Rosenhammer 2,571 Views
Joined: Jul 31, '12;
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if there is no policy regarding this requirement then you should not have the responsibility. Frankly, I do not think any co-worker should have that responsibility because there could be legal ramifications, chain of custody of the specimen and other issues.
In some ways I agree with you. However, I don't necessarily agree that all ill people should be dnrs. I think the discussion of what the pt wants should occur. I don't think health professionals should make the decision. I don't think insurance should make the decision. I don't think the government should make the decision.
Had a 65 year old cousin, masters prepared rn who was disabled. Went to hospital. Became critically ill. However, each time professionals asked her she stated she did not want to be a dnr. Should we make her a dnr against her wishes?
I currently work on an inpatient psych unit where we don't have patients dying on us. However, I used to work long term care and have helped many older patients through the dying process. I think that its normal to become "desensitized" or "used to" dealing with death. However, I will never forget some of the sadder cases I've seen, there is one in particular I will never forget. This poor elderly woman literally drowned in her own secretrions (end stage CHF) on Christmas day with her son by her side. I will never forget the look on this womans face as she died, in agony. The physician refused to order this woman any pain medications and she died a terrible death.
1) The middle-aged female who presents with abdominal pain and intractable nausea for which no cause is ever found.
2) Patients admitted for detox. I hate DTs and wouldn't wish them on my worst enemy. I also hate the fact that 99.9% of the time, they're going to go through hell and then right back to doing what got them into this condition in the first place.
3) Borderline personality disorder....especially when they have other psychiatric illnesses. I had one of these where I worked a few years ago, and she got on my last nerve. She was manipulative beyond belief, and her mood swings always seemed to conflict with mine (she had bipolar 1 and GAD, as well as BPD). Needless to say, it took everything I had to maintain my professionalism with her. Bleah.
4) Crazy families...'nuff said.
By contrast, the patients I LIKE best are grumpy old men......I love to spend time with them and listen to their stories. It almost always turns out that there's a heart of gold underneath the gruff exterior.
Trachs are terrible, seriously. All of the secretions! And the smell in their rooms. Like you're camped out inside their lungs.
Post-op Whipples are the worst. Just shoot me. Every complication can and will happen with these patients. It's heartbreaking and very frustrating.
I hate it when you've barely introduced yourself to the patient and family member and they drop some big wig's name "Do you know Mr. So-and-so?" ...I know that he's the CEO of the hospital...let me guess, you're best friends? Give me a break!
I'll start with people who say "I went to nursing school" Okay, but are you a nurse?
I need my meds today. Also I can't pay for them.
Moms who let their kids run wild and scream. I get that stuff hurts, go ahead and cry. No need to run like a wile monkey or screech like you're dying, I assure you that if you were dying you'd have no time to yell like that.
And let's not get started on the drug-seekers!
Manipulators who attempt to intimidate by using my name at least twice in each sentence. They are often, but not always, the male significant others of female patients with minor or vague symptomatology.
5) Crazy families. I had a woman keep me on a phone for 20 minutes, discussing her husband's (a patient) meds and his clothes and how we weren't taking proper care of him...and he wasn't even my patient and she knew it! She just wouldn't let me go, even to find her husband's nurse.
Why did you become a nurse? This is a common question that is asked of nurses. Here is my story of why I became a nurse and how I discovered my dream job.
In 1995, I attended an educational course sponsored by the Ophthalmic Nurses Society (ASORN). At the time I was a certified ophthalmic assistant which is similar to a medical assistant, assisting eye surgeons in a clinic setting. It was at this educational course, that I realized I wanted to be a nurse. It was the ophthalmology aspect of it that intrigued me. I also enjoyed working with patients. I am a people person. Soon after taking the educational course, I enrolled in my local junior college and took one class at a time while working full time and raising a family.
Ten years later, in 2005 I quit my job to attend college full time. I completed my prerequisites, transferred to the local State University and completed my BSN in Nursing. My original plan was to go straight into ophthalmology but after three years of school I realized that there was much to learn about the body and about nursing. It is said that a new nurse should work on med-surg for at least one year. Three and a half years later I was still at the bedside. I was fortunate to have had a telemetry unit position as my first job. There was a med-surg component mixed with some specialty (cardiac).
Six months ago, I felt as though change was going to occur soon. I didn't know what type of change but I felt that it was time to leave telemetry for something else. I asked friends how they liked ICU, ER, L&D, etc. Nothing sounded like the right fit. I was looking for my niche. Don't get me wrong, I would have been more than happy to work in any of these areas. I didn't need to leave telemetry but if I was going to leave I wanted it to be a place I really wanted to stay in. I am a planter. I don't like to hop from job to job. I like to plant myself somewhere and stay there.
Then one night as I was driving home from work, it was like a light bulb turned on above my head. Why not go back into ophthalmology? I had experience in this field. It was something I truly was fascinated with and enjoyed. I started researching different eye clinics and the ophthalmic nurses (ASORN) website to see what it is that ophthalmic nurses do. It seemed the main thing was working in surgery centers or Universities. The closest Universities that would have this set up are at least one or two hours away so this was out. I found a few local eye centers that had their own surgery suites. I walked into a few of these eye centers wearing business attire and resume in hand and asked if they hired ophthalmic RNs. I did not say I was an ophthalmic RN. I was honest and told of my pre-nursing ophthalmology background and my three and a half years of nursing bedside experience. The third surgery center I walked into was the one that hired me. Today I completed my first week as an OR circulating nurse for three eye surgeons, and a few other surgeons (ENT and Urology). And I love it!
