boy., you opened a can of worms on this one. It's about the same as nurses who smoke. some are thin, some are overwieght. We all have our faults. If you wanna take it to a higher level...what about the Doctors who are overwieght and smoke ?? i know some of those. and I also know some who drink alcohol to excess. Is it alright for a doctor to be overweight, smoke and drink, but not a nurse ??
I actually told my patient that exact thing today. She was very needy and if someone wasn't in her room every half hour she threw a hissy fit. I was 6 minutes late with her PRN pain med and she rang the bell. The tech answered the bell and came to find me. I was in another patient's room. I politely told the patient that I had other patients and that if I am not in the room at the exact minute the med is due it is not because I forgot but because I was busy helping someone else. She understood and we went on with the shift without issues. I don't usually pull out that line but sometimes it needs to be said.
I agree the RN who answered the call bell should not have waited 30 minutes to tell you.
And it's not like the Colace was going to give on the spot results. That's another thing I have run into, patients that don't understand you can't just "give them stuff" without an order.
Some people in my class got locked out when we did it in 2011. Don't feel bad you are not the only one. I actually did mine at the school so I could use the wifi and used one of the desktop computers so I didn't have to worry about the battery on my laptop. That exam is more of an annoyance than anything else
It's all so broken, any change would be an improvement.
First and foremost stop promoting the idea that patients are VIPs whose every wish and desire is available at the snap of their fingers or a ring of the bell.
I would like the ability to say, "no." As in, "No, I will not call the doctor and ask him to give you Dilaudid for your sprained ankle." "No, you do not get all the pillows in the facility to yourself." "No, we will not be doing CPR on your 97 year old grandmother with terminal cancer." "No, I will not bring you a second breakfast. Just because it's a diabetic meal doesn't mean you can have as much as you want."
I suppose this fits under the "Customer Service" post of Viva's.
That seems a little low to me. I applied to a LTC facility in Bedford. The DON asked how much I was making in SLC and when I told her I was making $27 she said, "Woah, well if you work here you'll make considerably more than that!”. I didn't want to sound greedy so I didn't inquire as to how MUCH more is "considerably more".
Also, am I correct in my assumption that hospitals pay less in Dallas than SNF?
"...I'm a young new nurse about a year out of nursing school and I haven been on the ob for about 10 months. During the past 4 months or so I have had increasing anxiety to the point of being physically sick and having to call off work, and now I only have one more absence left until they fire me.
My boss is very strict and unsympathetic. If you try to talk to her she says things like "well sometimes life just isnt fair." instead of trying to help you. She holds grudges and has favorites and least favorites, and if you are the latter you know it and feel it in the way she treats you.
About 2 months ago I had two patients pass away on me in a two week period, and since then I have been a complete and total mess. I have been getting dizzy and passing out both at work and at home, I constantly feel like something terrible is about to happen, and I have a constant underlying current of fear and anxiety in my mind and heart. It doesn't help that we have been consistently understaffed and overworked the past several months (I work on a med surg floor in a huge city hospital). Every night I go in I'm terrified of what I might face when I get there. I cry all the time. I can't sleep, I don't eat because I feel nauseated most of the time. I'm also facing stress outside of work, conflict within my family and trying to plan and pay for my wedding coming up in May mostly by myself.
...It came to a head last night when my fiance woke up to me sobbing my eyes out because I stay awake all night to make sure he's still breathing. I have been in denial, I know I have a history of depression and self-mutilation as a teenager, although I was never diagnosed with anything. But now I feel like a train speeding at 100 mph towards a solid concrete wall.
I have appointments this week to see both my PCP and a free counselor service provided through my work... I am going to try and talk to my boss, but I don't see her doing much to help me. I have tried yoga, exercise, meditating, hobbies, etc etc and I still feel this way. It's like I'm trapped inside myself and inside this job that I am so afraid of. I have also applied for several other nursing jobs in the community, but that was just recently and I haven't heard back from any of them yet.
...I can't talk to anyone at work because it will come across as complaining and if my boss gets wind of it we get written up or fired. I am pretty desperate at this point. I barely have the motivation to get out of bed anymore. Normally I'm a generally happy person. I want to feel happy again."
That was me three weeks ago. Since then, I have sought help in counseling, have started medication through my doctor, applied for several jobs, and have gotten a few job offers. TODAY, I accepted a job offer at an inpatient rehab center at another hospital in my area, where the nurse manager is amazingly kind and the patient's aren't as acute.
Also, I called in to work today and resigned without giving notice. Part of me feels guilty, but another part of me knows it was justified. The job was killing me, emotionally, mentally, and physically. I have plans now to write to my state's Senators and Congressmen regarding having a minimum patient nurse ration implemented statewide.
