Fox_RuN 2,602 Views
Joined Aug 31, '10.
Posts: 32 (50% Liked)
You think you are going to have a stroke over the no restraints policies they are pushing !
You really hate to let the newbie take the vents cause you want them all to yourself !
You draw straws with your co-workers for the sedated patients .
You grow to hate the hospitalist that wont order sedation for the intubated patient !
When you start coming up with lyrics & song titles for the sounds of your alarms.
When you do a little jig every hour that your patient actually meets index
When you can identify your drips by sense of smell.
When your patient's room looks cleaner than your own bedroom.
When you wonder why restraints never made it to the "10 wonders of the world" list.
When outside of work, you answer your cellphone with, "ICU this is ____"
You are superstitious about the words "Code" & "Quiet" being said aloud at work.
You believe in happenings of 3.
When the amount of devices in your room requires you to recruit a posse for traveling.
When you consider levitating open chest patients part of your weekly workout plan.
What you consider humor is considered deranged by others.
When docs ask what you think they should do.
Oh, and a favorite...
When you forget your patient isn't intubated/sedated and you pass gas in their room.
Not saying I've done this, of course.
When you can't stand your patient not to look tidy and calm in the bed with all their lines neatly organized.
When you get angry that a patient doesn't have a central line.
When you see a bad car crash on the news and you think "Well, I guess we're getting an admission." (I work in trauma ICU)
When you understand the saying "There are many things worse than death."
When you put the code cart next to certain patient's rooms to ward off evil spirits.
When you run down the hall yelling "I'll do compressions!"
When it's no biggie for your patient to have an open chest and be on 12 different drips takin' up 10 lines of space on your monitor, but the thought of a patient alone in a room on absolutely no continuous monitoring absolutely FREAKS you out!!
"Ladies: wipe front to back!"
Social isolation is a common problem for Camp Nurses. It is unexpected, and little has been written about it. It is not part of the idyllic camp-life stereotype many nurses have when they think about camp nursing.
I am 55 years old, and I nurse year round for a special needs camp in the Southeast. Our Camp Director, one of those rare great men, is in his late 30s. Our Administrator is in his 40s. We have a full-time staff of six, including me, who live here all year. That staff ranges from their mid-20s to early 30s. During our seven week-long summer sessions, we have a staff of about 60, all in their late teens to early 20s. Camping, obviously, is a young person's game, often a great starting point for them.
This leaves me 20 to 30 years older than the rest of our staff. I have great respect for all of them, but, other than our love for what we do, we have little in common, as should be expected, when you think about it. I briefly visit with the staff frequently, but I never "hang out." That would be creepy, and I never want to be what the kids call a "creepy old man." The role I have morphed into, and it feels right, is that of everyone's (except the Camp Director and Administrator) father. I take "my kids" out to dinner every so often. It's a treat for them, since they make less than half what I do. They can drop in with a problem when they need to. Like all "parents," there is a lot they don't tell me, and that's okay, too.
Familiarity breeds contempt. Nursing is one of the few professions that people still have respect for (I know, I know, not always). Camp Nurses are held in a bit of awe by your typical camp staff. We are older. We have finished our education. We have an "easier" job, in their eyes. We make untold riches, again, in their eyes. Our word tends to be law. We nurses are held to a higher standard, one not always easy to live up to. For that reason, I believe we Camp Nurses need to be a bit isolated. This does not mean the Camp Nurse should be stand-offish or unapproachable. After all, heart and warmth are the heart of nursing. I seem to remember, in nursing school, something called "offering of self." So, we need to be available, part of the team, but not part of the gang.
I'll give an example. A couple of summers ago, a nurse on my staff informed me that a male counselor sexually and verbally harassed one of my young nurses. I confirmed this with the nurse involved, and I asked her why she did not come to me with this problem. "I was afraid you would go off." was her answer. Well, I did go off! I stomped over to the Camp Director and asked him to fire this guy. "NO ONE will treat my nurses this way!" I had seen enough horizontal violence back in my hospital days. The Director interviewed the counselor, and the counselor stopped working at our camp the next day.
