Momto3RN 1,652 Views
Joined: Sep 7, '02;
Posts: 128 (5% Liked)
; Likes: 18
Amen to that sister.. I have been saying that for years... Gotta love the "customer Service" angle of these hospitals. We as staff will always be in the wrong. I have worked at some hospitals that even had staff on other floors BAKING chocolate chip cookies on the floor to give it a home feel. I am a nurse, I save lives. Not baking cookies at midnight so that the pts will feel more at home.
We get $1/hr for charge pay, not all of us do it. I work 11am-1130pm, and lately I've been in charge EVERY night I'm there! Several nurses have been there a lot longer than me (I've been there 7 years) and they don't do charge. Just don't have the personality/assertiveness to do it, so they are never asked to train to do it.
I like it, I think it's an honor, BUT, if everyone doesn't have a good night, then neither do I. I can also do so much less to help anyone since as charge we take a full assignment now.
I would be happy if pts/families understood just one rule.....This Is A Hospital, NOT A HOTEL!!!
I confess.....I do have Spongebob scrubs that I wear once in a while. I work with a largely geriatric population and get many comments on how much they like my scrubs. They say it's a cheerful distraction from the "blah" colors of the hospital.
Sorry to be a little nit-picky here but her last name is Ratched.
Thanks for the replies!!
Had a male pt in his 70's with peritonitis s/p lap chole. Alert, oriented but stoic, the type that will never tell you if he's uncomfortable.
So his crit was 20 and I got the anticipated order for PRBCS, two units. The doc wanted each unit infused over an hour and a half. That would mean around 200cc/hr. I wasn't terribly comfortable with that so I started out at 100cc/hr. Fortunately, there was no hx of cardiac/renal problems. (I typically start at 75 then increase if no complications.) VS were fine before the tx and a half hour into it. By then I had bumped up to 125cc/hr and since I was getting behind on time, I bumped it to 140cc/hr about two hours into the infusion, to be somewhat compliant with what the doc had ordered.
He did say he was cold just after I had started it but temp was fine and he didn't have any aches/pain. He thought it was from just having been exposed while being cleaned up. Still, the little bell went off in my head but I thought, I 'll just watch him. Well, two and a half hours after the blood started, he spiked a temp of 39.2 (101.2F) and a BP of 180/64. I checked on him (as I had frequently) and he was shivering!!! Still denied any pain/aches. I stopped the infusion though the bag was pretty much empty.
This is where I second guess myself, which I do frequently!! Should I have stopped the infusion when he said he was cold despite normal VSS? Why would his temp go so high so late into the infusion and was it the blood or the occasional spike r/t his diagnosis, which had happened the previous shift?
I'm assuming his bp jumped d/t to the increased rate. But with a crit of 20, he really needed the blood!!! Our docs don't typically premedicate with Tyl and Benadryl but maybe I should suggest that in the future!!
This was the first reaction I've seen. Sometimes I feel I'm a better nurse in the classroom vs. the unit!!!!
I appreciate your input!!:imbar
CHARTING! with the inability to be perfectly complete unless you stay many hours past your shift and have a perfect memory.
I usually don't have much time to browse here but I had to post this!
Yesterday, I got pulled from my medical floor down to the orthopedic surgery floor (yikes!!). I was really sweatin' it since my anxiety tends to spiral once out of my comfort zone.
Anyhoo,,,, I had three d/c orders all at the same time. I was nervous about teaching recent sx pts but did my best. My first one, a total knee, went ok until my CNA came out with his toilet seat extender. They'd only been gone five minutes.We didn't have a cell phone number and they lived 150 miles away!! Calls to the family proved fruitless. Sure, they could have obtained one another way but at considerable expense and time.
After beating myself up for a while, I was teaching my third d/c pt and she happened to mention her good friend/neighbor just had the same surgery and was going home, as well. I asked who it was and it happened to be the first pt I had discharged!!!!!!!!!
I said," You live close to them?"" She said, "Oh yes, about a mile away. We grew up together." Now the obvious question: "Would you mind dropping something off for them on your way home?" Of course, she was more than happy to!!!
What are the odds that two of my d/c pts would be neighbors so far away?!
Just had to share that!! It made floating a little less painful!!!
Whew! What a thread!!
I want to divert the subject just a tad.....
