onarie

Being new into lower management I love this post. As a staff nurse, I knew about the "bad folks" in management. It's strange, but those on the staff who complained the most about the administration are the ones who seem to have "issues" themselves. One nurse actually refused an assignment one night when I was off, and the relief charge nurse that was on-coming made the off-going charge nurse change her assignment. That was wrong! Guess there are good and bad on both sides.

Like the others have said med-surg provides a variety of patient diagnosis. At the hospital I work for, I'm on a med-surg/telemetry unit. On our particular floor we have between 5-7 patients per nurse. We try to divide the assignments by the acquity of the patients. We have everything from congestive heart failure/heart caths, etc to something as mundane as the flu. I worked on the floor while in nursing school and have been there ever since. I wouldn't trade the experience for anything. I graduated with some people who started in ICU right out of school and they're doing great, but I wanted to be able to teach my patients and their families. We do lots of teaching on our floor regarding diagnosis, medications, treatments. It's wonderful! Time management is a skill that you have to acquire on a med surg floor. While in school clinicals, look at what some of the nurses on the med surg floors do. You will have to find your own way of doing things, but don't be scared to ask for help. Good luck with school. There is a light at the end.

Yes, please make/take the time to use the bathroom and to eat your meal. I work on a med-surg/telemetry floor. We get a 30 minute meal break during our shift. I'm fortunate I work on a floor where we all are trying to work together as a team. We ask our staff not to wear perfume or fragranced lotions to work because of the sensitivity of some patients and other staff members. Unfortunately there are some who will wear them anyhow. We are not suppose to chew gum, but rather use mints. Personally, after I eat I chew a piece of gum while on break and once I return to the floor I throw the gum in the trash. My breath is better and I'm not tempted to smack my gum or to blow bubbles.

I happen to be a charge nurse on a 40-bed telemetry floor. Our day is split into 3 shifts. Each shift has 1-2 monitor tech since we monitor telemetry for 3 floors and an admissions/holding unit. Our patient load for day and evening shift is 5 -6 patients per nurse and the charge on these shifts the charge nurse does not take patients. She is working on bed placements, helping with orders, on the phone with physicians, looking at critical labs,assisting in whatever needs to be done, etc. For night shift the patient load is 6-7 patients with the charge nurse taking 2-4 patients, assisting the staff, bed placement, looking at critical labs, etc. I am flabergasted that you are on a telemetry floor with a designated monitor tech. If I can be of help just let me know.

First, I'm sorry that you are having to work with a nurse that you are so uncomfortable with. I am a new ANM on my floor and am learning some of the whys that you are asking. What I have learned so far is that if a nurse has been someplace for an extended period of time, it is going to take lots of documentation and proof that things need to be changed. If the things you mentioned are only being talked about among the staff, there really is not anything your nurse manager can do regarding the nurse. What would help your nurse manager is for you, and the other staff that you work with, to document (and turn in) the concerns and complaints that you have with this co-worker. Medication error is a huge concern and you need to make sure that the nurse manager is aware of the situation. I have already been put in the position of having to document, almost daily, the concerns that I have had about a particular staff member. The documentation needs to have specifics in it - including patient's names, room numbers, medications that were involved, times and dates - that sort of information. I hope this sheds some light on the situation for you. Please talk with your nurse manager about the situation and see what she/he needs from you to help take care of the situation.

You ask your non-night shift friends to meet for breakfast instead of lunch so that you can sleep. When you leave work at 0730 you're telling everyone "Good Night" You're first questions when making appointments are "How early do you open" and "What's your latest appointment time for the day?" You fall asleep at your hair appointment. You don't worry about how hot is is suppose to get during the afternoon - because you'll be sleeping anyhow.