The next spring, I asked the nurse to work another summer with us, for she is a great nurse. Before orientation, during a bull session, she confessed to me that she and another nurse (a nurse I did not ask back), had gone out drinking at a local roadhouse with some of the male counselors during weekends off, during the summer past. "What!? You went drinking with kids 10 or 15 years younger than you? Are you nuts?" That male counselor was still guilty of harassment, but my nurses "lowered the bar," and lost some respect that isolation would have gained them. That year, and ever after, I tell my nurses during orientation something like, "I cannot control what you do on your days off, but I would prefer that you NOT socialize with camp staff. Go home on your down time and hang out with your friends. I am no prude, and I do not mind if you have a drink on your days off, as long as you are off-campus. But I might get grumpy and irritable if I hear you are partying with camp staff." This applies to my new grad nurses, also. The issue has not come up since then, luckily.
I do know of a case where one of our nurses married a former camp director years ago, but it didn't last.
Okay, so we Camp Nurses get lonely. What should we do? Just because we should keep a professional distance from our colleagues, does not mean we should be isolated from everyone. It is important to talk to our families daily while at camp. The nurse should join in camp activities, when appropriate. For me, camp activities wear thin pretty quickly. I have several hobbies that I work on daily. I make sure I have a good internet connection by using my own data card. A data card means you can do your banking and pay bills safely. Don't do these things on the public camp network. I read, I play guitar, I Skype home. I am also very good at doing absolutely nothing, a skill that should be nourished.
I am the head nurse, and I make sure I do not hang out with my nursing staff too much. I figure I am bound, sooner or later, to say something offensive. I do invite my staff to dinner at my house a couple of times a month, and my staff know they can come to my house, in twos, any time, usually to have a snack and to tell war stories, or to watch something on the satellite dish.
A prospective camp nurse should come to camp prepared to be isolated. You will make friends, some you will never forget. The real opportunity here, though, is to take professional and social isolation, turn it inside out, and to end up with something good.
Which do you prefer...
1. High patient satisfaction scores OR semi-private rooms?
2. Staff clocking out on time OR bedside report?
3. Quiet at night initiative OR filling the unit with admissions all night long?
Because when you change "OR" to "AND", it doesn't work. You can't have it all. Thank you.
Night Shift Floor Nurse Who Works Her Butt Off But It Never Seems Good Enough.
Ahhh, well I don't think that's too bad. Once I was pushing a non-ambulatory pt in her wheelchair, down a slight ramp - I don't know where it came from, but I heard my own voice saying, "wheeeeeeeee!" The lady was in her mid-50s. I got a real good "withering look" out of that one.
My dream is to open a facility that only cares for comatose orpans. (no call bells or family) I figure neuro nurses will line up to work there.
coded many a baby, not a tear for anyone to see. maybe not even a tear. but they don't see you when you go the bathroom stall, stand in the corner, and just stare at the wall. coding a baby is no time for tears. neither is the aftermath. there is work to be done, skills to be exercised, parents tears to be dealt with, yours are not important.
there is a great deal to be said for being skilled. there is a great deal to be said for knowledge. you want a crying, cutesy, bubbling little nurse, they are a dime a dozen. give me a crusty old bat that knows what she's doing every time.
In the case you mention above I wouldn't have thought twice about dopin' him up, holding him down, and doing what needs to be done. If I heard most of those comments I would laugh. I must work with a bunch of bitter old nurses, because they'd all look at someone saying that like they were dumber than a sack of hammers. You were doing the guy a favor by dropping the NGT--it made him feel better! So what if you had to wrestle with him a little bit. It's not like you punched him in the face and choked him out to gain compliance!
