rnsrgr8t

That's what happens when you grow up in a medical family.....you get a children's benadryl and a few puffs from your dad's albuterol inhaler and a pat on the head :). Luckily symptoms got better with that. Obviously my parents would have done more if this did not work. Different when you are in a school enviroment!

I do not get anaphylaxis from cats but close. When I was younger, my eyes would swell shut, would get hives around my eyes and get a scratchy throat and my asthma would kick up. Luckily antihistamines worked when I got an acute reaction (never needed epi) and as an adult allergy shots and xolair where life savers for me. I own 3 cats now and they sleep with me and I am fine. When I was a kid though it was miserable. As a previous poster said, I could go in to a house that a cat previously lived (even if they vacuumed and cleaned well and the cat no longer lived there) and react that way. It runs in my family. My Dad does the same thing and one of my cousins (paternal) did the same thing when she came to visit me.

I did this for my first APN job. I could not find a job at all in the state where I graduated. I was young and single and had no ties to the area so I applied to jobs all over the US. The employer paid for my airfare, rental car and hotel for the interviews. It was a big hospital system so they also assisted me in finding a place to live (I rented an apartment initially). They paid I think 4 or 5 grand in relocation assistance (they reimbursed me with receipts). I also negotiated reimbursement of my grad school loans (4 grand a year until they were paid off). Granted, this was 15 years ago so I am not sure what the current market is for this. If they really want you, they will do it so no harm in negotiating. That is how I got my loans reimbursed. The salary they offered was on the low end and I told them I could not afford that with my loans so they offered to repay them for me. I am glad I did it. I love the area I live in and never want to move. I was at that job for 15 years and am no just moving on to a new job. I did not know the area at all but did my research to find out the area, cost of living, crime statistics, schools etc. I rented an apartment that was relatively close to my work until I knew the area well enough to know where I wanted to buy a house. Your future employer can help you with that as well (at least let you know good places to live, commute times etc). Good Luck!

I made that mistake in my first job. The APN I was working with, really did not function like an independent provider at all, just like a nurse who could order tests. I being the eager, newbie just wanted to do whatever they wanted me to do. In the beginning, it was good because that was how l learned by doing all the scut. Slowly I was allowed to see some patients on my own but I still had to do all of the nursing support for the attendings. Then I was being pressured to see more patients but there was no one to do all of the other support work that was demanded of me. I am moving on to a new position where I am a provider and they have enough support staff to handle all of the other things. I am there solely to see patients. There are a lot of APNs who would have been happy with the job I had but a lot of them would not. You just have to decide what you want. I was to naive as a newbie to know what to look for.

Be careful in these kind of roles as a new grad, especially in a specialty. I ended up in a role like this. I basically was acting like a resident and doing the scut the physicians did not want to do. In the beginning, I did not mind because I was learning a specialty that was completely new to me, and honestly that is the best way to learn. Now, I am miserable and finally found a new job where I can just be an independent provider. There are a lot of APN's that are totally happy with a role like this and more power too them. If your ultimate goal is to be an independent provider, this type of role may be unfulfilling.

RN, CPNP

I would like to share my experience with my preceptor my first nursing job out of school. I experienced a combination of bullying but I also did not get off to a good start either with my behavior which I think exacerbated my being bullied. I was a star in nursing school. I worked as a nurse extern all throughout school. My clinical practicum was in the specialty I ended getting a job in when I graduated. I came in confident. My preceptor and I butted heads from the start. Some of it was on her but in retrospect a lot of it was on me. I heard the same comment from her that you received, I was not paying attention and looking at her when she was trying to tell me something. I thought I was doing the same thing you did- listening while I was multitasking. I was trying hard to act confident but it came across like I was not listening. I was trying to show her what I knew, she interpreted it like I was arrogant and unwilling to learn. She would tell me things I knew and instead of keeping my mouth shut, I would cut her off and tell her I knew already what she was telling me. She eventually told me the same thing your preceptor did. I need you to look at me and LISTEN. Looking back on it as a mature nurse 20 + years later. She was RIGHT. Now on the other hand, the staff (because I was having personality conflicts with their star preceptor) took it SO far to knock me off my pedestal and take me down to a lower level. They did everything they could to humiliate me, talk about me, not help me, set me up for failure etc. I ended up leaving after a year and half after getting a serious right up questioning how I handled a specific patient situation. Caveat was, as I was navigating it, I was reviewing it with the charge nurse every step of the way. I thought I handled it well because I listened to what she told me to do and she knew everything that I did. Unfortunately I pissed off a resident and he reported me. Because of my earlier trouble, the charge nurse, when asked, lied and denied I ever asked for advice. I had no one stick up for me. I ended up being told I was not cut out to be a nurse at all. They were going to let me stay on (? really even though they did not think I should be a nurse?) but if I made ANY kind of mistake, they would fire me. They also would not let me transfer to anywhere else in the hospital. Luckily I found a job quickly after a few days outside of the hospital system and left. I ended up having a very successful career and now been a PNP for 15 years. Who knows how I would have done if I came in with the right attitude. How I ended up being treated was reprehensible and almost made me quit a career I loved. It did a lot of things to my psyche and confidence that still haunts me. That does not eliminate my culpability in the beginning of it. I am not saying that how I was treated in the end was right, it absolutely was not. But in the beginning, I can honestly say I was wrong. You may be being bullied like I was in the end or your preceptor may have a valid point (like mine did initially). When you are on orientation, best thing to do is keep your ears open, mouth shut and just listen to what you are being told. You may, in your head, be thinking I KNOW all this, but just listen. Now if you are ASKED if you know something, that is the opportunity to show your knowledge. NOT when your preceptor is trying to tell you something. Best of luck!