Okay so maybe it's not just the administration at my hospital that has it's priorities out of whack. I was so confused when they started to refer to my patients as "customers", I looked around to make sure that I was in the correct meeting. Sure, we want the patients to feel cared for and well treated, but these are sometimes the same people who refuse to allow us to do our job. They're spending more money getting in vending machines, extra chairs and sofa sleepers, which I agree are needed, but they should also be spending as much money hiring addition nurses to take care of these patients. One of the floors in our hospital has started a special program where they have additional aids hired to just go around and check on the patients, take them water/coffee/other refreshments if they need them. I wonder how many of them are reporting all these drinks, etc to the nurses. Makes a big difference if that patient happens to be with CHF, renal failure, etc. But the management is let's give the patient what they want, sometimes I feel like screaming!

Wow it sounds like you could be talking about a couple of patients that come to my hospital. They yell, fuss, and make all sorts of demands, keeping you from caring for the other patients. There is one in particular whose name we do not dare speak when we have an empty bed, because if we do he is usually admitted within 24 hours. But what gets me is that we stick to the physician's orders - ie fluid restrictions, special diet, etc..... but the physician comes by and says he wants such and such, go ahead and give it to him so he doesn't leave AMA. Sorry didn't mean to go on my own rant. Guess it's nice to know that I am in good company.

LPN1974 I'm looking forward to checking out the link from your original post. I do am always wanting to be prepared. Thanks for taking the time to post. I really do appreciate it, and I'm sure there are others who do also that just haven't commented.

When I enter a room, I do introduce myself. I usually say something like, Good Afternoon, my name is Angela and I will be your nurse until 11 this evening. I put my name and phone ext (we carry portable phones that the pt's can call us on) on the whiteboard, and if the CNA/Tech's information is not there I also put that (they do the same if they are the first in the room) on there also. I then explain to the patient what our Care Plan is for the day. If there are any tests that need to be done, samples that need to be collected, etc. I also then ask if they are having any pain (with appropriate follow up questions) and if there is anything that they need at this time. I also make sure the patient understands how to contact myself or the CNA/Tech either using the call light or calling our exts from the phones in the room. Once I introduce myself, most of the patient's turn around and introduce themselves back to me. It's funny after being their nurse for a few days, some of the patient's consider you family and are disappointed if you will not be there the next day. But then they also greet you like lost relatives on their next admission to the hospital - we have several that are frequents visitors.

Graduated August 2005 - Licensure October - pay became $18.54/hr + shift diffs. I had worked at this hospital as an extern while in school receiving $12/hr + shift diff. When my anniversary as an extern came in November - they increased my RN pay to $18.91/hr + shift diffs ($4/evenings; $5/nights).

My graduating class was small, because our class only started with 24 students. We were the first class to start in the spring semester and I they weren't real sure how it was going to work. Yes, that means less than 50% of us graduated; however, not all of that was directly related to the classes. There were a few who dropped out of the program for different reasons. I think I was well prepared to enter the work force as an RN after graduating from Macon State.

:yeahthat: And then when the second doctor says No - you have to call the first doctor back and let them know. Yesterday I ended up having to call 4 different doctors before I was able to assess all 7 of my patients - because the previous shift was tired of dealing with a situation. Thank God we had good CNAs who had made their rounds, and I knew that all patients were breathing and not in need of anything for pain, etc. Tomorrow will be a better day.

The day I took my NCLEX there were four of us from my class there. Two of us stopped at 75 questions and passed. The other two had 265 questions - one passed and one didn't.

I work on a 32-bed telemetry unit. Now, not always are all our patient's actually on telemetry. We average between a 1:6 - 1:8 ration. During day shift there are also 4 CNA/NA/Tech's; evenings there are 2 or 3 CNA/NA/Tech's and on nights there are only 2 CNA/NA/Techs. Each shift averages about the same ratio. There are times (very rarely) that we get a 1:5 ratio - and when we do you sure can tell. There are nights when things are extremely overwhelming and then there are the nights when you feel as though you have conquered the world. Tonight was somewhere in the middle.