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CNL2B 4,897 Views

Joined May 3, '10. Posts: 578 (40% Liked) Likes: 736

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  • Aug 6 '10

    Same shinola, different day: I received twin rejections between breakfast and lunch today. One was from the hospice where I'd aced two interviews, only to lose out to someone who lives closer, and the other from the local hospice where I'd really, really, REALLY wanted to work. They didn't even give me a fighting chance---I'd had a short interview with the HR director and never even got to meet the hiring manager, who rejected my application without bothering to check my references (among whom are two of her own nurses). After seven weeks of writing cover letters, sending out applications, and retooling my resume....after seven weeks of waiting, hoping, praying, e-mails, interviews, and phone calls, I'm no closer to finding a job than I was when I started.

    I have officially hit bottom. I feel like the word "LOSER" is etched into my forehead. All these years I've worked hard and built a good reputation in the community......and now I've got nothing to show for it but wrinkles and a handful of unemployment-check stubs.

    It's getting harder and harder to keep up with our expenses now. After all, my husband and I are surviving on only about half of the income we had from our jobs, and the numbers don't compute. I just cancelled our 30th wedding anniversary celebration that was scheduled for late next month because there's not enough money coming in to take ourselves out to dinner that night, let alone throw ourselves a second wedding and reception. We've got over $15,000 in medical bills and are being nagged to death about them, even though I keep telling the collections people that it's all we can do to afford our prescriptions now that we're without health insurance. And that little bit of light at the end of the tunnel? I thought that hospice job was it for sure, but now I fear it's only the headlight from an oncoming train.

    Granted, it's not all bad. We haven't lost our home or car..........yet. None of the utilities have been shut off.......yet. We aren't starving, and we can still afford Internet access and cable; at this point, I'm grateful for just about every little blessing that keeps the wolf away from the door. But what a comedown from the past fifteen years, when we only thought things were tight financially; we'd forgotten how bad things can really be. This is waaaaay too reminiscent of our struggles as young adults, and it's going to take more energy than I feel I'm capable of generating to start over again.

    I wonder about all the usual things, like what I'm going to do if, despite all my best efforts, I can't find a job after my unemployment benefits run out, and what I'm doing wrong to cause these repeated rejections. But I'm also beginning to question whether I need to think about relocating........whether I'll ever work as a nurse again........or even whether I want to. Nursing has not been particularly kind to me, as much as I've loved it; maybe all this is telling me that I need to do something else (although what that would be, I haven't the faintest idea). And if truth be told, I really don't want to work five days a week as so many jobs seem to require; four days a week is about all I can handle without getting burnt out, and three would be even better. I'm at a stage of life when work is no longer the be-all and end-all of existence---I've got a husband who recently retired and kids/grandkids I like to spend time with, I'm getting more involved with my church and developing a social life again, and I have plenty of hobbies to keep me out of trouble. Who needs to worry about work 24/7? Haven't I already spent enough of my life doing that?

    So perhaps these rejections, as much as they hurt my pride, are more blessings in disguise......and perhaps it's time, as my father used to say, to drop back and punt. In other words, accept the fact that I don't know where to go from here, and let that be OK for now. Stop freaking out over things I have no control over, be open to possibilities outside my comfort zone and ready to seize any opportunities that arise. Put a smile on my face and hold my head up because I'm not a loser. And above all, I need to "let go and let God", because my way sure as hell isn't working.

    Psssssst.....hey, you! You still got that ad for Truckmasters? I might need that.......

  • Aug 6 '10

    Actually, I think it is a lot tamer than it was back when I joined. I also feel the mods are involved a lot more in potentially explosive threads.

    I agree with the posters above who stated that things happen when people don't get the "warm, fuzzy" responses they were expecting. Now, not to generalize here, but I think that's a generational thing. I think younger people today were brought up hearing "Everyone's a winner" and "Follow your dreams, you can do anything you want to" which simply isn't the case. I would love to have a beautiful singing voice. All the voice lessons in the world isn't going to make that happen for me.

    Some folks love to ask questions, but don't love it when they hear answers that don't mesh with their view of the world.

  • Aug 5 '10

    Why cannot women have a discussion and exchange ideas? No! They get evil and toxic! Where does all this venom come from? Is this nthe base of lateral violence? My research side of me tells me there is more to the story. What is up with the old gals?

  • Aug 4 '10

    It shouldn't be used at all. It inhibits platelet aggregation and thromboplastin formation.

    "Wound infection requires surgical debridement and appropriate systemic antibiotic therapy. Topical antiseptics are usually avoided because they interfere with wound healing because of cytotoxicity to healing cells." -Emedicine

    You'll get lots of arguments, purveyors of witchcraft and voodoo still use it.

  • Aug 4 '10

    Quote from UnionRN2
    In the last staff meeting, NM states Dr. A has complained because the female nurses make eye contact with him. We were instructed to respect his (and other doctors) culture and NOT make eye contact or appear assertive. When asked to clarify assertive we were told assertive was "asking or suggesting something for the patients".

