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Joined: Oct 5, '09; Posts: 382 (31% Liked) ; Likes: 278

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  • Oct 8 '14

    I've been reading some posts on lately that reveal a pattern I've noticed in my practice. The nurses who are the least approachable and the most overconfident seem to be two year nurses. Students and new grads complain that the two year nurses don't treat them very well, and as an older nurse I've noticed that sometimes they don't treat me very well, either. I'm not saying that this is true of all two year nurses, or even most. But it is true of many.

    At two years, a nurse is just starting to become competent as a nurse and in their particular job. I know a lot of you out there feel you're competent after a much shorter period, and perhaps a few of you actually are. Very few. It takes about two years to learn to be a nurse, to learn your patient population and to be exposed to enough "unicorns and zebras" that you don't automatically discount the idea that the hoofbeats you hear might not actually be a horse. It takes about that long to start noticing the subtle changes that may herald a downward slide in your patient's condition, to refine your critical thinking skills and to perfect your time management. At about two years, some nurses are becoming senior on their units or are being asked to do charge or take on responsibility for precepting or co-chairing a committee. Two year nurses can be very good nurses -- IF they are also starting to realize how much they don't know. It's the two year nurse who is confident that they know everything who is dangerous, difficult to work with and demeaning to those they perceive as "less than" themselves. The "less than" would seem to fit students, new grads and anyone approaching retirement.

    It's true of new grads that "they don't know what they don't know," but it can be equally true of two year nurses who are convinced that they MUST be terrific or they wouldn't be asked to precept or learn charge. Maybe it's just that the unit is desperate for preceptors with fifteen new grads coming on staff this quarter or that all of the charge nurses are on maternity leave or fleeing the bedside for "greener pastures." Maybe it's not that they're such great nurses NOW, but that the management team sees potential and is investing in their development. Perhaps they've always been trustworthy in that they won't do anything stupid without consulting someone with more experience, more education or more expertise -- and they've interpreted that trust incorrectly as being seen to know all they need to know.

    The difficulty is that it's almost impossible to teach anyone anything when they're already convinced that they know everything. The two year nurse whose confidence exceeds their competence is a case of arrested development. They won't develop more as nurses until someone (or more likely someTHING) convinces them that they don't know as much as they think they do. Sometimes that someTHING can be detrimental to a patient. Or to the new grad they're precepting who carries wrong information forward in THEIR practice. Or to the unit as a whole . . . arrogant two year nurses are tough on morale. Crusty old bats can take it; new grads can't.

    Everyone -- even someone who is nearing retirement -- can learn something new every day. And we can learn it from anyone -- even students and new grads. If you keep that firmly in the forefront of your mind, you just might become that great nurse someday.

  • Oct 5 '14

    Ok. My 8 year old nephew was placed on life support after multiple attempts to revive him. They would bring him back and he would code right after. That's when they found a chamber closed and had to balloon the chamber to open it up and try to get oxygen to his brain. He was found by my sister unconscious and not breathing. He was with lack of oxygen for quite awhile before finally getting his heart to pump enough to start blood flow. He ended up on life support after, blood being flowed through his body by machine and on a ventilator. He was not coming out of it. His heart did manage to start pumping on its own although enlarged (he was diagnosed with Cardio Myopathy) he was vegetative like this young girl. We talked to him and stay around him a lot. He had those involuntary movements, eyes closing and opening, lips moving like he was swallowing, feet moving and hands. We thought it was his reaction to us talking to him and asking him to do certain movements. It wasn't. That's why this mom thinks her child is responding. My family has been there. The doctors told us there was nothing else they could do but to just support him. They could not declare him brain dead because there was a tiny bit of activity that was insignificant but there and that's what was causing the movements. We saw the MRIs ourselves and with the medical background we do have we could tell it was not good. His brain was swollen and filled with fluid from the severe damage. That poor girls MRI looks worse than my nephews.

    They were able to take him off the ventilator as well eventually but he lasted only 6 months. His heart gave out and they tried to save him again. They placed him on the ventilator again but we saw his soul was no longer there. They tried one more time to take him off the ventilator and although he was breathing alittle, his heart was not the same irregular, skipping beats, pausing you name it and he was trying to go completely. My sister held him in her arms and told him it was ok for him to go, we would not keep him here like that anymore. Told him she loved him and she would be ok. That's when he closed his eyes and everything stopped.

