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CoMoNurse

CoMoNurse

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CoMoNurse has 38 years experience.

CoMoNurse's Latest Activity

  1. CoMoNurse

    My Life as a Nurse

    Thanks Meagan!
  2. CoMoNurse

    My Life as a Nurse

    Through the Years Forty years, how can that be? Today it hit me on my commute into work, punched me right in the gut...forty years. I started out as a still wet-behind-the-ears nurse ready to take on the world one (or twelve) patients at a time. I would supervise an LPN with her 12 patients and I would have my 12 patients and that was the hallway we took care of. We had an aide to empty drainage bags and to take patients to the bathroom and to ambulate patients, but we did the rest. I hung all the IVs and gave all the IV meds for those 24 patients. I mixed up and gave chemotherapy drugs to patients who I would later care for during their death. I prepared Adriamycin, Cytoxan, 5-FU for use intravenously, without gloves, without a hood, without any sort of protection for me or the patient. I drew the correct amount up out of the vial and we weren’t even required to double-check our doses with another nurse. I even gave chemo through a chest tube, more than once. I prayed a lot during that time that I wouldn’t make a mistake. I gave my patients a night time back rub and sat with some while they struggled to fall asleep. Charting could always wait back then. I took care of patients on blue plastic laminar air flow mattresses and Stryker frames, even some patients who could only get comfortable in a recliner. I turned, I cleaned. I had poop thrown at me and have been thrown up on more than I can remember, I had my bright white nursing cap ripped off my head with the bobby pins still clinging to a few strands of hair. I accidentally filled a shoe with urine from a urine bag that I didn’t get clamped well enough. One of my patients flipped an entire bath basin full of Betadine soap onto my white uniform, for a good reason of course, that she didn’t like to do the soaks her MD had ordered. I have cleaned out bedsores, deep bedsores full of stuff I can’t even identify and have seen white bones shining up from the wound bed. I held many a patient while they died alone, alone except for me. I gave that last dose of pain meds to ease them into their next life. I watched a mother who was my mom’s age die from cancer that had eaten her breast away. A lot of these deaths were painful and hard to see. I was only in my 20s, yet I held so much in my hands. It was 1980, pulse oximetry wasn’t a standard of care, and my COPD patients had a daily ear oximetry spot check if they were really sick. When I started in the NICU in 1982 pulse oximetry still didn’t exist for babies and we evaluated how well our patients were oxygenation by pulling back on their arterial lines to see how bright the blood was. Or if they didn’t have arterial lines we just looked at their color, were they grey or pink or blue? If they were pink we lowered the oxygen by 1%. Those were the days before surfactant was approved in the US in the late 1990s...surfactant really changed the outcome of a lot of preemies. Less time on the ventilator, shorter hospital stays; but we were saving babies very young, which in itself led to a higher morbidity rate. More intraventricular bleeds, more eye problems, more gut problems, more airway issues, more feeding difficulty. The onset of developmental care for preemies came about in the late 1980s while I worked in the NICU as well. We made more developmental appropriate outcomes a possibility by trying to limit the noise, light and tactile sensations for our tiny patients. I attended a national conference to learn how to take care of the most fragile babies developmentally. I got to meet the clinicians who came up with those early protocols to protect the tiniest of brains. I worked in a pretty big NICU, so I was honored to see a lot of anomalies and sad cases...I saw conjoined twins more than once. I took care of babies without a brain, babies with their heart beating away on the outside of their bodies, babies with tails, babies with wonderful parents who were so saddened by their baby requiring intensive care. I watched baby with a newly placed hours old trach cough it right out on to his chest. I immediately slipped it back in without thinking and probably held my breath for 3 minutes as I waited for the baby’s color to change to pink again. I watched a baby as he perforated his bowel on Christmas Eve, regardless of how many times I notified the resident, I feared for this baby’s life. I held moms in my arms as they cried for a baby they would never take home. I cried too for this life that wasn’t meant to be. I have sheltered deformed babies from the prodding and staring of residents and medical students. I have held dying babies in my arms when a parent couldn’t or wasn’t in the same hospital. I have helped moms breast feed and have heard all sorts of stories from all sorts of families. I have had families love me and had some hate me. My own baby was in the NICU where I worked and so I learned why those moms cry when they go home without their babies. And that made me a better baby nurse. I worked during two NICU moves, one to another building close by and one across town. I moved on to adults, saw my first HIV patient in the mid-1980s, I ran peritoneal dialysis, watched as a man farted as a joke and died immediately from a myocardial infarction. I worked nights during a power outage when all the monitors went out. I worked during a hospital fire, evacuating patients. I took care of adults until I suffered a life-altering back condition that I struggle with even today. I worked as an IV nurse, starting IV lines on all sorts of people, I started PICC lines, just feeling for the vein, I also was privileged to use an ultrasound to place PICC lines. I was proud of my abilities to find even the smallest vein. I