BedsideNurse 3,436 Views
Joined: Sep 12, '09;
Posts: 141 (70% Liked)
; Likes: 290
I've dropped pills on the floor, and once I dusted it off and gave it. One time in 20 years and I still feel kinda bad about it. I was desperately busy but...(sigh). I know it's not right.
If you have 14 years in subacute you will be absolutely fine in m/s. Obviously any new environment has a learning curve, but there are lots of young new nurses on m/s floors and you have 14 years of bedside nursing. After you get acclimated to how things go I am sure other nurses will be coming to you with their questions. Don't work yourself up into a nervous wreck. You'll be fine.
Yeah, so, the answer would be to...what?. From the suburbs--not allowed to work in inner city hospitals, German immigrant--automatically unfit for practice in the U.S., Chinese--to work in predominately Chinese areas only. There is an endless list of ways we could divide people up. Talk about discrimination! Trying to match culture to patient population is a very bad idea in my opinion. Anyone can give good care, anyone can give bad care. It depends on the individual nurse.
Here's the "what planet are you on" non endorsement of nurse patient ratios by the MA ANA:
"This is the wrong path for Massachusetts, for patients and for nurses," said Diane Hanley, President of the ANA Massachusetts Board of Directors. "This proposal undermines the flexibility and decision-making authority of nurses and puts rigid mandates above patient safety, clinical nurse input, nurse manager's discretion, and every other consideration in a hospital."
HELLO: we don't have decision making-authority when it comes to patient assignments, or even much, if any, flexibility, hence the need for ratios. Mandates are all about patient safety, and nurses at the bedside nurse know this. What a bunch of nonsense.
Anyhow, I looked over Save Patient Limits and it looks really good to me--although, isn't PACU 1:1 now? Also, whatever ratio laws are passed they need to be written in a way that ensures hospitals won't be able to undermine ratios with bogus acuity tools. We almost always have 2 patients, and often have 3, yet our acuity ratios for ICU consistently show the nurse patient average to be 1.2-1.4 patients per nurse (whatever that means, right?). The ICU nurse patient ratio law in MA has been made meaningless by hospital work arounds. It's extremely disappointing and is certainly detrimental to the care of the patients.
All other things being equal, if I had to choose between an MD or a DO I would pick the DO.
Well, that's a bummer. You didn't reschedule right and she didn't pay attention. I'm sure you'll be more careful when reschuduling meds and she'll be more careful looking over last doses and such...But if Tylenol x2 doses q6 vs q8 is the worst thing that ever happens than count your lucky stars. There are worse things. Important to be correct in what you do, but it was an honest mistake and at the end of the day a sandbox order. Don't waste too much energy beating yourself up. You'll be more careful from now on and no harm done.
Not sure about France, but staff nurses in England and Ireland make much less than the U.S., and the patient ratios are generally worse, so 14-15 pounds/hr for an experienced nurse was the typical "local hospital wage." If you worked in a bigger city you might make up to 20-25 pounds an hour, but that was if you were working agency or in some kind of float pool, which demanded you were flexible to float around to different NHS hospitals and/or to different units that needed you. The cost of living is higher, so top agency pay was about like a new nurse here. I have no idea what the wage is in France. Europe and the UK tend to view nursing as altruistic, almost charity vs. a career to make decent money in. Surprisingly, nursing isn't as respected in the UK as the U.S. A British friend of mine told me that years ago and I didn't really believe her, but then after I lived there a few years I found that to be true. It's almost as though people look down on you for nursing (not sure if they feel sorry, are indifferent, or actually look down on you. Once someone told me "It's different over here than the U.S. Here, when you aren't smart enough to do anything else you become a nurse." Just their opinion of course, but I heard similar commentary a few times). I also knew more people that quit nursing than actual nurses. Not ragging on UK nurses or the UK, but there is a palpable difference as far how nursing as a profession is viewed. A staff nurse working 36-40 hours a week anywhere in England, from London to the rural Cotswolds, will have a hard time making rent on a very regular/just decent place to live...They do get a week or two more vacation a year, but at some point day to day money to spend matters, and it's not good. I read in some of the responses that France pays better. If that's true that would be surprising, and a good thing for sure.
I'd been fired 100x over. If I can't scan something because pharmacy hasn't "put it in yet" and I need to give it, or it just won't scan for some reason, or I've accidentally torn the bar code, I end up clicking the not scanned box. Hardly a shift goes by I don't "not scan" at least one med. Sometimes 2 or 3. Especially fluids. :/ Anyway, that place sounds nut-sy, treating such an exemplary employee that way over such a small infraction. :/
Just a warning about ratios: hospitals are using bogus acuity tools to undermine the ratio laws. So, since your patient doesn't have certain qualifiers, they aren't that sick or shouldn't take up that much time, so they only count as 0.3 of a patient, etc... It sucks and it is terribly disappointing I can tell you that. Just a warning, I guess, for nursing doing the victory dance about ratio laws. In MA they have been made essentially meaningless. The law needs to be written in a way that forces real numbers; 1 equals 1!
