What Makes a Great Nurse - page 4

by nkochrn | 30,326 Views | 48 Comments

When I was in nursing school, one thing I always remember hearing the instructors say is straight As are not what makes a good nurse. Theres nothing wrong with getting straight As of course, but it takes a lot more than that... Read More


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    Taking on the Experience part now, I had an LPN/LVN assisting me in ER one night when a 18 y/o female came in with Abdominal Cramps, Hemorrhaging, and stated long history of Dysmenorrhea.

    I got an humbling Assessment Experience, . . the LPN went in to prep her in gown, I got an IV going, and the LPN was placing chuck pads down under her buttocks, and that's when she ran for the phone.

    I was angered because I, being a male didn't want to be left alone with an exposed female. The doctor worked 36 hour weekend shifts, and I figured she was going to wake him after obviously seeing what must have been worse than she thought-I wasn't impressed with the amount of blood which looked like a heavy period(remember her Hx?).

    The girl is wrenching in pain, and begging for a "Pain Shot." Then the LPN came back in and notified me the Doc was coming, then looked at the girl, and said, "Where is your newborn?"

    I nearly passed out.

    "Ma'am, I'm not pregnant!"
    "I realize that honey, not anymore, Where is the baby?"
    "I am hurting so bad!"
    "You have given birth, Where is your child?"

    I was in shock, I was glad to see Dr. Walking through curtain, I was just locked in place at the head of the bed. "Let's hang blah blah fluids, get a . . . "She's given birth, she is freshly postpartum," the LPN told the doc.

    "I AIN'T GOT NO KID!" She yelled.

    "Give her Demerol 50mg and Phenergan 25mg slow IVP, it's obviously not GI, and he did a quick a assessment while she went to prepare the injection for me.

    "HELP ME! It hurrrrrrrrrrrrrrts!" The doctor did a quick assessment and said, "She's out of her mind, she must think these old tears, and stretch marks are new, I see no afterbirth."

    "I told you!!!!

    When the LPN got back, the doc left, she threatened to spray the shot in the sink if not told where the baby was. I argued with her, and reached for the syringe.

    "You got three seconds Ms. Xxxxxx," she calmly said popping the cap off and pointing at sink, "3,. . .2, . . . "
    "He in the south field by the concession stand in a Nike shoe box, he ain't right, somethin' look wrong with him."
    I told her to call EMS, county fire and rescue (very rural), and police.
    I gave the shot. Several pieces of Placenta were removed that would have surely become infected, or lead to a real hemorrhage!
    Then the little Infant was brought in the Bay doors in a towel, and placed in our incubator, he WAS perfect, no problems other than we warmed him, and got fluids going (he had been there 3 hours.

    The LPN's experience saved 2 lives that night, and I could have seen the News the next day or so, and lost it, but she, one of my nurse heroes, stopped that.
    Last edit by BostonTerrierLoverRN on Nov 15, '12 : Reason: Format, and spelling.
    PRICHARILLAisMISSED and nkochrn like this.
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    "A good assessment and medical history can take up to 20 minutes; a bad one can take a life."

    -written on one my Emergency Department's Office Walls.
    Last edit by BostonTerrierLoverRN on Nov 15, '12
    Tenebrae and nkochrn like this.
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    Quote from PRICHARILLAisMISSED
    Hi, Good article. I am only still in the pre-req stage in my journey, but there is one thing about your article that REALLY, and I mean REALLY bothers me. It is about addiction being a disease... Now, even if the medical and nursing community can TECHNICALLY give a million reasons why a pt's addiction is similar to (or, as is claimed) an ACTUAL disease, I have to point out a certain piece of information that is akin to shouting " The Emperer has no clothes..." These addicts CHOSE to take whatever substance they are addicted to that first (or second, or third or 50th time...), knowing that the possibility of them becoming addicts existed.

