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jmiraRN 6,999 Views

Joined Sep 8, '10. Posts: 361 (32% Liked) Likes: 225

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  • Mar 4

    I wish I learned this lesson years ago and I ma ever so grateful that my daughter has learned it by the age of 21..

    Relationships should enrich your life.
    Don't fight for a bad one unless it's truly redeemable and there are kids at stake.
    If your relationship ever makes you feel like crap, get the eff out.

  • Mar 3

    My opinion is that I am the best thing since sliced bread, so I should be paid more. I don't have anything against the techs or the physicians, though. They're all okay. Physicians can be a little... weird, but not in a bad way. In a "building robots in the basement" kind of way.

    Seriously, though, if anyone from work is reading this I should be paid more.

  • Mar 3

    Quote from Infofreak411
    Well I agree you have too much to do, in fact I do the same thing. We actually had a consulting firm come on and asked why the the techs were the ones running around doing everything
    Anyone who believes that techs are "running around doing everything" is simply showing that they are completely clueless.

    Who knew I could delegate "everything" to techs? Wow, I'll remember that next time I have to hang blood, push IV narcotics or pressers, manage an epidural, give chemotherapy, formulate a nursing care plan, triage patients on a rough night in the ER, perform a comprehensive assessment, give a new drug I'm not familiar with, assess a pressure sore, troubleshoot a malfunctioning feeding tube, give IV sedation, hang TPN, give insulin, waste a narcotic, titrate a drip, assess funky heart sounds, interpret and treat an arrhythmia on the telemetry monitor, initiate a code blue and perform actions per ACLS protocol, intervene during a severe vago vagal episode, assess the integrity of a free flap so the patient doesn't lose a body part, give narcan to patient in respiratory failure, assess subtle symptoms of a DVT and intervene, inform a doctor of patient status and take a verbal or telephone order, etc.

    All this time I could have been sitting on my tush at the nursing station while the techs do "everything!" I have really been such a buffoon to have not caught on to the BIG SECRET!

  • Mar 3

    Quote from Infofreak411
    Well I agree you have too much to do, in fact I do the same thing. We actually had a consulting firm come on and asked why the the techs were the ones running around doing everything while some of the nurses sat at the station on their cell phones. So I know about the time crunch while giving reliable and safe care. But, at the same time why do nurses (some not all) complain about having too much only to get defense when anyone tries to help.
    No, you do not "do the same thing". RN's have responsibilities that you are not aware of. Neither does the consulting firm.
    Your attitude is coming out loud and strong. Perhaps it is that attitude that leads to a defensive reaction.

  • Mar 3

    Quote from Infofreak411
    I work alongside nurses and am in the process of becoming a nurse myself.

    While I have great respect for the profession and my coworkers as well as a passion for it (hence my reason for going to RN school), I've noticed nurses (many but not all) have this superiority attitude like their job is the only job in the Healthcare field that matters. They talk down to all the other professionals (respiratory therapists, social workers, occupational therapists, etc) and disregard any of the hard work they do and just expect a pat on the back for every little thing. I've even heard some nurses say they should get paid more than the doctor because their work is more important.

    Also, I hear many nurses complain that they have too much to do, and then when anyone tries to give them a hand they have this turf battle and think everyone is trying to take over their job and isn't competent enough to do so even if it's something as simple as helping bathe a patient.

    What's your opinion?
    My opinion? You don't know what you are talking about.

    Nurses are the very backbone of healthcare. We make up the largest workforce in the health system and we are central to patient care. We are the last stop/barrier to the patient. We are the patient's advocate. A hospital, clinic, nursing home, etc, could not function without a nurse.

    I have absolute respect for other healthcare professions, and I look to them for their area of expertise. But make no mistake. They don't have to put up with half the crap that nurses have to as they are not "chained" to the patient and the family for an entire shift.

    I have never heard a nurse say he/she should be paid more than a doctor...ever. And the vast majority of nurses I know would LOVE to have more ancillary staff to help out with simple tasks such as ADLs so that they may focus on things that only a nurse can do.

    For someone who wishes to be a nurse, you sure seem to have a low opinion of nurses.