I would just apply and see what happens, as Ruby Vee said. If you can't get in that way, you could find a hospital with an open heart program, work in ICU or cath lab there, then put in for a transfer to the CVICU after a year. Sometimes internal hires can slide into positions without the experience they require from the outside, especially if you are well liked. That being said, even though they are asking for 3 years of open heart, I'm thinking you will be able to get into a CVICU somewhere with your experience.
I've always checked the donor box on my drivers license and told my loved ones that's what I wanted. However, regardless of what happened in the news story, after being inundated with donor patients since the opioid crisis, I've come to the conclusion that I want no part in that tedious, decidedly unpleasant process. It's selfish, I know, but I just...I don't know... And, honestly, looking at the vast majority of people who are donating these days, I wouldn't want their organs in me. No thanks on either end.
I don't mean to sound ingrateful but I am not interested in trinkets or disingenuous blather from hospital admin, thanking nurses for all they do, putting patients first, whatever. If they truly appreciated what we do they wouldn't skeleton staff us everyday. I don't want a mug or a water bottle with the hospital logo on it. I want a *******' tech and enough nurses to take decent care of the patients. Seems to me that most people aren't looking for some special commendation for doing the job they are paid to do, but most of us do want to at least be enabled to do a good job (ideally without feeling like you've been beaten with a bat by the time you get home).
Nurses Week and the associated ice cream socials have come to irritate me.
...In regards to the initial post about being disappointed at the lack of thoughtful or usable gifts for nursing staff, I guess nurses could offer feedback. Anonymously might be better.
When I graduated there were too many nurses where I lived and you had to beg for work and take what you could get, with terrible pay. I worked there for about 2 years and moved out of state & got some step down/tele/ ICU experience under the belt. When I moved back to the area --about 6 years after I graduated--there was a nursing shortage and I went from my initial $13/hr to $40/hr. That was a pretty good raise. lol. Admittedly that was a contract, non benefit job. Once I signed on as regular staff I made 30-something, can't quite remember.
In general healthcare is very expensive so you could correctly say that "the NHS costs a fortune", however the NHS is actually far cheaper than our system and if anything they could use to spend a bit more.
The per annual capita cost of healthcare in the developed world ranges from about $3000 to $5000 with the UK spending about $4000. The US is way, way out of that range at about $10,000 per person, and for that we have generally worse healthcare outcomes. Wait times for surgeries, tests, etc aren't actually significantly different between the US and the UK.
It's not really a question of whether we can provide healthcare to everyone since we're already doing that, just in the dumbest way possible, we guarantee treatment of every medical condition but only once it's gotten really, really expensive to treat. It's a matter of how do we keep costs down or at least slow it's inflation as medical treatment advances, and making sure everyone is paying their fair share.
The NHS costs a fortune. Importantly, it is "free at the point of service," not free. A 21% VAT tax on almost everything you buy means it seriously impacts what you spend every day. That percentage will likely continue to go up as costs continue to rise. The VAT tax was 17% not that many years ago. The UK government also takes money out of your paycheck for National Insurance (National Insurance helps to fund the NHS as well as pay for unemployment+disability benefits and state pensions).
Despite massive taxation and fees, the NHS is broke. Nurse patient ratios, outside of the ICU's, are often *much* worse than the U.S., and they are certainly not better. There is often a waiting time of many, many months for non emergent surgeries (hysterectomy, joint replacement), psychiatric care, and even to get a CT. Doctors are generally poorly paid and nurses with 20+ years experience --top pay-- is about the equivalent of 25 dollars an hour, and that's if you are willing to float all over, and work in London. In rural areas experienced nurses make the equivalent of 14 to 16 dollars or so. (Of note, it matters not what the exchange rate is to the U.S. dollar. If you live in England 20 pounds spends about like 20 dollars does in the U.S., but probably a little less due to higher costs of living due to the housing shortage). We can't afford the nightmare of Obamacare, and we certainly can't afford anything like the NHS. Partly because a large portion of our population would end up not paying for any of it, while the rest of us would pick up the tab, unless we had a substantial VAT tax, which I doubt would happen here. Seeing how we have over 5x as many people than the U.K., the financial burden for the average worker would be incredible. Thanks but no thanks.
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