Nurses eating their young-venting

leslie :-D · May 24, 2004

Absolutely. MSO4 can be totally appropriate for resp. distress...it can help the pt breathe more effectively, and if the pt has some pulm edema, it can help "dry" the pt.

mso4 has diuretic effects? never knew that.

leslie

mattsmom81 · May 24, 2004

I understand. Maybe they are very careful workers and expect the same out of you. Maybe they don't trust you for some reason. Not sure. When I was in my first year or two of nursing, I found the opposite....the experienced nurses gave me all the heavy patients and left me to swim or drown. I swam, thank God.

I'm so sorry you had that experience. When I'm in charge I try to decide WITH the newer nurses what their patient care needs/wants are, and avoid deciding FOR them whenever possible. But...this isn't always possible.

In the ICU, I have been accused more often than not of avoiding assigning complex patients to the newer nurses. Making a poor choice in assignments and/or failing to supervise can be construed as a violation of my NPA.

Too often younger nurses will jump on the 'eating of the young' bandwagon whenever they don't get their way on the job, and I guess that's easier than looking at things in full perspective.

When it is a shared liability situation I will err on the side of caution. Particularly when I have my OWN assignment and limited time to supervise/teach a new nurse or new employee.

llg, PhD, RN · May 24, 2004

Nurses eat other nurses, period. Young nurses accuse the older ones of "eating their young." Experienced nurses criticize the lack of skill. work ethics, and committment of the younger generation. Staff nurses blame everything on the managers. Managers blame the educators. Etc. etc. etc.

It doesn't stop when you get more experience. Some other nurse is always going to be thinking that she can do your job better than you do it. ... and she will be vocal about it.

llg

leslie :-D · May 24, 2004

Nurses eat other nurses, period. Young nurses accuse the older ones of "eating their young." Experienced nurses criticize the lack of skill. work ethics, and committment of the younger generation. Staff nurses blame everything on the managers. Managers blame the educators. Etc. etc. etc.
It doesn't stop when you get more experience. Some other nurse is always going to be thinking that she can do your job better than you do it. ... and she will be vocal about it.
llg

i've been saying that from day 1; nurses eat whoever they damn well please.

leslie

LuLu123NY · May 24, 2004

You are correct...she didn't say all, but she did say "in general". I have NOT found this to be the case and have worked nights in two different hospitals. I have also worked the other two shifts and have found just as many nurses with no social skills on those shifts as with nights.

I also said from what I have seen. This post is not a personal attack on you or any night shift nurse, but MY observations of those and ONLY those nurses I have seen on night shift. I also said to remember to pick your battles. This topic obviously seems to be a sensitive topic for some nurses and I'm afraid we all have been victimized in one form or another by other health care professionals for whatever reason. I have learned to blow off a lot of inappropriate behavior and accept that some I work with are not there for the same reason I am.

LuLu

NursesRmofun, ASN, RN · May 25, 2004

I'm so sorry you had that experience. When I'm in charge I try to decide WITH the newer nurses what their patient care needs/wants are, and avoid deciding FOR them whenever possible. But...this isn't always possible.
In the ICU, I have been accused more often than not of avoiding assigning complex patients to the newer nurses. Making a poor choice in assignments and/or failing to supervise can be construed as a violation of my NPA.
Too often younger nurses will jump on the 'eating of the young' bandwagon whenever they don't get their way on the job, and I guess that's easier than looking at things in full perspective.
When it is a shared liability situation I will err on the side of caution. Particularly when I have my OWN assignment and limited time to supervise/teach a new nurse or new employee.

Thanks. I really just would have settled for a *fair* assignment back then. I really got dumped on badly...but it helped me to learn how to hustle. :)

NursesRmofun, ASN, RN · May 25, 2004

absolutely. mso4 can be totally appropriate for resp. distress...it can help the pt breathe more effectively, and if the pt has some pulm edema, it can help "dry" the pt.

drug category: analgesics -- morphine iv is an excellent adjunct in acute therapy. in addition to being both an anxiolytic and an analgesic, its most important effect is venodilation, which reduces preload. also causes arterial dilatation, which reduces systemic vascular resistance (svr) and increases cardiac output. narcan also can reverse the effects of morphine. however, some evidence indicates that morphine use in acute pulmonary edema may increase the intubation rate.