  • Mar 3

    Quote from Infofreak411
    Well I agree you have too much to do, in fact I do the same thing. We actually had a consulting firm come on and asked why the the techs were the ones running around doing everything while some of the nurses sat at the station on their cell phones. So I know about the time crunch while giving reliable and safe care. But, at the same time why do nurses (some not all) complain about having too much only to get defense when anyone tries to help.
    I've been sitting on my wide tuchus "playing on my cell phone" at the nurses station. Never mind I was waiting for a call back and calculating total dose received/total fluid I&O in relationship to that call back, I'm sure it's just much easier and nicer to imagine all nurses to be playing candy crush and chuckling evilly while they make the techs run the floor.

    So you can't see how you're being offensive, huh? Have fun in clinical with your current attitude then.

  • Mar 3

    I have, in passing, threatened to levy fees on certain residents for each screw-up I fix without word getting to their attending.

    I have also mentioned garnishing washes from a few of the long standing hospitalists regarding every telephone/verbal order that was taken by me unnecessarily.

    But I'm joking when I say it. I don't honestly believe I deserve a physician's salary. In fact, last week I told a favorite attending just that - "I don't know! I don't get paid the big bucks and wear the fancy lab coat like you do! "

    I agree with PP: I am crazy overloaded and much of it cannot be delegated out. Certain tasks with my vent patients could theoretically be farmed out to RT, but they're just as overworked as I am, so no help there.

    Until you have ran a 12 hour shift in a nurse's Nikes, please do not inform us that we are too full of ego. We are literally the last stop before something reaches the patient. Let that sink in. *We are the last people to potentially prevent iatrogenic harm to the patient.* You're dang right I'm going to be territorial over that patient, expect the best out of everyone involved in care, and bust balls/ovaries if someone is 1) not giving credit where its due 2)making life harder by not doing their job.

    And it's not "just a bath". If there are dressings, I have to come change them once you get them wet from the bath. Or there's an open wound needing staging/cleaning that is due at bath time. Don't *assume* anything.

  • Mar 3

    I think the work we do is very important and we recognize that. I think anyone who has not done the work we do, shouldered the responsibility, accepted the liability, lived with the consequences and carried the memories as we have cannot understand that it is not arrogance or entitlement, it is simply the kind of mindset that comes with having lived with all of the above. We have earned our stripes.

    It also comes, to some degree, from being marginalized by patients, families and even other medical staff so frequently. I had a doctor tell me the other day that physicians critically think and should not be subject to protocols, but checklists for nurses are totally appropriate because of our lack of training and critical thinking experience. Wha??

    I don't think very many nurses think what we do is more important that others we work with but we do think what we do is just as important. Perhaps that has lead people to overspeak in an attempt to make that point. I wasn't there so I do not know. I find it hard to believe anyone would realistically feel we should be paid more than physicians. I also think because this tends to be a women dominated career field that the experience of women being something other than deferential and self deprecating makes some uncomfortable. Oh well.

    As far as having too much to do, we DO have too much to do and the load gets heavier by the day. Most of it cannot be delegated. When we do delegate half the time we get called lazy and treated with resentment by the CNA/PCT for doing so. The other half the time it isn't done correctly or to our standards or we find out it wasn't actually done at all...again....liability. Having too much to do is one thing. Being able to realistically give any of it to someone else to do is something else entirely. When it comes down to it the nurse is responsible. We all have too much to do, which means we are nazi about our routines, which is the only thing that lets us squeeze 18 hours of work into a 12 hour shift. This has the unfortunate consequence of meaning if we give something to someone else to "help" us, we get our routine all screwed up and it doesn't help us after all or it is done at a level or pace we cannot live with and we have to go ahead and do it or redo it ourselves anyway.

    Observing what we do and actually doing what we do are two different things entirely. Come back two years after you work as a floor nurse and we'll talk.

  • Mar 3

    Ill agree with we have too much to do, but not with anything else.

  • Mar 3

    My opinion is you're being deliberately offensive. And that the nurses you describe are idiots.

  • Mar 2

    I just started a psych job recently and it is different from what I expected. I think I am more annoyed by my job duties and the facility than I am the patients, though. It is completely paper charting, which I sort of hate. I am spending my whole shift doing unnecessary paper work that could be done in 2 hours with a computerized system. I'd rather have more time to interact with my patients and get to know them on a different level. I am mainly a medication nurse so I feel like the "bad guy" at times. I enjoy teaching about the meds, but I find there is hardly any time to do that thoroughly as a night nurse handing outs meds to 25-30 pts. There are a number of med seekers here. I also work PRN as a med-surg nurse, and you will find many med-seekers there are as well.

