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Discussion

1 month off orientation

hey guys! i posted a month ago or so about it being my first day off orientation. i must say it has been as busy and scary as i expected and didnt expect. on my first day i had 3 post ops (busy busy). im finding there is always something that happens that puts me behind lol. this job is HARD! but very rewarding. im finding even on the craziest, nothing is going to go right, day, i love it. ive found myself remembering a little more each day (sometimes surprising myself) lol like "when did i learn that?!?" ive had some very challenging patients from a guy going through ETOh detox and a guy bleeding out, plus admission and transfers in between. ive found that theres nothing wrong with asking for help when im drowning in an emergency. i feel that i have picked the right decisions in an emergency situations.

i have also realized that i will not make everyone happy all the time. for example, last week i came onto my shift at 3pm. there was a NH discharge scheduled for 430. the discharge planner informed me that they wanted to "keep the NH happy". well i would also love to keep the NH happy, but the poor woman down the hall with a bp of 80/40 did give two hoots about keeping the NH happy. so i made the decision to put the bp before the NH and started the works of helping her. well then that was settled the bp had a bolus running looked good and i was satisfied she would be ok for a few minutes for me to keep the NH happy. well the pt i was discharging was someone id never taken care of and now its 410 and the paperwork is being finished. the discharge planner is mad at me and the NH isnt so happy. and u know what? i didnt really care lol. i just made the decision i felt was the best for my patients and not the NH. what would other people have done? btw there was also a sick man on hospice on my assignment that day and his family was concerned so i spent some time with them during my initial assessment.

any advise? this job is very hard at times (most of the time).

this was long lol sorry!

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    • Featured Replies

    Sounds like you are doing great!! Way to follow your instincts and stick to your priorities! I'm pleased that you are doing so well. Congratulations!!

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    Good for you. I would have done the same thing! From my experience, you can't make everyone happy all of the time. I had a patient who was in pain and would be furious if their pain meds weren't brought in on time, and I would be accused of "purposely holding off on pain meds" - ugh! That same time I had a new admission and I was also trying to manage a dopamine drip...I'm sorry, but you're not going to die from pain. But like I said, some people are never satisfied!

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    • Experts

    BP issue vs. discharge to nursing home within 90 minutes of start of shift to keep the receiving facility "happy"? I would have done the same thing as you did.

    Transfers require more paperwork and time (even more than admits, it seems), and I hate doing them. That freakin' paperwork again...

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    Sounds like you're doing good. I would have done the same thing too. My instructors always said, "pick the one that's going to kill the patient first" hehe that's always the priority.

    I'm a new grad, about to start orienting. And I'm nervous! These days before I start working, I try to imagine myself already working on the floor and all the possible situations that could happen and think of ways to deal with them. haha then I ask my mom if she would the same as me since she's a nurse as well haha

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    1) BP first, as always.

    2)I would have told the hospice family I would be back in a bit, and then gone and done the discharge, before spending time with the family. They aren't going anywhere. Touching base with them would let them know you are aware of their situation and coming back would have built trust that you are a person of your word.

    Maybe since I do discharges, I know how pressed nursing homes are to get people admitted and meds ordered before their important people go home.

    Congrats on making it through the first month on your own!:yeah:

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