MunoRN 60,453 Views
Joined: Nov 18, '10;
Posts: 9,019 (71% Liked)
; Likes: 24,462
Critical Care; from
10 year(s) of experience
Easy big fella...
You initial descriptions was not of an ER, but of a screening and admission area of a pediatric hospital, so it should be surprising that the patient's you saw there were different than that of an actual ER.
As to the patient's you've been seeing on a med/surg unit, it's certainly true that the typical patient on a med-surg unit is far sicker than they used to be, but this is an inevitable trend and there is no real alternative, so it shouldn't be surprising that you'll care for patients that 10 or 15 years ago would have been on step down or full ICU.
As a RR nurse, the more important question is how will a patient be cared for differently in the ICU? Your example, a patient with an (assumed HR) of "140+" is a good example. There are plenty of patients who could be considered "symptomatic" although the HR is a symptom and not a cause of symptoms, and therefore there is no indication for rate control and there is no reason for ICU level care. For instance, a 35 year old symptomatic pancreatitis patient with a HR of 145 in SR, this is not particularly unusual and is an appropriate systemic response to pancreatitis and a HR of 60 would be far more concerning and potentially justifying ICU level care.
If you have permission from the facility, then it isn't stealing.
If - on the other hand - it is against policy to eat the patient's food, then it is stealing. And it could get you fired.
Anything that has gone into a patient's room is repulsive to me. If dirty trays have gone back to the cart, then anything on the cart is radioactive. A new tray for a discharged or newly NPO patient is fair game, though. However, I usually can find a patient's family member or extra hungry patient who will take it.
I ALWAYS have my own lunch and snacks, though. Always.
What is a "toonie"?
Snacks and food from the unit kitchen probably make up 50-75% of my nutritional intake while working mostly in the form of crackers and peanut butter, the rest comes from a Clif bar that I eat in the few seconds here and there I have to eat.
I'm still confused about the idea of nurses "running" when a fire alarm goes off. I have never, ever seen a nurse run because a fire alarm goes off, where would nurses be running to? or from?
It's common to feel like nursing school didn't adequately prepare graduates for emotionally challenging situations, but I'm not sure that's really the role of nursing school. Developing more effective coping with end-of-life care isn't about insufficient knowledge, it's a personal growth issue, so what is it that nursing school isn't doing to ensure this personal growth that they should be?
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