Content That Been there,done that Likes

Content That Been there,done that Likes

Been there,done that 30,213 Views

Joined Aug 4, '09. Posts: 4,733 (72% Liked) Likes: 17,350

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  • 4:26 am

    When I worked full-time as either the acute care nurse, the ER nurse, or L&D we did 12 hour shifts - 3 a.m. to 3 p.m. (day shift) and 3 p.m. to 3 a.m. (night shift). It was done this way so each shift had to share "nights" and was instigated by the nursing staff, not admin.

    Getting adequate sleep is important. I'm grateful I don't work that shift anymore.

  • 4:25 am

    I've worked nights for 12 years with many different people and I believe there are just some people that can't do nights. There are people like me who can switch back and forth between days and nights relatively easy. Then there are other people that struggle on nights no matter how much rest they get. Some people never adjust.

  • 3:39 am

    Just make it through orientation, then do whatever you want. It's difficult to work with or under someone else when you have your own way of doing things ...but it won't be forever.
    People of all ages experience this, by the way.

  • Aug 29

    I never could adjust, even with adequate sleep.

    I felt as if I was in a perpetual stupor, 24/7/365. Hated it. Paid my dues on nights, and have never looked back.

  • Aug 29

    Quote from GeneralistRN
    Why are you being so rude as to call the OP a kiddo? How do you know how old she is? Nice ageism. Get over yourself -- seriously.
    I always find it interesting when someone calls someone out for being rude by being rude. Sort of like smacking your kid for smacking another kid and telling them "don't hit people"!

  • Aug 29

    I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.
    Hooooo boy. I sincerely hope this isn't your attitude in the unit.

  • Aug 29

    One more thing: SINCE you have had all 4 of your kids in the NICU, I would presume you would have wanted the most qualified and capable nurses caring for YOUR 4 kids?

    Or is that an unfair assumption?

    Why should these kids' parents not want that for THEIR kids? Your turn will come, if you improve your attitude and realize you surely have a lot to learn yet.

  • Aug 29

    Quote from RNinCali15

    Sour,

    Not sure how you think insulting my capability as nurse is constructive.

    I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

    .

    Charming.

  • Aug 28

    STOP. call a lawyer familiar with the BON and the policies and procedure surrounding this type of question. We don't know, and you don't know how your state handles this issue. Pay for some good advice on how best to approach this. The BON is to protect the public and if they decide you a risk for any reason they can make you jump through hoops or restrict your practice. The system is not on your side here so a little caution can go a long way.

  • Aug 24

    Quote from Learningtobenurse101
    The preceptor delegated medication administration to a PCA, and also used medication from a different patient on their current patient, also it was not prescribed yet either.

    So Yes, I am CERTAIN the preceptor went outside her scope.
    It's not really as clear cut as all of that. In some situations, delegation to a PCA is allowed. And there are degrees of delegation. If the PCA is feeding the patient and I have a pill to give, crushed up in pudding it is reasonable to hand the PCA the pill mixed with pudding and have her feed it to the patient. That is not delegation of medication administration. I pulled the med, identified the patient, crushed the pill and ensured that the patient received it, and then I charted it as given. All the PCA did was hold the spoon. *I* gave the medication.

    Also, in some situations it is not only appropriate but desirable to take a medication from Mr. Jone's drawer to give to Mrs. Smith. The physician gave me a verbal order to give it because the patient needs it right now. He'll put in the order as soon as he contacts IT so they can remind him of his current password for the order entry system. I cannot get the pill for Mrs. Smith from the pharmacy until two hours after he orders it, and Mr. Jones won't need the pill for another four hours. As soon as I get Mrs. Smith's pill from the pharmacy I'll put it back in Mr. Jone's drawer. That has been common practice for years, although the practice is gradually fading away as medication administration systems change.

  • Aug 24

    Firstly, CNAs are by far not the most important healthcare workers. Anybody can do their job. The tasks assigned do not take too much of a special knowledge and don't require a license. Only a certificate stating the CNA has the basic knowledge not to harm a person while caring for them. A resident will likely not die from a soiled brief or dirty teeth. They can however die without the needed surgery, or their medications and medical treatments.

    Now trust me, I value my CNAs that I work with. I was a CNA before a nurse so I completely understand the feeling of being undervalued and overworked. I really do feel that CNAs hold an important job in completing the tasks that don't require a deep knowledge base to free up the time of the nurses who can then provide necessary patient care. CNAs keep patients happy the best they can and help to keep them clean and fed and meet their basic needs. Certainly a very important job. However, this skill set is basic and requires minimal education. Therefore it will never pay well.

    People will not usually get paid well for how "hard" they work, but for (as another poster pointed out) the knowledge and experience they have. Low education requirement jobs that pay more than minimum wage become competitive to those who do not possess higher education. When there is a wide pool of eligible employees, the employer doesn't have to pay well. It's u fortunate, but it is how it is.

