sandyfeet, ADN 4,929 Views
Joined Jul 26, '10 - from 'CA'.
sandyfeet is a RN.
She has '4' year(s) of experience and specializes in 'Emergency Nursing'.
Posts: 417 (40% Liked)
I believe some nursing student sins are forgivable. Before I started my pre-reqs I ran a red light with a camera, and got a ticket. Went to traffic school and got it all taken care of. When I applied for NCLEX I had to declare that I'd had a traffic violation over xyz amount of dollars. I wrote a personal statement about how I had changed, and had a friend write a personal reference to my character. Now I've been a nurse for 4 years.
A nursing school may be willing to take you if you can demonstrate how you have changed and have references that attest to your character (volunteer service for example). You will have to sell it, maybe meet with the dean. You might also get some good answers from the Nurse Addiction forum. Good luck!
This is always a hot topic. It would be interesting to include in your research the acuity of patients waiting in the ER lobby for an open room...also at risk of worsening symptoms. When we have over a 2 hour wait in the ER lobby, the entire hospital hears an announcement about it.
I am in your target demographic; I just passed 2 years this summer. I am starting to get more involved by doing clinical ladder. The people I started with (also mostly new grads) are starting to do Triage because of a shortage of triage nurses on night shift, and people on day shift have complained that they are too new to take on such a task. I can see where the complaints are coming from because I don't feel ready to take on the responsibility of a full lobby!
I will say that I thought I would know more by now and I've learned that knowledge is just a slow, steady process. And that sometimes I need to hear something several times to understand it, just like in nursing school.
I had a patient on a 5150 who threatened to call the news because we were holding her against her will. Luckily her husband was able to take her phone away from her. I always wondered what the news would do in a situation like that- would they report the 'story'? Or would they protect a vulnerable person?
The "iodine allergy" is a bit of a myth. Simply because a person states an allergy to iodine does not automatically mean that they will have an adverse reaction to the iodine used to prep for foley insertion. In fact, iodine allergies are really questionable since iodine is in your body and is necessary to maintain life.
Couple of tips...
Does meditech have something like 'acronym expansion'? I use SCM and will use the acronym $discharged that the system writes out as "Patient AOx4, respirations even and unlabored. Patient states pain level tolerable to leave facility at this time" and use that on my discharge note. Little things like this save only seconds, but over 12 hours it adds up!
When I first started, it was hard for me to get a patient history unless I was standing still and looking the patient right in the eyes. BIG time sucker. Now I get history while hooking them up to the monitor. If they are vomiting I get history while starting the IV. You get the idea. Before I leave the room I make sure to chart and then I might say "I just want to clarify, you said your symptoms started yesterday?" or something to that nature.
When you are new and have a preceptor, other nurses usually won't help you out for two reasons. One, you already have two nurses to cover one patient load, so you technically already have "help". Two, when you are new is the time to struggle, figure out your rhythm, figure out your resources. You can't start out relying on other people's help. All of this does not include Level 2 ESI or higher. If your co-workers are not helping you during acute strokes or full arrests there is something wrong.
It gets better but these are the rough times!
Ancillary is the correct term, because it means someone who provides support. It's not diminutive.
I had only one serious problem with an US tech in my two years so far as a nurse. I had a pregnant patient in police custody because she was using drugs and was arrested in the street. She also had a UTI and was receiving IV antibiotics. The US tech came to the bedside to verify the pregnancy and said the the police officer "They're giving a pregnant woman antibiotics? That's awful." She didn't realize that I was right outside of the room and heard everything. Now I would have walked into the room and said something to her face about the meth probably being worse for her fetus than a Category C antibiotic, but at the time I was too shy and new so I talked to my charge nurse and wrote an incident report. Luckily the patient was so out of it, she didn't hear anything. But I always wondered what the cop thought of me and my competency after hearing that comment.
The problem with leaving a shoe or a purse in the backseat (or a diaper bag in the front) is that the parent has to have the foresight to arrange it that way. Excluding negligent parents, the problem with forgetting your child in the car seems to be one of multitasking and distraction. Someone is in a hurry and is not going to take the 10 seconds to throw their purse in the back because they are focused on completing some other goal.
I am currently pregnant so this is a hot topic for me. Maybe a sensor in the back seat that registers weight (like a car seat) and alerts you when you open your door? Like how my car tells me to buckle up my heavy work bag when I put it in the passenger seat?
Patients usually don't get violent out of nowhere. There are many verbal and physical cues that lead up to physical violence and you should be trained to spot them so you can de-escalate the situation. If I feel threatened I back away and yell "Call a Code Gray!" and yes, situations have occurred when staff came running and the patient is looking at us innocently. But I would rather be safe than sorry. Usually once a patient starts raising their voice, if it's not my patient I will walk over to see what is going on, and other staff members will come over too. My ED also uses MOAB training and our staff is really good about backing up each other.
