Latest Comments by JBMmom - page 3

JBMmom, MSN, RN 8,655 Views

Joined Jun 24, '09. JBMmom is a Nurse. She has '4' year(s) of experience and specializes in 'Long term care; med-surg'. Posts: 476 (42% Liked) Likes: 835

Sorted By Last Comment (Max 500)
  • 0

    My husband and I have each had small health issues over the years, and it's a challenge to balance being a loving and supportive spouse with encouraging change. I think that in most cases like this, the spouse with health issues knows what needs to be done, but there's something blocking that from happening, and it's unlikely that outside influence (especially from a partner) will fix that. I think it's more likely to come across as nagging or coaching, and then the partner dynamic changes, and sometimes that backfires into someone digging their heels in and just not changing. Just like with patients, we can provide education, but they have to take the initiative and responsibility for their own health. Otherwise the balance of a marriage is in danger of being tipped into something more like parenting. I hope that your husband finds a motivation to make the best health decisions he can, but don't put it all on yourself, you've done your best and you have to let it go and enjoy your years together. Here's hoping there are many left with wonderful memories!

  • 1
    EGspirit likes this.

    I went the ADN to MSN route. Everyone I spoke with told me there would be no downside to that route. Well, when I applied for a bedside position I was told that because of union rules I couldn't be hired in at the BSN rate, I would be on the ADN pay scale, the MSN didn't count (I think it was because they want magnet status which looks at BSN specifically). Unlikely that you'll find an organization as ridiculous as that one, but just cautioning you that they do exist. I haven't had a problem other than that. I agree you should go with what's going to meet your personal goals, good luck.

  • 37
    LibraSunCNM, Maritimer, FutRNJ, and 34 others like this.

    I gave blood last month and I kept the paper that has the pint identifier on it. I got an e-mail the other day saying my blood was sent to the hospital I work at. What are the chances, I infused my own blood into my patient the other night (not that I would tell the patient). Small world, made me glad I could make a difference- in more ways than one.

  • 1
    almostRN116 likes this.

    I don't necessarily agree with the first advice. I completed my MSN in management and executive leadership, I really thought that was where my career should go. I realized in the two final classes, I would hate being in management. Wished I knew that earlier, but now I'm moving on towards NP. Guess I have some unnecessary credits, but I think all education can be beneficial, so my post masters NP certificate program will hopefully get me what I want. All I mean is waiting until your sure, doesn't always mean you're sure. Good luck.

  • 0

    It will be hard for other people to give you the best advice, especially people that don't know you. Test anxiety can be a huge problem for some people, and it has ended more than a few educational pursuits. Maybe find some testing experts, you might get help from using relaxation techniques because now no matter how well you know material, you've got a mental block related to testing. Do you still want to be a nurse? If so, then you can find a way to be successful in the school process. If you're questioning whether nursing itself is your ultimate goal, what has made you doubt that since you first enrolled in your AA program? Nothing was wasted as long as you've learned from the experiences. You're still so young, you're going to find the path that will lead you to success. Good luck.

  • 3
    AJJKRN, Crush, and Davey Do like this.

    If they weren't bathed because they refused and you did your best to provide the best care there is no reason for you to feel guilty. If you didn't provide the best care you could have, then there might be some guilt warranted. There will always be someone around that feels they should point out where everyone else falls short of their standards/expectations. You can't please these people and I find it best to ignore them. If you feel you were unable to bathe the two patients for a legitimate reason and you should not have been made to stay, you should speak with the nurse privately and discuss what happened. If you stayed late to help out and get patients the care they needed, you might have to get used to that because we all end up late at times because things happen. I'm not really sure how this translates to you shouldn't be a nurse, are you concerned that you will have trouble with time management? Each work environment has good and bad aspects. Good luck in your future career.

  • 1
    tinaefox likes this.

    You will find people that have been successful after graduating from any number of programs. For-profit programs, direct entry programs, CC programs, all have advantages and drawbacks but there have been very few accredited programs that I know of that have been a blanket "career killer". You can be successful in many situations, good luck to you!