I definitely agree the internet is helping further the vaccine hysteria. When I was in PNP school, I did a project on the false information online on vaccines (that appears legit to a non-medical person) and how that influences parental decisions on having their child vaccinated. If I did not know better, I would have been horrified and never let anyone vaccinate my child based on the things I found online. That was 15 years ago and the amount of false information out there was frightening. It is even worse now. I have dear friends, well educated people, that have bought into the anti-vaccine craziness. One of them posted a link to a facebook post that was so alarming. It is a mother who was showing a binder she has of over 1500 pages of "documents" showing vaccines are unsafe that she got from the internet. It has been spreading like wildfire on social media. I looked up some of the links she has and it is all bogus. If you work in healthcare, these people unfortunately do not want to hear it because they think you are part of the conspiracy. Nothing you tell them works. I had a friend argue with me via text message one night trying to tell me I was wrong on the benefit of the HPV and flu vaccine. This is someone who has a master's degree and teaches science to middle schoolers. I got nowhere with her and finally told her to do what she felt was best for her children. She told a mutual friend about our conversation and said all I gave her was "the party line". It is very scary.

I just saw that documentary last night and was thinking the same thing. He should have reported it. Whether or not anything came of it is not the point. He made a very astute observation and it should have been reported. That way, the second time they were reported (and the police went to the house) Mom may not have been as able to manipulate the police like she did because there would have already been a record.

NEVER say the "Q" word or anything resembling it. WAY back when I was a nurse extern on a pediatric floor (in a larger hospital) working nights. Around midnight, we only had like 2-3 patients so we sent everyone home and we had one nurse and myself to cover the floor. My beloved nurse (who was my mentor) propped her feet on the desk, leaned back in her chair and said, "wow it is SO quiet". 8 admissions later, in the span of about 2 hours, and we had to call in the people we sent home to come back in the middle of the night I was ready to kill her!!!! Never say it!!! Totally believe in the full moon thing. Cannot tell you how many times I have had an insane day, crazy people, crazy patients and you look up the moon calender and low and behold, it is a full moon. You also NEVER say the full name of a frequent flier. They will show up without a doubt. There are some you can say their initials (and every one knows who you are talking about) and get away with it. But there are some who if you even think their name in your head they will show up.

I agree with this point here. I work in a clinic for voiding dysfunction in children. I order KUB's all the time to assess stool load and decide if the child needs bowel cleanouts etc. The patients go and get the Xrays and review them with me duirng the visit. With my years of experience, I know how to assess stool load on the KUB and give the family the treatment plan based on my interpretation of the Xray. In my busy hospital, it could be hours before one of my Radiologists has time to read a non- urgent KUB. I am not going to make the family wait that long for the treatment plan. Now I always f/u on the Radiologists interpretation of the films and be sure to read the report to make sure I did not miss something. It is within our scope of practice to interpret imaging like this (same goes with the example above to interpreter an NG tube, pneumothorax etc.). I also feel pretty comfortable looking at renal ultrasounds. Now when it comes to CTs or MRI's, no I do not feel comfortable and would rely on the Radiologists interpretation. The urologists I work with are the same way. They are completely comfortable with interpreting ultrasounds etc. but when it comes to the more complex imaging, they need the Radiologists interpretation as well. But to have a blanket law that says a NP can never make a treatment decision off an imaging study on their own is, in my opinion, ridiculous.

