nurseman99

i try always to tell my pts my name,how long i;ll be their nurse and either by callbell[if i;m working in icu],or by phone,[yes,we MUST tell our"customers" our phone #,s on the med/surg floors!] as to how they can reach me.i also ask the pt how they prefer to be called,mr smith,alvin,al or any nickname.

i actually as a male rn was curious many yrs ago to find out in the late 80;s early 90;s how many actually made it thru my diploma program here in nj.i found out that if more than 60% of those starting finished it was unusual!the reason was 2 fold.1;the instructors clearly thought it was their jobs to push out the weak and uninspired.they pushed you relentlessly until you either quit or "came up to speed"!2;they also wanted a high pass rate on the nclex!so,if you were a great student nurse but was a weak test taker beware!you might be "weeded" out!.

1991,i lost my job.i had been playing golf with an rn/manager of an icu in princeton nj.she said,rich,with your love of people and christian upbringing would you ever consider nursing?i laughed[ i have 7 boys,no girls in my family],well a few months later after losing my job i started nursing school.it was absolutely the best thing besides my loving wife and 2 loving children to ever happen to a guy like me!i would never consider another profession unless it had the same feel good feeling i get now knowing i help people every day of my life!.

my brother once joked how much more a master plumber such as he makes compared to a nurse.my response;my brother,i am a master plumber 'cause who better to make sure my pt;s "pipes" are working then me,the rn?i have always felt in my 12+ yrs of nursing that every facet of a pt;s life is my problem;albeit most may not be pleasant.from n/v to diarrhea,these are my everyday problems best addressed by the rn who is supposed to know the pt best!

I have never gotten sick at work thru all the infected bed sores,trachs and vomting blood,but the one thing that still gets to me after a dozen yrs is colostomies.you can vomit on my shoe and i;ll just as soon take my dinner break.but the poor guy with c-diff and a colosomy to boot just makes me lose my appetite.there is no way i;d want to be a roommate to someone who can "hold" 6hrs worth of gas in a bag and just unleash it in burst of glory to cringe my nose hairs!

a dx of cancer is a sad thing.we feel and pray for you and your father.unfortunately, the lady that informed about the trial is partially correct.the md and company that she is affiliated with may run the trial but your dad;s primary oncologist should have access to the same trial if your dad fits the criteria.i would advise you go to the national cancer institutes home page and type in treatment protocols for stage 3b/4 nsclc.my job at work deals mostly w/post chemo side effects than actually giving the chemo but quality of life has improved over the last few yrs with newer tx modalities.he may have to go thru the 3some approach of sx,radiation/chemo but pt;s do much better if they are well informed of each step and it;s side effects.god bless and good luck!

my hospital does not use cma,s,qmt,or any uap to give out meds.but,i felt the need to comment regarding assessing pt;s r/t the meds they get.working in oncology does the med tech know to ask about the side effects of all the meds they are passing out?do they look up the pt;s k level for lasix?take a manual b/p for tenormin?i;m just curious.during resp tx;s are you required to assess breath sounds?i know when we first started having our pca,s do ekg;s and blood draws they were less eager to do q2hr turns and skin care w/me.DO NOT MISUNDERSTAND ME PLEASE,i do not want to offend anyone,but i think when you give uap;s more resposibilty the bread and butter of their job description gets overlooked.i know administration is looking for cheaper ways to deliver care,but almost every study ever conducted shows the more r.n. hrs per pt day the safer it is for the pt.if i have a good cna/pca,working as a team my 7pt oncology assignment is much easier to do.

i wish all new grads could get there feet wet doing a yr in med-surg.i believe it gives you a great foundation.as far as l+d goes i would think the manager would be happy to have an in hospital transfer than a new nurse to train because you will already have a proven track record.however,with the nursing shortage my hospital is even taking new grads to open hrt recovery,never was like that before....

i;ve done over 1000 abg sticks....every pt rates them differently.one fact remains;who's gonna stick you!try and make sure it is a veteran of abg sticks.in icu we train our new nurses on vented,sedated pt;s first because in the hands of a poor "sticker" you may hurt alot.