I think it's been made clear by previous posters that you can never hit a patient. No matter what.
Patients who "know" they need an MRI or other expensive test for chronic condition. I love when the doctors shut them down with statements like "Since this is a chronic condition, it is technically out of my expertise. You need to see an XYZ specialist."
Helicopter parents of children of any age, especially of grown adult children. How are you not embarrassed that your mother "has to" argue on your behalf?
The drunks that repeatedly come in wasted and say they are suicidal, then sober up, deny suicidal ideation, and become nightmares. "I hate this place!!!". Well, great. Then stop telling the ambulance to come here.
I happened to look this up recently because I was worried about my own exposure to second hand marijuana smoke and found this article referencing a study from 1986. Not much else out there. Basically, you'd have to be exposed to high levels (no ventilation, pure smoke) for extended amounts of time over several days. In the study it was 1 hour of exposure for 6 consecutive days.
Legalized marijunana and secondhand smoke: Is it possible to get a contact high?
My patient was playing sports and hurt himself, came in my ambulance SCREAMING. When the doctor came into the room, his cell phone rang and he took the call. I.e. pause the screaming, take a phone call. The doctor was so surprised he left to see another patient. When the patient got off his phone call he asked me what was going on and I said his exam was incomplete because he took a phone call, but I could ask the doctor to come back. The patient became furious and said "My dog is dying and I don't care what happens to me. That was my dog's caregiver. I don't need your judgement about my phone call. I need to speak to your manager because this treatment is ridiculous!". My charge went in to talk to him and came out quickly; she said to me "I guess I couldn't help. He told me I was worthless and to get the %$@ out of his room. We can give him the number for patient relations." All I could think of was that playing sports while the dog was dying was ok, but now we were holding him back from being with his dog by giving him medical treatment for his hysterical pain!
Had a 17 year old female come in by ACLS; heroin OD in field, found by mother. Medics bagged her and gave Narcan IM. When she arrived in my room she was angry at the world. Patient refused vital signs (alert, skin PWD, speech clear). Explained to parents half-life of Narcan. MD entered room. Patient interrupted us several times to "please talk to my parents ALONE, don't I have the right to do that?!?". With various curse words thrown in. Once doc and I had everything sorted out, we stepped out.
Patient proceeds to beg, cry and whine to parents to take her out of ED because "I've been through this before and all they do is watch me!" and "I know I'm not going to die. I can tell." I get my Charge Nurse involved, thinking this will be a restraints and security watch moment, and leave the floor to transport up a patient on a Cardizem drip. When I come back, my charge shows me the AMA form the parents and doctor signed. I burst into tears (hey, I'm pregnant and having mood swings!) and as I discharge the patient I look the mother in the eye and say "I just want to verify that you understand you are risking permanent disability or death". Mother acknowledges.
What makes me furious is that these were not your usual crap parents that you would expect to be, well, crap parents. When the visit started the parents seemed to be on board with medically treating their daughter that had OD'd on heroin. And at some point they had this thought: "Hey, these medical professionals don't know what they are talking about. I'm going to listen to the reasoning of my IV drug-addict daughter!". And then she got them to buy in on what she was saying! So clearly the heroin is the tip of the iceberg of a family where the parents have no control and the daughter gets to do whatever she wants. To that I say "Why even call 911? If you really don't care if she lives or dies, what does it matter?".
What I wish I would have said to her and her parents was "If you OD again when you are 18, you are legally an adult and no one can take you out against medical advice. We will tie you down in order to monitor you and keep you safe. You will have no rights because you'll be considered incapacitated." And also "Yes, we are judging you, parents. We are judging your complete lack of control and lack of common sense. Yes, we think you are bad parents!" The only thing that makes me feel "happy" if that is even possible to say about this terrible situation, is that they will foot the entire bill since they went AMA.
After they were gone I had parents bring in their 7 year old daughter who swallowed a penny. Upon discharge the mother asked if she could take home our ED blanket. I told her no and she said "Oh. But it's so cold!". Um, hell no. It was 102F today and people were literally dropping like it's hot all over the county. You don't get to take a blanket!
Phew...thanks for letting me vent. What are your bad parent stories?
Yup. Home care instructions: "Stop smoking pot. It is making you sick." Done!
The best anology I can come up with for you is this. Nursing care is sort of like being a watchman on the walls of a castle about to be attacked. you cannot relax your guard, and when you see that an attack is coming you'd dam well better make sure that you passed that message along and kept on it till it was acted on. You aren't the commander, you aren't the king, you won't win the victorious sortie but you are the one on whom all the rest of that happening depends. that's where your autonomy comes, when you make that call even though it's 3 AM and you know you're going to get yelled at because you just have that gut feeling that something is going wrong. You can suggest all you like but ultimately, you cannot win that war by charging into the fight.
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