    Excuse me! I am American and I am living in America! How come these doctors don't have to respect my culture? How come they don't have to respect me (I am a woman)?

    Of course I will continue to make eye contact and I will continue to request things my patients need and I will continue to suggest things that the patient needs. I will continue to advocate for my patients. If the doc doesn't like it... tough crap. I live in America and have the rights afforded American women. I am not giving them up to stroke the ego of a bigot.
    I am more offended by the actions of your nurse manager. Why didn't she stick up for her staff instead of acting as a mouthpiece for some arrogant physician?. I don't mind respecting others' cultures as long as it doesn't require me to act in a way that is not true to myself. In this case, Doc A needs to understand that the culture here is different and he is just going to have to get over it.

  • Aug 4 '10

    If we want to pull out the cultural sensitivity card, I would go down the route of women. In fact, throughout all of antiquity and modern times women have been and will continue to be the most oppressed people on this planet. It continues today. Therefore, feel free to pull out that card.

    While I generally disapprove of such moves, it is all good when somebody else opens that door, and it seems that is the case in this scenario. A person hiding behind the banner of cultural sensitivity so they can act like an arse. Two can play that game and an oppressed, frightened nurse is going to win every time.

  • Aug 4 '10

    STANDARDS OF COMPETENT PERFORMANCE
    Excerpt From California Code of Regulations
    Title 16 - Chapter 14

    ......Acts as the client's advocate, as circumstances require by initiating action to improve health care or to
    change decisions or activities which are against the interests or wishes of the client, and by giving the client
    the opportunity to make informed decisions about health care before it is provided.

    http://www.rn.ca.gov/pdfs/regulations/npr-i-20.pdf

    __________________________________________________ ___________________

    If this was happening in California, I would be approaching my Nurse Manager about her breach of duty to ensure that the RN's are allowed to perform to recognized standards of practice in this state.

    What state is this happening in? Is there similar wording on your State Board of Nursing website?

  • Aug 4 '10

    Quote from healthstar
    I totally understand. I agree with you. I just don't like the way ( the doctor) acted, they both work in the medical field and they both should find a way to respect each others culture. You can't make people respect your culture, you also have to respect theirs. I would be okay if this was a patient who complained about eye contact because it is all about what the patient wants and not what the doc/nurse wants.
    Why do I "have to respect theirs"? I am tolerent and sensitive to many cultures I do not respect. I do not have to accomodate a need to avoid eye contact or suggestions for my patients while practicing in the United States. Even when I was in the Middle East I advocated for the patients.We actually had a physician write "Nurses not to request more pain mediction" for a 10 years old child who had been hit by a car. He had a broken bone in each limb. He got Tylenol Suppositories for pain. I "have to respect" that? What I "have" to do, and did, is try to help my patients. Cultural accomodation should never be allowed to become harmful.

  • Aug 3 '10

    Quote from brownbook
    CNL2B I do moderate sedation for GI's, I give patients from 3 up to 8 mgs of versed. In our eye clinic cataract patients (often elderly) get fentanyl and versed from anesthesiologists. Both these patients are safely out the door 1/2 hour post procedure! I wouldn't call it "putting them down." I'm not giving versed to a sedated patient, he was WIDE awake and anxious!
    Conscious sedation is very different from general anesthesia. Many people (typically teenage boys) wake up and hit the ceiling. We have the entire OR team restrain them for 5-10 minutes until they come down enough to be transported to PACU. If the safest thing to do was to give a benzo for transport, I'm sure that would be the standard practice, but it isn't.

    To answer your original question, when I have patients react like this (in the OR and and PACU, not the floor or unit), I try and reorient them to where place and situation, and take whatever non-pharm measures I can to keep them from hurting themselves. If the patient is actively at risk of hurting himself (like trying to jump out of the bed, or has jumped out of bed and is running nekkid through the hallway), I get help from other nursing staff and anesthesia to restrain the patient appropriately.

    He was uncomfortable, but not a danger to himself. No, I don't think versed would have been to his benefit.

  • Aug 3 '10

    Get tough.
    Start telling patient's relatives that they can help themselves to drinks - don't you have a patient kitchen where they can get their own drinks? If they can't be bothered, or don't want to go down to the dining room/canteen to buy drinks/muchies whatever, tell them that you have NURSING DUTIES to perform and can't run around after them as well. Explain that your patients won't get quality care if you are distracted all the time. I have told people this and they (grudgingly) accept it, though you have to choose your words with care.
    Also write in the nursing notes that you were constantly distracted by so-and-so's relatives, that way, it is documented.
    Get all the nurses together and complain to management as well. I agree that we get interrupted too much; we are all too accesible. And many of the queries/complaints doctors and management should be dealing with. But because you are THERE at the time, you are it, and you are somehow expected to wave a magic wand and solve everyone;s problems. Because patient's relatives are in a hospital, they think for some strange reason that they should get special care as well; little Timmy needs his sore leg looked at; Dad has chest pain, can nurse just listen to his heart?; Mum's swollen leg needs a 'second opinion'. I have told all these people for legal reasons, they must attend an emergency department to be properly assessed and don't get sucked in by it anymore.
    I do not have any idea how we are supposed to get our duties done. Then if you do say to the NM you were constantly chased after by other people, that is not seen as an excuse.
    Also in some units/hospitals I have worked in, the senior nurses are very strict with visiting hours - people aren't allowed to stay after hours no matter what. That is OUR time, not theirs. Can you get management to get stricter with this perhaps?
    It makes my blood boil when managers don't do their job by backing us frazzled nurses up, and don't listen to our complaints.