unfortunately the trauma center in n.j. where i work has "reclassified" our lpn,s as pca2,s.this means they give meds but the management has taken the stance that they want all bedside practioners to be r.n;s.a pca2 is demoralizing to our hard working practical nurses.however i think that many lpn;s would agree in the education department an r.n. is required to take more classes,write more papers and do more clinical to earn the title r.n.i;m not saying in my many yrs as an r.n. that i would gladly trade a few of my r.n.,s for my lpn,s!that aside, we are in a day and age where titles seem to undermind actual knoweledge.i;ve worked with both bsn,msn,s and even one working on her phd who value my diploma trained insight more than any professor they have ever had,but the bosses prefer the degree!it stinks!soon just as my beloved lpn,s got reengineered to a different position the diploma nurses will be next......guess i;d better go back to school.....

my hospital uses syringe pumps.so whether it;s lopressor,lasix or bumex,you can give it full strength via a kvo line.[in icu we never have a pt without at least a kvo.].but when i do oncology i call the pharmacy and ask for minimal and maximum dilution if any is needed.with the exception of adenosine and very few other drugs almost any med can go in a 10cc syringe pump and be run slowly over 5-15 minutes.an aside to the phenergan issue;it has been one of the most side effect producing drugs i have used in my dozen yrs in oncology and icu....yes it works better and faster than most antiemetics but it;s lethergy s.e. can be potent.family members have run out to the nurses station on as little as 12.5mg ivpb to let a nurse know that mom or dad is very "sleepy" or hard to arouse.it also can cause hypotension....

although i do agree that management has a poor hx in helping nurses with their struggles r/t families,i am convinced in my many yrs in my hospital that families are much more intimidating and bothersome to the younger looking nurses than they are to the more seasoned male and female nurses.any nurse new or old needs for their visitors to know that you as the primary nurse is in control of the situation and/or needs of the pt at any given time.if they do,they are less inclined to be a "pest" and will let you go on with your job.

unfortunately many family members know the old adage that the sqeeky wheel gets the grease.i'm not saying that being a male nurse is by any means makes me better off, but the fact that i;m bald,over 200lbs and have that jack nicholson grin makes pt;s family less inclined to verbally berate me.i believe most family;s that go after the nurses for every little thing are mostly either guilt ridden or clueless as to what we actually do in our 8 or 12hr shift.they feel if they bully us then their family member will get more attention then the next pt will.i always put an end to that quickly.i take them aside and give them my speech on priority and policy.for example,i hate when someone's meds are do at 9pm.it;s 930pm.you are busy as all heck.the family is riding you like a new pony.i explain to them all 8hr meds as well as q6hr/q12hr meds can be given 45minutes either way early or late.when proper info is given they seem to calm down.if not ,that;s thankfully where the charge nurse can come in and tell the family they should be thankful for having a nurse who goes far beyond the extra mile for his pt;s.i no longer let familys get the best of me.i guess 12yrs in the business you realize for every nutty family member there is a dozen who really appreciate what we do.fyi;please forgive my grammer and typing.i type with 1 finger,and less than 30wpm.

one of the sad things being an rn is that we all talk a good talk until the crap hits the fan.many a nurse over the yrs has had the same complaints i have had.unfortunately,when confronted by the manager i seem to do most of the talking.here is the reason,nurses by nature are nonconfrontational.we are so used to comforting or helping people we just want to complain but not go the extra mile to report poor performance or downright dangerous behavoir because if mr/ms poor nurse loses her job who;s going to feed /clothe her family?but.....what about mr pt??!!!doesn;t he deserve at least moderately skilled nursing care?reporting a dangerous situation or pattern of nursing is the least we can do to safeguard the pt;s in icu!i wish you good luck and pray that your hospital sees beyond that manager and looks at the bigger picture.if you truly are well respected by your peers than all will work out if you desire reinstatement...god bless..

we use the ramsey scoring system.with pt sedation it is best to know if they are going to be vented for awhile as in ards or are they a quick extubation in the a.m.for short term i think diprivan is now 10x;s better that we have discovered it can be piggybacked to far more meds than previously thought.it does require frequent checking of volume left because once the imed beeps empty the pt has only 1minute or 2 before they sense the confinement of the ett.and in icu with codes and crashing pt;s it;s not easy if the pt is on 30mcg or more.diprivan is also a cause of hypotension in the unit.now,versed and fentanyl are used frequently at my hospital because of cost and the the synergy of sedation and pain control.just remember that pt;s unfortunately develop a tolerance to all meds and on monday are on 30 of fentanyl and 6 of versed and the next night it;s 40% higher in dosage to keep the pt calm.