Content That CrazyGoonRN Likes

Content That CrazyGoonRN Likes

CrazyGoonRN 9,893 Views

Joined Aug 14, '09. Posts: 427 (30% Liked) Likes: 337

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  • Sep 19

    Quote from Twinmom06
    a bit different as I'm inpatient acute dialysis

    when you get a text that you have an assignment of 6 patients, walk in to 8 patients as there have been 2 admits overnight, and
    #9 is in the ER having skipped a week of dialysis with a K+ of 7+ and +4 pitting edema, and the nurse you're working with (only one other) can't possibly stay past 5 pm.
    When you are work acute dialysis and assigned ICU for the day. You have an assignment of 3 patients on CVVHD, have 3 add ons, your tech is sitting a 8 hour SLED on an acidotic vented patient. You get told that there is a tylenol OD that needs a 12 hour SLED stat. A coworker assigned med surg dialysis gets that started ( leaving med surg dialysis short), and then find out that life flight is bringing in an cardiovascularly unstable pt with a potassium of 7.5 that needs a SLED, but every dialysis machine in the hospital has a patient on it, and the ED has a patient in volume overload on Bipap who needs urgent dialysis also.

  • Sep 19

    Quote from Creamsoda
    Well at least you know they probably wont live that long into your shift....incoming hot mess admission afterwards!

    That is true. When I have a patient that I know is not going to make it .... that we know is circling the drain ... Family will either withdraw or they'll die shortly. The good thing is that it takes a long time to get all the death paper work filled out by the MDs, the Chief Nurses, and so forth. Then the funeral home has to come so that always gives me like 1 to 2 hours to catch a break, some food and check on my 2nd patient.

  • Sep 19

    When you walk in to your inpatient oncology unit (normal patient ratio 1:4-5 depending on acuity) and find out one of your patients is a 1:1 and you are not an ICU. Patient was young, beautiful inside & out and had a rare form of leukemia. Family (mom a RN, dad part of hospital admin) has requested you as the primary nurse. (Ended up working 8 days straight until the patient was no longer 1:1.) Great family but very scary situation.

  • Sep 19

    Quote from CardiacDork
    Think I peed reading this....
    I am happy and quite proud that my training and experience kicked in and held up in one of the most stressful situations that I have ever been in. I don't think I have EVER had to Critically think so hard in my professional life or in my life at all for that matter. Especially when my attending and fellow were inserting the cannulations and needed to concentrate on the task at hand. I took over managing the patient's oxygenation via the vent, and hemodynamics via drips, fluid, and blood administration.

    I am certain that the trauma bay and ED had never seen an ICU RN calling the shots and managing the patient while an attending was performing surgery. I am not sure if I ruffled any of the ED MD's feathers since I basically took the reins from them (basically what I saw when I came in was the ED MDs telling other MDs and RNs to titrate and change things and then my attending telling them "no" but not explaining the reason since he did not have time to explain the physiology of what was happening and was getting visibly annoyed). Whether or not the ED MDs/RNs were annoyed or impressed, I have no idea, but I made all of the right calls, and none of them were contested.

    My mind was so racked from all of the critical thinking that I could barely speak English at the end of the shift......and yes it is my first language haha. I freaking love my job!!!

  • Sep 19

    -Crash cart parked outside your patient's room

    -You have one patient. Everyone else has 3.

    -You can smell the stool as soon as you get off the elevator

    -You pass one of your most obnoxious frequent flyer's wife walking out in the parking lot. Without her husband.

  • Sep 19

    These are hilarious and so true guys! Thanks.

    I'll add more...

    --- When you walk in to the ICU and your assignment has a crash cart in their room and a sign that reads "hemodynamically unstable, no turns, please see RN".

    --- When you sit for report and the phone goes off 5 times from CT, lab, Vascular, and pharmacy all on the same patient.

  • Sep 19

    Quote from NanaPoo
    I have to admit that when I'm really sick, like sick enough to be hospitalized, I don't want to be treated like a nurse. I don't want the hospital staff to use medical terminology with me. I want them to speak in simple terms & treat me like a normal person. I remember always being somewhat nervous when I knew I had an RN for a patient and I don't want my nurse to feel that way with me.

    With that said, I believe it's noted in my record at my local hospital because the nurses instantly ask me about my nursing job when I'm admitted!
    My expertise is in SICU, CCU and CTICU. Fortunately, I haven't been hospitalized in any of those areas. When I was hospitalized with a CSF leak following back surgery, with breast cancer and with orthopedic issues, I has out of my comfort zone knowledge wise. Yes, I know more about how the body works in general than the average patient, but I didn't know the protocols for back surgery, orthopedic surgery or cancer. I wasn't the expert and I didn't want anyone to overlook some aspect of education that I really needed because they thought I already knew.

    When my father was hospitalized in CCU, I kept quiet right up until the orientee told me that "Your father doesn't need any more sedation. If he were anxious, he'd be over breathing the vent." "Do you think that might be the Vecuronium?" I asked, before I could stop myself. "It's a paralytic, you know." She went off and consulted the resident or her preceptor and came back with more Ativan. Dad's blood pressure had been soaring into the 200s every time he heard someone enter his room or a nurse touched him. Despite the effectiveness of the paralytic, he needed Ativan!

    Not having any expertise in the area has never stopped my sister, though. I remember her telling some poor nurse that "I went to school with your manager! If you don't find my mother a comfortable place to sleep in Dad's room, I'll have your job." The thing was, Dad was in VT at the time and the staff and I saw that as the priority, not Mom's sleeping arrangements. I don't ever want to be THAT nurse!

