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Lev <3, BSN, RN 52,912 Views

Joined: Jun 3, '11; Posts: 2,895 (53% Liked) ; Likes: 5,349

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  • Apr 3

    My friend said "Hey ER nurse!", then proceeded to show me a darkened spot on the tip of one of her toes. It's been going on for years actually.

    I dutifully examined the toe, then proclaimed "That's not an emergency.". Case closed.

  • Apr 3

    This is why I stopped discussing any personal topics with patients and families.
    My birthplace, my accent, where is my family, who is my husband, how many kids - I am sorry, sir/ma'am, I DO NOT WANT to speak about it. Change the subject. No excuses like "but I am just curious". Repeat as needed. If they want another nurse after that, better for me.

    And I just wouldn't work in a place which puts someone' nosiness and something worse above it's own employees' safety and comfort.

  • Apr 3

    To be frank, I deal with patient's only for a short amount of time (ER nurse). If someone is verbally abusive/screaming/yelling/acting inappropriate we will place them in a room, on the monitor, and shut the door partially. We deliver care and follow through on the MD orders, but if the patient refuses then we stop and again shut the door partially and continue to monitor the patient. If they are unable to control their actions due to medical diagnosis we will medicate them with haldol, geodon, ativan, or benadryl. We will place spit masks on the patient's that are biting/spitting, place pt's in restraints if they are physically aggressive. During all of this we do not engage/speak/attempt to placate the patient if it only furthers the behavior.

    If the patient is alert and oriented, I will tell them to stop. I do not make demands, I will simply say: "That is unacceptable, you need to stop. There are children/other patient's nearby who are sick and this is not fair to them." I will then deliver the ordered care without verbally engaging with the patient. If the patient continues to be verbally inappropriate, I have had the MDs discharge them from the ER and have security escort them out. Legally we have an obligation to ensure they aren't dying/treat obvious life and limb situations but we do not have to put up with harassment.

    If the patient is sick enough that they need to stay, I will continue to provide care but will not go to the bedside unless security is present/at least one other nurse is present to protect myself from being both physically assaulted and/or to prevent the patient from saying I did something inappropriate/did not medicate at ordered/etc.

  • Apr 3

    Quote from Sour Lemon
    It is odd that nursing staff is not allowed to set limits at all, though. I have to put up with difficult patients like everyone else, but I will let them know when they step out of line ...and that I'll be back in "ten minutes" to check on them so we can try again.
    Yes, we are not allowed to verbally reprimand or anything like that. Better to just excuse ourselves under the pretense that we have to check a call light or something and then come back in ten.

    This patient says horribly abusive statements to many of the staff and has the whole place in an uproar. Many staff are actually considering quiting and going somewhere else because they do not feel they have the backing of the administration.

    When nurses feel they do not have any value where they work they get depressed. It's a very sad state of affairs. Makes me sad and depressed to think about it.


    I am trying my best to see administration's point of view, they say this patient has the right of freedom of speech. However, Freedom of Speech does not include hate speech, rascist remarks or verbal abuse.

    It's time for a change.

  • Mar 1

    Orientation would be 2 months with a preceptor on one of the units and then one month on my own on the same unit. After that month on my own I move on to the next ICU and do the same process until I complete all four. It would be about a year before I am fully oriented on all of them.

  • Feb 1

    Quote from Been there,done that
    Not harsh.. speaking the truth.
    Perhaps, but it was done in a quite harsh manner.

  • Feb 1

    Ruby Vee, I totally agree happiness is a choice. So is sustained misery

  • Feb 1

    Quote from deej394
    I am a nurse on a cardiovascular stepdown unit and I have been there for about 2.5 years. I am very involved on the unit and have tried to come up with other things to help me be more satisfied with my job. I am a charge nurse, active on unit committees and involved in new nurse education. I'm feeling stuck because I don't know if there is anything that will make me happier and more challenged.
    I've never really had an interest in going to the ICU. I just don't see myself caring for 1-2 patients at a time, even when they are much sicker. I think it would still end up being boring after a little while.
    Basically if anyone can help, I feel like I've stagnated and I don't know what to do. I don't want to be one of those people who switches to a new job every two years, but this may be what I have to do for myself to be happy with work.
    I am likely starting school in the fall for my FNP, but I am thinking that maybe I should go for the ACNP route, just to prevent myself from becoming bored as quickly.
    If any of this makes any sense, and if anyone has any ideas for improvement, please let me know. I just applied to an ED job, and while I think I would like that, I don't know if it's the right solution.

    Thanks!
    Boredom may be an early sign of burnout. Or not. There are plenty of threads on how to deal with burnout -- google a few of them and think about whether any of the suggestions seem as though they will help. Two and a half years is long enough to be competent at your job, but there is always more to learn. Are you focused on continuing to learn? Or are you just going through the motions right now? Only you can answer that. The key to being more challenged at work is usually to challenge yourself to learn more . . . sending blood gases on your patient? Make sure you understand the ins and outs of normal blood gases and what an abnormal result may indicate. Do you understand all the meds you're giving inside and out? Side effects, toxicity, interactions with the other drugs the patient is getting?

    As far as happiness - most folks are just as happy as they make up their minds to be. That includes at work as well as in general. If you make up your mind that you are going to be happy with your job, in the absence if any truly toxic aspect of your job, you probably will be happy. You have to CHOOSE happiness, not just vaguely want it. I'm not saying I'm happy every single day -- but most days. Focus on the positives, not the negatives.

    If you choose to be happy and to challenge yourself, you're well on the way to being happy.

  • Feb 1

    I hate it that nursing professionals are using the term "mini stroke" for TIA. A TIA is not actually a stroke, mini or otherwise. I think this term is very confusing to patients and great care should be used when explaining to patient or family what a TIA actually is (as well as what it actually is not).

    Agree with others that just passing on information like that was not the wisest thing. I would have gotten a lot more clarification from the outgoing nurse (why did she believe the patient had a TIA, what is the patient's DNR status, was family called with onset of symptoms, what kind of follow up was done, etc.).

  • Feb 1

    What a fun read! Thank you. Please do share more.

    I wonder which "Nursing Interventions" we use in 2018 will get chuckles from nurses (and nursing students) in 101 years...

  • Feb 1

    Nux vomica is still used a lot on CAM, especially in aurvedic medicine. As the name says, it causes vomit which is supposed to "purge the body" of whatever thought to cause the disease. I'd seen liver failure caused by it once.

  • Feb 1

    "We are very fortunate to live in the times that we do, and have the experience and information of all the nurses that come before us to implement into the standards we have now. If you want more early 1900 state board questions, tell me and I will share. I have a whole book of them!"

    Yes, I would love to hear more!

  • Feb 1
  • Feb 1

    Thanks so much for writing this. I have been in recovery for 15 years. Stone cold sober since 2004. I participated I an alternative to discipline program and came back from the depths of suicidal depression to regain a life I love. I admire your bravery. My life is pretty much an open book and I share my experience, strength and hope often. I like people to know that they can be in recovery and be practicing nurses once again. Keep on Stepping.

    Hppy

  • Feb 1

    Brave, brave, brave nurse. I am absolutely looking forward to your next installment and would like to toss my hat in the ring of admiration and support, both for your continued sobriety and for your ability to rebuild your life. Thank you so much for sharing this with us. It may save a life.


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