Been there,done that 64,922 Views
Joined: Aug 4, '09;
Posts: 6,066 (75% Liked)
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But wasn't your duty to call the medical doctor like the surgical doctor told you to do?
Lesson learned - when you need to communicate with the physician regarding YOUR patient, do it yourself.
You just do it. The days where I'm completely drained, my family lifts me up. Coming home to the smiling faces of my 3 boys changes my whole day and outlook. They are always excited and happy to see me.
I chose the in-between option: Four 8's per week. It only came out to 32 hrs/wk but that was all my mind and body could take, and everywhere I worked it was considered full-time for benefit purposes. It worked well for me for a lot of years.
Travel nursing is for experienced nurses well versed in their specialty. They get one day of orientation and then are expected to be fully functioning with a full.patient load. Not for new nurses and definitely not for the faint of heart..
I know it is impossible for me to have the knowledge base of a 20-year veteran nurse anytime soon but it's so frustrating.
It's amazing how little some patients know about their own treatments. When I worked on the floor where most of our patients would be on just fluids with maybe intermittent antibiotics, I often have patients or family members point to the bag of NS and ask "is that a morphine drip?". No, you're walking in the hall and taking PO pain meds like the majority of post-ops do on the floor. They just don't know how things work in medicine because it's outside of their normal experience.
Depending upon exactly how it was worded, I could see someone saying that staff is "pushing potassium" to mean in the same way that we "push fluids"....meaning we give a lot, not necessarily meaning that we're doing an IV push of fluids. Some patients pick up on just enough medical jargon to make their statements confusingly incorrect.
I dunno. I would personally prefer someone to address me in person if they had concerns about my practice, rather than talk about me to others, and I try and do the same to others. I guess that makes me a critic?
In the ICU, after a pt who had gone to comfort care had died: her sister gave me a big hug and said "Thank you for your beautiful care. You made a horrible day easier for all of us."
Once around 8 pm, we were debating whether or not to attempt extubation. Nobody was extremely convinced it would go well. The resident on put her arm around my shoulders and said "I do feel better about it knowing you're here."
Another pt was a pre-op organ donor. His daughter had been somewhat estranged... he hadn't been abusive, but absent. That night she invited me to sit and see some pictures of him, and then she started to cry and thanked me for making this time possible -- because he was on the vent while organs were being tested and the OPO was working on allocation, instead of in the morgue... she got to talk to his friends and hear stories. Apparently not a day went by he didn't talk about his daughter. And then she knew he DID love her...just didn't know how to be a dad. Then she apologized to me for taking up my time and said that it's helpful for her to say all this out loud, and she felt like I really cared. We were BOTH crying by that point, and I assured her I did and was honored that she shared with me.
Last story was actually when I was a CNA/in nursing school. I was maybe 35 weeks pregnant with my first daughter, and I was caring for a retired RN following hip surgery. A few weeks later, my manager gave me a box that had been mailed to the unit. It was a hand-crocheted baby afghan with a note saying good luck with the baby and school, and that I was going to make a good nurse. I still have that blanket.
Had a toddler (child and parents well-known to us) come back from.a huge complex open-heart procedure with multiple pressors and drips, vented, drains and all the accoutrements. My partner and I were getting her settled, detangling lines and as such were speaking our own shorthand to each other, while.updating Mom and Mom's sister.
After a while, Mom told her sister to come along and get some dinner since it was late into the evening and they had not eaten on some.time. She said they would then be going to bed. Sister was a little upset Mom was going to leave to tend to her own needs.
Mom said "First of all, I trust Nurse MMJ with my baby's life. All that secret code she was saying when we got here? That means she knows what's up - she's really smart. Second of all, the last time she had surgery, Nurse MMJ told.me how important it was to care for myself so I could tke care of mychild when the time came. She was right."
When I was a new nurse, I took care of a late-middle-aged patient over the course of several days. In so doing, I got to know her pretty well, and we exchanged more than airy pleasantries. During her bed bath one day, she asked me why I'd become a nurse relatively late in life, and I told her a little about how I was a former welfare mom with an unemployed husband and four young children. (This was obviously before I learned *not* to disclose personal information to patients.) On the morning of her discharge, she handed me a huge bouquet of flowers from her room and said, "You are an extraordinary woman. I'll never forget you" and gave me a hug. I've never forgotten that...it made me feel that I really was in the right place at that moment in time.
