scottrho 3,262 Views
Joined: Jan 3, '08;
Posts: 6 (50% Liked)
; Likes: 8
Pain is subjective. What might be a 5 to you might be a 10 to a person with a low pain threshold.
It's too bad you people don't take all this effort from patient bashing and use it say what you do like about your job and patients.
Whether you undermined him or not, he has no right to yell at you in front of 15 other people. I understand the point some of the PPs make about hearing him out and seeing it from his perspective, but if he indeed came raging out and yelling at you, I see no reason why you need to extend him an ounce of respect by "seeing his POV".
You wouldn't let anyone else talk to you like that. A doctor is no different.
Asking me 1,000 questions during report regarding information that can be ascertained from the chart (whether paper or electronic). .
Asking me 1,000 questions during report regarding information that can be ascertained from the chart (whether paper or electronic). Report takes long enough lately due to bedside report. I don't need an extra 30 minutes tacked on because you're asking me questions that, had you had the motivation, you could know if you took 5 minutes to look it up yourself.
Similarly, if you arrive right on time for your shift, be prepared to get report. Don't look up labs, PMH, and review orders when you SHOULD be getting report. If you feel the need to know that information, feel free to come in much earlier than report starts and look it up yourself.
My daughter declared that her toy horse Jack had “died”. She was very carefully checking him over and giving him “medicines” with her toy vet kit. I asked her if Jack was going to come back to life, to which she replied, “No mommy, Jack is dead” My immediate thought was why are we attempting to treat Jack at all if he is beyond help?
I immediately thought of an issue that had been annoying me at my current job. Recently I began working nights at a postpartum unit, after working days on a telemetry unit. One of the biggest challenges has been learning to group my cares and work around the patient’s preferred schedules; after all, as my unit is low risk and my patients are generally young and healthy, they do not require the same frequency of a nurse’s presence as the patients on a telemetry unit. Moreover, there is a lot of emphasis placed on our patients getting enough rest and sleeping according to their baby’s schedule.
Sure there are exceptions: the fresh c-sections, the preeclampsia patients, the late preterm babies. But generally speaking, far less is needed from me on an average night than at my previous job. Still, many of the senior staff members insist on doing interventions and assessments that are completely unnecessary. There is a consensus on following “rules” because “we have always done it that way”. To me, this means these nurses are not using critical thinking and are not individualizing their care plans based on what a particular patient actually requires.
A perfect example is the “order” that babies that weigh less than six pounds automatically require every four hour vital signs-even if their birth weight started out above six pounds. As this is my first OB job, I did not question this practice at first. But as I began to become more comfortable and knowledgeable, it began to trouble me.
Carrying out every four hour vital signs often meant that I was going into a room at 0400 and waking up mom and baby for no specific reason. Often these babies were term, AGA, low bilirubin level, had no body temperature issues, and all other systems had been WDL; sometimes these frequent vital sign checks were occurring at 0400 when the mom and baby were scheduled to discharge home later that morning.
After a while I began to ask “why?” Was this really necessary? Is it even an order?
I sat down and examined my order sets- there was no order for every four hour vital signs due to weight. I checked my facility’s policies and procedures- it did not exist there either. Eventually, another nurse new to the unit began to question it and help me hunt for evidence of this order; there was none. On the night we were doing this, a charge nurse verified for us that there was no such order, as did the nurse educator early the next morning.
Apparently, in the past it had been a standing order- but several years had passed since this was the case. The unit educator agreed with that it was often unnecessary, and that it is up to us as nurses to use our judgment and decide when more assessments than are ordered are needed.
In my opinion, this is the crux of the matter. It is up to nurses to use our critical thinking skills and determine when more monitoring and assessments are needed, and when they are not needed. Additionally, we are supposed to be individualizing are patient’s care plans- many of the order sets put in by the physicians state “at the nurses discretion”.
Nurses who blindly follow “we have always done it that way” without carefully examining their patients are not using the full scope of their nursing role and are missing a crucial piece of nursing practice.
There seems to be a fear on my unit that without these unwritten rules, nurses will carelessly allow patients to go unmonitored and decline; perhaps this has been a problem on this unit in years past. My co-workers are not giving enough credit to themselves and each other when they do this- I do not know of one nurse who would not re-check a temperature on a baby with low temps, simply because it is only ordered every eight hours.