glued lines back together when they tore and they were desperately needed. During this time I made some good friends in my work and I raised my son while I worked. I worked outpatient pediatric clinics and got to see all sorts of things and again, meet some great people, patients, and their families. I worked with incredible doctors and some who had opportunities for improvement. I moved halfway across the country for a new job. I have been fired from a job, even escorted out of the hospital with an armed guard (not to worry, I had done nothing wrong to warrant that type of an escort). That was my most painful nursing experience ever, but I survived that. I don’t regret any of my nursing experiences; they all are a part of the tapestry that is my career. Now I work in an area where I only say what is scripted, where I cannot offer advice to my patients, I must say only what my script says. I never meet my patients, I only talk to them over the phone...It’s been a difficult adjustment. It’s a business job, but it’s alright and I work with some great people. I think it is a fitting way to end my last two years before retirement. And, I'm Still Not Finished ... This morning I got a text from an associate on Linked In, asking if I was interested in a traveling nurse position in a small rural hospital near Washington DC. I asked some questions, and it sure sounds nice... Not sure what I will do, but it sure sounds nice.
  3. I remember what it was like to be a new nurse, being unsure of what or how to do whatever my patient needed. I jumped in and asked a lot of questions and for the most part, my more seasoned coworkers helped me out by guiding me to the appropriate solution. I learned by listening to and watching those nurses. There were a few nurses who were difficult, who didn't want to help a newbie out; I rapidly determined who those nurses were and didn't go to them with my questions or for guidance. Eventually, I became a seasoned nurse and enjoyed helping the next generation, and then the one after that. I was a good nurse, conscientious and loved my job and loved learning. Somewhere down the line, I became an old nurse in a new position; I retired after 30 years in one hospital system and decided to try something new, totally new, in a totally new state 1200 miles away from home. It took a lot of nerve, but I knew inside me it was something I needed to do if only to prove to myself that I could. I was recruited for my new job and was well qualified for my the position, I had been a co-investigator on a research project, had published an abstract for a national conference, had experience and was certified. My new job was in New England and I loved the scenery, the ocean and life there; but I found I had lots of things to learn--the local hospitals and clinics, the likes and dislikes of my "new" chronic patients, which pharmacy would compound meds and which ones always lost the script we sent, the nearby resources that my patients needed, the preferences of each of the three doctors I now worked with. I worked as the only nurse in my clinic three out of my four work days. I struggled with not having my fellow nurses to talk to, consult with, commiserate with. I struggled not being known for my abilities and my knowledge and skill. Everything that makes me a good nurse I had to prove again. I received very little orientation to this new job and although I did my best, eventually I decided it wasn't working out; the job wasn't a good fit for me and I wasn't a good fit for the job. Move ahead two years and I am back in the Midwest, my part of the country; working at a big city hospital. I was really excited to be back with my original love, the NICU. This 100+ bed inner-city unit was much larger than my previous NICU. I could work an entire shift and never see a fourth of the nurses working that night. I honestly felt lost there, I knew no one, no one knew me. Again I wasn't known for my skills or abilities. To them I was just a new nurse, I was treated with less than respect by many. I toughened up to that treatment. Even after two years I just don't fit in...I had surgery and was off 4 months, one person came to see me and when I came back to work very few noticed that I had been gone; I got married and no bridal shower, only one coworker came to my reception. Many notices/invitations for bridal showers and baby showers for other nurses cover the bulletin boards in the lounge and the Facebook page was full of them as well. I float into a different part of the NICU and I get the easy assignments, the ones a non-NICU float could handle. I missed having sick babies, I offer to start PIVs and am declined as "this kid is a hard stick". In my former jobs I have placed many an IV in many a patient, many times when no one else could get one; however my skill is not accepted here, I am not known. I have been certified in high-risk neonatal nursing for 25 years, I was one of the first in my hospital to take the certification exam. There are a few nurses who trust me, but for the most part, I am new and therefore without skills. This a hard concept to accept, I sometimes take it personally, I wonder if indeed I'm "too old". Providers also question my capability to care for my assigned babies. I often hear "I haven't seen you here before" or "are you floating" or "where do you usually work?" I feel like I am constantly trying to validate my qualification to be here, and that's frustrating and sometimes humiliating. So here I am two years later, still explaining carefully that I know what I am doing, still hoping to be accepted and have coworkers acknowledge my skill and knowledge. I am trying really hard to accept that this is the way it is, that most likely the culture of nursing will not change. Sometimes I think about retiring early and doing something else with my time, but I do love my patients and for the most part, love my job. For right now I will just settle for being not known.
  4. CoMoNurse

