Back on med/surg after 15 years

[unknownjulie]

I live north of Texas but South of Illinois.

[guest52816]

I am wondering if you can move to an area with more reasonable job prospects.

[unknownjulie]

I have a job 2 shifts a week that is easy. My plan is to work one shift a week on the medical floor. I've lived all over and maybe will again someday. Or maybe I'll be a "supercommutor" to a state with better working conditions.

I started the thread just to let other nurses know it's possible to be functional at the bedside even after a long absence.

[applewhitern, BSN, RN]

My comment is that I agree with you~ nursing has really been dumbed down. Nothing like it used to be. We have new grads who don't have a clue how to administer blood products, figure drip rates for pressures, etc., because the iv pumps do it for you now. Nurses here can no longer intubate, and for ACLS we no longer have to intubate a manequin, nor do we have to place an I&O catheter. Oh well, good luck!

[unknownjulie]

Yes, there is very little leeway for subjective analysis by nurses now. I suppose I understand why but in some ways it is annoying. Things like measuring I+O to the decimal due to the exact pumps etc. I also am used to describing wounds in narrative notes and estimating size in mm's based on the experience of looking at a thousand of them. Nope. Not acceptable now. You have to photograph and use a ruler. I get it. I understand why all the controls are there, but it is as if every single mistake made in the last 15 years in any state has resulted in another screen to go through to give a med, hang an IV, or document a wound.

In the meantime, while taking so much time to document so much- things like the personal belief that I was taught as a new nurse that "ANY decub. is unacceptable and is the result of poor nursing care", is just not voiced anymore. Decub's are just accepted as part of the course of a hospital stay- but you better make sure you document the heck out of it!

I have been surprised that I have been able to physically keep up. I thought I might have some trouble. I just finished working six, 12's in seven days. I have been concentrating on eating healthy, drinking lots of water no matter how busy, and mentally keeping it all in perspective.

One thing I do struggle with is allowing the techs to do many nursing tasks that I am used to doing, and also the mental concept of "paying hommage" to the bedside computer in place of making eye contact with my patients. This lack of connection with patients really bothers me. The screen middle man exists in all interactions.

Just my thoughts for this 5th week! I hope you all are surviving and thriving in your own work environments!

[TinyDancer01]

Thank you for sharing! You're an inspiration to me as I'm also debating giving up an easy job to return to the hospital around your age. Please continue to let us know how you're doing!!! :)

[Lisacar130]

Look I used to work on a medical floor for years and I kind of know what will happen. You will struggle with the technology stuff... the computers and the pumps. The newer younger nurses will not and they will help you with that stuff. It will take you awhile to get used to the charting and computers.

You will be good at the other stuff... assessing patients, critical thinking, etc. You will help them with that stuff.

Everyone has their own talents and you work together. You will add to the team with your experience but don't expect to be a mentor right away. It will take a little time to get used to everything again.

[applewhitern, BSN, RN]

I didn't read all the responses, but I can say that I have NEVER called them "chux" and I've been an RN for 30 years.

[Sour Lemon]

I've enjoyed reading about your experience. My last job required a similar-type physical. Surprised the heck out of me. I felt especially silly walking up and down the stairs for a set amount of time and carrying a heavy box around in circles.

[TinyDancer01]

Lol! Maybe it's a regional thing as they are STILL called "chux" around here!

[unknownjulie]

Wow, this job is hard! I hit the wall this week. I made it through my two, 12 hour shifts but I feel just barely. The first night it was almost 9pm and then I had to go back the next day. Not only am I working these insane hours, but I am also trying to take care of my two remaining kids at home that are 10 and 11.

Things are just so strict now in the hospital. While being preoccupied with scanning things multiple times and asking double identifiers to the patients I am having trouble finding the time to really consider "does this patient need this med? And should I be giving it?". For instance, a big dose of Levimer being ordered order along with scheduled humalog, along with sliding scale humalog for someone on a diabetic clear liquid diet that might go to surgery later...Plus the shot of heparin....Everything scanned, but I sure as heck didn't give any of it. And then overdoing the IV fluids and noticing the pedal edema creeping up.... All the calls to the doctors basically telling them what to do. Which I am happy to do, but my actual job and focus is scanning the meds and giving the meds! I don't really have time to be constantly rearranging things! And what I mean when I say this is that "the management focus is on the scanning and documentation" but MY preferred focus is on the actual patient health. There just isn't enough time.

I did have trouble this week also. It involved accessing what I would call a "port-a-cath" but evidently, they are now called "infusa-ports". The needles and dressing are just totally different. I'm used to dressing changes of central lines using betadine, and my young preceptor appears to think I'm an idiot for even thinking this. I didn't know how to pop the chlorhexadine stick, did not know to shake it, and did not know I had to forcefully press down while trying to use it. Then I caught her talking about me at the nurses station basically mocking me in the presence of other staff. I was so tired all I said was, "Don't make fun of me too much". Which really wasn't terribly assertive... I probably should have said something like, "You know, everyone can hear you talking"...Oh, it was awful... Also, I am used to feeling the needle hit the metal at the back of the port and that's how I know I've advanced the needle enough. I don't know if they are made of cheap plastic now or what, but my preceptor didn't even know what I was talking about...

There are some older nurses on my unit that I am connecting with more, since I've been there awhile. It seems like tons of new grads and then, my unit appears to actively trying to recruit us older/experienced nurses- so they have a mix. it's nice to be able to joke about carrying insulin vials around in our pocket for our 4 labile diabetic patients with people who understand how things used to be. Never policy, but what you actually used to do to get the job done...

I'm getting through it. Taking longer than I thought it would... Thanks for the supportive messages!

[guest52816]

I am an older, newer nurse, and I was taught NOT to shake the chlorhexadine stick, but to squeeze the sides, until you hear a click, and then watch tilt stick forward, til you see liquid fill chamber.

Equipment is different everywhere you go.

Continued good luck.