Anna Flaxis, ASN 26,920 Views
Joined Oct 15, '10.
Posts: 2,867 (67% Liked)
I started out in nursing because I felt I had missed my window of opportunity to go to medical school, and nursing was a far more realistic and attainable goal. When I started nursing school, I thought I'd become an NP or CRNA. I had no intention of stopping with a 2 year degree and staying an RN.
Things have changed. My priorities have changed. I don't want to spend the next several years of my life in school, going further into debt and taking on greater liability. I want to spend my free time enjoying my life, doing the things I love to do, before my life is over.
I've seen too much tragedy, human suffering, pain, heartbreak, and regrets for risks not taken, life not lived to its fullest before it is cut short, and I don't want that to happen to me.
I know I'm smart enough to be a doctor, but I'm satisfied with my role as a bedside RN. My decision to stay an RN has nothing to do with how intelligent I may or may not be, but rather, how I envision my life path.
And to be honest, "NP" doesn't automatically confer intelligence, IMO. In my relatively short time in health care, I've seen plenty of NPs that aren't exactly brilliant. One can manage to make it through an NP program and pass the boards and still not be the brightest bulb of the bunch.
So, I say let them think what they will. Someone with that attitude is just setting herself up for some really humbling experiences. Just smile and nod, knowing this.
OP, I completely understand your frustrations. I almost went to MS right out of nursing school, but ended up on a post interventional cardiac unit instead. Though the specialties might be different, they're still both floor nursing.
At first, I would get sick to my stomach just thinking about going to work. During my shifts, I would look longingly at the elevators and fantasize about what it would be like to get on them and never come back.
But, I did what someone told you to do, and just kept going. Just kept trudging along. And you know what? It DID get better.
After 2 years, yes, I still had the occasional crazy shift with no time to tend to my personal bodily functions, just glad nobody had died on my watch, but more often, I felt like a pretty darn good nurse. I learned how to structure my days, and when structure had to go out the window, go with the flow. I learned tons about pathophysiology and pharmacology, and feel now like that experience was a solid background for starting in the ED.
I would give it some more time. It will get better. You'll either continue to hate it, or you might actually start to like it. If you continue to hate it, then you can transfer to a different specialty with a solid clinical foundation under your belt.
Best of luck to you!
Yes, my managers sided with me on the out of scope of practice, but did still choose the preceptor over me and it makes perfect sense, they've invested a lot of time, money and energy into them more than me and human nature tends to value the those opinions we've built a relationship with over a newer relationship, just part of our nature. Also I would be the most expendible due to being the most new and less skilled of the two. While it may not add up to you, that is okay. It is what it is, and I do need to move on. While I do feel that I would have thrived with a different preceptors whom I worked with side by side in different situations and they taught me well on certain skills, that doesn't really matter either since doesn't change the outcome now. The reason I had written the original post is more due to trying to figure out how to move on, and figure out how to pursue my next job since it was already difficult to get a job as a new grad, let alone someone who was let go.
The preceptor delegated medication administration to a PCA, and also used medication from a different patient on their current patient, also it was not prescribed yet either.
So Yes, I am CERTAIN the preceptor went outside her scope.
also it was not prescribed yet either.
Thanks, guys. It helps to know other people understand and aren't judging.
I have seen bodies, young and old, mangled by car crashes, heavy machinery, freak accidents, falls or jumps from heights, gunshots, stabbings; I have seen dead babies, children with skull fractures, some head wounds you wouldn't believe, a young man with his face shattered beyond recognition; I have seen cardiac arrests, debilitating strokes, electrocutions, near drownings, amputations, successful (and many unsuccessful but impressive) suicide attempts...shall I continue?
You don't think that I am *acutely* aware of what horrible things can befall my friends, my parents, my siblings, my chidren, my lover, my SELF?
For anyone to imply that I lack empathy for what the victims and their families endure in these situations, simply because I chose to vent about a frustrating aspect of my workday shows such a complete and total level of ignorance and holier than thou-ness that I can only shake my head in utter amazement.