taken from this site:

emedicine - congestive heart failure and pulmonary edema : article by shamai g

mattsmom81 · May 27, 2004

drug category: analgesics -- morphine iv is an excellent adjunct in acute therapy. in addition to being both an anxiolytic and an analgesic, its most important effect is venodilation, which reduces preload. also causes arterial dilatation, which reduces systemic vascular resistance (svr) and increases cardiac output. narcan also can reverse the effects of morphine. however, some evidence indicates that morphine use in acute pulmonary edema may increase the intubation rate.
taken from this site:
emedicine - congestive heart failure and pulmonary edema : article by shamai g

ah yes, ms in small doses can assist in a chf patient....but i have had too many cases where the patient has crashed on the floor unnecessarily due to too much ms.. it needs to be given verrry carefully. with narcan handy.

most facilities recognize the wisdom of admitting these types of patients (if they're full codes) to our stepdown where ratio is 4:1 and they can be monitored closely by our critical care staff. generally they may need other drugs (ntg, dopamine iv) and that can be instituted on pcu, and pt can be transferred to icu emergently if required.

leslie :-D · May 27, 2004

but fab4 stated that mso4 can actually dry out a patient's lungs....has anyone heard of that? would it have anything to do with reducing preload?

anyone? i really never heard of this and can't find any literature...

leslie

Houstonnurse · May 29, 2004

I have found that those nurses that are like this are really in doubt about their own abilities or shortcomings, in nursing, and/or in their private life, and look for someone to bully just like in kiddy school.

I remember when I was a young nurse, an older nurse took me aside after a similar experience with another nurse, and told me that.

SHe also told me that I was giving people my permission to talk down to me, and could take it back too!

I learned to just tell them fast (ONLY WHEN THEY ATTACKED, not trying to teach) that they were NOT my mother, and if they had a complaint about me, then make an incident report and I would GLADly tell my side.

IT SHUTS THEM UP FAST, or in the least shows admin that THEY have people trouble.

Keysnurse2008 · May 29, 2004

I have been a nurse for 14 years.I am in NO WAY taking up for the "older nurses" behavoir.....but sometimes when you get a new nurse....they have to LEARN to kinda have a sixth sense about patients.That doesnt come easily.It only comes with experience.Sometimes I can glance at a pt.....and something inside my gut just tells me "SOMETHINGS WRONG".With new grads they dont have that gut instict caused by experience and for a large part they will have to depend on the more experienced rns.That sixth sense will come in time ...and by watching.Its not something attainable in a book.And....sometimes.....when we are as understaffed as we are, and our pt acquity is too high...the older nurses do get frustrated that they have to kinda be another set of eyes and ears for the new grads.Some.....hide their frustration well....others do not.And in this profession ....you cant wear your feelings on your shirt sleeve.The number one priority is not to "be careful" of everyones feelings...its to make sure that not one pt suffers bc of lack of experience from a new grad that doesnt YET have that sixth sense.It is a shame that more well seasoned nurses dont spend a lil extra time teaching the new grads WHY they feel the pt needs a EKG...bc it would help not only your feelings but also founder your experience and help YOU develop that sixth sense.

About 1 year ago a new nurse on my unit was arguing with a care partner over a pt being too sedated after surgery and a lil combative.From the jest of the converstaion I assumed the pt had MR.About an hour later the care partner came to me in tears saying something wasnt right with the new nurses pt.She wanted me to evaluate the pt.The CP told me the young pt was suppost to be mentally intact but had not spoken in the hour or so while on the unit.She also had NOT complained of pain at all after an extensive and very painful surgery.I walked in and found the pt to be in full grandmal seizure and the sedated behavoir was focal seizures.This is what the other new nurse called "just rousing from anesthesia and a lil combative".Her v/s were ok,her output was ok, her o2 sats werestill ok.......but her ICP was out the roof.We called a code.....and the end result is that a young pt eventually left our facility with residual brain damage many days later.The carepartner is wellseasoned and had been doing this job for 15 years.The CP gained that sixth sense that something was NOT right.So........after a few episodes like this(that occurs at ALL hospitals)...seasoned nurse sometimes tend to "not worry" over a new grads feelings.Its true that we should spend more time teaching instead of preaching though to you guys.Does this help you see the other side?I am so sorry that you are havinga rough time.But ask ask ask these nurses why they feel a ekg need to be run.did this help?I hope so.

sorry for my typos guys!

NursesRmofun, ASN, RN · May 30, 2004

Ah yes, MS in SMALL doses can assist in a CHF patient....but I have had too many cases where the patient has crashed on the floor unnecessarily due to too much MS.. it needs to be given verrry carefully. With narcan handy.
Most facilities recognize the wisdom of admitting these types of patients (if they're full codes) to our stepdown where ratio is 4:1 and they can be monitored closely by our critical care staff. Generally they may need other drugs (NTG, dopamine IV) and that can be instituted on PCU, and pt can be transferred to ICU emergently if required.

Yes. :) Also, it can help with respiratory comfort in terminally ill, comfort care-only patients.