Latest Comments by Kooky Korky

Kooky Korky 26,504 Views

Joined Feb 12, '10. Posts: 3,685 (52% Liked) Likes: 5,028

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    I think (just my opinion) a thank you card and a small gift are nice.

    By small, I mean no more than maybe $25. I started to say $10 but remembered that milk, bread, eggs, just basic stuff costs that much.

    Take in some bagels and cream cheese or holiday cookies for the whole group that helped you and a gift card to someplace your preceptor likes is nice.

    If money is a problem for you, don't do the group thing now but do it after you've been working there for a while.

    What types of gifts are you considering? And how many preceptors are you talking about?

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    EGspirit, wondern, and TriciaJ like this.

    Quote from EGspirit
    Then what are you going to do? Ruffle feathers by spouting "opinions" and forcing your personality on others? Remember, it's YOU who wants to work with them. It's you who put in the application. If it was the other way around, if you had skills so rare and in demand that they simply had no choice but to do whatever they could to retain you, then you'd be able to ruffle feathers and give your daily opinions without fear of consequence. Without that, what are your choices? Either you will ruffle feathers or you will stifle you desire to do so. Neither is a good option. But what if you just had no desire to ruffle feathers or give your opinion or express your unique personality in the workplace.

    And I'm not talking about giving your opinion when it's part of your job to do so. I'm talking about all the other times in the nurses station when its really just part of the chatter that goes on.
    Stop chatting in the nurses' station. Stop expressing your unique personality at work. just do your job and go home. It's a job, you go there to work. you do not go there for social fulfillment, rather for the paycheck. Hopefully, you can enjoy the patients, certain tasks and aspects of the job, and some of the coworkers, but mostly it's about the work.

    I am so glad I'm not in it full time any more.

    Good luck.

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    EGspirit and brandy1017 like this.

    Quote from EGspirit
    No, of course not. But if you are going to report a colleague or supervisor, or facility for that matter, it better be for something really serious.

    And even then, you may have to realize that you will fall on your sword for doing it. And when all is said and done, all your next job is going to know is that you might report them, that you go behind your bosses back and report him or her, that you think you're better than others, that you will be spying on others, and that you have trouble working as a team.

    Because here's a fact: in any given day at work there will be medication errors, neglectful care, ignorance, failure to call a doctor, doctors who don't call back to give an order, etc., etc., ad nasueum--every single shift. So, what sword are you going to fall on? Because you can only do it once.

    And no, they can't fire a whistleblower, but you will make mistakes--every single shift, I guarantee it. And they will just start looking at them. And that's how they will get rid of you.

    I know this sounds negative, but I really don't see it that way myself. It's definitely Machiavellian, but it's neither negative or positive. It's just the way things are, and nurses burn out all the time for not understanding it. That's all I'm trying to say.
    Whistle blowers can be fired - just not necessarily openly. If the boss wants you gone, you will be gone sooner or later.

    I have worked with many people for the last few decades. Some were awful and some were wonderful. I don't think that college or the lack of it makes a person pleasant or not.

    I do know that particular personalities tend to end up in particular specialties, although there are certainly exceptions.

    Just try to keep a low profile. Do not be unfriendly but do not talk to people if you can help it. That is, don't gossip, don't gripe, don't chart in anger.

    If you expect trouble, you will likely find it, so try to keep a positive attitude. Don't let this be too well known, as someone will likely want to rain on your parade.

    Good luck.

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    ThePrincessBride likes this.

    Quote from ThePrincessBride
    I know there have been a thousand or more threads on this subject, but hear me out:

    I have been working on a neonatal ICU unit for almost two years now. Prior to that, I worked in adult med-surg and still work there casually.

    I love working with the babies and their families but socially, I feel like an outcast. Some coworkers refuse to acknowledge my presence and ignore me even when they are assigned to be my patient's secondary nurse (for when I need to use the restroom or go on break). Just today, I was happening to go the cafeteria at the same time as a group of my coworkers. They all waited for everyone else to get their food...except for me. No "see you later" or anything. They just walked away.

    They are constantly talking about stuff they do with each other outside of work and to events that I haven't been invited to. When I try to join a conversation, sometimes I am ignored or given a quick response and then they go back to talking among themselves.

    There are some coworkers who are wonderful. They are older and more experienced, but they are slowly leaving the unit, leaving me with a clique of younger nurses. I am an island of a person.

    Should I start looking elsewhere? I am planning on going back to school next year (FNP or NNP, not sure which yet). The place has good tuition reimbursement (though not astounding or anything).

    What is the rational thing for me to do? I have been bottling this in and keeping my nose down and working, but I think it might be time to leave.
    How do they get by with ignoring you when they are your secondary nurse? How do they demonstrate that they are ignoring you in this situation?

    Do they refuse to relieve you if you ask them to?

