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madwife2002, BSN, RN Guide 98,752 Views

Joined Jan 17, '05 - from 'Ohio'. madwife2002 is a Clinical Service Specialist. She has '26' year(s) of experience and specializes in 'RN, BSN, CHDN'. Posts: 10,271 (21% Liked) Likes: 6,063

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  • Jan 9

    This article was written by a member of allnurses. Due to the delicate and emotionally charged nature of the article as well as details, the member wanted the topic posted anonymously. If other readers have articles they would like published anonymously, please contact me by private message.

    Let’s start out with my first encounter with a parent. I was a paramedic (a newbie..a innocent.,,) called to a home of a 4 month old that rolled off of a couch. The baby is seizing and the father is talking about how he was making the baby a bottle. He was alone with the kid and the mom was at work. He claimed to put the baby on the couch and the baby rolled off the couch. A short couch...onto carpet. The story didn’t add up. The baby seized the entire 30 minutes it took us to get to the nearest hospital, and then later died from massive head trauma. Shaken baby syndrome. That was some fall.

    This was my induction into real life. I was out of my protective cocoon and my rose colored glasses cracked in the truth of real life. I have scraped children off of the highway who were unrestrained; I have whisked children out of homes that were besieged with fighting under the protection of cops; and I have taken children to the ED scared to be touched by anyone.

    The pressure of being a paramedic became too much, so I chose a new profession...pediatric nursing! (insert snarkiness here).

    I was working in the ED when a mom brought in her 13 year old. Both were afraid and the mom said the dad would be there soon. Mom did not have custody, and the dad was not happy the kid was in the ED. Dad, I am sure after meeting him, is in a gang. The cops were brought in, the mom asked to leave, the dad was cursing up a storm and I confronted him. “We will absolutely not tolerate that type of behavior in the hospital, in a CHILDREN’S HOSPITAL. If you don’t sit down and be quiet, you will be escorted out.” Nicer than a punch, and I kept my job.

    I myself was escorted by security to my car after work….fearing what may await me.

    A 15 year old on life support who OD’d to see if her mom loved her. She did not want to die, she wrote me in a note when she was intubated, she just wanted to see if her mom cared. The child took a turn for the worst with multi-system organ failure. As we strived to make her comfortable and keep her body in a hypothermic state, the mom was mad at ME because the room was too cold. She tried to fire me from being her daughters nurse. This after she so nonchalantly said, “pull the plug”. I stayed at the bedside and held her hand as she passed away, mom went to go eat.

    A 13 year old dying from HIV/AIDS. The dad wanting to be at her side, the step-mom wanting to go do stuff. The dad confided in me once, when he was irritated with his wife, that his daughter was never treated fairly by his wife. He wanted to bring his daughter home to hospice and wanted to redo her room - a makeover - just how she would have loved it. The wife would not hear of it, since the girl was ‘gonna die anyway’. And she did, in the hospital room with nursing staff at her side.

    The mother of an 18 month old who was beaten by the mom’s boyfriend. The grandmother had unofficial custody since the day the child was born. She had unofficial custody of 3 of the children because the mom was always partying and never had time for the kids. When the family decided to remove the child from life support after the baby was declared to have brain death, the mother banned the grandmother from the room. That was the only time I did not let a parent help me bathe a patient after the patient died….and I gave them a time limit for grieving as well. The fact that the mother was holding her dead child and talking about going to Chili’s and a movie later in the day sort of made up my mind, along with her acting like this was a party and yelling at her brother to “go get me a coke, hey, my baby just died and you need to be nice to me”, and “hey, you know that ************ was going to go get a new car today?” Absolutely no feeling at all about the loss of a child, but enough bitterness in her to block the one true person who cared for the baby from being at his side.

    The four year old who was NPO for surgery. As usual, the patient did not go to OR before lunch and she became fussy and..hungry...I walked past her room to hear her father yell at her to “Shut up!” as she was crying. I went in right away and she was reaching for his lunch. His McDonald’s fries and burger he was munching down on. I absolutely kicked him out of the room (sans roundhouse kick to the face).

