OnlybyHisgraceRN 11,791 Views
Joined Mar 29, '12.
Posts: 755 (52% Liked)
I made way more money in LTC then the hospital.
Short version of my story is I accidentally told a pt I did not want her "to go down on me" when I really meant fall down on the floor. Oh I was dying trying to get out of that room I was so embarassed.
OK I am going to disagree. A proper slow code is an art. How to make it look like you are doing something when not really trying to save the patient. As far as I am concerned the slow code will be needed as a self defence mechanisim for health care providers so long as our society maintains it's irrational refusal to talk openly about end of life issues and accept that dying is part of life.
I am a full time rapid response nurse. I am the code administrator for my hospital and the alternate code team leader until / if the "code chief" (usually a senior med or surg resident) arrives on the scene. Occasionaly I will run the entire code like the few times there have been two codes going on at the same time or the code chief doesn't show up for some other reason.
ON several occasions I have refused to code a patient at all. Other times I will let the team know this is going to be a a "show" or "slow" code. In every instance I had reason to know the patients wishes and knew that being coded was aginst their wishes. For example one man with severe necrotic bowel, literaly rotting from the inside out did not wish to be coded. When he was alert and oriented early in his hospitalization he made the informed decision to be a DNR. Later, when he could no longer make his wishes known, his estranged wife changed his code status to full code. The real problem is that she would be allowed to do that at all. That his weak kneeded-fearful-of-a-lawsuit physicians agreed to the change in his code status is another major problem that needs to be adressed. However all that is water under the bridge when "code blue" is called on him.
If the patient has made an informed decision to be full code I will code the heck out of him. I will not go aginst a patient's informed decision and wishes. I hope it doesn't cost me my job (so far not an issue) but if i does it does.
due to documented evidence of increased risk of infection, real nurses who do patient care do not wear nail polish or acrylics. no nail polish or acrylics in patient care. try not to swoon over this.
I'm going to pick on myself for a moment. I have to admit that sometimes I blurt things out without truly thinking about it. Today I said something ( without thinking) to a patient that was purely stupid.
Long story short: My patient had to drink a medication that did not taste so good. She had to drink a whole cup and the only thing I could do to make it bearable was to add a little ice.
Patient: "This taste horrible"
Me: "Just imagine it is a magarita on the rocks"
Patients' husband: " That is not a good idea, since we are both recovering alcoholics"
Me: " Oh you are right...bad idea, never mind.( then I proceed to use more therapeutic interventions)
Needless to say I learned my lesson, never assume anything.
I now except my award for blurting out the most stupid thing ever!
OP you seem like a great preceptor who any new grad would be blessed to have. However, many preceptors are NOT like you and I would like to write a ( short) "love note" to some of the preceptors I had to deal with. Here it goes:
First, I so want to be like you when I grow up. I admire your skills, expertise, and knowledge. However, I do not wish to have your personality, attitude, and unprofessional behavior. What gives you the right to yell ( yes, raising of voice), spread rumors on the unit about your orientee, talk about everyone( including the charge nurses' sex life), put your hands on a fellow co-worker, and speak rudely to patients.
You say you hate precepting, yet nurses have quit because of your constant nagging, threats, tandrums and bullying. If you hate precepting so much then you would change your behavior to boost the morale on the unit which will retain staff. Not only have new nurses quit but experienced nurses too, some people just don't want to put up with this.
Please note that I will make mistakes, however do they really have to be reported to the nurse manager who is in charge of half the hospital. We have discussed my mistake and I've realized what could have been done better and have done better. While we are on the topic of mistakes, I have never and never will report the mistakes I've caught from you. Why? I realize that you are human and even though you've been a nurse longer than I've been alive you too make mistakes. I didn't report you when you made up vital signs did I? No, I didn't, besides who would believe me any way... you've always told me that it'll always be my word against yours.
