Veteran nurses.... I appreciate you! - page 2
There have been some talk on AN recently about older nurses and when they should retire and blah, blah, blah. I just want to say that I appreciate the wonderful veteran nurses out there. I recently started a new job and there... Read More
- 0Apr 11, '12 by unplannedRNIt is the strangest feeling to remember my first year as an LPN like yesterday, and yet be one of these "mature" nurses you're discussing that can remember (just barely, though) when community hopsitals still used urine testing to calculate how much sliding scale insulin to give, and papwer requisitions for labs, and huge metal oxygen tanks , becuase they didn't have wall O2. We gave real backrubs and drawsheet changes and "peri care/Foly care" and dentures scrubs to everyone every night, and made the underweight ones special Ensure + ice cream or fruit milkshakes in the unit's kitchen. This was all in a tiny old "City Hospital" the year before I took my first LPN training at the "new medical center" in town--all of--gasp! 400-plus beds! High tech beds and o2 and suction in the wall and computers in the nurse's station--oh, my! (though not for charting).
I even knew a retired nurse (who worked as a ward secretary in acute care) who could remember when nurse stood to attention when doctor entered a unit (then called a ward), and gave up her seat. They also carried the (heavy metal) chart stack for the doctor, accompanying him/her to the bedside on rounds and handing him each patient's chart. Ostensibly it was to leave his hands free for reading and writing and examining, but often he would glance in it, hand it back to the nurse and give a verbal she would have to memorize until they got back to the station with the stack, where she would write it herself for him to co-sign.
I feel ancient as a nurse when I read and remember some of "way back in the 80s comments". But when I go to the hospital the pumps are what we used 10 years ago, and I can still do everything, so I don't feel out dated. Sometimes the nurse caring for me or a family member is so green and overwhelmed she does not know how to do something right, and I see much danger in that. Recently a friend had agonizing back surgery abd was agitated with pain. Finally the nurse agreed to ask for a manual bolus of something beyond what the PCA included.
While she was gone I checked the PCA settings and usage history, and saw that the pump was programmed for basal rate and patient-driven bolus and locked, but had never been released to run, and the syringe was still full. In other words, 15 hours and 2 shifts of nurses had not seen that my friend was completely unmedicated, and THAT's why she was agitated and delirious! Ironically, that had happened to me just 5 years before her, so PCAs must be tricky for junior nurses. And it was clear that even the charge nurses were green and young on that floor. When I reported it, I did so gently, but it took the team leader getting the much older unit manager to come in to confirm I was right.
I didn't chart yet in bedside computers--whch were just arriving as I left bedside nursing, though now my entire day is spent at a pc. Learning new skills is fster than gfaining years of experience, so an experienced nurse who is up to date might make the best mentor here in the staes, and an older one who remebers the old ways would cope better with a 3rd-world environment where you have to go with your gut, live with uncertainty and without technology, and find ways to invent on the spot when you have to, all the while knowing what is safe to risk trying and what not.
But I do have to grit my teeth when a younger nurse (and a few the same age as me, but newer in nursing) destroy an "easy" and previously healthy vein because they have poor IV skills/inexperience and they don't want any tips from me....they're used to technology doing a lot of what we learned to do well before technology made it easier, and so consequently they have trouble thinking outside that ease-n-conveneice box. I think we still make better thirld-world nurses because we had to function on instinct and observation more, and accomplish a lot wthout something preinvented to handle that very problem. When I ask a younger nurse to feel for a veinn, and use knowedge of anatomy to determine where it goes and where the valves are, they look blank, and impatient, and just poke again, almost randomly.
They don't yet have tips and tricks for tricky cases, and most are not as inclined to think it through and try a different way, nor listen to experience. I try not to be a "let me show you how" butt-in...So one by one my good veins are being painfully and needlessly ruined with lumps of scar tissue when I have IV treatments. Very frustrating.
But I was a good nurse form the start, and though I had a lot to learn I had some fresh ideas...if young nurses don't presume they're as competent as experienced nurses form day one, they stand to add a lot to the profession as each new cohort does. So I always hope to work where I can be one of the good, kind , respectful--and respected in return--"mature" nurses.