    Do they ask someone to relieve them if they need relief? (instead of asking you to relieve them)

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    ThePrincessBride likes this.

    Quote from ThePrincessBride
    If I go for my NNP, I will stick it out, but upon graduation, would transfer. They don't respect me now as a person...why would they respect me as a NNP?
    Why do you think they don't respect you as a person?

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    Ruas61 likes this.

    Quote from SpankedInPittsburgh
    I think the real question here should be "why do I care about what this yippy pack of dogs think"? Nursing is many things to many nurses but what it is for all of us is a paycheck. If you have a direction to go in your life then get there. If this place will help pay for you to become an NP let them (I'm working on my DNP now and it gets expensive but as important as financial support can you work around your clinical hours). Anyway, this isn't high school and I see no reason to leave a good job because you don't fit into a cliché of rude hags.
    Are we sure they are a clique of rude hags? Or a yippy pack of dogs? LOLOLOLOLOLOL

    All we really can tell is that OP feels she doesn't fit in with some coworkers and is sad because some she does get along with are possibly retiring or leaving.

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    Quote from np830
    The job of nursing is hard enough without having to account for the cliques. There's been some great advice here about ignoring the bad apples and focusing on your patients, finding allies and nice people amongst the other staff where you work. I think if you decide to be a NNP, it's obviously a no-brainer to stay. (Where I live, NNPs are so high in demand, that's the route I'd go!) At any rate, be the best nurse you can. Although that will piss them off even more.
    It won't necessarily make them even angrier. Some might be jealous, others might be genuinely happy for her.

    Some might not care a hoot either way.

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    Quote from FPNP
    Find an ally. Go out of your way to befriend someone on your shift. Find out about who they are, people love to talk about themselves. Then slowly start doing coffee or social events together. You don't need to be friends with everyone, or even most people, just start with one person.

    Yes. One at a time. Rome wasn't built in a day. And do be a great listener.

    I have been in your situation and it does hurt. But I didn't leave a job I loved just because I felt not much a part of the group. Anyway, is there really a group?

    You might be surprised to find that the ones with kids about the same age might get together once in a while. If their kids are in school or extracurricular activities together, two nurses might see each other outside of work because of that.

    Some might be related or have another friend in common, go to church together, whatever. Maybe they live near each other and are in the same Home Owners' Association.

    I wonder if you are just a naturally quiet, shy person while some of the others are more extroverted. No matter. I think you should try to just be yourself and make peace as best you can with the situation. Don't leave if you're not sure you are ready to do so. If you like the work, get along with Management and others, and have at least some peers you are comfortable with, it seems to me you should just be nice, help if someone asks for help and you are able to do so.

    Maybe they are at somewhat of a loss about how to relate to someone who is going to go to NP school.

    Might they envy your childless freedom? As much as people love their kids, kids do sort of clip our wings for a few years.

    Best wishes.

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    Axgrinder and OldDude like this.

    I'm so sorry about your father, MHDNurse.

    Even thought we expect to lose our parents, we suffer when they pass.

    I pray that you find strength and comfort in the days and weeks ahead.

    Try not to overdo. Take time to grieve and to rest, fortify yourself in whatever way is best for you.

    Thank you for sharing your loss with us.

    KK

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    Coloradonurse1983 likes this.

    Quote from klone
    Gone are the days when nurses are physicians' handmaidens and we blindly follow orders. You need to know much of what the physician knows so you know whether or not it's an appropriate med/treatment/intervention. If you carry out an inappropriate order, YOUR license is on the line.

    And yes, pathophysiology is incredibly important to know. Nursing is not tasks.
    Isn't Nursing tasks plus knowledge? Certainly there are tasks to learn, to master.

    Nursing professionally includes understanding why we do what we do, why the docs order certain meds and procedures.

    The nurse if the backstop, the last person who can catch wrong med orders, wrong or incomplete various other orders. So there is a great deal you must learn.

    Best wishes.

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    gaylarn4 and Lil Nel like this.

    Quote from AutumnApple
    I used to supervise on night shift at a nursing home. I saw charting deficits that would make most alert&oriented nurses facepalm. One nurse felt "Pt. coded, sent to hospital" and absolutely nothing else was perfectly fine documentation after a patient went into respiratory distress and 911 was called. I'm so grateful I was not working that night. The patient did not make it and, well, you can imagine the outcome after management saw her documentation.

    On the other hand, as has been stated already, there are those who love to hide behind the computer and (cough) document all day. I don't know what they were documenting because they never left the nurses station to do anything. And of course we had the ones who'd spin around in their chair after report and start documenting their pt assessments. Never saw such detailed assessments as those done by the ones who never left the nurses station.

    Point is, documenting is a part of what you do. Like everything else, it must be prioritized into the day. Over documenting, lacking in documentation, it's all the same thing. *But*, the problem is rarely the documentation itself per se.

