Latest Comments by P B and J

P B and J, ADN 2,938 Views

Joined Nov 30, '10 - from 'Grand Rapids, MI, US'. P B and J is a RN. She has '3+' year(s) of experience and specializes in 'Nursing Supervisor'. Posts: 115 (32% Liked) Likes: 124

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  • 0

    A lot of what you need to know will only come with experience, and it's all dependent on what your environment is (SNF, hospital, etc)

    Without knowing the specifics...

    Help out anytime you can, be understanding and a sympathetic shoulder, try to balance the workload of your staff, delegate, prioritize, and most of all.... freely give praise when you see something good!

  • 0

    I am a new Supervisor (have been on orientation for about a week on a month long plan) at a small rural hospital (40ish IP beds). I have been a RN for just over 3.5 years, and night shift charge nurse at this same hospital for about 2.5 years. My position is technically days and nights, however most of the supervisors do not want night shift, and I actually prefer nights so that's where I'll be for the most part. Yay me!

    The learning curve is steep (NEDOC scores and such), but I am very much enjoying the challenge so far but I am looking for advice on this new position...

    What do you wish you knew when you started out?

    How do you handle difficult situations? (e.g. reprimanding former workmates/friends when they know better....)

    Did staff immediately start trying to take advantage of your lack of experience in this position? (Trying to get away with things they wouldn't even try to pull with the seasoned supervisors... every single &*^# shift so far.... grrrrr!!.....)

    Any sage advice?

  • 0

    I as well am unsure what you mean by affecting ADLs? JW's don't have dietary restrictions (unless health related or personal preference), and nothing else stands out to me other than the blood/blood products refusal.

    Can you elaborate on what exactly you're thinking/looking for?

  • 0

    I work med-surg, and sometimes our aides have 12 patients each. Depends on the night, the floor, acuity, and lots of other things. But we appreciate when the call light is used. If someone stops me in the hall to ask for something, I feel like they are standing there waiting for whatever it is, and I feel (maybe wrongly) obligated to do X right now, so I (almost always) do. Even if I'm in the middle of something.

    If a patient or family member uses the call light, whoever has a second will answer on my floor. It could be an aide, someone else's aide, me, another nurse, the charge nurse, or even the supervisor. But whoever has a second to pop in and see what's up, also usually has a second or two to do whatever it is that's needed. This is not necessarily the case for the nurse that's hurrying to give a certain med, or urgently call a doc, etc.

  • 10

    OK, I'll say it.

    Yep, you're crazy. Nosey sister-in-law not withstanding, you're 35... It's time to put your big girl panties on and grow up. Get a job, move out, support yourself, and then if you feel the yearning for further education go ahead and go for it... while continuing to support yourself on your own. Then you can tell your sister-in-law to (insert your wording of choice here).

    Besides, even if your parents continue to "support" you, I'd bet that (not-so) deep down they are anxiously awaiting having the house to themselves... Speaking as a parent, and as a sibling with brother(s) still living at home in their mid-thirties... get a job, support yourself, and MOVE OUT.

  • 1
    xholly likes this.

    Quote from xholly
    -Do you love or regret your career of nursing?
    -What was your life like before, and what's it's like now being a nurse
    -Did you have the same doubts?
    - What's your opinion of qualities that you think nurses should have, and what weaknesses do you think are a deal breaker?
    My only regret is that I didn't do it sooner. I was a stay at home mom of 4 for about 14 years before I decided to try nursing, but I was too scared. Bit the bullet and 1 year in, I am loving it, finding my place and my way, and feeling successful. I learn something new everyday, and help newer nurses find their footing as well!

    Qualities? Compassion, intelligence, be a team player, and have some confidence (nobody knows it all, if they think they do they are just going to hurt someone, but for god's sake have a backbone)!

  • 2
    sharpeimom and starwood500 like this.

    Quote from phaniea69
    1.) Collaborate w/ a pharmacist and get a recommendation from him/her that we can then suggest to the MD.
    This. In my facility asking pharmacy for a pain consult is a nursing judgment. We call pharmacy, talk to them about pain management (or lack of) and they come do a thorough assessment, including gleaning info from the chart as far as current pain meds, usage, home meds, effectiveness, etc. Pharmacy then makes suggestions directly to Doc, and follows through to assess effectiveness of the new regimen. Our pharmacists and doctors seem to get along very well, and work together. I had a patient recently that was not getting effective relief from his meds, pharmacy was consulted, and the solution (that worked fabulously!) was a BID Xanax added to the scheduled meds.

    I will also talk to the patient about what they have used in the past, and ask for this directly. "Smith in 252-1 complaining of back pain 7/10 45 minutes after X was administered. States he takes Y at home q6. Can I get an order for this? Thanks!" I almost always get what I ask for, and if not Doc will usually call and explain rationale.

  • 0

    Hello, I graduated last December as well, and have been on nights on the med-surg floor for about 6 months now. I love it If anyone tells you nights are easy, all the patients do is sleep, yada yada... tell 'em to kiss off...

    Night shift has issues all its own, at times it can be slower than days, yes, but at times it can be insane too!!

    We don't sit around listening to our patients snore, eating bon-bons, and watching video's, as I was told was all night shift nurses do last week lol.

    Try nights. You might like it, you might not. If you accept a night position, you'll likely start your orientation on days, and transition to nights after awhile.

    Then you can make your own informed decision whether night shift is for you, no one here knows you, your life situation, etc.

    Good luck!! I hope you find a position that fits you

  • 0

    By the by... no feedback is negative if you learn from it!!

  • 2
    SoldierNurse22 and poppycat like this.

    I would think this would be a good question for your PCP, the one who has prescribed your methadone... or I guess I should ask where you're getting that from?

    You should self-report, and I think you think you should, or you wouldn't be asking.

    And personally, I think time off for treatment is a GREAT reason, just as worthy as maternity leave... (whether or not it would be granted I couldn't hazard a guess...)

  • 0

    We do something similar at my hospital, only the nurses don't usually go to rounds. We report to our Clinical Leader (Charge Nurse), who then takes any outstanding issues to rounds. Sometimes the nurses do go too, mainly if the issue is complex and/or difficult to explain.

    "Rounds" here are also attended by Pharmacy, Dietary, SW, Case Management, the Hospitalists, Surgical and whoever else is anticipated to be needed.

  • 0

    Quote from Adele_Michal7
    Yes, I have seen many parents rooted in fantasy. While I understand, it makes it harder on everyone. Expectation management is important.
    Devil's advocate here,

    It's not always "a fantasy" or unwillingness to accept reality...

    Sometimes it's "hope", and that hope is all they may have left.

  • 0

    Not going to give the answer but I would.... figure out how many mls of fluids the pt is getting per hour (oxytocin and mag combined), subtract that from 125, and there's my answer.

  • 0

    I bought one for nursing school, and thought it was good enough. Then one clinical day I needed it and had set it down who knows where and borrowed my nurses Littmann... no comparison!! For graduation I asked for a Littmann Hubby bought me a Littmann Cardio III, Love it!!!!

  • 0

    I learned about competency, or lack of, like this. Legally for someone to be competent there are several requirements: First, the person must have the treatment options explained to them in simple to understand terms (usually at a 5th grade level or below). Second, they must be able to understand these options. Third, they must be able to rationalize and think about the options to decide what course of action they wish to take. And lastly, they must be able to make their wishes known. This last part is where most competency is decided, but it doesn't have to be verbal, turning their head away when food/drink, etc. is offered can be a clear indication of wishes, even without words. Competency is a tricky issue, especially if family decides to override the express wishes of their loved ones, very sad.