BE HONEST! What part of your job do you hate?

[Cheers_G]

Hi All,

I'm in a nursing school and some of the stuff we see during clinicals gross me out! I AM getting used to most of it BUT, do you have any tips on how to take it easy?

Thanks!

[Miss Rayanne]

I hate unrealistic expectations. For example, family members who blame us because their 98 year old mother who broke a hip is not able to walk 2 days after surgery. Puke is pretty gross too.

[Tenebrae, BSN, RN]

Snot/sputum

[psychrn2008]

LICE!!! Or scabies, bed bugs etc. I would rather clean up CDIFF on a total care pt all night long that's puking than to deal with Lice. I get itchy just thinking about it.

[vuphan86]

i hate the smell of dead tissues, especially stage IV of pressure ulcer. it made me not to eat any grilled meat for 2 weeks.

[WinterLilac]

I hate faeces, vomit and sputum! I also have an extremely weak stomach when it comes to those three things and I have been known to throw up immediately after dealing with any of them!! My friends and colleagues tease me a lot about being a nurse and having such a weak stomach! 13 years of cleaning up human faeces, vomit, urine, sputum, especially when they are painted over the walls or all through bedding....Oh my goodness, I am actually gagging as I type this! How ridiculous!!

I do wish to make note that I am very professional when dealing with those things in front of the patient, they would have no idea I am gagging inside or am about to throw up myself. I remind myself "How would I feel if I needed someone to help me clean up after an accident?". It still is a very hard aspect of the job!

[rnsheri]

Haha... some of the little annoyances I have:

1. Scripting. "Is there anything else I can help you with? I have the time!" I will have time to find you a TV guide and bring you some little crackers, but it will be after I get everyone stable, off the potty and changed, time-sensitive medicine given, and blood hung. Trust me, I will make time for you. It may not be right this second. C'mon, how can I sound like an engaged professional when I'm reciting lines like a telemarketer? I have had the privilege of being a patient on a Med/Surg unit and anytime I heard scripting I found it hard to talk to the nurses and CNA's because part of me said, Wow, either he/she doesn't care or is lying to me, and how can I put my faith in someone who is OK with telling me things he/she knows aren't true? This was before I became a nurse and I still refuse to use scripts. Luckily I am somewhere now where I am not forced to insert "exceptional" or "very good" in my statements if I don't mean it. On that note...

2. Health care professionals who omit certain aspects of care. This includes, but is not limited to: telling me a patient is saline locked when they actually have fluids running but the IV needs restarting, not emptying the bedside commode, not changing IV tubing on time, not taking vital signs when indicated or neglecting to delegate the task, or forgetting to update the SBAR; etc.

3. If the Lasix is due at 9 AM, don't wait till 6 PM to give it because you don't want to deal with potty patrol. It means that the medication wasn't given on time and for Pete's sake don't document that you gave it at 9 AM. You could potentially hurt your patient, and night shift has a skeleton crew as is (and no nursing assistants in my case). Oh yes, and you false-documented. And yes, I will say something about it if it isn't a one-time Oh my goodness I can't believe I missed that! thing.

4. Take out catheters on time. Trust me, very rarely does that fall at 6:50 AM or PM.

5. Don't lie to me. If you can't get an IV because he/she is a "hard stick", that's fine. However, if I am going to restart that IV, you will still need to stay over to cover my other patients until all shift duties are complete. It is not acceptable to miss an antibiotic because starting an IV takes time. It takes time for me, too! On that note...

6. Shift change. Our CNA's/NA's/desk clerk thought it was perfectly acceptable to leave by 7 PM as there was no night shift tech to report to. Because of this, shift change took forever because all the patients seemed to suddenly have to pee/need pain medicine/want a drink/etc. during shift report. Because of this patients were unhappy all across the board.

7. Don't just brush a patient off because "He/she's not my patient." Um, every patient on your floor is "your patient" and if someone needs to be helped to the potty, help. Even if all you can do is find the nurse responsible for care, please do and follow through.

8. Don't abuse the CNA's, techs, and nursing assistants. You're lucky if you have their help! If you're in a room passing meds and the patient needs to go to the bathroom, don't just pass it off because you don't like to do it!

