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Been there,done that 47,938 Views

Joined Aug 4, '09. Posts: 5,460 (74% Liked) Likes: 21,256

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  • 4:14 am

    If it means you start hiring the best people for the job instead of just the person who was there the longest, I see nothing wrong with it.

  • Sep 17

    In all seriousness, nursing is all about noticing things. IMO nurses may not have superior senses, but can have greater awareness of sights, smells, sounds, etc. because performing assessments becomes second-nature. Maybe now you're just noticing and scrutinizing those observations more closely.

    I swear that since I became a nurse, I can't help but assess strangers when I walk down the street. I notice gait, veins, skin discoloration/condition, WOB, and all kinds of things I never thought about before nursing. I've sat next to people on the bus and thought, 'I wonder if this guy is in heart failure?' just from those small observations.

    Or maybe we need to get you one of these eye-roll inducing mugs...

    Attachment 24950

  • Sep 17

    "But to what expense all my other great needy ones would feel the bane of my neglect. Oh, the choice is tearing me apart! Deep gut wrenching sobbing escapes my lips. Salty tears cascade down my otherwise pale, but flushed cheeks. My bosom heaves as I race to be by his side.

    Onward I fight my way to my beleaguered patient. I look away from all the others waving desperately as they vie for my attentions already so precariously stretched to their overburdened limits. No matter to meeting their seemingly petty needs. HE needs me. HE is my calling. For HIM I will forego all others ..."

  • Sep 17

    Quote from Horseshoe
    "It was a hot and sultry night as I approached the nursing station for my shift. Though the temperature was oppressively high as I signed in at the computer, I felt a chill at the dark and moody atmosphere oozing from every pore of the unit. This did not bode well..."
    "Suddenly, a tortured cry shook my foundations. It crumbled me to the core. It shattered my shimmies. I ran, though I ran blindly, not seeing but hearing, feeling, tasting the anguish which I knew I must quell. All my senses, but my eyesight, beckoned me to go.

    Rounding the corner, I could finally see what had called me. My eyes had opened like a defiant flower in Spring. It was a man. A very handsome man... my patient who had entrusted his life to me... and he was in pain. My heart melted, but I knew I must be strong. Somebody had to save him. I readily accepted the challenge..."

  • Sep 17

    Those don't bother me as much as many of the "articles" published here on AN. These are supposedly scholarly articles, but often they are poorly written, don't impart much practical information, and/or don't present any particularly compelling problems or issues. And the writing style is often just so unprofessional.

    "It was a hot and sultry night as I approached the nursing station for my shift. Though the temperature was oppressively high as I signed in at the computer, I felt a chill at the dark and moody atmosphere oozing from every pore of the unit. This did not bode well..."

    GAG me.

  • Sep 14

    It is physically impossible to work a night shift and then stay up all day taking care of your family with no sleep. You have to sleep. It's not something that is optional. You need to figure out what to do to get some help here. If day care isn't an option then something else needs to become an option.

  • Sep 12

    Quote from ashrnbsn12
    I'm working in CVICU and just graduated last May. I feel like a crappy nurse because there is still so much I don't know. I leave work after a shift and the next morning when I show up for my shift the next day, my preceptor/ night shift nurse ambush me with things I did wrong or issues that they noticed (i.e. forgetting to hook a heparin line, mix my antibiotic, chest tube was off of suction, a med wasn't given etc.). I'm almost off my 12 wk orientation and I still feel like I can't do anything right and don't know if I'm just being too hard on myself. Anyone else ever experience these issues when they were starting out? Words of wisdom?
    All of these are serious matters. 3 med errors and a treatment error. You are right to be concerned. Hopefully, they did not result in problems for the patients.

    That said- and you do already know it, right? - where is your preceptor? Isn't he or she supposed to be teaching you how to not make these errors? Does she bear some of the blame for letting this stuff happen by her preceptee?

    By this time - at the end nearly of your orientation - you need to put a stop to all these errors. Now. You are NOT being too hard on yourself.

    You simply need to figure out a way to remember everything. Lots of folks here use a "brain". You simply write down every single patient's name, all of their IV's (rates, location, type of fluid, piggybacks, etc.), all of their oral, topical, eye, orifice, aerosol, spray, etc. meds by name and time, write down everything about each patient, everything. Tests and treatments they're scheduled for, discharges to be done, and so on.
    Follow your list, check each item off after you do it, do not allow yourself to be pulled into giving any bedside direct care that you don't have to do. Let the aides answer lights if at all possible. Once you are 100% on your RN duties, you will be able to help with other things. If anyone faults you, give in and do other than RN stuff if you think the person will crab about you not doing it even if you explain why you're not jumping at the bit to give baths and get people in and out of bed - unless these are absolutely expected of you.
    Do your I&O's on time. Try to round with the doctors. You learn a lot and can ask questions that might help prevent calling the doctor later.
    Get some extra sleep and take your vitamins and become a real whirlwind. You can do this. You are working in what I assume is your choice of jobs. So give it all you've got and come back and tell us you made it!!

    BTW "ambush" - it might feel that way, but they do need to tell you when you do stuff wrong. I hope they don't try to make you feel stupid or tell you stuff you did wrong in a public way. They know you're new, they should be helping. Take their informing you of errors as teaching, which you do need. Thank them for caring enough to let you know. What does your boss have to say about these things?

    Best wishes.

