MoLo

All of my work has been in-patient, so I have no idea about the out-patient world, but this sounds like a very effective way to practice. We tried in the hospital, it does not matter if a patient gets on the right med if they can't afford it, or now have a therapist if they cannot get there. But given we were working in a space of 3 - 10 days, it was hard to cover all the bases.

Then I am sad that your organization is not taking advantage of the front line knowledge and expereince. I was lucky.

Get into administration, or on committees! It takes you away from patient care somewhat when you step into management roles, but then you can enact a lot of change, probably not everything you want, but a lot! Best decision I made in my nursing career. Lasted 16 years until it was too much, but a lot of change happened.

thinking of personalities, I think of things I can and cannot change. I attempt to reality check some truly out there behavior, but other than that, knowing it may not make any difference, I have to decide where my own limits are, and when and how I will approach someone, and deal with my anxiety about not being able to control the outcome.

Ideally I would like to see a set number of years as an RN prior to advanced practice. A lot depends on the person, but in the big picture, I think the value is worth it.

Luke, You are clearly experienced in this field, and your patients are lucky to have you. I would observe that what you do for yourself is to recognize the illness, the limitations on what the nurse can expect, and a way to conduct yourself that maintains your professionalism and compassion at all times, and allows the door to be open for your patients to return for a possible more successful outcome in the future. That is a lot! moe

There is a balance somewhere that says this is not OK, and I want to work with you on it. Unfortunately we cannot control their response. I'm a psych nurse, we process to the death!

They look so pathetic when they are sick. Like when a child throws up for the first time, and they are so shocked.

A very smart thing, thank you! Should be in all nursing programs.

Bladder scanners! Why are they so hard to keep track of??? We are not talking about something the size of a dime!

Have you ever respectfully called her out? 1:1? "Debbie, I am doing my best for the patients, and I feel like you seem annoyed with me when I am giving report. Is there something I could do differently that would help?" (I would hope Debbie would recignize she is being mean and it is impacting your relationship, and feel badly and vow to change). (I also believe in Santa, but you hae to be optimistic)

I thnk you are brilliant. I get so focused on the interventions to maintain your best health, I have not recognized the importance of finding the job/type of nursing/schedule/peer group that brings you passion and job satisfaction to help in the more difficult times. Thank you!

I am so appreciative of the cat compassion! Have been on both sides, staff nursing and administration. As much as it can be challenging to manage call outs, it is both the right and the ethical expectation of the nurse to care for themselves. I have watched nurses drag themselves in and work miserably (one with a broken wrist after a fall on the way to work, staff came and got me and I dragged her to the ED), and its painful to see (patients have come to my office and told me to "send that one home!"). My schedule has gone out the window as I have been the replacement nurse many times, and after the initial frustration, I have ALWAYS had a good time being part of the team, refreshing my skills, being reminded of their challenges, and BEING A NURSE (just plain good for the soul).

The benefits of having an advanced care directive, so you can control decisions even when you cannot. And Pondering - thanks for a laugh!

It has been interesting to be in the field as advanced practice RNs have come into existence. (Yes I am old). At first I thought that experienced nurses brought something to the profession that was missing otherwise, as it was a beautiful blend of nursing insight and mentality and advanced practice. But now, not so sure as I saw the inexperienced (as RNs) APRNs coming into the hospital and gaining the respect and trust of the staff. It may be the teaching that makes it work. But it works!

I am encouraged!! There has been so much attention to peer behavior over the years, maybe we have finally turned most of this corner.

We need an education campaign for patients to realize what we are trying to do, and what we need from them (respect). And then a course for nurses on how to respond to it professionally patients just aren't able or willing, and JKL, I love the way you put it, people are some versions of themselves no matter what the circumstances! And bad behavior from peers, management, etc cannot be tolerated. This is a tough one, having fought that battle. It takes a dedicated management to look hard at their own staff and themselves.

We need an education campaign for patients to realize what we are trying to do, and what we need from them (respect). And then a course for nurses on how to respond to it professionally patients just aren't able or willing

What is one thing that you do to maintain your personal strength, optimism, energy when working with this population?

Curious - how many years did you work as a nurse prior to NP, and how does it impact your NP practice?

Interesting that as nurses we give our patients our best, no matter the cost, but we are not always kind to the next generation of ourselves, who would benefit greatly from the mentoring and nurturing. It's good to hear that maybe this is becoming more of an outlier than the norm. I remember as a new grad sticking close to my new peers for survival.

Curious if we think we are still eating our young in nursing, or if we have progressed to a more welcoming, mentoring attitude in general?

What role does nursing research plan in a new in their first year?

Where does nursing research fit in the day to day world of nurses?

Londonflo, Thank you for this detailed response! I am going to take notes on your suggestions, and start building my how-to. I haven't had access to the syllabus yet, but will work on developing a class plan for every hour. Thank goodness I am starting with just one course - I think this will be big!