    I know that people deal with grief in unusual ways. I have seen grief, I have seen the absolute absence of grief, and I have seen those who pretend to have grief. For me, the people who have not one ounce of compassion for the child who most needs their love are the ones who I cannot and will not ever understand. I know that people don’t think beyond their own needs, even when a child is crying and does not understand what is happening.

    But it doesn’t mean I agree with it, or have to like it.

    As a nurse, the hardest part of my job is to not say and do what I really think and feel. Or I would have been in jail a LONG time ago.

    What have you seen that makes you want to commit an assault?

  • Dec 11 '15

    Have you been looking for the perfect Christmas gift for your co-workers? Or maybe you need some ideas to give your family who are shopping for you. You know.....let them get you a gift that you might actually use.

    Nurse Beth has compiled a list of great Christmas gifts for nurses.

    To take a peek at her list, go to:

    25 Top Gifts to Buy a Nurse for Christmas.

    Thanks, Beth for helping us out with this shopping dilemma!

    What's on your list this year???

  • Nov 18 '15

    Quote from madwife2002
    First of all thank you for caring so much that you are asking for advice on the renal diet, two things you need to know are your patients on dialysis or are they on a renal diet to slow down their kidney deterioration? By this i mean are they stage 3 or 4 pre dialysis patients?

    The reason I ask this is because the Renal Diet is different for pre dialysis patients-my suggestion is call or send a note to the dietitian at the renal centre where they get their dialysis. Each patient has their own specific diet prescribed for them and the dietitian at the dialysis facility would be more than happy to send you information on each of your patients.

    Dietitian love it when nursing home staff contact them about this as they have a deep frustration when it appears NH patients eat just what ever they want, plus drink what ever they want and their lab results suffer as a consequence.
    Call the facility before you leave-staff in renal units start very early and leave a message on the dietitians voice mail or speak with an RN who can get you all the information you would ever need.

    If the pt is in end stage renal failure but not yet requiring dialysis then you need to speak with a dietitian at the doctors office or you can fax the dietitian and ask for them to provide you with a diet for that specific patient

    I hope this helps
    Tonight's project was scouring her chart to see if I could actually find any specific info. I could find a dietary consult nowhere in her chart. I could find no specifications on potassium, sodium, or phosphorous amounts. What I did find was that it said high protein renal diet so that was helpful to me. She didn't actually ask for any snacks or food. I will look and see where the dialysis center she goes phone number is and if food requests become an issue I know who to call. My other two dialysis patients were actually in the hospital right now so I didn't look at their charts last night. (Plus it was kind of a crazy shift to be looking up extra stuff ) Thanks for all your (and the other posters) help!

  • Nov 17 '15

    I would never,ever give a pre poured med.

    Can a mod move this to the PDN forum?

    Just want to see what other Pdn nurses do in these situations.

  • Nov 17 '15

    To me, this is no different that giving someone an injection that someone else drew up and handed you. Once you're the one sticking the needle in the person (or, in this case, pouring the formula into the bag), you're 100% responsible for the medication or formula and its administration. I would not be any more comfortable administering a tube feeding I hadn't prepared myself (or, at least, observed the preparation) than I would be taking an unidentified syringe or tablet from someone else, taking her/his word for what it is, and administering it. I don't care how much I trust the person who is handing me the formula or the medication, it's just bad practice. I'm surprised the nurses there have been agreeable to this practice. My position would be that, if Mom wants to mix the formula, then Mom can administer the formula, and I would be documenting the situation thoroughly.

    I'm sorry to say that I agree with the write-ups and report to BON. I hope this will turn out okay for all of you.

  • Oct 24 '15

    I am surprised that a national corporation such as Interim Healthcare would resort to placing an ad with such a flagrant cultural bias.

    I am assuming the family told the staff at Interim that they wanted no Haitian nurses, which is why the ad has such overtly discriminatory wording.

  • Oct 24 '15

    I just wanted to thank all of you at allnurses for posting such supportive and helpful threads in this forum. As a new grad, I read through old coping strategies and tips for new grads after a rough shift. These posts always make me feel so much better about my first year as a new RN (I'm still in orientation on ortho)!