  • Sep 12

    Quote from ashrnbsn12
    I'm working in CVICU and just graduated last May. I feel like a crappy nurse because there is still so much I don't know. I leave work after a shift and the next morning when I show up for my shift the next day, my preceptor/ night shift nurse ambush me with things I did wrong or issues that they noticed (i.e. forgetting to hook a heparin line, mix my antibiotic, chest tube was off of suction, a med wasn't given etc.). I'm almost off my 12 wk orientation and I still feel like I can't do anything right and don't know if I'm just being too hard on myself. Anyone else ever experience these issues when they were starting out? Words of wisdom?
    These are not minor mistakes.

    I would be concerned about a pattern. Did they all happen at the beginning of your orientation and are getting fewer? Did they happen when you started taking more complex patients? Have you made any of these mistakes twice?

    You use the word "ambush" but how would you like to be informed of these errors? Call you at home after your shift? Have the whole list laid out before you at your exit interview?

    Do you have a self-prepared check-off list of stuff that you know you have to get done or chart on? It is not always possible to get your stuff done and leave on time until you really get your habits and routines perfected. I used to make it a habit to mix my antibiotics before I spiked the bag after running in 50ml of plain ole D5W and having a day nurse chide me.

    Of course we all make mistakes, it's what we do about them that makes the difference. Do your best to objectively analyse how you made the mistake and think of a way to correct that. Don't just count on your memory. Believe me, that is a losing proposition.

    Most, if not all, nurses have a "Brain Sheet" they use to keep themselves organized. You need one specifically for you. Ask around. There are also some templates on this site that you could tweak.

    Work the problem. You can do this.

  • Sep 3

    I could go on and on about this, but I'll keep it short. I help when I am able. I can't remember ever working with a nurse that acted "too superior" to clean or toilet patients. Seriously. Nurses deal with emesis, sputum, blood, and all types of body fluids, so I really doubt that most believe they are too good to help with poop and pee. I also have always heard CNAs complain that the nurses don't help "when they're right there" or "they're not doing anything". I also have had CNAs roll their eyes or even refuse when I've asked for assistance because I had other priorities at the moment. I've never seen a CNA work overtime finishing their shift for more than perhaps 30 minutes, but I have seen nurses stay 1, 2, or more HOURS late finishing their work on a regular basis. When my 12 hour shift has morphed into 15 hours long and my CNAs left right on time, it can get really frustrating hearing this. I agree that CNAs have a very difficult job and are not paid nearly what they deserve, but this CNA vs Nurse crap has got to stop

  • Sep 3

    Quote from ShockMe
    There is a nurse I am working with tonight who refused to clean her pts up and she's been sitting at the desk playing a candycrush-like game on the hospital computer.
    Guys, we found NOADLs!

  • Sep 2

    I wouldn't take A & P and Micro together. I did very well in Micro, but it was the only class I took that semester.

  • Sep 2

    What you don't understand, because you can't unless you become a nurse, is that many times we absolutely do not have the time.

    I can put someone on the toilet, take them off the toilet, help with a boost/reposition/transfer all day long, sure I"m a team player.

    However, there is no one but me to complete the tasks and assessment/monitoring that I have to do. I can't take the time to toilet someone who I can't leave alone and I can't take the time to change briefs, either.

    You don't see 70% or more of what the nurse is doing or what is happening in her brain. My CNAs have 12 patients each. I have 30. I have meds to pass, skin checks to complete, blood sugars to obtain followed by insulin to give. Then I have to document it all. I am ALWAYS at work at least an hour longer than any of my CNAs, and that's okay because it's my job.

    Unless you can go medicate my patients and do my assessments, I need you to help me do the things you CAN do, and that is patient care.

    If nurses are delegating out of convenience, that's a different story, but most of the time you just don't know what you "don't know"

  • Sep 2

    Daniel Gilbert, in his book "Stumbling on Happiness" says that it makes us feel better if we have someone or something to blame for our lot in life. And often, when we blame someone or something other than ourselves for our stressors, it's merely a case of not being able to deal adequately with those stressors that causes us to make a decision and take action, whether wise or unwise, healthy or unhealthy.

    Joseph Campbell said, "Mystics swim in waters where others drown". There are those who are able to transcend an experience and utilize that experience to grow in consciousness.

    And finally, Richard Bach in his novel "Illusions" says "Argue for your limitations, and, sure enough, they're yours."

    I fault no one in drawing boundaries and saying, "Over this line, I do naught!" for I have done it myself. No job is worth my health and well-being. I have quit Nursing twice in my career and pursued the freelance Art Thing. I came back to Nursing when the business end of things in Art got at as comparably stressful as working as a Nurse.

    The very best to you in your endeavors, NursingBro!

  • Sep 2

    Good for you! Nursing has also ruined my quality of life, and I'm getting out as well. It sounds like you have great computer programming skills, and I wish you all the best.

  • Sep 2

    Honestly? I can relate. Nursing, at least hospital floor nursing, ruined my quality of life. At one point, I found that I was drinking more than I ever had. It snuck up on me. I didn't leave nursing. I just found somewhere else to work, a different specialty, a different place. Things got so much better after that. The high anxiety I was experiencing went away. I actually like nursing now. But back then, I definitely dreamed about leaving the profession. I just had put so much hard work into it and wasn't ready to completely give up. But I can understand why you would want out. Nursing can be brutal. And if you are an anxious person to begin with, it can really beat you up. I wish you the best as you move on to what works better for you and makes you happy.


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