9. I hate when nurses or techs don't treat nursing students with respect. Similarly, nursing students shouldn't be disrespectful to anyone either. I have had to pull some students aside because they started ordering the CNA's around. (I personally think every new nurse should spend a few shifts working with a CNA/nursing assistant. I learned so much about positioning, equipment, and body mechanics from the CNA's I worked with.)

10. If you don't know how to do it, don't just act like you know how and put someone in danger. Get someone proficient in the skill in question to help.

Just a few... I didn't touch on staffing issues, unrealistic expectations, outdated equipment, or major management problems. Because, you know, that's a given. :)

[WinterLilac]

rnsheri - love love love your reply and agree with every single point!

[cayenne06, MSN, CNM]

I don't mind any of the body fluids I deal with in my job (LDRP). What I hate is doing VITAL SIGNS. OMG so many vital signs, especially in the immediate postpartum period. I also have a really hard time dealing with nursing issues. It's just not my strong suit and I wish I was better at it!

[Nursynursenurse, ADN, RN]

What grosses me out the most is sputum. Theres something about the stringy, mucusy slime with bubbles. When I worked in a lab I wouldnt even look at the specimen if it said sputum. The potentially infectious watery stool samples never bothered me as much. I feel sorry for anyone working in dental hygiene. I hate the inside of people's mouths and bad breath is my least favorite smell.

The part of my job I hate most is having 60-70 residents to myself working overnight in a skilled nursing home. I'm literally on my feet all day and passing meds, treatments, tube feedings, wounds, or assessing problems the entire night. There is never a time when someone doesnt need something. I'm always running behind. I wish I can blame it on poor time management skills but it is just too much for one nurse. And then someone falls. Or cant breath. Or wanders out the door. Then the morning shift comes and wonders why I havent finished my HUGE med pass. There are some people that believe nights are easy! I also hate having to stay 2-3 hours after my shift every day just to finish charting. Its hard working 11 hours straight without getting a single break. I guess paying me overtime is less expensive than hiring a 2nd nurse. I simply dont have time to be a the nurse I want to be.

[Adele_Michal7, ASN, RN]

Hate it when shift in and shift out, one encounters various examples of abuse from the client's family members when working in extended care home health. Especially when the 'lacking in social graces' individual reminds you that they can make your job disappear with a phone call. Every shift you have to put up with their unreasonable and grating behavior fully knowing that on any given day, they will indeed make a call to your employer and you won't have a job. And your employer won't do a thing to support you, yet they expect you to bring them new business and new employees.

One of the many reasons I had to get out of that area of nursing!!!!

[Elvish, BSN, DNP, RN, NP]

Forceps deliveries. Fortunately they are very very few and far between, like almost never.

At c/sections when they grab the abdominal fascia and essentially rip it open to get to the uterus.

We used to use Pregestimil formula a lot, and Pregestimil poop could gag a maggot. Thank God those days are gone.

[OneDuckyRN]

I hate when families have unrealistic expectations of their loved one's outcome. You know, the ones where the pt looks absolutely miserable, but the family is convinced he or she is getting SOOO much better! The prayers are really working! He's going to get off the vent and walk again! Let's totally ignore that the pt has been unresponsive for a week or so now, and has essentially doubled his original weight because he's third-spacing like crazy. (But can't we just dialyze him? Um, not with a B/P of 70/40...) Oh...and he or she had a beautifully written advance directive stating that he/she didn't want ANY of this done, but the family overrode the AD and went ahead with it all. I've seen it more times in my short career than I care to count.

Direct patient-care related thing that I hate: vomit. I can handle seeing it after the fact, but the sound of someone retching and heaving is enough to send me running to the bathroom. I have been known to make deals with my colleagues: I'll go suction and do your trach care on your vent pt if you take care of my puker. You'd be surprised at the number of people who actually take me up on that!

Rude pts are also not my favorite. I just had one last night...He didn't think we were quick enough to get him to the bathroom (I saw the tech go into the room, at which time the tech told him we'd be more than happy to take him, but if he had to go quickly to use the urinal), so he decided he didn't need vitals, assessments or any medications all night. Fine, whatever. You're only hurting yourself and making my job a lot easier. Jerk.