I feel compelled to clarify:
1) The Duggars are not Mormons (aka LDS).
2) LDS religion is VERY Christian-official name is The Church of Jesus Christ of Latter Day Saints. I've noticed several references written as "they're Christian , not LDS"-I assume they mean "Christian" as a broad term.
3)FLDS and LDS are NOT the same!! Not even close!! Very different beliefs and practices!!
Just my $0.02
I have four kids, 8,6,3, and four months. I started working M/S two years ago and I've been doing 50/50. I think this has been a great schedule!!
The night shift pace is usually awesome, a little slower but busy enough to keep me awake. Just when I'm getting too overtired, my schedule switches to days.
My body prefers days but my kids don't miss me as much when I work nights. The night shift differential is also nice!!!
Good luck with your decision!!!!:heartbeat
You guys are awesome! Thanks for your words of support. It's always nice to have a sounding board!
ACLS is next on my cert list! I just recently finished Tele so I'm a little more comfortable.
I wasn't so much embarrassed as I was frustrated at my inability to think! I know it's a normal reaction but I've always been a tad neurotic!!:chuckle
AlisonBSN, I totally appreciated your story! And, honestly, though I regret my pt having multiple asystole episodes, if it had to happen again, I'm glad I wasn't alone!
I love my job though nursing has given me the tendency to second-guess myself more than I should! Yet I finished that shift a better nurse than when I started!!
You guys rock!
I am a former poster to this site but I've gone so long between posts that I've had to change my user name a couple of times! (formerly known as Waggy).
I love this site but don't get to spend much time here but today, I have to post!
I've been an RN for seven years. To accomodate my young family, I've mostly worked part-time/PRN in rehab and urgent care. A year ago, I decided to try an acute Med/Surg floor to regain my rapidly disappearing skills! I have three small children so I work two 12hr shifts a week. My mind hasn't stopped spinning since starting my job!
My last two shifts, I took care of an elderly lady being treated for a UTI w/syncopal episode x1 at home. Hx of CABG, stents , on tele, SR, occ SB in high 50's, asymptomatic, etc. PO abx and IVF . No problems the first shift. The next day, I thought something's going to happen with her today. !!!!!
Midmorning, she converted to a bundle branch block. No change in her condition. BTW, she's full code! The doc orders an EKG. Shortly afterward, tele asked me to check her leads since they seemed to see "asystole". I booked it to her room. She's fine, leads in place, her monitor shows SR w/ BBB.
Tele comes up with a strip showing two nine-second runs of non-conducted P waves. Yikes! Just as I'm paging the doc, my PCT comes running saying she was in asystole. (deer alert!)
I find her glassy-eyed and "0" heart rate on her tele. I immediately pulled the code button and basically freaked! I didn't manually check for a pulse or see if she was breathing! I just noted her changed appearance and the monitor. Just as everyone came in the room, she came out of it and her rate went up to the 60's. I basically couldn't remember my name at that point but I was able to give some hx on her. Plus, the house docs taking care of her were there.
Yet I felt so stupid! Was calling a code necessary? At first it seemed indicated, but she came out of it so fast. I didn't think about oxygen-she'd been RA but, of course she would need 02! Another nurse kindly put it on for me.
She seemed OK at that point but we got her ready to transfer to CCU. The doc asked us to place pacer/defib pads on while waiting for an available bed. I finally got my wits about me, implemented the other orders while the charge put the pads on her. I was hanging her LR and the charge was explaining the pads and her heart stopped again!
Amazingly, this time I was very calm! The charge pulled the button and the whole team came in again. Within ten seconds, she came back without intervention! We immediately put her on the transport monitor and got her to the CCU where, by last report, she was stable with pending cardio involvement!
After the first event, I berated myself for what I thought might be overreacting and panicking. Although I consider myself a pretty good nurse, this level of acuity is new to me and I feel like a new grad again without the benefit of the recent education!
Yet now that it's happened, I think I'll be more confident and focused now that I have a frame of reference to this particular situation.
What are your experiences/suggestions?
Thanks for listening!
Originally posted by RNnTraining1973
Fat free cottage cheese mixed with Yoplait Light Apple Turnover yogurt with a handful of cut up granny smith apple chunks mixed in and a dash of cinnamon. Sometimes I will throw some vanilla protein powder in there.
Also, a slice of whole wheat bread with natural peanut butter.
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