Lastly, I have allowed you to tear down my confidence, make me feel incompetent, and leave my job. I should have never allowed you to do so and I take FULL responsibility for that.. In reality you have self-esteem issues, you hate your job, and I should have known that your behavior had nothing to do with me but everything to do with your personal issues. I will not allow this to happen again. I may not have been the best and the brightest RN on the unit but I did my best, knew what I didn't know and did what was best for the patient.
If you ask me a question and I don't know the answer I will look it up and get back to you, however starring at me for five minutes and rolling your eyes will not elicit the correct answer any sooner. I love when you ask me questions, so please keep them coming.
To my primary preceptor: You were a great, I've learned so much from you and it didn't have to take all of the above for me to "get it". I'm so sorry that you quit, however I do understand that you too could not put up with the politics of the unit.
Thank you to all of the preceptors such as the OP who really do take strives to maintain professionalism while raising a nursling. Precepting is not an easy job, and I really do realize that.
I'm tired of ER,ICU nurses thanking they are God. I used to hear my ICU co-workers put down every single specialty in the hospital. I would get so offended. Specialities are not a one size fits all. Everyone has their own unique gifts and talents that contributes to every area of nursing.
I worked having every other mon, fri, and weekend off. So my schedule was Mon-thur. and sat/sun. then Tue-Friday, off sat. sun.
LTC can be very overwhelming, especially for a new grad. One thing that helped me when I was in LTC was having a list of the residents' names and writing down how they took their meds. That is a battle in itself. Some meds need to be crushed, some taken with certain beverages, you will have to know how the resident takes their meds so it will save you time from running back and forth. Ask the previous shift to quickly give you this information.
Make sure your cart is stocked before you start, once again can save you time. Ask your CNAs to get vital signs for you, for your patients that take BP meds. Once again, a time saver.
It will take time to have a routine. Some meds can be grouped together as well. If you have 5 and 7 pm meds give them both at 6, you have an hr. window, use it.
Jot every thing down as you go. Cluster your tasks. It will take time, hang in there.
Commuter- You have done it again.... Put my feelings into an article. I was told to start off in a hospital because "that is the right thing to do" as a new grad. Even though I had previous LPN experience prior to becoming a RN, I had a really hard time adjusting to the hosptial setting.
Stat orders, codes, critical labs, call lights, all memebers of the disciplinary team, rounding, and etc. It was overwhelming. I think I'm a mixture of A and B personality, mostly b though.
During my time in ICU, I thought this was just normal new grad blues but I was wrong. Working in ICU nearly drove me into an early grave. I was drinking wine almost 3-4 times a week, taking ativan, and just really really depressed. Ofcourse my co-workers didn't help with creating a hostile environment. I came to the realization that this specialty and type of nursing is NOT for me and doesn't fit my personality.
To test my theory, I interviewed and shawdowed at another ICU and felt the same way.
I typically like a routine with an occassional code to keep me on my toes. In ICU, I felt like I was putting out fires all day long. I have an offer pending for the ER, my husband tells me I shouldn't take the job because he knows my personality does not fit one of the ER. I agree with him, however I need a job.
I'm praying I get into PP or NBN. I think I would be excel in that area.
I don't understand why you were grossed out (it was a private moment you happened upon (not a wet trach that makes you dry heave to suction/do cares on/hear it hawk! ... that's my personal gross out). Especially when you acknowledge it's a fact of life. It's not like he purposely did it in front of you or asked you to watch/participate.
I gather from your screen name you're a new nurse. Maybe that had something to do with it. Suck it up, get over the hump and know that once you've got more hands on experience, it will be easier to deal with.
Instead of having an objective, maybe you should have a profile. The profile is a summary of your nursing skills and personality. Here is an example:
Motivated and compassionate nursing candidate with hospital and clinical training. Successful in managing time, prioritizing tasks and exercising the sound judgment required to improve the quality of patient care. Moreover; I have outstanding interpersonal and communication skills, able to relate with patients in a therapeutic manner and work well with other members of the health care team.
I don't think it is a big deal to share your steth as long as you disinfect the ear peices with wipes. What if you need to borrow one someday? Just saying. However, if you feel really uncomfortable just say" I don't loan mine out, sorry" . Keep it simple.
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