  • Aug 2 '10

    Ha!! Where have you been all of my life?! I was always a bit of an odd duck in my nursing class because I held the very same views. I think people get too caught up in the "idea" of nursing rather than the reality of the profession. I always saw straight through the smoke and mirrors of the long testimonials about changing people's lives etc... I'm not refuting the fact that you do change people's lives, but it's not like they cue a string quartet, everyone hugs, and Rainbow Bright pukes glitter.

    I'm not a cold or uncaring person, but I do feel as though nursing schools can pull the wool over the eyes of students. Being a new nurse myself, it's been a real reality check. I think there seems to be this mysterious and metaphysical concept of "caring" that glistens in the eyes of nursing students.

    You can care for a patient on multiple levels and many different ways. I'm learning that often times, the highest level of caring is being an advocate for your patient.

    End of Rant

  • Aug 2 '10

    I'm sure I'll get burned for this, but today I attended a graduate panel for my former nursing program. The students got to ask us questions about pay scale, what we enjoy about nursing, and how to find jobs... etc. Well all my fellow nurses went on and on about how you touch people's lives, and you become a part of their families. They love all their patients, and *tears flowing* we're just so honored to be like Florence Nightingale. They told stories about sitting around with their patients telling stories about grandkids, and exchanging pictures. The usual cliches; a patient doesn't care how much you know, until they know how much you care. I feel like an outcast because I don't treat each patient like I'm their sweet old granny.

    Seriously the way they describe nursing is like a wal-mart greeter in scrubs. Don't get me wrong I have people tell me I'm a great nurse, and a great person. I sit with little old ladies and hold their hands when needed. But can we get the sugar out of nursing? Can we stop calling everybody sweetie, and saying how cute they are? I'm a professional, if you have pain I'll get you a pill, I'll call the doctor, or I'll try my best to fix it, but I won't kiss your boo boo. If you need to be changed, I will change you. If you're scared, then we'll discuss whatever issue you may have. I run my rear off everyday providing care for my patients but never have I treated them like my puppy. Furthermore I don't see doctors acting like Pre-K teachers with patients. Honestly as a patient I don't care how sweet and loving you are, if I'm having a massive heart attack do you know ACLS?

  • Aug 2 '10

    Everything you have stated is hearsay and only states that at worst she is a bad employee, not a bad Nurse.

    Do not feed the gossip monster.

    You nor you coworked know what her medical history may be, she may be full of it or maybe she does have migraines.

    What you should do is educate when needed, assist when possible, report if necessary and most important, keep your opinions to yourself in the workplace.

    You are a professional and are guilty of just the kind of unprofessionalism you are scared of.

    Not all Nurses are made the same and not all Nurses are good at the same things and not all Nurses learn the same way at the same speed. Be professional, may be you who is being trained one day.

  • Aug 1 '10

    Oh yeah, and I did all that for less than $10 an hour.

  • Aug 1 '10

    Quote from SuesquatchRN
    A class isn't going to change that.
    That sounds awfully pessimistic. Sure, a class isn't going to teach maturity- but it can prepare nurses to expect to have to meet a certain standard of behavior in the workplace, so they're not surprised when they're chewed out by their employer for texting in a patient's room. But it goes far beyond that. We spent one of our lectures discussing the importance of documentation. Yeah, it may seem like a no-brainer to document patient care thoroughly and honestly- but the fact is it's not getting done. One of the number one reasons for nurses getting their licences suspended and revoked is incorrect documentation- either for failing to document care or falsifying documents. Does the fact that we had a lecture and discussion on documentation mean that every single one of my classmates is always going to document correctly? No, but I expect that they'll do better than someone who was simply told to document without a discussion of the ethical and legal ramifications of failing to do so.

    Sure, attending a class on professionalism isn't going to make everybody behave professionally- just as attending a clinical skills class isn't going to guarantee that everybody is going to correctly implement sterile technique when required. But it seems completely appropriate to me for a nursing school to fully educate nurses as to the role they will be expected to fulfill when they enter the workplace.

    One of my favorite things that my clinical skills teacher tells us over and over again which cuts to the heart of professionalism is "you have to choose what kind of nurse you are going to be." It sounds cheesy, but coming from her, in the context of what we're learning, it doesn't come off that way.


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