. your nose ring may be perfectly charming, but if your dress code says not to wear it, don't.
    • be responsible: if it's your job, do it. if it's new to you, look it up -- don't just stand there and expect someone to teach you; be responsible for your own learning.
    • recognize that as a new grad, you're expected not to know much. it's ok to say "i don't know."
    • but the third time i ask you to hang blood, you'd better have at least an inkling how to start.
      i'm willing to go over something as many times as it takes you to "get it" as long as it's obvious you're trying.
    • yes, i'm older than you, probably even older than your mother. but that doesn't mean that i'm "over the hill" or "an old dog who can't learn new tricks" or "a dinosauer who ought to just retire and get out of your way." be respectful. (i do have a lot of input into your evaluation, after all.)
    • know how to look things up, and be proactive about doing so.
    • understand that we all have bad days . . . a preceptor who doesn't leap to her feet and bow at yours may just be having one of those. it doesn't mean she's nasty, eats her young or hates you.
    • the first year of nursing sucks. honestly, it just does. expect that.

  • Oct 17 '11

    Have enough compassion to care, but not too much that you fall apart when you see people in pain.
    Carry yourself with composure and a cool head.
    Do not panic or fall apart in an emergency, especially in front of patient.
    Never set someone up for failure.
    Be able to admit that you made a mistake.
    Be able to learn from your mistakes.
    Leave personal issues at the door and never bring them onto the floor.
    Practice within your scope of practice.
    Show up on time.
    Do not judge your patients based on your personal beliefs.
    Your tasks are to be done in an effective and efficient manner.
    When reporting to work make sure you look presentable and not disheveled.

    This it what it means to be a Professional Nurse in my opinion.

    I never believed that nurses are "Angels in Disguise".

  • Oct 9 '11

    Some locations in the U.S. are still hiring new grads at a healthy pace while other regions have drastically slowed or stopped recruiting newer nurses.

    I afraid that we're creating an entire generation of nurses who are not learning the skills and accruing the experience needed to make it in the working world. Sorry, but the graduates from 2009, 2010, and 2011 who have not yet landed their first nursing jobs are going to have a rough time competing against future graduating classes for those coveted new grad jobs.

    Furthermore, expertise and skills are transmitted from one generation to the next. This new generation of unemployed new grads is not receiving the mentoring, skill level, and expertise from the currently employed nurses with many years of experience. It is inevitable that the 62-year-old nurse with 40 years of med/surg and specialized OR experience is going to retire someday, but today's unemployed nurses are not equipped to fill his/her shoes because they are not acquiring any experience.

    When we throw the dwindling Medicare/Medicaid reimbursements into the mix, I foresee plenty of dreams deferred in the future. I predict an increasing trend of hiring more and more unlicensed people to take over many of the hands-on nursing skills such as wound care, oral medication administration, and 'data collection' (vital signs, EKGs, etc.). Fewer and fewer nurses will be responsible for more and more unlicensed people. Therefore, I predict that corporations and facilities will utilize less nurses and more unlicensed personnel to cut costs. This is going to result in a lot of unemployed nurses since we continue to produce new RNs and LPNs at astronomical rates each year.

  • Sep 27 '11

    Quote from teterichko123
    after my first few days of clinical i have notice that student nurses are either barked at or avoided all together and rarely does a nurse on her own accord try to educate the student nurse. i know that is the job of our clinical instructor but it would be nice to ask me if i want to tag along to a interesting/important procedure/task. one time a neurologist asked me if i wanted to observe a spinal tap and another time a nurse asked me if i wanted to watch her change a dressing. other than that the majority of the nurses i have seen are my age with expressionless faces staring into their computer screen and attending their patients in the same manner. what's up with that? don't they realize one day i may be their nurse and will taking care of them or one of their family members? besides, they have all be through nursing school and may have had a lot of the same experiences as we will. where is these peoples love of the world and all it's people. i hope i never become that kind of nurse, that's one lesson they have taught me.
    the bolded statement above is your problem. i am a nursing student in my last semester. it is not the nurse's job to find you when something good is happening, it is your job to know what's happening with your patient and be there for it! i constantly ask my patients real nurses, is there anything going on with your other patients that i can help with/do. i left my lunch break just last week because i heard an overhead page for a translator, which i thought might be for my patient, good thing i did because the translator was for my patient.

    clinical's are what you make them; it's your responsibility to learn as much as you can from as many resources as you can on the floor. i asked a random floor nurse if i could suction a patient's trachea next time, just to get it checked off for my list. take the lead and ask for what you want to see, i.e. who is getting a foley put in today. and can i do it?

    your nurses will love you for this and more importantly, you will learn more this way.

    good luck with the rest of your clinical's.


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