I am a PNP and I work in a specialty. I occasionally will hear an innocent sounding murmur when I examine my patients. I always let the families know and ask them to f/u with the PCP. A lot of times, the PCP does not hear it. Innocent murmurs come and go and are more pronounced with fever/illness. That is likely what this child had. Trust your assessment skills!

We had a pharmacy dispense methadone instead of methylphenidate to a teenage patient of ours when I worked in primary care. Mom called concerned because after taking it he was sleeping all day. I had her read the bottle and it was methadone!!! Also had a pharmacy dispense aspirin (to a CHILD) instead of tylenol. Mistakes happen and whenever you are giving medications, you have to STOP and be extra vigilant. Such a sad situation.

I had a teenage boy as a patient for years with lots of urologic issues. He was complaining of a lot of dysuria and I needed to watch him void to assess his stream. Since he was a minor, Mom had to be in the bathroom with me while I watched him go. He was a good sport about it. As he was standing there trying to relax so he could void, his mother was pestering him about how he was standing, pulling his pants/underwear down etc (why I do not know since this was embarrassing enough as it was for him). He looks over at his Mom and without missing a beat and completely deadpanned says, "Mom, this is not my first rodeo, I DO know how to pee!!!". We could not stop laughing!! Bless his heart!

I think you are more of a friend to Flo than she is to you. Sounds like she is only "friends" with you because she feels it benefits her on the work side. when things do not go her way, she definitely does NOT treat you like a friend. She seems very toxic. If she is not speaking to you, leave her be and I would not engage with her outside of work for now. If she asks you why you have been distant, you can simply say that she has not seemed happy with you as a friend and you need to focus on work for now, not a friendship outside of work. She is really NOT being a friend to you. She seems to be manipulating you, a lot.

I work in urology that is part of a whole department of surgery. We do not officially get bonuses from the hospital. In our division, the MD's pool $$$ together and the NP's and our specialty nurses each end up getting about $500 cash at Christmas as a gift. For all of the support staff for our whole department of surgery (the MA's who room our patients and our secretaries and front office staff who check in our patients for appointments as they are shared by the whole department)- we all give some $ for a monetary gift for them. The MD's each give $200 and the APN's/nurses give $30. This gives the support staff a monetary gift too. This is voluntary, we are not required to do it. I personally would never be able to afford giving $500. Especially if nothing is done for you, why would you have to pay that much for the other staff?

I have been a pediatric nurse for 19 years. I have seen some truly sad cases.... There was a toddler little girl where Mom's boyfriend had kicked her abdomen so hard, she had pancreatitis and he had put her hands on a hot stove and burned her hands. There was a 5 year old little girl, I did not know her history but was assisting when she was having a foley put in. First time I ever saw evidence of sexual abuse on a child. There was a little baby who was brought in for what initially they thought was an ALTE. Once in the ER, Mom (who was morbidly obese) stated she had her in the bed with her and rolled on top of her when she was sleeping. Seemed feasible due to Mom's size. That was until they did an eye exam and saw retinal hemorrhages. It was shaken baby syndrome. I remember one of our pediatric residents sitting at the nurse's station crying with that one. There was a family (Mom, several children of all ages and an Aunt) that were living in one house. Dad was estranged from the family and lived in an adjacent state. One night, he broke into the house and stabbed all of them. There was one survivor (she was around 9) who he cut her throat from ear to ear. She was the only survivor and played dead while he killed the rest of her family. He then got in his car and drove back to his home state and went to work. He was prosecuted because the brave little girl was able to give a description of what happened. When I was in grad school to become a PNP, one of my clinical rotations was in a pediatric ER. I got into a room to do my H&P on a cute little 7 month old baby. He was adorable. Sitting in dad's lap, smiling and a huge afro. Dad was stoned and told me he had fallen out of a chair a few days a go and "had a little bump on his head". I got to palpate his head (because of all of his hair, you could not see any physical deformity) and it was the first time if felt what step off is. The entire side of his head felt like broken egg shells with obvious skull fractures. I remember being so afraid to show any emotion on my face in fear the father would bolt with the child. I calmly stepped out of the room, ran and grabbed my attending and told him my exam. They brought the cops in right away and removed the father from the room and started an abuse work up. I never knew the outcome but I will always remember him. It is so hard to see. It has not deterred me from working with children because it is the only area I ever wanted to work. I try to focus on all of the good outcomes.