    You said you do so much work that when the time comes to document, you end up leaving late. I'm going to disagree with my peers here and say your problem isn't likely to be over documenting. I'm more inclined to believe it's time management and taking control of your assignment during the day that is your problem.

    I see it like this. If it takes an hour per day to document properly, but you're running in circles with other things and leave yourself only 15 minutes to do it, you'll get out late. Most of the time when I see people getting out late, yes, they are sitting at the nurses station documenting. But it's not the documenting that made them stay late. It was mismanaging the med pass and/or other things that caused them to put off documenting until the very last minute.

    Unfortunately, there is no magic wand to wave to make you suddenly able to improve here. For all I know, you may be a speed queen in completing your tasks and manage your assignment beautifully. Often, problems like yours are the result of poor staffing and over sized assignment loads. So there really is no place to improve on to fix the problem unless you are willing to sacrifice quality care for speed.

    Welcome to nursing.

    I did Med/surg my first five years in nursing. I faced this problem as well. As time passes, your view on what is a "priority" and what is not will change and how you manage your assignment will change. It will also start to include you getting out on time as a priority. But this part of the journey in nursing can't be "taught". It's very zen like. You experience it and you find your way.
    time mismanagement is not always the problem.

    There's only so much that can be managed in a given amount of time.

    OP, chart shorter narratives if you chart narratives at all.
    Chart only for problems.

    For example: pt c/o SOB; wheezing and rhonchi noted bilat LL; resp 30/min, O2 Sat 84%; Dr. Smith notified, orders rec'd; chart the temp and whatever other VS you obtained.

    After you have carried out the new orders and rechecked the pt, write:

    CXR done, shows pneumonia per hospitalist Dr. Andrews; antibiotic started, chest PT done, (add whatever O2 supplement pt is now on, type of mask or whatever); resp 22, less labored and other VS, like a temp; family (name) notified, says will visit tonight; (This is for LTC, where families are notified for changes).

    I used to be the last one out, staying late to chart, not having taken any breaks. I checked my CNA's charting of I&O's, wts, etc. The other nurses had not only meal breaks but smoke breaks. Guess what - they didn't check their aides' charting and they barely did their own charting. They also never called a doctor for problems unless someone was literally dying. If you noted problems and didn't leave them for a doctor to see the next day, you got behind. Never mind that the pt was suffering with a sore throat or something painful but not life-threatening. It takes time to get orders for gargles, lozenges, sprays. Not getting the orders means your pt will be uncomfortable. Can you live with that? If you want to get out on time, you might have to just pass that stuff on in report and hope it gets addressed on the next Rounds. ( If it was a decent hour, I would call for stuff like that.
    Late evening, midnights - let Docs sleep.

    Their key was to make sure the med and treatment carts were restocked so the nurse following them couldn't c/o that. They charted their meds and did the minimal charting required. They got out on time.

    Good luck. You should read some of your colleagues' notes to see how they chart. You can learn.

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    Quote from LovingLife123
    But we are talking about brain death, not a terminal wean. Don't confuse the two. The patient is dead. There are no miracles to happen. I completely understand a person who is so sick that they need to be terminally weaned, and it's obvious to us, but the family is in denial. They can hold out hope, and to be honest I can see it. I may react that way with my loved ones. I hope not, but if was my husband, I can't say I would pray for a miracle.

    But death is death and it's permanent.
    You sound awfully certain.

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    Quote from Jedrnurse
    I don't feel thrilled about the idea of someone who can't do a lot of the job going directly into teaching others how to do it, if this is part of what you meant. I would consider these people "direct entry" nurse educators, not the same as those who have work experience but can no longer perform some of the duties for various reasons...
    I guess the person who has never done bedside care would not be teaching skills. I agree, that would not be a good idea.

    But he could teach theory/lecture. Or History of Nursing/Fundamentals/Introduction to Nursing or other subject he has mastered.

    Also, I envision the person would observe in the clinical arena, so would have at least some knowledge of that setting. It wouldn't be the same as actually doing the hands-on care but would be at least some exposure to actually doing it.

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    wondern likes this.

    Quote from KatieMI
    I went to undergrad with one guy who couldn't lift anything above 5 lbs. and a few more who couldn't do some parts of "traditional bedside care". All these people found their niches after a while. Later on, I met an amazing nurse navigator (blind and using guide dog), a nurse educator specifically made for this trade by God (wheelchair and Flolan pump) and quite a few of talented nursing IT specialists who never worked bedside due to physical disabilities.

    IMHO, to name or not someone who never struggled bedside care "a nurse" is a technicality. If one graduated ftom nursing school, he/she is a nurse. What and why this person is going to do with it is nobody's business.
    You give me hope for the future of the person I'm writing about.

    What is a nurse navigator?

    What is a Flolan pump?

    Thanks!


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