Latest Comments by JBMmom - page 4

JBMmom, MSN, RN 7,857 Views

Joined Jun 24, '09 - from 'CT'. JBMmom is a Nurse. She has '4' year(s) of experience and specializes in 'Long term care; med-surg'. Posts: 430 (40% Liked) Likes: 656

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  • 19

    I'm a "cranky old ___" whisperer. Give me an assignment with a curmudgeon or two any time. Usually by the end of the shift we'll be getting along just fine. And if they still don't like me, God bless them anyway. I'll provide the best care I can and listen if they need. I never would have guessed in school the crazy old people would be my niche. Gotta love 'em.

  • 1
    brownbook likes this.

    You're going to be fine, you obviously care about learning and doing what's best for the patients. It's too bad the CNA took the opportunity to make you feel badly about being inexperienced rather than help you gain experience and confidence. In nursing school there were so many skills being introduced that you couldn't possibly retain every detail, they'll come back to you when you're practicing regularly. Or you'll learn some new ones that you didn't have in school. Don't get discouraged, find some positive people that you can use as resources and just keep your head up.

  • 3

    Clearly you are a very conscientious person and I'm sorry you're dealing with a difficult situation. I would recommend you meet with your manager and ask that in the future if someone asks that you be removed from their care team, your manager or charge nurse follows up with that patient to get more detailed information about the issue. Once you have specific feedback about whatever the issue might be, you will know what you can work on to make improvements. Try not to take it to heart too much, you obviously have had many happy patients as well. Good luck.

  • 0

    In my long term care facility, we've had many people make statements about dying, and some really did. One gentleman we had was a real prankster who was always joking around. He had no acute anything going on. Out and walking in the hall just before midnight he told my coworker, his assigned nurse, that he wouldn't need his medicine that night because he was headed to his room to die. They both laughed, and he went to bed. She got to his room about 12:15am and sure enough he was gone. Not the first time he had threatened it, but we were all shocked he followed through. That's how it want to go someday, walking around one minute, gone the next.

  • 1
    NightNerd likes this.

    You're going to be fine, give yourself a break while you're settling into a new position. Little things are easy to fix, for example, I always pop narcs into a clean med cup and then add to the rest. Not that I've never dropped a med, but those narc packages are tricky.

    As for the other things, do you have an organized way of tracking your activities during the shift? Some people call them brain sheets. If you have a minute to jot down the meds ahead of time, you'll be less likely to forget. On my sheet I have check boxes for things like fall risk. If it's checked I know I need to check the bed alarm. When I first started I had more check boxes for individual activities and I've updated with fewer boxes as I don't need them.

    Attitude is all you. Everyone was new at one point, and your preceptor doesn't expect you to be perfect. If she gets annoyed, unless she offers you feedback about it, just ignore it. Maybe she's annoyed about something else, or having a bad day. People get annoyed, don't take it personally. You can do this, take a deep breath, put a smile on your face, and be the professional nurse that you are. Good luck.

  • 0

    You might call OBGYN services in Norwich, I know they have APRNs on staff, maybe one can precept you. Good luck.

  • 0

    My facility has a short term sub acute rehab wing with 30 beds. One charge RN 24 hours a day, with a med nurse 7:30 am- 2pm and 4-8pm. , It can get ridiculous, especially with how quickly they're shipped from hospitals to rehab- day two post ops, lots of IV antibiotics, including PICC lines, TPN, etc. Makes me nervous sometimes.

  • 3
    brownbook, Karrony, and cleback like this.

    Many of my coworkers in my long-term care facility (short term rehab, dementia unit and long-term care units), made the transition to acute care after gaining experience. It can be done, don't sell yourself short, or the value of nursing in long-term care for building assessment and communication skills. Good luck, and congratulations on accomplishing all that you have after some challenging circumstances.

  • 4
    xoemmylouox, brownbook, wernicke, and 1 other like this.

    I had a similar experience when I finished nursing school and got a job in long-term care. Many of my classmates started conversations with "I'm sorry", as if I faced a fate worse than death as another "not real nurse". I've since started an acute care job, while keeping my long term care position per diem. I know the acute care experience will help open doors for me, but I don't think it's the end all be all of nursing. We're all nurses, providing care in many ways with many sorts of services. I've never understood the talking down to others, but it happens in all walks of life.

