Runnergirl84

I agree! I would never think to kiss a patient on the forehead but I have seen nurses do that in the hospital mostly to elderly ladies when they discharge or when they say goodbye at shift change!! I was shocked when I first saw it because I don't even do that to my own grandma... but I could appreciate the bond that these nurses had with their patient. I am talkative to patients and most coworkers and will ask questions of both to get to know them but it's just so exhausting for me. I don't think it shows at all but inside I am so drained after work. Just think about how many people nurses interact with in a given day. So many! I always kind of keep a wall up around me but I wish I didn't. Then at times I'm so relieved that I don't mix work with pleasure and am not socially connected with other nurses on Facebook etc. when I'm off I'm open to talk to really no one but family. I just think it's one aspect of my job that I find extremely difficult. Even after I ask a question to a patient and they answer there's somewhat of an awkward silence after. Sometimes there's nothing worse than awkwardness though some of it just might be me being hard on myself and it wasn't awkward for the patient. I usually am my own worst enemy. And its true, I might not be out having a night out with coworkers on my nights off or getting a daisy award but I still want to find ways to be a better coworker as well as finding ways to build rapport with patients. A lot of time I think being quiet can exude not being confident which can make patients and families not as comfortable. So I guess it's a work in progress. Being a nurse has really forced me to interact with the world which has taught me a lot.

Anyone else have an awkward personality and work as a nurse? I'm not that awkward but a little bit and I find it hard sometimes to make the small chit chat with patients that really helps to build rapport. I am very kind and gracious but sometimes I don't have that quick remark that can make a patient laugh or smile like many extroverted nurses I see do. I'm not good at it in my personal/social life so it makes sense that I'm not good at professionally. It bothers me some. Social interaction is a lot more work for me and I find it harder to go above and beyond in terms of making a patient comfortable because a lot of what patients remember is their wonderful nurse's personality. I try to make up for it in other ways but much too often I can come off as too serious. I have had many patients say I'm a great nurse but im not confident in my social abilities. What are some ways to improve this and does anyone else have the same problem? I wish I was comfortable enough to go give patients hugs and kisses on the forehead like some nurses do but I don't even do that with my own family. I don't know how much I really need to go against my nature and how much to just accept the nature I have. I find it challenging as a shy person to be a memorable effective nurse but I am going to keep trying because I love being a nurse! Cheers☺️

I'm totally not doubting LPNs' abilities or intelligence I just thought that the ICU would not be a setting they would get hired to work in. I also thought they could not do initial assessments or assessments period, teaching, care plans, and other things. A lot of nursing is assessing: assessing an IV site, assessing a wound, assessing a reaction to blood, meds. I guess I am unsure how one could work in icu and 1) not hang an IV med or give an IV med (if you're a patient and not on IV meds I imagine you're not in the ICU,) and 2) not have to assess any of the above and a lot more frequently. I guess I still don't understand how an LpN could function in the ICU. Even if IV certified do they have the background knowledge to know what a reaction to a med might be and how it might show up clinically (again assessing)? I can see it somewhat being okay doing the RN/LPN approach but when an RN has 4 ICU patients I'd imagine that could be very bad if one or more goes south... the LpN wouldn't be able to do a whole lot in that case and the RN is now responsible for 4 lives! I'm not trying to be insulting to LPNs because I totally get that it's more about abilities than the credentials but in terms of scope of practice etc., I'm still scratching my head. I will have to do more research. I also know the scope varies state to state.

I'm feel very ignorant that I assumed that it wasn't possible. That's very interesting to me. I'm still not clear on what LPNs learn and don't learn and what the differences are beteeen an RN and an LPN. Thanks for your responses.

I had a terrifying conversation but I am not sure if maybe I just do not understand what LPNs can do as I don't know many and haven't worked with them much. I met an LPN at a new job I started and she was saying how much she missed working in the ICU. She said she learned so much. She's IV certified so she said she could manage all the drips and everything going on in the ICU with just nurse "supervision." Is this a real thing? And she said she doesn't routinely work their and was floated there some. So that means she never really learned ICU. It's something that isn't safe for RNs to just drop in to and do well. I've worked in the medical unit at a hospital that just became my PRN job and I've never heard of an lpn working there let alone working in ICU. And this is not a small hospital (a different one) she was talking about. Sounds insane to me.