    I like psych, for the most part, but there are some things I need to work on and that is the med seekers and the very aggressive/rude patients. I come from a med surg background. They are very customer service oriented at my first job so I am finding it hard to be nice/respectful but firm at the same time in psych. I will tell you one thing, so far my psych job has taught me that it is okay to be firm with patients and set limits. It is rewarding to see my patients get better - no matter why they are there. I just wish I had less patients and more interactions with them. I had a really agitated woman, who is normally nice enough to me, get really frustrated with me because I would not give her ALL the meds she could possibly get. I was annoyed by her outburst, of course, but then I thought about why she was there and her background. She had a daughter who committed suicide. I thought about being in her shoes and how she must feel. Medication might be her way to "escape." If I am not mistaken, her daughter OD'd on drugs and maybe she wants to do the same to be with her. Of course I won't allow her to do it, but I can emphasize with her. The best I can do is to be honest with her, be respectful, and be firm in the rules.

    I can totally understand your frustration, but maybe if you think about why/how they became that way, you might be less stressed and annoyed by these patients. You will find the good and bad in all nursing specialties. You will find med seekers in all specialties. When I was in my early 20s, I dabbled with some alcohol issues, although I was highly functional. While I do find med-seekers annoying, I realize that I
    was once that person - in a lesser degree. I, thankfully, overcame those issues but these people might not be there yet. Now I can see why my family was so pissed/annoyed by my behavior. These people need care, too.

    We have a bunch of bitter people at my work, too. Screw them. Don't become that. I have quite a few patients say they were happy to see me on my day back, that I was the best med nurse, that I was one of the few who told them what their meds were (which is preposterous!), and that they were even scared to ask some other nurses for meds. Revel in the appreciation you receive from these patients. Many others are probably appreciative of you, too, but can't put it into words.

    Bitter folks are everywhere. BE better and maybe it will rub off on them. And if it doesn't, at least you will feel better.

  • Mar 2

    Re-reading this, I'm a little embarrassed that I sound like the nurses whose attitudes I frown upon. I have nothing against the "3 hots and a cot" thing, that just shows a major flaw in the structure of society, but the frustrating part is when we get calls for actively suicidal people (there is a major shortage of Psych beds everywhere), but we never have beds available because they're occupied by someone who wants to skip jail for a few days longer. It's frustrating. I think maybe I'll choose another area, I'd hate to have my attitude affect my care.

  • Mar 2

    Quote from Farawyn
    Again, I don't get this "legit" psych patient stuff.
    Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.
    Far, as a former school nurse, this may help...

    You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

    So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

    I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.

  • Mar 2

    One of the great things about nursing, IMO, is that it is the ultimate "big tent." There is literally "something for everyone." The majority of nurses wouldn't touch psych nursing with the proverbial 10 foot pole, but there are also plenty of us "hardcore" psych nurses who would go hungry before we'd do any other kind of nursing. No one here can tell you whether psych is "for you," but, if you think you're interested, I would encourage you to give it a try.

    Best wishes for your journey!

  • Mar 2

    Help! I feel like our psychiatrist on our adult inpatient psychiatric and detox unit is being completely UNSAFE. I don’t feel comfortable administering the crazy dosage amounts he orders for the pts and I’m not sure how to approach the situation either!

    He puts every single new admission (whether they’re here for just psych or just detox or both) on Effexor XR. The part that really concerns me is this:

    He will start them on either 37.5mg or 75mg po daily for one or two days.
    Then he will increase the dosage to 150mg po qAM and 75mg po qNoon (total of 225mg/day) for two days.

    Then he will increase the dosage to 150mg po BID (total of 300mg/day!!!!)…..So the pt. is going from 37.5mg or 75mg/day to 300mg/day in a matter of about 5 days.
    The FDA Prescribing Information for EFFEXOR XR:
    Extended release
    · 37.5-75 mg PO once daily initially; may be increased by 75 mg/day every 4 days; not to exceed 225 mg/day


    Additionally, the psychiatrist will order Trazodone either prn or scheduled. Trazodone and Effexor are listed as a “Major Interaction” combination (can increase the risk for serotonin syndrome). Wouldn’t the rapid introduction of high daily doses of Effexor XR, plus 100-300mg of Trazodone qhs greatly increase the possible risk of serotonin syndrome???

    Not to mention, since some of these pts are detoxing from opiates, benzos, and ETOH, they are also on other meds like Ativan, Klonopin, Subutex, Suboxone and ordered prn Zyprexa for agitation.

    Any thoughts?


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