I have drafted letters to both the nursing administration office of my old job and to the hospital's CEO outlining my story. I hope that through telling my story I might be able to help improve conditions for those fellow nurses I leave behind whom I have come to love and care deeply about.
Don't ever let anyone tell you you are trapped in a job that is hurting you. You cannot take care of your patient's without taking care of yourself.
"We don't want you to suffer, but unfortunately detox isn't pain-free. We're trying to help you learn to live without these meds." That's good. I'll have to use that one.
One of the clients told a crisis worker that she was going to have seizures cuz I wouldn't give her any vistaril & that she was supposed to have it 3 times a day to prevent seizures. Um, either she doesn't know the difference in neurontin (which she does and did get 3 times a day) & vistaril, or she was just trying to find any reason to get sympathy from someone. She & and I started off on the wrong foot because when I did her nursing assessment, she didn't meet the COWS. She argued & cussed me because I wouldn't start her on suboxone right away. I remained professional, tried to explain the purpose of the COWS and that I could not deviate from it & didn't treat her any differently, but we have 3 right now who are really manipulative & will look you straight in the eye and lie and are constantly seeking meds. It's really frustrating, especially when they get the others riled up & thinking they need more meds, too. Ugh.
One of those three was stretched out on the couch in the day room when I was delivering scheduled meds to some others and when she saw me, she raised her hand up in the air and yelled, "Tylenol!" I completely ignored her. I don't treat anyone else that way & I'm not going to accept that type of treatment from anyone.
Oh, I have received what I refer to as "the look" many a time before from nurses, doctors, friends, family, etc. when I tell them I'm a psychiatric/addictions nurse. "The look" is a combination of shock, fear, and disgust - usually followed by such statements as, "Why would you ever want that job?", "Aren't you scared?", and "You're going to lose all your skills!"
I want this job because it is fascinating and challenging. I can honestly say I am never bored. While it is true that we get many "frequent flyers," we do have a few patients that overcome their illnesses and it is incredibly rewarding.
I would be lying if I said there were times I was not scared, we all get that patient every now and again that shakes us to the core but the old saying is true "safety comes in numbers." I don't feel afraid with adequate staffing and, if needed, security and supervisory presence.
As for my skills, what about the new ones we learn? I pride myself on my interpersonal communication skills and strong patient advocacy. As for inserting Foleys, IVs, etc. Those things are EASY to re-learn.
To both shifts, I get so tired of the KARDEX being read, followed by a paper shuffling sound to read copies of the Physician Orders, more paper shuffling- then the Progress notes.
I want to know 1) name 1a) diagnosis or CC, 2) RM# 3)Dr. 4)how they done on your shift 5) new stuff 6) exceptions. 7)next patient. I can read the KARDEX and Chart the sooner I get out of this stuffy room.
Ex: Ms. Doe is 123 y/o Full Code pt. of Dr. Fisishun w/Dx of CHF/CRF. She gets dialysis MWF, so in am. Breakfast Tray to Dialysis. 300cc of 1K ml restriction. No CP or SOB. O2@2L via NC. No new c/o. Family is giving her Salt, extra education needed. Foley-strict I and O, scant output tea colored. VS stable/afebrile. Heplock 20 ga R FA. Hold PO AM Meds for Dialysis per Dr. Fisishun. Tonight's weight 253.4 kg. loss of 0.4 Kgs.
This nurse took 6 minutes on this patient, on her report. (this is what I said in report).
boy., you opened a can of worms on this one. It's about the same as nurses who smoke. some are thin, some are overwieght. We all have our faults. If you wanna take it to a higher level...what about the Doctors who are overwieght and smoke ?? i know some of those. and I also know some who drink alcohol to excess. Is it alright for a doctor to be overweight, smoke and drink, but not a nurse ??
Addicts live in a world of magical thinking and denial.
You might try something along the lines of them not worrying about labels so much, and just focus on the issues that led them to seek help.
I actually told my patient that exact thing today. She was very needy and if someone wasn't in her room every half hour she threw a hissy fit. I was 6 minutes late with her PRN pain med and she rang the bell. The tech answered the bell and came to find me. I was in another patient's room. I politely told the patient that I had other patients and that if I am not in the room at the exact minute the med is due it is not because I forgot but because I was busy helping someone else. She understood and we went on with the shift without issues. I don't usually pull out that line but sometimes it needs to be said.
I agree the RN who answered the call bell should not have waited 30 minutes to tell you.
And it's not like the Colace was going to give on the spot results. That's another thing I have run into, patients that don't understand you can't just "give them stuff" without an order.
Some people in my class got locked out when we did it in 2011. Don't feel bad you are not the only one. I actually did mine at the school so I could use the wifi and used one of the desktop computers so I didn't have to worry about the battery on my laptop. That exam is more of an annoyance than anything else
It's all so broken, any change would be an improvement.