I had a patient I had taken care of for a few nights. He was progressively getting weaker each shift. He was newly diagnosed with cancer after coming in for something else. But it was in his lungs, brain, hip bone and a few other places. Anyway, each night I took care of him he always was alert and oriented and in fair spirits and watching movies on his laptop and reading the newspapers. He always denied pain which was very surprising to me. He was a DNR from the beginning. His actual wishes after learning of the cancer diagnosis was to have physician assisted suicide but that is a process that wasn't being actively pursued during this stay for reasons I'm not sure about. The plan was for him and his wife to discharge on hospice the next day after the last night I took care of him. The holdup in doing so was getting everything arranged at home. He had an awesome supportive family who truly wanted to help him to follow his end of life wishes. The last shift I worked with him, he had had an MRI of his hip on day shift to see how much cancer there was in it and he had been too weak to get out of bed and so we helped him with a urinal/bedpan. I attributed a lot of this to being wiped out from the tests done during the day. Still no pain at bedtime. Said goodnight after getting him some hot tea he requested. No pain or changes in his assessment noted until later in the shift he suddenly had pain in his right hip. He had nothing but Tylenol for pain. But this was 10/10 so I notified the hospitalist right away and she ordered a dose of morphine 2mg IV which I gave as soon as I could after checking his BP which was 90/60s. His Bp had been trending lower like 90s/60s. Which I mentioned to the doctor. I gave the morphine and he dropped real low like 70s/40s and his daughter/POA soon after was requesting additional morphine. Patient still alert and requesting pain meds also. I told the daughter that she want to call in her sister (it was 4am) because I sensed he was not going to last very long but figured it would be at least be hours from then before he passed. Notified the doc and told her the low Bp after the first dose and she ordered 0.5 mg morphine to give now. Patient not looking well. Charge nurse was aware of the situation and agreed to give the additional morphine. So she came with me and I did. Patient expired within minutes of that last dose. His family thanked me profusely for giving him morphine so he didn't die in pain like he had wished. His wife had also been a patient next door on our med surg floor and also was newly diagnosed with cancer also. The other daughter had made it just in time to hold his hand as he took his last breath. I was so shocked that this all happened so fast... from alert and conversational to dying within 30 min. My charge nurse assured me I did the right thing in administering morphine per his request so he was comfortable but part of me feels it may have hastened his death. I was very comforted to know the family was extremely thankful but I still feel unease with this mainly because of how fast this all occurred and my second concern is that why were they pushing the further testing the day before the morning he passed if he was going home to discharge on hospice the next day. I think honestly that it just wore him out and his body was done. Also shocking to me was to go from zero pain to 10/10 so suddenly. Being a previous rehab nurse that didn't typically handle dying/cancer patients I want to know if that is common? What could I have done to handle this situation differently or did I do the right thing. It still weighs on me because there was really no debriefing after. Cleaned the room after doing post mortem cares for the room to be cleaned for a new admission:/ all before shift change at 7am.

Thanks for your response! I am thinking of taking the day job!

And for the record I'm truly disappointed in myself. I wouldn't have taken a job that I didn't think I could do if I anticipated feeling so badly like I do now. I'm a hard worker and I have dealt with so much and worked so hard to get where I am and have eternally exhausted since nursing school. I don't have a social life and feel isolated as a single mom and working nights I have little time to meet people. I'm usually to tired to worry about it. I do everything I can to make my daughters life good when I am off. I just don't know what the right decision is long term:( my family doesn't understand the ins and out of nursing but all know how much nights is affecting me negatively these days. It's allowed me to make a decent living as a single mom and take care of myself and daughter comfortably but I don't think nights is sustainable anymore. I hate to let my manager down as he chose to hire me over another applicant nearly six months ago. My eval went great. Should I maybe ask to stay on PRN? I don't know how to think things through anymore. My brain feels frazzled and the dread of having to stay up all night even one more time gives me terrible anxiety. I am normally very calm and never struggle with anxiety. Even went to doctor because I've been having heart palpitations trying to fall asleep and even at odd times during the day that are really a terrible feeling. Maybe I'm talking myself in the direction I am desiring but just need some affirmation! Thanks

Hi everyone! I have been a nurse for five years! I had a daughter who was ten months old when I started nursing school, worked part time through it and graduated top of my class. Got my BsN online while she was 3. So I feel like I can handle a lot!! I've worked nights now for five years. First year in subacute rehab, three and a half years as charge nurse on nights in a rehabilitation hospital. Thought I needed to get in the hospital, so finally got a position on a medical unit in the main hospital system where I live. There are only two other hospitals nearby one in this system and one in a different one. Needless to say it appears to be a highly coveted job which means though my body is not liking nights at all anymore my manager has informed me that no day shift opening is expected to be available any time soon. I started having trouble feeling bad physically, mentally, emotionally about 9 months ago. I thought it was just my job and that getting the almighty hospital job would solve my problem and I'd be fulfilled (ha!). I like bedside nursing most of the time, and at the hospital I have great coworkers usually, I like my patients, even the cranky ones. Even still, I feel as though the twelve hour shifts just drag. There's plenty to do but they seem to last double the time that I'm there. I now have to take trazadone 100 mg and Benadryl 50 mg to knock myself out everyday after work and on my nights off only fall asleep with the same dose of meds which leaves me feeling hungover the next day. I've never had trouble sleeping before this last 9mo. I emailed my manager and nothing soon will be available on my unit. I am a month away from being there 6months which is when I can apply internally for other positions within this system. But it's not a given I would get a different position. I don't feel like I can do even one more shift. Due to childcare reasons I need to do them 3 in a row. I need to be home for my child as she's more active in school and activities. I had an interview today with a new rehab center that said the job is mine if I want it. I physically feel so badly from the stress of nights. This job would be 7a-3p full time with every other weekend which sounds like a dream come true (funny how dreams are different when you're adulting). The facility told me they have some kinks to be worked out but I'm used to handling a lot and I actually miss the responsibilities of having to be resourceful (no Iv team, no lab service, no wound team or RT) so I know the shifts would be hard but rewarding and fly by. I feel somewhat like just a number in the hospital and totally replaceable. The only thing is... leaving the only hospital system without a full 6 months. I had hoped I could last a reasonable time on nights and when the time was right find the specialty I was interested in (ICU). But I physically don't feel I can even pull off another week of three 12s. I'm so tempted to take this job and kiss my "great" hospital job goodbye just for my health and happiness... home at night with my child who has done this night stuff shuffling back and forth for too long. I just need some nurse to nurse advice. Thanks in advance. No rude comments just looking for advice. I have worked so hard as a mom and nurse and am very conscientious and want to make the best decision but don't want to close doors for myself! Thanks for anyone that answers. ✌������