    Is it wrong to expect kindness?

    Thank you JKL33 for the thorough critique.
  5. CoMoNurse

    Is it wrong to expect kindness?

    Yes in response to the thirty minutes, I work in an NICU, both of my patients were pretty unstable and I was interrupted many times during this particular report.
  6. CoMoNurse

    Is it wrong to expect kindness?

    Kindness is a topic I keep seeing in emails and on bulletin boards; being kind to others, being kind to ourselves. In my big city Midwest hospital, I see kindness quotes on the wall by the time clock, in the break room, at the bottom of every email I receive. Often I feel as staff nurses we are not very kind to one another even with all these reminders everywhere. Definition of kindness: the quality of being friendly, generous and considerate. Antonyms of kindness include thoughtlessness, intolerance, meanness, selfishness, cruelty, ill will. Synonyms of kindness include courtesy, decency, goodwill, graciousness, hospitality, tolerance, patience, understanding, consideration, tact, and thoughtfulness. One morning a few weeks ago I left the unit feeling very underappreciated. I had been treated with disdain and disrespect when I tried to give report. My report had been interrupted by three phone calls made by the nurse to whom I was giving report, only one relative to the patient we were discussing. As I tried to continue with report, I was interrupted multiple times with questions whose answers I had already given; my listener wasn't listening. Sadly this situation has occurred before to me, although not to this degree. As I walked away that morning, I heard the nurse I had given report to telling another nurse what a bad job I had done taking care of this patient; I left after a very frustrating experience with tears in my eyes, feeling judged and humiliated. My night had been very busy and the entire area I was working in was very busy, and we were understaffed as well. My patient had taken a turn for the worse just a few hours into my 12-hour shift. I hadn't had a lot of help when I needed it, hadn't taken more than two bathroom breaks and had no meal break at all. I was thirsty, hungry and tired and very worried about my patient who was getting sicker as the night flew by. I had dealt with MDs who couldn't understand my concern, another patient to care for and the very scared looking parents of my patient who were asking me lots of questions about why their baby's heart rate kept dropping and why all her milk was leaking from around her gastrostomy tube. I dealt with surgery staff who told me to continue the feedings even when the milk was pouring out around the tube. I drew blood samples and hoped the results would help me convince not all was well with my patient. And this nurse couldn't listen to me for even 30 minutes. This led me to consider my own report receiving behaviors; do I listen? do I interrupt with wild abandon? are others frustrated after giving me report? I'm going to be especially aware of these things over the next few months and making changes to my own report listening skills as I go along. Now I'm acutely aware of my listening skills, have tried to wait to ask questions until the end of the report, to make eye contact and be friendly and supportive. It's great to ask questions; that's how we clarify information and instructions; however, constantly interrupting is not helpful as it destroys concentration and may prevent accurate and concise report. Something vital could be lost or forgotten and as nurses, we realize that every little detail is important. As nurses we need to lift each other up, to support and encourage, to acknowledge that each of us brings valuable skills to our shared patients and workplace. We need to be kind to one another.
  7. CoMoNurse

    Will nursing wreck my hands?

    Yes, nursing is hard on your hands, back, kidneys, heart, knees, social life, family life. On the other hand, it's a very rewarding profession.