Don't you dare lecture me on therapeutic communication until you have been the one reassuring the pediatric trauma patient's mother as you push the sedative and paralytic into his little vein so the doctor can intubate him.
I think that until the DEA removes marijuana from Schedule 1 designation and the FDA approves the smoking of marijuana as a medical treatment, then Nursing as an institution is hardly any more responsible for relegating marijuana to CAM status.
But to me, that's beside the point. I don't think of "CAM" as a dirty word. I don't think things have to be mainstream or FDA approved to have value in the health care milieu.
As far as I know, nurses are not employed in marijuana dispensaries.
I've cared for many patients who use MM. Since smoking is prohibited at my facility, they are not allowed to smoke it while at the facility.
I think, with the question of dispensaries staffing nurses aside, the role of the nurse with MM is the same as the role of the nurse with any type of CAM.
I want my patients to trust me enough to tell me what other modalities they use. This is important information for the health care team to have. For example, nutritional supplements and herbals have many interactions with pharmacalogical preparations (St. John's Wort is a biggie).
Even if their CAM doesn't have any known interactions, it's still important information to have. For example, if my patient sees a Reiki practitioner twice a month to help with their PTSD symptoms, that's good information. It tells me a lot about that person, and can open the door for further communication.
How I might feel personally about any particular CAM does not matter, and should not interfere with the patient's ability to trust me enough to disclose their use. I want my patients to trust me, and I work to make sure that trust is well deserved by being nonjudgmental about their health care choices.
The "Ebola Crisis" caused me a significant amount of distress. When my workplace started preparing, they gave us PPE that left parts of our skin exposed. The room they selected to place potential Ebola patients had glass doors, and I was told that the doctors would not be required to go inside- they could just look in through the glass. The phlebotomists would not be required to go inside- the nurse would do all of the blood draws. Housekeeping would not be required to go inside- the nurse would do the cleaning. When I questioned all of this, the exact words were "It's for the greater good".
Paramedics are flogged with "scene safety" and are not required to put themselves in harm's way in order to do their job- because if you don't take care of yourself and keep yourself safe, then you can't take care of the victim.
And yet, nurses are expected to sacrifice themselves for the greater good.
Good for Nina Pham. I hope she wins.
I want you to be my family members nurse!
Depends on the clinical picture.
Is this a new medication for the patient, or have they been taking it for a while?
If it's new, I agree that it would be safest to have them on the monitor for at least the first few doses.
If they've been on metoprolol for some time, and it's simply a route change due to NPO status, it is important to avoid abruptly discontinuing the medication, as this can lead to a whole host of problems, such as Acute MI. It would be of great import to make sure they get their dose. If you're not comfortable with an IV push, then mixing it in a mini-bag and infusing over 10 minutes would be a good compromise.
Let me first preface by stating that I do not work corrections, but I do receive inmates on occasion in the Emergency Department.
I would think about the harm that could come from making the wrong assumption. If you determine that the patient is lying, and it turns out they really *are* having an MI, they could die.
If you determine that the patient is being truthful, you follow protocol, send them to the ED to r/o MI, and the workup turns out negative, what is the harm that can come from this? None, that I can see.
My advice is to follow your facility's protocol to the letter, and leave the question of whether the person is lying or not out of it.
The rationale is if the H&H is 1/2 of what is should be but all are saturated with 02 then of course your going to get a decent sat BUT they don't have enough RBC's to adequately oxygenate the rest of their body. Is that correct?
My question is: If a patient is in respiratory distress, what do I do especially if the MD is nowhere to be found and my RN co-workers are busy with their patients? I’m new and I don’t want people to die on my watch.
Thankfully for this patient, she got an ICU room before her breathing got too bad. She was also perfusing fine and her O2 sats were reasonable if she wasn’t doing anything. I’m just scared for when I get a patient who is in respiratory failure and I have nobody to turn to. PLEASE HELP ME!!
Advertise With Us