  • Sep 19

    Quote from NanaPoo
    I have to admit that when I'm really sick, like sick enough to be hospitalized, I don't want to be treated like a nurse. I don't want the hospital staff to use medical terminology with me. I want them to speak in simple terms & treat me like a normal person. I remember always being somewhat nervous when I knew I had an RN for a patient and I don't want my nurse to feel that way with me.

    With that said, I believe it's noted in my record at my local hospital because the nurses instantly ask me about my nursing job when I'm admitted!
    I agree with you. When I had an emergency cesarean with my last child (first 3 normal vag deliveries) I knew the nurse taking care of me and she did not do a good job of talking to me about what to expect or how to care for myself afterwards. Basically, she figured I was a L&D nurse and knew it all. I got no teaching at all.

    Well, from the perspective of a brand new experience, for me, and a scary one at that, I would have appreciated being treated like any other patient.

    Another experience not related to being a nurse especially but we have an awesome hospice volunteer whose background is as a social worker. When her husband was dying from cancer, she completely needed our help with how to manage at home and to tell her what to expect with the kind of cancer her husband had. We didn't assume she knew how to handle things.

    My own father-in-law ended up being in our hospice and I stepped back and let the nurses handle talking to my family about things. I wanted to be the daughter-in-law, not the hospice nurse.

    I rarely tell people I'm a nurse when I'm in a medical situation with a family member.

  • Sep 19

    I am too much of a chicken-little to resign from a job without another one lined up. I enjoy the security that a steady paycheck brings.

    Nonetheless, sometimes the finest of us eventually reach our breaking points. I wish you the very best of luck with your future endeavors.

  • Sep 19

    If you have the time I'd go for your RN but, you can base your choice on many factors.
    -What's the job market like for LPNs or RNs in your area? In some areas LPNs aren't utilized as much.
    -What is the LPN scope of practice in your state? In some states scope is more limited than others.
    -How much time do you want to devote to school? LPN school is usually 1 year but, typically Mon-Fri 40ish hours per week in a full time program. RN is 2 years plus prerequisites but, a lot are less hours per week than an LPN program. Or there is the option to get your LPN and then transfer to an RN if that's your ultimate goal.
    -What are the wait lists like for you local programs?
    -Are you wanting to stay with your current employer? Do they hire more LPNs or RNs?
    -Financing school and salary: RNs make more but, school will probably be more expensive. LPN school may be more affordable but, some vocational schools don't take student loans if you need to go that route.
    Ultimately the decision is yours and there are many deciding factors, either is a good choice. Good luck.

  • Sep 19

    What is your support system like?

    How comfortable are you with your current income? If it suits you and you have the time and/or support, I'd say go straight for your RN credentials.

    I personally went to LPN school first because I was desperate to make better income being that the waiting list for the RN program was a 3 year wait.

    I was young with kids. Both me and my husband made embarrassingly low wages. Even with both of us working full time, renting a one bedroom apartment, living on our own in CA was a constant financial struggle. Eventually he got a better job and it got a little easier for us, but I was still set on achieving my goal of becoming a licensed nurse.

    Not wanting to be stuck at my minimum wage job anymore, I hastily joined the LPN program so I could gain better employment quicker, and just be able to at least get my feet wet in the nursing field.

    I'm now about to begin my pre reqs for the RN program at the local community college. I would have honestly gone straight for my RN if I could have.

    Some people I know are completely content with making LPN their final frontier. It's what suits them. Most of them love what they do for a living. On the other hand, some of these people have kids, little support to continue their education while working or are just not fond of the idea of returning to school to be honest.

    There's so many factors, really, to why you might want to choose one over the other. Or for what reason you might choose to go from LPN to RN instead of directly to RN.

    What do you want out of your future career in nursing?

    Is the money important?

    Is it a longing to be certified to perform a wider array of skilled techniques?

    I'd love to hear more from you. Let me know !

  • Sep 18

    Yes. It is. I posted from my phone and seems like the formatting didn't take ๐Ÿ˜. My apologies, I know it makes it tough on the eyes to read.

  • Sep 18

    Nurse lady, your open post to all of us shows such humility and grace on your part. You have placed everyone else's needs before your own. I felt compelled to let you know you are going to be okay. It may even be your time to "relax" and let life's burdens fall on your husband for the moment. He may be telling you all the "amazing" things he is learning in the ED as a new graduate. But in reality he is probably feeling overwhelmed and intimidated by his new experiences. Don't forget about your accomplishments....providing for your family, supporting your husband through nursing school and becoming an accomplished home health nurse with no prior experience. I could not imagine becoming a successful home health nurse right out of college. The thing about nursing is that we are always learning new procedures and best practices....in every speciality. Good luck in your next chapter. Sometimes we just need a little help in turning the next page.

  • Sep 18

    The docs should clean up their own dang mess.

    I generally make sure my own messes are picked up, but no way am I going into OT to clean someone else's. Besides, in the time oncoming RN spent hunting and griping at offgoing RN, oncoming RN probably could have had it cleaned up.

    Or reminded the MD their mom doesn't work here.

  • Sep 18

    It's oncoming shift's responsibility. You get paid to do good work for 8 hours, not to make sure everything is perfect regardless of the day's circumstances. By those standards in an ICU, on some days you would never go home.

    If oncoming nurse asks nicely, I would often either clean it up myself (if I've got the time) or offer to do it together (if I'm tight on time). Professional courtesy and not wanting to start a shift war, etc. It sounds like the 3-11 RN didn't have the decency to ask politely, so frankly I would probably dig my heels, refuse, and tell her to write me up in if I were the 7-3 RN. But then again, I'm not a new RN or new to the ICU. Not too cool of the oncoming RN if you ask me.


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