    I know as an aspiring Nurse that I'm supposed to sympathize with these people-and make no mistake, once I am an RN I will do what is expected of me regardless of my personal feelings- but they made their bed, and now they expect the rest of us to lie in it with them... I'm sorry but I don't agree. Many of these addicts are going to the ER on the taxpayers dime, and I personally think that this needs to stop.
    I don't think it really matters if we agree that it's a disease or not. I personally don't buy the "disease" part of addiction either. I've had a lot of experience with addiction in my personal life, and even though I think it's mostly a choice, it doesn't impact the way I view the patient. Maybe that would be different if my life experience had been different. I don't know.

    For example, if a patient who is an addict just had surgery and they are begging for more pain medication even though they've been given more than what the "normal" patient is given, what should we do? I say, give them more! Yes, that's right. Why? Because I know that giving someone two lortab 5's who is used to taking eight lortab 10's on the street just for fun is NOT going to help their pain. I told a doctor this just last week when requesting more medication for a patient. He said, "he can get it every two hours." I said, "yeah, but he takes ten times that amount on the street. it does NOTHING." These people didn't become addicts in one day and we are not going to turn them around in one day either. It infuriates me when nurses treat drug addicts poorly, refuse to medicate them adequately, or even just fail to advocate for them as they would any other patient. I mean, what do nurses gain by witholding pain medication from an addict?

    Should we treat people with type 1 diabetes better than we treat type 2 diabetics? Should we treat someone who got breast cancer better than the smoker who got lung cancer? I've seen that btw - with the lung cancer thing. It doesn't matter why the person is there and whether they ended up there by chance or by choice - they need help and they deserve the same respect and compassion as anyone else.
    WAheartnurse likes this.
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    Quote from Ntheboat2
    I don't think it really matters if we agree that it's a disease or not. I personally don't buy the "disease" part of addiction either. I've had a lot of experience with addiction in my personal life, and even though I think it's mostly a choice, it doesn't impact the way I view the patient. Maybe that would be different if my life experience had been different. I don't know.

    For example, if a patient who is an addict just had surgery and they are begging for more pain medication even though they've been given more than what the "normal" patient is given, what should we do? I say, give them more! Yes, that's right. Why? Because I know that giving someone two lortab 5's who is used to taking eight lortab 10's on the street just for fun is NOT going to help their pain. I told a doctor this just last week when requesting more medication for a patient. He said, "he can get it every two hours." I said, "yeah, but he takes ten times that amount on the street. it does NOTHING." These people didn't become addicts in one day and we are not going to turn them around in one day either. It infuriates me when nurses treat drug addicts poorly, refuse to medicate them adequately, or even just fail to advocate for them as they would any other patient. I mean, what do nurses gain by witholding pain medication from an addict?

    Should we treat people with type 1 diabetes better than we treat type 2 diabetics? Should we treat someone who got breast cancer better than the smoker who got lung cancer? I've seen that btw - with the lung cancer thing. It doesn't matter why the person is there and whether they ended up there by chance or by choice - they need help and they deserve the same respect and compassion as anyone else.
    I am in near total agreement with you. If the word "Deserve" wasn't in your last sentence, the word "Near" wouldn't be in the first of this response. But yeah, you did a FAR better job than I of making your point.
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    Eh, we can debate that people don't 'deserve' respect, but have to earn it. I don't think that's really applicable in a nurse/patient relationship most of the time. I don't expect someone in the ER or OR to have to earn my respect in order for me to respect them as a patient. People are notorious for treating drug addicts with less respect than they would treat an old lady who got hit crossing the road. I had a meth addict who literally sat there digging at his imaginary bugs throughout my assessment, and that made me feel a certain kind of way, but he was very respectful and polite. On the other hand, I've had a "sweet little old granny" be nothing but hateful and rude for no apparent reason at all. I've had to respect them both, but in a case like that, guess who is easier to respect?
    WAheartnurse, KyleLVN, and cp1024 like this.
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    Fair enough, Ntheboat2, fair enough.

    As a change of course, I would like to thank the Op for starting this post. By looking at all the responses to my and other comments, it gives me an idea of the "Flavor" of general opinion in the nursing field. I see I have an uphill battle ahead of me (and a steeply graded hill, at that ) upon entering the nursing community. It is always good to know what you are getting into, and this article and the responses in it has given me a decent snapshot of how my way of thinking will certainly be unpopular with my fellow coworkers. Likely it means I will have to keep my opinion to myself on things such as this. Lesson learned.
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    Not exactly there pricharilla, wait one sec. There is this Army nurse that came to work with us at my little close minded hospital. She was very opinionated as well.