    Thank you, nurse buddies, for helping us "Baby RNs" out! It really is appreciated.

  • Oct 22 '15

    Thank you so very much for being willing to answer any Dialysis related question. I am interested in PD nursing and just wondered what a typical day is like for a PD nurse and where will the position lead me. I eventually wanna be a manager?

  • Oct 18 '15

    I did Home Care in some of the worst neighborhoods on the South Side of Chicago.

    My patients and their families would watch out for me. I had one patient whose next door neighbor always "just happened" to be sweeping his stoop when I made a visit.

    I had one patient who was fairly important in the gang hierarchy. I made it clear that I never wanted to encounter anything I would have to swear to in court-when I made a visit, his lieutenants would nod to me as they exited his apartment.

    I did my job, got in and out, held my head up when I was walking. One patient told me, "If it wasn't for visiting nurses, we wouldn't have any kind of good care."

    As opposed to the rich family who expected me to come in the servant's entrance and take off my shoes.

  • Oct 11 '15

    I will tell you from personal experience what makes a good leader; screwing everything up majorly.

    My first management job (as an assistant manager), I had all my employees ready to walk out the door in 2 weeks. What I learned is that leadership is learned through experience. Six months later, I was a top manager and my company was sending me to under-performing locations to rehab them. Thankfully this was during my 2nd year of college and my post-grad employer.

    I also learned to work for myself. I am now damaged goods, can never work for someone else again because I will not put up with BS. Last management job where I worked for someone, I told them they could not micro manage me, that I would make mistakes and take full responsibility for them. When I turned the business around and started to grow it, I was micromanaged. I walked out.

  • Oct 9 '15

    Dirty as in people who come to clinic with tiny roach infestations dropping from them as you take their vitals? Or do you mean bedbugs that infest your exam rooms that require fumigation? Head lice and scabies are our friends.

    Maybe you were referring to people whom you can smell before they walk in the door? Patients who eat in your lobby and spill every sticky substance known to mankind, then tread through it and contaminate the entire office?

    If not them, maybe people who use the restroom, don't flush and manage to leave the facilities trashed as well as a trail of excrement that follows the sticky trail throughout the office?

    Then people, for some reason, think it's okay to play with any equipment, including the computer, or allow their kids to play with the equipment. I won't even tell you what kind of goobers I've found lodged between keyboards and in otoscopes--and not cerumen either.

    So to answer your question--clinics are perfectly sterile places where you will never get dirty, sick from a patient, or become infested with critters.

  • Oct 8 '15

    Thank you everyone! This is something you hear a lot about but never get to experience at all unless you specialize (where I've worked we weren't even allowed to change a wet or half-off dressing on a dialysis cath even though the dressing sure looked the same as any other central line.)

  • Oct 6 '15

    Maintaining friendships is exhausting to me. When I get home from work, I want to be left alone. I am friendly when I am at work, but that's as far as I like it to go.

  • Oct 6 '15

    There was a great suggestion made on starting an "ask us" thread regarding what one does, and how you can become an LPN (and there are other threads scattered throughout AN)

    So, ask away, and I will check and answer what I can about being a career LPN.

  • Oct 6 '15

    Just want to point out that not all great leaders are in management, and that not all those in management are great leaders. I know the terms get used interchangeable a lot, but I think there are times they are done so incorrectly.

    If we don’t respect our managers or leaders we will ‘Feed the Hog’ a workplace phenomenon that is discussed in detail by David Maxwell and Kerry Patterson in their book ‘Crucial Conversations’
    Feeding the hog is about disengagement, lack of enthusiasm, spending time talking negatively and not doing their job. Feeding the hog affects productivity, resulting in unfavorable outcomes, not something we want to encourage in healthcare.
    I think that this can be a double edged sword, though. Leaders need to earn the respect of their staff- it isn't a given that they should receive it simply for holding the position. My direct supervisor? Respect the heck out of her. When there's no help for lunch relief, she's right there giving people lunches. When there's an emergency, she's right there to help out. That makes her worthy of my respect.