  • 3

    Oh right, what I was I thinking trying to post something positive about my experience? I've seen many posts where people ask about whether nights would be good for them, so I thought pointing out some benefits might be good. Yes, where I work it's all rainbows and happiness all the time. No, I've never had a night with six needy patients, one right from the unit and a new admission. I've never had the patients setting their watch for their Q2 dilaudid so they wake from a dead sleep, but far too nauseated for the PO medication first. I've never had to run around for all eight hours without a break to pee. Thanks for the reminder, and I'll be sure to focus on that in the future. For now, few positive experiences I described make the other nights worthwhile.

  • 2
    ivyleaf and RainMom like this.

    I recently started a med-surg position with a few weeks orientation on days before starting my contracted nights position. I got up to a full six patient assignment on days and felt like all I could do was keep my head above water and address the immediate needs as they came up. Barely had a chance to look at H&P, reports, labs, tests, etc. and when it came time for shift report I really didn't feel like I knew them all that well. Switching to nights I feel like I might be able to be the nurse that I want to be. We've got six-seven patients on nights and so far I've averaged two that really sleep all night, and the rest have had something I need to address. I haven't quite learned how to manage my sleep, but as far as the job portion, it's great. I can't sit down or I'll fall asleep, so I station myself somewhere near my block of rooms and I can spend my time learning. I have time to read through most of the surgeries, tests and labs that were done. I look through all the med lists and learn the ones that are new for me. And most importantly to me, I've had uninterrupted time when a patient needed me to be there. I held the hand of my 80+ year old dementia patient who kept trying to climb out of bed. She settled down and talked, animated and nonsensical until she finally fell into a more restful sleep. My 40ish alcoholic patient that just needed someone to listen as he talked about what drinking had done to him and his family and how he really hoped that this time he would be able to stop, knowing how close he had come to death. The older gentleman with concerns about not only his health, but how his wife's health seemed to be failing a bit, but she refused to admit it and he wasn't sure how to best help. Having a chance to make that connection with people is what I wanted out of nursing. Sure, I'm sure I'll have some boring nights, but fortunately I enjoy cleaning cabinets and studying, so I can easily keep productive. I know most other shifts think we don't do anything, and I'm okay with that, as long as I know when I go home, I've done my best for my patients. So, if you're considering night shift and don't know if it's for you, maybe my experience will help!

  • 3

    I'm so sorry to read this. When I first came to LTC, I searched through threads looking for your posts to learn from you. You sounded like my dream boss!! I would have considered commuting from CT to work for you- assuming you're in eastern Mass. Anyway, the state of LTC in general can be super depressing and I'm so sorry that this recent opportunity didn't work out. Your health is absolutely way more important, I hope you can find a place that will recognize and appreciate your considerable talent and knowledge. If not, the quilting world will gain a great asset! Good luck.

  • 7

    I've worked in long-term care for years, and I have walked out the door with a clear conscience every night- even the night I had a patient tell me she hoped that on my way home I had a fiery crash and died. In any patient setting, we're dealing with people that are ill to some extent. Pain/ disease/ dementia/ environment change, all of these things affect the patients and their ability to process. Does it excuse bad behavior? No. And there are some people that are just jerks in life. I think you're acting in a professional manner and that's the best you can do. I know that in all of my communication I am confident that whether it occurred between just me and the patient, or someone else was watching/listening (because you never know when they are), I would speak in exactly the same manner. You can't get through to everyone, you can't fix everything, and sometimes you have to just let it go. Good luck.

  • 1
    cleback likes this.

    Wish I had a magic answer for you, I hope that something works out for both of you soon. My only suggestion would be to reach out to any contacts you might have to see if you can get a foot in the door for other positions. I know a number of nurses that have had similar problems finding jobs, even with experience, while others are able to find them through contacts. Good luck!

  • 1
    FolksBtrippin likes this.

    I had a positive test almost 30 years ago after being a candy striper in a local hospital. I also got a year of INH therapy while I was in college because I was living in the dorms where communicable diseases could be a problem. Over the years I've had to have a couple chest x-rays, for nursing school and a new job, but other than that I've never had anything happen. Don't worry, get the information you can from your doctor, and take care of yourself. Good luck.