Furthermore, they are forgetting that as nurses we can always re check vital signs (and on our unit blood sugars on baby) if we feel it is warranted. We do not need an order for this- it is within our scope of practice. The physicians and other care providers we work with rely on us to use our thinking skills, monitor the patients, know when something is not WDL, and act accordingly.
Conversely, we should not forget that less is often more. How many times have nurses witnessed a 90 year old patient with a full code, despite actively dying, or the patient who demands every diagnostic test available despite there being no indication (except fear) for those tests?
Less is more; we do not need to endlessly assess and put our patients on edge or disturb a new mother and baby who are healthy and stable. We need to stop, think, use our nursing judgement and ask ourselves what a particular patient may or may not need.
Finally, we must always ask “why?” Why are we doing these assessments and interventions? Does this patient need something additional not ordered, or do they need less interruptions?
We owe it our patients , and we owe it to ourselves; trust your judgement, use your brain and trust yourself. Our patients will thank us for it.
Sorry, I don't mean to be harsh but no marriage/ relationship is perfect, especially in marriage there are going to be tough times. Personally I don't believe in divorce unless physical abuse is involved. You two live under the same roof and see each other every day. Even if a man works 12hrs+ and comes home that to me is enough. I'd have gym, work, housework, and personally I'd feel smothered if he came home too early.
Nursing school is two years, med school/PT is harder and even longer. Nothing in science is easy. Perhaps you could offer to quiz him? I am sure he is not neglecting you. Men show through their actions not words. Your husband wants to do his best to provide for his family yet you are arguing and complaining; you will push him away even further and he will feel unappreciated. Nursing school is temporary and not forever. Personally, I want to see my man work hard, come home at the end of the day, and for me to appreciate his hard work.
I wouldn't chance it without good snow tires and four wheel drive. You won't by far be the only one. I'm no hero.
Personally, Unless you have a 4 wheel drive, I wouldn't chance it. You will help no one, if your in a ditch. Tell your hospital to send a 4 wheel drive to get you, and bring you home, then you'll come in. They should have these people oncall under this unusual occurance.
I can speak from both a nursing and paramedic point of view... just keep driving!
Once emergency services are there they are perfectly capable of providing care to the patient, even if it is the FD, since most are trained as EMTs, and at a minimum first responders. Even most PD officers are trained at the first responder level.
I will be honest most of the time people "trying to help" just get in the way of progress, sometimes even trying to inform us of how to do our job. Another car on the side of the road just adds to the confusion at the scene and another person we have to ask as to whether or not they were in the accident. You are also adding to the traffic hazard!
In other words... just keep driving! You have no equipment anyway so your ability to 'help' is minimal!
Someone mentioned metoprolol....I've always wondered how it's supposed to be pronounced as I hear it both ways all the time.
So is it:
FYI, Stone Age humans all did the wild thing any old place.
In a civilized society, there is such a notion as etiquette. Certain bodily functions are considered private, out of consideration of the feelings of others.
Oh, I forgot, that makes me a puritanical, uptight prude, because I don't don't want to see people doing it at work, in the park, on the bus.
I obviously need therapy ...
Maybe I'm mean, but if you're well enough to have sex, you're well enough to go home.
You know what? I may be old fashioned, but I think it is another sign that visiting policies, and society, have become way too lax. In a word, it's disrespectful and, actually, ridiculous.
And people wag their fingers at that bad, judgmental nurse for feeling like it's not right, and maybe there should be policies forbidding it?
How low have we sunk? And, how much more garbage are we nurses supposed to put up with until we say "Enough is enough!"?
It is a sad commentary but so true. Everyone wants the sunshine and rainbows and they whine when they don't get it. I have said time and again to people I know, I would rather have the most gruff caregiver that is fully competent in their skills than a really nice incompetent one. I may sound bitter about it but a cute smile and sweet demeanor mean nothing when a patient is going down the tubes. A smile without skills is just a smile. I have been in some very difficult situations, in hospitals, in burning buildings and in battlefields, skills matter. You can smile later.
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