    My family went through this for 6 months so I know how this mother feels, I was with my baby sister through the whole ordeal. It is hard but it is so much better for this darling young girl to rest in peace instead of the mother keeping her body here. She is gone to Heaven. I am praying for her mother and family. It is a hard decision but eventually the girl will show them that her body needs to be laid to rest. They will have to let go. Her body is already deteriorating from the pictures of her feet. My nephews was swollen as well. So I pray God will strengthen them and help them accept that she is gone home to God. She is in a better place.

  • Oct 5 '14

    Quote from Esme12
    I just found this! Look at the necrosis....
    Was it just me or do her feet look swollen?

  • Oct 5 '14

    Quote from TheGooch
    Here's the MRI-someone on the Team Jahi-a family in denial had this to say about it.

    structurally it could be her and it appears that the tonsils are gone. what is more important is it appears the the brain stem has become mostly degraded, the brain it's self has shrunk considerably. The cerebellum looks like it might be calcified and the corpus callosum is missing.

    a normal MRI

  • Oct 4 '14

    I agree with Munro~ apparently the nurses see one chart, and the physicians see another one, in their computer system. However, now they are claiming the problem has been fixed. Personally, I think the nurse should have called the medical person to make sure this wasn't overlooked, and initiated isolation and protective measures.

  • Sep 30 '14

    I believe his screen name is "Song In My Heart." I could be wrong.

  • Sep 30 '14

    While I understand the sentiment, I think such a flag would only add more ammo for those who cannot stand to read any viewpoint but their own.

  • Sep 30 '14

    I just read the thread that seems to have affected Singing in my Heart so deeply.

    I think he overreacted. Someone took him to task for pushing a nursing student to do something that might have gotten that student in hot water with his program. One person got a bit snarky in the midst of the debate. A lot of people supported him. It was a good springboard for discussion about how nursing programs are conducted, and interactions between nurses and students.

    Do we really want All Nurses to become a tattle-tale fest? Is that the type of culture we want to foster? Or should the site encourage lively debate?

    I've started a few threads. I got criticized and agreed with. Welcome to the world. If we put our opinion out there, some people are going to disagree, and maybe even attack our views.

    We do have to have a somewhat thick skin and self-disciplinel. We can step away from individual threads if they are making us feel bad. We can also walk away from the site if it's undermining our self confidence.

    I hope Singing is just taking a break and not leaving forever. His contributions here are by and large positive. But, his dramatic exit seemed a little overwrought to me.

  • Sep 27 '14

    Ironically, I had the Wakefield study quoted to me just today. Someone wondering if she got an MMR booster, might she "pass on autism" to her as-yet-unconceived future child?


  • Sep 27 '14
  • Sep 22 '14

    Quote from prnqday
    Sorry for your loss. Perhaps you can offer these suggestions to that OB office so that another women will not experience the same thing.
    I do believe they did there best but when you are in that situation everything is so palpable and can easily outrage you.
    Turn your anger into something positive.
    Exactly! And no two people are the same. The OP said don't be afraid to cry, if my nurse cried while I was miscarrying I would be so uncomfortable. Some may find it comforting, others find it unprofessional. That's what makes nursing so hard is trying to help while not offending, and not knowing what is going to make the pt feel better. The staff was doing their best and as long as they didn't do anything malicious to offend, I don't see anything wrong with them.

  • Sep 8 '14

    I feel like ED and PACU are probably the most similar jobs in the hospital. Only exception is you always have docs right there in the ER. You have many of the same stressors, some different too. The best part is generally dealing with family less and the second best part is most of your patient's don't die.

    Surgery in general seems to have a lot less BS to do with computers and making sure you do this or that. It seems more patient care oriented.

  • Sep 1 '14

    Maybe I'm mean, but if you're well enough to have sex, you're well enough to go home.

  • Dec 24 '13

    Quote from tigerRN2013
    It's so sad to see so many nurses (people who are supposed to advocate for life and people's wellbeing) acting as though a child who is not our definition of 'normal' and healthy is an unworthy burden and undeserving of life or our care. How can people not see that killing a disabled child is wrong?
    No we don't advocate for life. Nurses advocate for their pt. whether it's a pt wanting an abortion, a pt wanting to die with dignity or a pt not wanting to be kept alive as a human incubator. What makes a fetus loos subtle life worth more than the mothers needs? If you have such a narrow view of what nursing is, you really need to open your eyes.

  • Dec 16 '13

    Have you considered a DNR tattoo or bracelet?