You need to think long and hard on what exactly you mean as "doing a good job as a nurse" and what exactly makes you happy in life.
Not every nurse wants or thinks as of important to "truly connect with patients and their families". Worse still, in ICU it can be impossible, or do g so can be detrimental for your own mental health. So, you might benefit from a new job or new attitude.
I would advice you to sit down and write 10 things you absolutely want in your professional life and 1, which you absolutely hate. Just keep them real enough ("I want to work in the office when I feel like it, get 6-hundreds/year and never saw another living soul anymore" probably won't help that much). Play from the results
Professional identity crisis in nursing is an almost totally neglected area. Hold on, you're not alone
Having made my share of mistakes, I can tell you my first reaction is to be defensive, and to look at outside causes. I think this is normal. And legitimate. A human can only do so much. When we get overloaded, something has to give.
There is plenty of finger pointing and blame to be shared for this fall, including the PT. But, in reviewing it, compartmentalizing the issues is helpful.
If management truly wanted to reduce falls, they would change the environment that contributes to the falls.
So I had my first patient fall, not sure if ill get criticism or consoling, but I'm doing this to vent a little... So I have almost hit my first year of being an RN never had a fall until now. I work on a dumping ground type of unit with tons of different sick patients, so basically a med/surg/pulmonary/telemetry. I got a transfer from a higher level of care on my first day of work in a semi private room, the patient was a wreck, RR in high 20's, constant pain medications, O2, ETOH intake, etc. etc. and a normal patient about to be discharged the next day in the next bed.
Well all my focus was on the transfer patient the next day, bed 1 crazy sick, I had to fight with the providers to get to look at them and eventually get antibiotics and specialty providers involved, in my professional opinion, I wanted them transferred back to the higher level of care unit, the floor Doctor ultimately refused. Bed two started to over hear what was going on with bed 1 with the doctors talking to the patient and family and how her prognosis was and what not. Well all day the patient had to get up and use the bathroom due to diuretics and called all day for help to use the bedside commode; from me, the tech and whoever got to the call bell. Well throughout the day the bed alarm somehow didn't get turned on, I remember pushing the buttons, but didn't pay attention if they actually activated because bed 1 was so anxious and sick I kept coming over to them. On top of these 2 patients I have 4 other patients to keep up with as well.
A few more hours later, I took my bed 1 somewhere for a test, ultimately bed 2 decided she wanted to get up to use the bathroom and didn't use the call bell. We heard them fall saying help, we all ran in; the patient was hurt and hit their head, I asked them why they decided not to call vs all the other times they called and they said "I overheard that my neighbor was sicker than me, so I didn't want to bother you". We did everything from CT and X-rays to look for fractures and other injuries. No fractures but they ended up having an injury to their head. I contacted neuro surgery and did neuro checks every 30mins to 1 hour until my shift was over, plus more, I stayed an extra 2 hours to make sure the patient was okay and the orders were put in correctly.
I got an confirmation from my director that the patient was OK and pending discharge. But from what my coworkers said recently, administration is angry about the fall and is threatening a lot of repercussions for the next fall for anyone.
I understand the Bed alarm was not on and I'm not sure why it wasn't on, We help each other on our unit with bathroom and what not, so it could have been me, a tech or even another nurse, but ultimately It was failed to put it on, we do not know who, but I still accept responsibility because I'm the RN, I was in an out of the same room all day I should have been more diligent on looking at the bed alarms. I have always impressed administration and my patients, my name is constantly mentioned by patient on HCAHPS and even providers mention how attentive I am and how I "think above my level" I'm so disappointed in my self for letting something like this happen, I'm hopefully transferring to ICU soon and I feel like I don't deserve it now, my coworkers keep telling me to "stop beating yourself up" but I can't seem to help it. I made work harder for anyone else with the looming "next fall you will be fired" type of deal and I feel like I caused it.
*I tried to keep the patient information private by not using Genders and using Vague descriptions, if it is too confusing, I just put "bed 1" and "bed 2"*
I usually just say "Doing ok, I make half of what a plumber makes, without the post-retirement medical or pension."
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