On my lab coat, business cards and my signature in charts, I put rnsrgr8t RN, CPNP (I am a Pediatric Nurse Practitioner).

I used to work in a pediatrician's practice. The owner of our practice was the only male pediatrician (we had 4 females as well). Summer is a crazy busy time for well physicals. Most the the teenage boys elected to come to our only male pediatrician. He did a lot of teenage boy well exams in the summer. At the end of a busy day, I was collecting all of his charts (this was way back in the day before EMR). They wanted the nurses to check each note to make sure they signed and were done with it before putting it back in the rack. On one particular chart, a teenage girl he had done a well exam on, he put in the GU comments "testes down bilaterally". We had a good laugh over it when I showed it too him with my saying, "I hope not!!!". Any idea what he had been seeing all day? LOL!

You can also say "waiting on" as well . "I was fixing to eat dinner but I am waiting in everyone to get home!" And I totally hijacked the thread now!

I heard it on the news last night and was horrified. I then wondered if anyone in our allnurse family would be affected by this directly. Prayers to all of you. Such a horrific tragedy.

I agree with this as well. I work in pediatric urology and we see things ALL the time that got missed because children were not examined regularly and kids were too embarrassed to complain. I do give them heads up before I do it. I tell them that I am going to look and why it is necessary. I rarely have any kids object. Every kid should be examined at the well child exam once a year (just like adults should be). With little kids, good teaching opportunity to talk about "good touch, bad touch" and that it is ok for me to look because the parent is there in the room with me.

I have used Blue Apron and Home Chef. I currently use Home Chef. I have used one of them for over a year. I am a PNP and single. I do not work 12 hour shifts (thank goodness) but do work around 50 hours a week M-Fri so I am often tired when I get home from work (though not 12 hour shift tired). I have the basics of cooking down but am not very imaginative and tend to get bored VERY quickly. Then I end up eating junk or take out b/c I am too tired to think about wanting to cook (and I tried doing the whole meal planning thing ahead of time, did not work for me). I initially started with Blue Apron. Pros: I loved that their recipes were very imaginative and I used ingredients I would have NEVER thought of. Produce was very fresh and would last up to 10 days- case in point, my box for the week came at the start of a horrible bronchitis and I was so sick, was not cooking anything. Every thing was still good 8 days later (and meat had 10 day expiration on the package). Portions were good, always had left overs. Definitely the 2 portions advertised They have a great Facebook page and youtube channel. You tube gives instructional videos on techniques for prep and cooking (learned a lot). Each recipe each week gets a Facebook post so you could get good tips from other uses online on how to cook a recipe if they had done it ahead of you. Price was reasonable. Customer service was good the few times I had issues Could deliver on Saturdays (when I would know I was home). Easy to cancel with no penalty. They have a IOS and Android App which made it easy to order meals. CONS: Was TOO much food for one person. Not many choices (I agree with what PP have said). I did not always like the options I had so would have to cancel a week b/c one of the recipes I was not going to eat Only option is for 3 meals a week, cannot do less than that. I then switched to Home Chef and still use it PROS: The main reason I switched was b/c Home Chef gave you many more options for the week and I could pick as few as two meals a week. This was perfect for me and exactly what I was looking for. Produce quality is good. Night QUITE as fresh as Blue Apron (I live near the Blue Apron distribution center and they use local produce which could explain it). Produce does NOT last up to 10 days like Blue Apron, but they do give you guidlines on each recipe how many days you have to cook it. Stay within their guidelines, you are fine. Because I can pick just 2 meals- it is cheaper for me. They also have an app as well which works well. CONS (but they were not deal breakers for me) They do not deliver on Saturdays. I picked Fridays. I was worried about the box sitting out all day in the heat. I will have to say, we had a horrendous summer (almost 100 degree heat) and my front door is in the direct sun all day. I had some nights I did not get home until after 10 pm, and everything in the box was still cold. They used a LOT of ice packs in the summer and I had no issues (I was really worried about it initially) Meals are not as imaginative as Blue Apron and you do have to check the caloric content of the recipes before you order. They definitely have some VERY high caloric options (800-1000 calories a serving!!!) but there are plenty of healthy options to pick as well. Their FB and Youtube channel do not really have much traffic. I do miss that about Blue Apron. I did like the option of discussing the recipes and how to cook them online but again, not a deal breaker. I love these services. For a single person like I am, it works great and prevents me from eating junck and take out. I did not find the prep time that bad and it got quicker with practice. Definitely go on the Blue Apron you tube channel. They teach a LOT of tricks. Also important to have a good chef knife/tools etc, makes prep easy.