  • 0

    Wow, I've been there five months now and Wednesday was the first day I've heard of anyone getting called off. It wasn't on my shift (third), and I've been able to pick up 1-2 shifts every week since I started. I kept my per diem job elsewhere in case I couldn't get enough time, but so far that hasn't been an issue. Guess I hang onto it, though, in case I experience anything like this in the future. I had no idea you had to use PTO if you're called off, I thought it was just an unpaid day. I would be really upset if I had to use my own time unnecessarily. Good luck!

  • 4

    I was a nurse in long term care for a few years before I had the opportunity to transition into a hospital role through a program for both new grads and those transitioning from other areas, into acute care. I was so concerned about coming across as thinking I knew it all that I acted as thought I knew nothing at times, and took criticism that wasn't warranted, which I think contributed to my termination in the end. Looking back, had I spoken up for myself I think I might have retained my position (although it really did work out for the best that I'm not there anymore).

    Here are a couple examples. I had a patient two days in a row. The first day she had just been admitted a few hours earlier, she was talking with me, even got up to the bathroom with just supervision, and seemed to be pretty stable. The second day I could barely wake her to assess her, and had to non-administer her morning medications because she wasn't awake enough to safely swallow. I notified my preceptor and the hospitalist of what I thought was a change in condition since the day before and the non-administration of her morning pills. Nothing done by anyone. My morning went on with my other patients. Lunch time came, she had a friend come to visit, couldn't really rouse her to visit with her friend. Again, I mentioned to my hospitalist that she was really lethargic. I've assessed her vitals a couple times at this point, can't see anything wildly out of order, except respiration rate was a little slow. Throughout the day, my preceptor is one-on-one with me, when she was on the floor- but she would be gone for long periods of time, I don't know where. Patient doesn't really wake up much before I leave, but I've told everyone, including second shift nurse and I head home. First thing next morning my preceptor is in my face about how a couple hours into second shift they had to call a rapid response on our patient because I didn't accurately respond to a change in condition. Clearly I'm not going to be able to adjust to the acute care environment because I'm used to stable patients in a nursing home and I did not use my critical thinking- labs drawn at the time of the rapid showed acute kidney failure and they think she was withdrawing from benzos that no one knew she was taking. I didn't even speak up for myself, but it was well documented that I had informed the hospitalist twice about her condition, and my preceptor was standing next to me during two of the interactions with the patient. If it were that critical, she should have intervened. But, I took the criticism, signed the form that stated I was re-educated, and went on my way.

    The following week I had a patient that had taken lisinopril at home for years, it was held for the first couple days of hospitalization and was going to restart that morning. I took a pre-administration bp and I think it was in the 160's, which was pretty much his baseline since admission. I gave the 10mg lisinopril and went on with the day. Two hours later my preceptor asks what the follow-up bp was, I hadn't taken one. Again, at the end of the shift I'm told that I'm not able to critically think otherwise I would know that all bp meds need a follow-up reading within an hour after administration to make sure it didn't drop too low. In my head I'm thinking that I know that lisinopril might show an effect at 1 hour, but doesn't peak in activity until about 6 hours, so why would I reassess when the patient has taken it for years, and was not showing any signs of side effects. But, I didn't say anything, I signed the paper about re-education and went home.

    I had quickly progressed from 2 to 3 to 4 patients, but then I started getting feedback that I was spending far too much time with the patients and not getting my charting completed. I understand that the goal was to get me to prioritize my time for a 6 patient load, where I wasn't going to have time to chat with the them about small things, but for the most part my conversations were geared towards getting information about how I could provide the best care. By contrast with this culture, my current coworkers and managers use phrases like- the computer is a tool, but the care of the patient is the most important thing- a nice change.

    Anyway, after a total of 11 shifts I was told it just wasn't going to work out and I was being let go. My confidence was in the toilet with that. I questioned whether I could ever work in an acute care setting, and how did this go so wrong? I wasn't perfect, gave a milk of mag one time instead of the scheduled mylanta (there were prn MOM orders), and I know there were some other blips, but nothing huge. Just told I couldn't cut it. I wonder if I had spoken up with my reasoning in those two big re-education instances, would I have kept the job?

