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  1. steelydanfan

    New Job -- Unfriendly Welcome By Staff

    The ones on 3rd shift are probably WORSE than the day people, because the boss isn't AROUND! Rude and impolite are pretty much grounds for dismissal anywhere, and if YOUR DON has gotten rude and impolite CNA's to deliver GOOD nursing care, I'll eat my hat. I have dealt with all kinds of rude and arrogant CNA's, some want to test you and shut up the minute they see you are a team player (put the pt. on the bedpan yourself instead of hunting a CNA down for 5 minutes); and some are JUST mean, angry and NEED to be fired. I get lots of support from MY CNA's because they know I'm right there with them in a code brown, take the time to explain WHY they are wrong when they want to tell me the IV in room 4 is 'DEFINETLY blown" and THANK them at the end of EVERY shift for the fact that I coud not have gotten through the day without them. The longest "win over" was 6 months, but I got her on my side too, in the end. I have also done my best to get 1 or 2 fired.
  2. steelydanfan

    Should I retest a patient with a positive PPD history?

    Yeah, I had the same thing happen, and at my new place of work, they INSISTED on testing me again. Lo and behold, I was NOT positive. I would guess that someone long ago read it incorrectly, and I went through too many unnecessary CXR's, and a slew of antituberculin drugs as a result. The test and the parameters around have changed, talk to your HCP about it.
  3. steelydanfan

    Report without Orders?

    In my experience, no pt. can be sent to the ICU without the basic bridging orders being WRITTEN: airway, cardiac and prn pressor orders, and an Intensivist handoff, PERIOD. Otherwise, it's a dump pt., and they can stay in ER all night for all I care.
  4. steelydanfan

    .9 = Nine 8-hour night shifts in two weeks. Too much?

    This is TOTALLY dependant upon your age. When I was 23, 3 12's were no problem. Loved the continuity, loved the 4 days off in a row. As a 50 year old, 12 hours just about kills me, and if I had to work full time, I might well kill somebody else.
  5. steelydanfan

    Lunches: Brown bag or cafeteria?

    I have only worked in one hospital wher I wanted to buy lunch, because the cafe food was SOO good! But now I brown bag it, because getting there and buying it would consume the entire 30 minutes! (Not to mention that the fodd is rank!) A sandwich or a leftover mini-meal, a yogurt and a cookie ( or olives, or carrot sticks) take no time to pack at all. Make tuna or egg salad the day before and stock the cold cuts or PB&J and you have the makings of a good lunch you will try to make time to eat!
  6. steelydanfan

    Nurses not making enough...wait what?

    I think you should mind your own business. Since you have no idea what your friends do, or are responsible for, you have no way of judging thier worth. When you can come up with a value table that can tell me EXACTLY how much someone should be compensated for the education and experience needed to recognize impending trouble; and the skills needed to intervene to save a life, then and only then can you tell me what your nurse friends OUGHT to make.
  7. steelydanfan

    New nurse... Dressing change?

    I don't understand why you are so confused about such a clear order. "Daily" means "Daily" or once every 24 hours. Why is this confusing? If the dressing is signed and dated, yes by all means use that as your guide, if you can't find any other documentation. Though of course, YOU will document both in your nursing notes and on the dressing label.
  8. steelydanfan

    Do you worry about your patients after leaving work?

    At the time we do shift report, every one of us is undergoing a self evaluation as we report our day. Some may recognize it and communicate our lapses and "to do lists" at that time, some may not. Report should contain my observations, what I see as goals, and the things I have suceeded at and have failed at as a template for the next nurses shift plan.They will then assess and replan priorities as they see fit. If I have mostly suceeded in my goals for the day, and have communicated my concerns , I can go home with a clear head. If I forgot something, I will call when I remember it (usually in the parking lot). OBTW, the example of the newbie you gave is an old joke among ICU nurses, in re: the easiest pt. is a pt. intubated and on sedation. No calls, no problems. Has nothing to do with a nurses values or propensities. He just heard it somewhere, and thought it was cool to say.
  9. steelydanfan

    declining a nursing job without burning a bridge?

    There are probably 50 more posts after this one, but this caught my eye. In rejecting a job offer, only two things should be said. 1. "I must decline your offer of employment as I have been offered a position that better suits my needs." 2. "I really enjoyed interviewing with you and should my situation change, I hope that I might apply to your institution again". Done.
  10. steelydanfan

    Customer Service? Maybe on your home planet.

    Do I laugh or do I cry? I'm not handing out hotel room keys here, I am trying to keep people alive, and restore them to health. This situation is far too serious for me to have to spend masses of time placating idiots who think that good nursing care is being on speed dial to every one of thiier 40 family members who URGENTLY neeed to speak with me. My SCHOOLING went into great depths as far as handling difficult people (2 semesters of pyschology and sociology each, as well as psychiatric training and role playing in leadership skills classes; thank you very much). As for the statement that "nurses think that patients 'owe' them something", your thinking is so out of the ball park as to be ludicrous. I have done this for a VERY long time, and I know for a fact that there are no "ALWAYS". Your statement just says that you have been VERY lucky so far. You WILL be faced with the pt./family from hell; you will be abased, humiliated and frustrated in all that you try; and then you will remember this post. Best of luck to you.
  11. steelydanfan

    I gave a back massage yesterday

    Sorry that you never get to do some of the nicer things in nursing. Giving a bath or a back rub (we are NOT talking MASSAGE here) can reveal a wealth of information, or simply allow YOU to feel good about going the extra mile for someone who is sick and stuck in a hard bed all day.
  12. steelydanfan

    What scares you most as a rn?

    Absolutely my worst nightmare! Is this your baby? SOOO adorable!
  13. steelydanfan

    when the day shift arrives

    It's not lack of resources, it's lack of guts. I worked nights for 10 years, and yeah, you call a doc in the middle of the night, you get reamed. SOO what? I have seen nurses who don't call for admit orders for pt.s admitted at 3 am DESPITE explicit writen orders to do so. Why? "He will yell at me". Well, wait to see what happens when that pt. has a complication and the chart shows that no doc was responsible for the pt. since his transfer from ER. I worked with a doc who when called at night would rant, rave and hang up on the nurse who called. You could literally count to 100, and he would be calling back and give you what you needed. Scary, yes. But NOT a reason NOT to call. Somebody didn't, and the pt. died.
  14. steelydanfan

    If YOU were the patient, would you feel comfortable...

    This is why I cringe when I see families bring babies in to see 'Grandma". I ALWAYS have a talk with them about how we have visiting regs and why a hospital is not a good place for a litttle one with an underdeveloped immune system.
  15. steelydanfan

    RN's are part of one huge CULT!

    What is REALLY killing American companies is the idea that the shareholders are God, and that profits are the be-all and end-all of a companies function. The idea of producing a quality product has gone by the wayside. If a worker cannot make a decent wage, he cannot BUY the products you MAKE. Workers who make 14.00/hr cannot buy Ethan Allen, they buy Ikea. So Ethan Allen loses revenue and lays off employees,those workers go to Ikea who pays 9.00/hr, now nobody can afford anything, 60 companies go out of business. Thus, the plight we find ourselves in today. But by all means, keep voting Republican. They just HATE those darn unions!