Oh I love this thread!!! Ruby starts another great one!!! Work related: -Cell phones! I work in an outpatient clinic. Signs up about no cell phone use during visit. Cannot TELL you how many times I walk into an exam room and they do not get off the phone! Or worse, the hold one finger up to get me to wait. - Kids with cell phones. I work in pediatrics so the kid is my patient. When the parent will not make them get off their phone so we can start the visit/I can examine them (Don't make me be the bad guy and tell them to turn the phone off) -Parents that let their kids tear up the exam rooms (shred the exam room paper, ruin multiple gloves, don't throw trash in the trash can etc. - One of my biggest pet peeves is in our hospital cafeteria. The amount of rudeness I see in my fellow employees drives me bananas (and add at that point I am hangry too). They cut in front of our families/patients in line, they have conversations while in the salad bar line or dink line(with 10 people behind them waiting). They wander aimlessly around and blocking people trying to get through. - People who do not restock when they use the last of something. Happens in our clinic all the time. When you take the last fax coversheet, handout, consent form etc (things we use a ton every day).... PLEASE go to the front of the clinic and make copies. Always happens when you are in a zoo of a crazy day and you need something and they are all gone, including the hard copy. -Not identifying yourself to people. If you are walking through our clinic, INTRODUCE yourself!!! -Phone etiquette- LISTEN when I identify myself on the phone (Urology clinic, this is RNsrgr8t!)- reply "Susan???". Uh NO!!! I just told you who I am. Why don't you indentify YOURself and I MIGHT help you find who you are looking for! - Phone ringing of the hook in clinic, resident is sitting right next to the phone and all of the nurses are on the other line. ANSWER the dam* phone please! -Not using please/thank you- I am from the South so we also say Yes sir/no sir, Yes Ma'am/no Ma'am. - The hospital where I work, does not have separate transport/pt elevators, so staff and patients/families all have to share. I get so angry when you are on the elevator and the doors open on a floor, there sits a patient in a stretcher with 3 monitors, 2 nurses, the family etc and I am the ONLY one who gets off the elevator to let them on. Seriously??? This is a hospital people, if they are moving a critical patient, get OFF the elevator and get out of the way (this is for the hospital employees, not visitors). - Families having no phone etiquette when you call them. Example "Hello this is RNSrgr8t from the Urology office returning your call" Patient end- ***crickets*** (but you can hear breathing so you know they are still there) "Hello?" ***crickets*** long drawn out pause then "Yeah?" "Yes, this is rnsrgr8t returning your call?" "Yeah?" Long pause as I wait with bated breath for them to tell me how I can help them....... "How can I help you?" FINALLY- like after 3 LONG minutes they FINALLY tell me what they want. Sheesh... - another phone etiquette- Families that leave a message asking for a call and when you call them right back...their phone is busy.....forever. Try multiple times to call (b/c the message they left sounded urgent) and after 5-6 attempts, they FINALLY answer. I will make a comment that I had been trying to reach them and their line was busy. "Well YEAH, I was on the phone!!". Why don't you wait to leave us a message to call back when you are able to be ready by the phone to answer? -I have one coworker who sighs, heavily whenever she feels "stressed". She is a very special snowflake so her coworkers are doing twice her work load but she still feels overwhelmed and all I hear all day is an exaggerated sigh, over and over again. Sorry babe, not going to do your work too no matter how much I can hear you breath!!! -treating the MA's, check in people, housekeepers, transport techs like second class people. Smile, look them in the eye, THANK them, they work hard too! Outside of work -hate how people cannot drive nowadays. Tailgating, not using directional signals, going too slow in passing lane. I REALLY try not to get road rage! -People who are noisy gum chewers. -People who do not know what an indoor voice is -I have a LOT of respect for people who work in the service industry (waiters, cashiers etc) b/c people are CRAZY. But that being said, do not have an attitude, especially when I am being nice and polite to you, do not talk to your coworkers when you are checking me out, do not huff, sign or be rude. Will have to think about the "no problem" thing. Have to admit I DO say that as a response (b/c I seriously mean that whatever I did was really NOT a problem to do) and I am 40!