Having wrangled many patients as they emerge from anesthesia, I find most patients get a chuckle from it after they're alert & oriented again. They understand. Even if they don't understand, it's your job. Just do it. Same goes for the story above about the initial management of a trauma patient--you've got to do what's necessary.
I am bothered when someone loses something unexpectedly (life, function, a family member, whatever), but honestly it's someone else's loss, not mine. I can usually feel bad for someone then a little later go eat a cheeseburger and joke about farts.
I don't think I'm a sociopath, just a realist. We're all going to die sooner or later. Life's hard and bad things happen. All we can do is deal with it.
I have participated in this topic numerous times over on the NP side of this site and have seen the argument from both sides, so I will just post what my experience has been. I have been an RN for 14 years and have been an NP for 2 of those years. For those NP students or those brand new NP's who claim that you don't need any bedside RN experience to be successful as an NP - I wholeheartedly disagree with you. NP programs were initially developed to build off of the "nursing" foundation that you are "supposed" to have prior to entering the program. In the not too distant past, NP programs would not accept new RN's with less than 1-2 years' nursing experience; hence the term "Advanced Practice Nurse." There have been numerous times where my years of nursing experience have helped me to not miss critical diagnoses that could have been easily missed. Yes, NP school will teach you the "common" and "typical" signs/symptoms/presentations of various different conditions, but what it won't teach you are those atypical, subtle presentations that only someone who has seen them before will likely pick up. Textbooks are great, but they can't teach you everything. This is where bedside nursing experience comes in to play; also being humble enough to admit when you don't know something, but being knowledgeable enough to refer to the appropriate specialist.
Yes, being an NP is entirely different than being an RN - but (contrary to what some will lead you to believe) having bedside RN experience will only HELP you to be a much better provider, especially in the very beginning of your NP career. It truly is about being able to know what you don't know - and not trying to pretend like you do know it all. Everyday at work I am extremely thankful to have been an ER nurse for several years, especially since I work alone. You will not typically get several weeks' orientation with another provider as an NP. You will be expected to perform competently on your own from the very beginning. No hand-holding happens at this level. For those who say RN experience won't help you to be a good NP, then I am afraid you are one of those who does not know what you don't know.
I'm an NP student, with slightly over 2 years of experience, and I resent the OP's post.
I say this as a ICU nurse who, with a measly YEAR of experience, had multiple opportunities to save the asses of SEVERAL "experienced" nurses both in ICU and in rapid responses on the floor.
I can also say this as an ER nurse who has had to take on facets of care of critically ill patients for allegedly "experienced" ER nurses who, for instance, couldn't use the IN-LINE SUCTION on a VENT. Don't even get me started on how these "experienced" nurses don't know how to properly start or to titrate nitro drips, pressors, or propofol.
I get the gist of your vent. A person is a fool if they say or think they know everything. This is independent of how much experience they have. Do not paint us all with such broad strokes.
I understand your frustration Ruby and as always you have put it eloquently.
there is a reason NP's do not have much bedside experience anymore and it is because we are burning them straight out of nursing. Increased patient loads, dramatically skyrocketing acuities, steadily decreasing resources, complete lack of mental health benefits, increased legality, and lateral violence are chasing new nurses out as fast as they can fill out the application to go back to school.
There are many facets behind the green NP other than just their lack of experience. Go back a few decades and nursing was a solid profession that you got into and stuck with (tell me you don't feel that vibe from nurses who have been in the profession for longer than say fifteen years). Today, to be honest, if you spend too much time at the bedside you risk depression, OCD, anxiety disorders, and all the health complications that come with it.
Now, of course, there are soon to be NP's like my good friend who simply are using nursing as a stepping stone to get where they want to be. That is a goal, and sometimes the quickest route isn't the best, but it gets you there. Hopefully there will be a strong nurse who will gently grab these new NP's by the chin and help guide them along their path. Because you can't change the trajectory, only try to help them navigate the obstacles.
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