    If I thought red, she proved it was blue. If I thought it was up, with my unit behind me, she dryly showed me it was down. She didn't have one ounce of empathy, compassion, or sweetness to her name (not saying you don't, just using her unpopular ways), and then-one day it hit me- she's one hell of a nurse! She can code like a pro, she knows her stuff, she doesn't cut corners, works circles around the other staff members, and took it personally if a treatment regimen wasn't working.

    Her politics were sooooo foreign to my conservative, southern, and mostly spoon-fed views of the world. I learned what it takes to be a great nurse isn't a list of qualities, or a charming/empathetic caregiver- it's more complex. Her skill and tact were unmatched. When she got called to a second tour of duty- everyone else realized they would miss her too.

    You see, it's the sum of all the parts that makes it awesome, and if all our beliefs, all our values, and all our interpretations were the same-Allnurses.com would be a monotonous place to be. I hope you know I appreciate your input, and I will keep an open mind. There are other members of the medical, nursing, psychological, and scientific field that believe the same way you do, so while I currently disagree- I certainly respect your stance. I have.

    Thus far I have changed my mind on the death penalty, criminal rehabilitation methods, Women's rights, the American Justice System, and so much more- so see, a closed minded Southern boy can see the light too. But your opinion is worth just as much as mine, and I appreciate it as a Valid one, and no one has lost a "debate" here.

    Theoretically, if I was in overdose, I wouldn't care "what" my nurse "believed," but "what" she "knows" and her/his ability to save my tail. Thank-you for your patience.
    Last edit by BostonTerrierLoverRN on Nov 17, '12
    GrnTea, MedChica, NRSKarenRN, and 2 others like this.
  8. 1
    Quote from BostonTerrierLoverRN
    Not exactly there pricharilla, wait one sec. There is this Army nurse that came to work with us at my little close minded hospital. She was very opinionated as well.

    If I thought red, she proved it was blue. If I thought it was up, with my unit behind me, she dryly showed me it was down. She didn't have one ounce of empathy, compassion, or sweetness to her name (not saying you don't, just using her unpopular ways), and then-one day it hit me- she's one hell of a nurse! She can code like a pro, she knows her stuff, she doesn't cut corners, works circles around the other staff members, and took it personally if a treatment regimen wasn't working.

    Her politics were sooooo foreign to my conservative, southern, and mostly spoon-fed views of the world. I learned what it takes to be a great nurse isn't a list of qualities, or a charming/empathetic caregiver- it's more complex. Her skill and tact were unmatched. When she got called to a second tour of duty- everyone else realized they would miss her too.

    You see, it's the sum of all the parts that makes it awesome, and if all our beliefs, all our values, and all our interpretations were the same-Allnurses.com would be a monotonous place to be. I hope you know I appreciate your input, and I will keep an open mind. There are other members of the medical, nursing, psychological, and scientific field that believe the same way you do, so while I currently disagree- I certainly respect your stance. I have.

    Thus far I have changed my mind on the death penalty, criminal rehabilitation methods, Women's rights, the American Justice System, and so much more- so see, a closed minded Southern boy can see the light too. But your opinion is worth just as much as mine, and I appreciate it as a Valid one, and no one has lost a "debate" here.

    Theoretically, if I was in overdose, I wouldn't care "what" my nurse "believed," but "what" she "knows" and her/his ability to save my tail. Thank-you for your patience.
    Thank you, BostonTerrierLover.

    I meant that I would learn to curb my opinions in a pt setting

    I'm sorry, but AN readers are probably still stuck hearing it from time to time
    BostonTerrierLoverRN likes this.
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    Really good listeners (readers) to bounce an idea off of, lol!
    KyleLVN likes this.
  10. 0
    I doubt I'd take a pain reliever, unless I was seriously injured like both my legs were broken. Though I had braces one time and just had them adjusted, and I took half a vicodin when I was 17, I still had pain all day. Braces hurt.


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