    Vent nt away and get this off your chest. But if you intend to stay a CNA, you will have to get over this. If you move into dietary, you will have to be more understanding of the low pay there as well for similar reasons as the low pay for a CNA. If you are looking for better pay, increase you education and experience.

  • Aug 24

    I bet you don't resent your pay check from both jobs. You wanted 2 jobs you got 2 jobs why are you resentful?

  • Aug 24

    Why are you running potassium piggybacks as a primary? Just get a small bag of NS and piggyback it. Waste problem solved.

  • Aug 23

    "5 beats of pulse-less vtach converted to sinus tach" I told the doctor.
    "Guys we need the crash cart here fast" I yelled out the hall to my pod mates.

    The physician intuitively placed his right hand beneath his left elbow making a 90 degree angle, placing his left hand on his chin.

    "Doctor the Bicarbonate is 9, do you think we should do two amps of bicarbonate? I've actively titrated the levophed for the past hour, and I believe it is starting to fail in the presence of this acidosis" I suggested.

    ---No response---

    "Doc....!?" with a higher sense of urgency I questioned.

    Breaking him from his pensive state he uttered through his thick accent, "ah yes yes, let us do two amps of bicarb"

    It was then when I turned my back to find an army of ICU nurses, ECMO nurses, a crash cart, a group respiratory therapists, junior doctors, and even my nurse manager all behind me. In the most figurative and most literal way possible.

    "Two amps of bicarb my dear" my charge said as she handed me the medication. She winked with a smile of assurance.

    It was a rather rainy and gloomy day. Large windows in the patients room reveled the dreary and wet, yet shiny, modern, majestic architecture of the adjacent buildings that are also part of the same hospital.

    "Two amps of bicarb in at 1722"

    The monitor began to display a MAP of 57, 42, and 34 all too rapidly falling, the ECMO machine began to alarm as well.

    Quickly without much hesitation, or regret I opened the roller clamp on my blood tubing as to free flow it in. I squeezed the emergent squeeze chamber.

    My interventions displaying an effect before my eyes. The MAP rising to a steady 65 after about what seemed to be an hour but was in reality about 2 minutes.

    Tapping me on my shoulder was my former preceptor "Here's 1 gram of calcium chloride, next time the pressure drops suggest to the doc to push this"

    "Hey I'm writing all this down for you dude" another nurse called out from the corner.

    Through the course of the next hour a series of events occurred. Lethal cardiac arrhythmias, lab results close to being incompatible with life, the addition of 5 vasoactive drips, and medication push after medication push. Painful discussions with family. Sobbing and crying from family. The whole sequelae of events we all know too well.

    But through this entire experience I had the guidance of centuries of combined ICU experience. Yes as the primary RN I was at the forefront by the patients side with the cardiology fellow, but it was all a team effort.


    I want to emphasize to ALL new nurses, but especially NEW ICU nurses that you are never ever ALONE. You have centuries of combined ICU experience at your disposal. Use it. Embrace it. Absorb it.

    This is what I love about the ICU. The collegiality, the teamwork, the fresh ideas of the baby doctors, the wisdom of the older more experienced doctors and nurses.

    I truly believe that the most dangerous nurse is a nurse that believes he or she knows it all.

    When in doubt, ask! When you need help, speak up, ask for help. Don't be ashamed. This is the ICU, sometimes it takes a whole army.

    Coming from the floor, I had to learn to be OK with asking for help. As floor nurses, we usually keep to ourselves and since we seldom have emergencies there's oddly a need to have more than 3 people in the room at once.

    This kind of teamwork further convinces me more that I want to become a CRNA. I will absorb all this knowledge. All these lessons about teamwork and apply them to the OR one day.

    When I'm asked, "Why do you want to become a CRNA?" I will say, one of the reasons is because I want to be part of a team.

  • Aug 23

    Quote from Alicee
    I've seen a lot of nurses who obviously hate their jobs and are extremely rude to patients, so in my opinion I feel like you do need to have some sort of passion or motivation for doing it.
    Others have pointed out the possibility of burn-out. I'd also like to point out the possibility that maybe those nurses just happen to be rude-- and would continue to be rude-- even if they worked in another field.

    You also don't know what's going on with those nurses. Their life could be really really crappy at the moment. I always hear people excusing patients from their negative behaviors because "oh, they're not well"... well how about extending that compassion back to the nurse for a change? I'm sure if you met these nurses on a better day, your opinion of them might be much different.

    And I have to ask anyone who's on this "passion" bandwagon... what does this exactly mean? Making it #1 in their life? Living and breathing it 24 hours a day? Being a martyr to it? Working for free? Hell no. If you really loved nursing-- and yourself-- you would not would not do any of those things.


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