    As I mentioned, it's all worked out for the best. My new job has been 90% positive and 10% (warranted) constructive criticism. I have great coworkers and I really can be an acute care nurse. So I just want to offer to others that even if you're new, you might be right some times, so make sure you speak up for yourself when appropriate, and don't let other people make you question yourself on everything.

  • 0

    I did read most of the textbook readings in the my undergraduate program, mostly because I was concerned that there would be information that I would need that wasn't covered in lectures in order to provide safe care. I know many students didn't read much, some did fine, some did not. In my MSN program I readily admit that I did not do all the assigned readings, sometimes I didn't even buy the book, but those classes were more administrative in nature and I could find the information on-line from free resources (human resources management, informatics, healthcare management, etc), but anything that impacted my patient care knowledge base I read pretty closely.

    As I move into my NP education, I intend to spend the time to learn as much as I can that will improve my ability to practice clinically. It's all about prioritizing, you might be fine with your current practice, as long as you feel you've prepared yourself for the highest level of clinical practice you can provide.

  • 0

    I'm sure it depends on the program. The one I applied to counted GPA of prerequisite classes, TEAS test result and grade in A&P1. That's it. It was of the state community colleges program.

  • 0

    If a stable patient is taking a blood pressure med that they have taken for a while, and the vital signs were within normal limits when they were taken, I will use the reading even it's not within an hour. If they haven't been stable on my shift for some reason, or it's a new med, I'll take my own set prior to administration.

  • 3
    NurseBlaq, Orion81RN, and evastone like this.

    I think most programs discouraging you from working, but the reality is not everyone can attend school without a concurrent source of income. I worked full time through my ADN program and it was doable, thanks to a pretty flexible workplace environment, and family.

    A.M. Wolf- pretty harsh advice on the family plans. It's not that I don't care about the planet, but I wouldn't exchange my kids for anything. We may be leaving a larger carbon footprint, but we're also doing our best to raise kids that understand the importance of giving back to others.

  • 2
    serenity now and dexilna like this.

    Quote from CCRN2BE
    I can completely relate......

    I don't know when this shift to the following happened, but I know I, nor my fellow coworkers, appreciate it.

    Dump your student on my floor and tell them they're assigned to "me".

    Recently had a student "assigned" to me whose clinical instructor was not even present on the unit/floor. Did not see said CI at all throughout entire shift. Student shows up with no stethoscope, no books, no paper, not even so much as a pen and tells me they'll just be "following me around."

    For one, I cannot stand to be followed around (anywhere!) and don't appreciate when I can't even sneak away to the break room to shove some food in or to the bathroom without a student trailing me.

    The student gains no educational benefit from chasing around a nurse who just wants to get her own work done without being interrupted 5 million times with questions. I want to say, "go look it up!" or "where is your instructor?!?". If they'd put just a tiny bit of effort into thinking or attempting to learn, I might not be so irritated by it. But a student who shows up completely unprepared and then grills me with questions about every action I take or do not take and expects me to regurgitate the what, why and how of everything is just wasting both our time.

    I know I sound harsh, but this method leads to a poor experience for the student and the nurse both. I wish they'd realize they are not doing their students any favors by structuring clincials this way.

    With the exception of a few great students, we've had a rash of unmotivated and unprepared students with MIA clinical instructors from programs like this lately and it's caused a lot of frustration for all.
    That's awful! I know one thing I miss out on being on third shift is that we obviously don't get any students. I would love to have the opportunity to payback for the awesome nurses I had in my hospital during my clinicals. We had to pass meds with our CI, and other than that we were expected to answer the lights for our patients and do more of the PCT stuff. But the nurses I had were awesome about involving me with other aspects of care, like inserting Foleys, dropping NG tubes, sending me to learn from the monitor techs for the tele patients. We did our best to stay out of the way so they could work, but we were there if they were willing to spend the time with us. Thanks to all of you that are helping the students, and I hope these programs wake up about appropriate use of clinical time!

  • 5
    Here.I.Stand, saskrn, sallyrnrrt, and 2 others like this.

    How awful. And of course these sorts of stories are the kind that get attention, so many people have the impression that nursing home staff members are often negligent and conditions are horrendous. I'm so sorry for this family that they had to see their loved one die such an awful death. Really tragic.


close