My advice to those who are trying to find your niche in nursing: really do your research. Talk to other nurses in different fields of nursing. See what they like most (and least) about their fields of nursing. Ask a seasoned nurse you work with what type of nursing they think would fit with your personality. If you have a good seasoned nurse mentor they may have an idea where you might like to work. Another question is if you have any previous background that you can use to your advantage. Can you use anything from your past to market yourself positively? This is what I did. None of the places I went to had a "help wanted" sign or listing of employment. I just went with a prayer, a professional, confident attitude, my previous experience and resume in tow. And now I am working at my dream job. I feel like I have found my niche and I am home.
Respect begets respect. Thank you for this article. Truly worth reading!
Having good social skills is crucial when working in a field like nursing where a large part of your day is caring for and communicating with people. It is important to develop positive social skills so that it will be easier to succeed with your goal of becoming a good nurse. It is my goal in this article to assist you, the nursing student, to be perceptive to the patient's needs and feelings and to treat them with dignity and respect. We will discuss ways of developing a good rapport with your patient at the beginning of your clinical day. You will be surprised at how much easier your day may be when this is done.
Have you ever been to a drive through window or at a restaurant and had an employee with poor social skills "help" you?
They didn't make eye contact or may have been rude. It was obvious they didn't care. In the back of your mind, you wonder if they might have spit in your food.
How did this make you feel?
Was this a pleasant experience?
Did it make you feel welcome or want to return to the establishment to be treated poorly again?
Of course not, no one wants to be treated poorly. Now put this into the perspective of a sick patient. They don't feel well and now they are being "cared for" by someone who doesn't really seem to care. In my opinion, this is not a therapeutic atmosphere for a patient.
Working with people can be very interesting because we are all different. We respond differently in how we are treated and how we learn and retain information.
This is where your social skill building will come into play.
As you work with patients you will learn how to interact with different types of patients (this also applies to a patient's family). Some patients may fit into neat little categories: the nice patient, the grumpy, stubborn patient, the scared/fearing the unknown patient, the patient who wants to be listened to, the needy patient. Some patients are all the above. I could go on and on.
I have noticed that if a patient feels that you really care and you are there to advocate for them they will be more receptive to you. When you first meet the patient, it is important to make good eye contact with them, use positive body language (they are more perceptive then you think).
Make it obvious that you care and that you are there for them. If the patient is on pain medications (using a post-op patient as an example) make sure and discuss a plan for the day and discuss how you will try to control the patient's pain. Doing these things will show the patient that you care. As you work with patients you will get better at interacting with them. Remember that they are people just like you, going back to my bad service at a restaurant example.
Put yourself in the patient's shoes.
Do you want bad service, or good service?
The answer is obvious, we want to be provided with good service. Showing a patient dignity and respect is the key.
Making the most of Clinicals Part 1: Turn negative experiences into positive learning
Making the most of Clinicals Part 2: You're on stage-Make a good first impression
Very true! I'm a CNA and students can be a huge blessing for us sometimes. Other times, they turn up their noses and act like they're better than us. Those are the ones I always reallllly hope don't get a job on our unit. Just fyi... on our floor, our manager always discusses the candidates with the staff... from RN down to housekeeper. He also values our opinions. Treat every time you step foot in a hospital like it's a job interview, because really... it is.
Just because someone switched jobs multiple times doesn't necessarily mean anything negative about them, maybe they aren't willing to work in a subpar environment or had to move or who knows what. I left 2 jobs where the nursing standards were horrible, employees were treated like garbage, and patient care was not a priority. But if you look at the dates it just looks like job-hopping. In reality though, I refuse to lower my standard of care for my patients, or my self-respect as as a person and as a nurse.
A 42-year-old man, husband and father of two little girls, who was a direct admit from his workplace after complaining of "a little chest pressure". Taking his medical history as I admitted him to our med/surg unit, I learned that he had the same inherited heart defect that had killed his father and his uncle at ages 51 and 48 respectively; this admission was strictly for precautionary purposes, he informed me, as he "really didn't feel all that bad".
A co-worker and friend of mine who was taking over his care asked me to grab a telemetry monitor for him. Just as I came into the room, this red-headed, freckle-faced man who looked 10 years younger than his real age---and who'd been chatting with us only minutes before---suddenly became pale, short of breath, and profusely diaphoretic.
"Oh please, don't let me die," he begged us as his color changed alarmingly from white to grey to purple. He grabbed my hand as if it were a lifeline and repeated his plea. "Don't let me die, I can't leave my wife and girls......."
Naturally we both promised him that we wouldn't let him die, even though we could see we were losing him even as we ran his bed down the hall to the ICU with RT and several other nurses working on him in transit. He lost consciousness almost immediately after we got there, followed in quick succession by his pulse and BP. Meanwhile, his wife and daughters were still in the med-surg waiting room, having no idea of what was transpiring.
We coded him for over an hour. But despite our promises, we were never able to re-establish a rhythm and he was pronounced dead, a mere two hours after feeling that "little tightness" in his chest at work. There wasn't a dry eye in that ICU after the doc called it........we all felt horrible. Even the physician and the RT were crying. Worse, we had to walk by the family on our way back to Med/Surg after it was all over; they'd been sent to wait outside the ICU and obviously hadn't yet been told that their loved one was gone. We didn't want to be around when that happened.
That one still haunts me, years later. We had a debriefing with the social worker and hospital chaplain after that, but dang, when someone clinging desperately to his last moments of life begs you to save him......and he doesn't make it.........well, there are some nights when sleep is slow in coming and I hear that poor man's voice again, and I see the fear in his eyes and feel the terrible knowledge that my hand, and not those of his beloved 'girls', was the last comfort he received on this earth.
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