First and foremost stop promoting the idea that patients are VIPs whose every wish and desire is available at the snap of their fingers or a ring of the bell.
The Galactic Paperwork Reduction Act of 2013:
Chart it one time in one place. That's all you get, that's all you need.
I would like the ability to say, "no." As in, "No, I will not call the doctor and ask him to give you Dilaudid for your sprained ankle." "No, you do not get all the pillows in the facility to yourself." "No, we will not be doing CPR on your 97 year old grandmother with terminal cancer." "No, I will not bring you a second breakfast. Just because it's a diabetic meal doesn't mean you can have as much as you want."
I suppose this fits under the "Customer Service" post of Viva's.
That seems a little low to me. I applied to a LTC facility in Bedford. The DON asked how much I was making in SLC and when I told her I was making $27 she said, "Woah, well if you work here you'll make considerably more than that!”. I didn't want to sound greedy so I didn't inquire as to how MUCH more is "considerably more".
Also, am I correct in my assumption that hospitals pay less in Dallas than SNF?
Also, I called in to work today and resigned without giving notice. Part of me feels guilty, but another part of me knows it was justified. The job was killing me, emotionally, mentally, and physically. I have plans now to write to my state's Senators and Congressmen regarding having a minimum patient nurse ration implemented statewide.
I have drafted letters to both the nursing administration office of my old job and to the hospital's CEO outlining my story. I hope that through telling my story I might be able to help improve conditions for those fellow nurses I leave behind whom I have come to love and care deeply about.
Don't ever let anyone tell you you are trapped in a job that is hurting you. You cannot take care of your patient's without taking care of yourself.
For the first time in months, I feel hopeful.
I feel your pain. Addicts will wear you out - body and soul...
"We don't want you to suffer, but unfortunately detox isn't pain-free. We're trying to help you learn to live without these meds." That's good. I'll have to use that one.
One of the clients told a crisis worker that she was going to have seizures cuz I wouldn't give her any vistaril & that she was supposed to have it 3 times a day to prevent seizures. Um, either she doesn't know the difference in neurontin (which she does and did get 3 times a day) & vistaril, or she was just trying to find any reason to get sympathy from someone. She & and I started off on the wrong foot because when I did her nursing assessment, she didn't meet the COWS. She argued & cussed me because I wouldn't start her on suboxone right away. I remained professional, tried to explain the purpose of the COWS and that I could not deviate from it & didn't treat her any differently, but we have 3 right now who are really manipulative & will look you straight in the eye and lie and are constantly seeking meds. It's really frustrating, especially when they get the others riled up & thinking they need more meds, too. Ugh.
One of those three was stretched out on the couch in the day room when I was delivering scheduled meds to some others and when she saw me, she raised her hand up in the air and yelled, "Tylenol!" I completely ignored her. I don't treat anyone else that way & I'm not going to accept that type of treatment from anyone.
Oh, I have received what I refer to as "the look" many a time before from nurses, doctors, friends, family, etc. when I tell them I'm a psychiatric/addictions nurse. "The look" is a combination of shock, fear, and disgust - usually followed by such statements as, "Why would you ever want that job?", "Aren't you scared?", and "You're going to lose all your skills!"
I want this job because it is fascinating and challenging. I can honestly say I am never bored. While it is true that we get many "frequent flyers," we do have a few patients that overcome their illnesses and it is incredibly rewarding.
I would be lying if I said there were times I was not scared, we all get that patient every now and again that shakes us to the core but the old saying is true "safety comes in numbers." I don't feel afraid with adequate staffing and, if needed, security and supervisory presence.
As for my skills, what about the new ones we learn? I pride myself on my interpersonal communication skills and strong patient advocacy. As for inserting Foleys, IVs, etc. Those things are EASY to re-learn.
love this post!....we need many more just like you!
To both shifts, I get so tired of the KARDEX being read, followed by a paper shuffling sound to read copies of the Physician Orders, more paper shuffling- then the Progress notes.
I want to know 1) name 1a) diagnosis or CC, 2) RM# 3)Dr. 4)how they done on your shift 5) new stuff 6) exceptions. 7)next patient. I can read the KARDEX and Chart the sooner I get out of this stuffy room.
Ex: Ms. Doe is 123 y/o Full Code pt. of Dr. Fisishun w/Dx of CHF/CRF. She gets dialysis MWF, so in am. Breakfast Tray to Dialysis. 300cc of 1K ml restriction. No CP or SOB. O2@2L via NC. No new c/o. Family is giving her Salt, extra education needed. Foley-strict I and O, scant output tea colored. VS stable/afebrile. Heplock 20 ga R FA. Hold PO AM Meds for Dialysis per Dr. Fisishun. Tonight's weight 253.4 kg. loss of 0.4 Kgs.
This nurse took 6 minutes on this patient, on her report. (this is what I said in report).