tcpmom

Thanks to all for your answers. I'm guessing there is no danger with having the tube lower than it should be???

Hi, I'm a new nurse (9 months on a med surg floor). I had a pt the other night who came in with a SBO (he had a history of them since his cystectomy many years ago). Anyway, he had an NG tube hooked up to low wall suction and fluids running. Throughout most of my shift the drainage was green and bilous and totalled about 50-100ccs. Toward the end of my shift, he called me into the room and said he thinks the tube moved when he got up in the bed. He tried to push it back a little. I listened as a syringed some air into his tube and could hear a very faint sound. I secured the tape a little better to his nose and for the remainder of the shift (2 more hours) the drainage was thicker and more yellowish brown and very foul smelling, like stool, In the 2 hours I think another 200ccs drained. The tube kept clogging too. I was still trying to unclog it when the day nurse came on shift. She listened and could not really hear anything when she shot air in the tube so I told the doc who ordered a KUB. I'm not sure what happened after that because it was time for me to go home. I'm questioning my assessment skills as I probably should have had the doc order KUB when the pt called me into the room. I also feel bad for dumping that situation on the day nurse but it was my last night shift in a big stretch of being on and off days and nights and I was pretty exhausted. Do you think the tube ended in the duodenum when it was moved? Is this bad to have a tube in the duodenum attached to suction? Any advice would help:confused:

Hi, I consider myself a new grad as I graduated last May and started working in September. I am a day/night rotator on a very busy general medical floor. I was so nervous when I worked my first few nights because all through school you hear about how there's not a lot of support at nights. I had the opportunity to come off of nights after six months (my manager originally told me a year) and I chose to continue to rotate. I have kids so the night shift gives me a little more flexibility. You may really like working nights, I'll list a few reasons: I can always find a computer at night-during the day there is so much extra staff on the floor (case managers, social workers, attendings, etc) that you wander around looking for a computer to look stuff up and by the time you find one, either you forget what you're looking up or you're paged to a pt's room I never have to do discharges at night (discharges can be a nightmare if there is a lot of coordinating to do) You sometimes (not always) have time to look up your patient's disease, past medical history, hospital course, etc, giving you a clearer picture of what's going on and what you need to do for nursing care. This is really hard to do during the day The night staff where I work have been there for a very long time and are an excellent wealth of knowledge. It's an excellent opportunity to pick the brain of some great nurses who often have the time to explain things. I just wanted to throw these things out there. Since I rotate between days and nights (sometimes within the same week) my sleep schedule is really off so I think a consistent schedule of nights would be better for one's system. I'm not sure. Congratulations on your new job and best of luck.

but do you ever find it really hard to care? or even, worse, do you ever not care? I mean, how do find the inner strength or just plain ole' stamina to clean up someone who is yelling at you? I just wish I could buy an "encouragement pill" . I'm looking for a quick fix to my feelings of inadequacy and fear!

Um....I think you won...

Wow! That sounds pretty f*%*ing awful! Please tell me you persevered and you are in a good place now.

These stories are so helpful! Since being accepted to nursing school I was afraid of my first ass-wipe, and afraid of my first beligerant patient. I'm glad to have them both under my belt. It's just incredible scary when you're so unsure of what you are doing. "...let's see, I think this button will raise the bed so I can feed you your breakfast..." "AAAAAAAAAGGGGGHHHHHHHHHH!!!!!!!, what are you doing??? I'm in pain?!!! Fortunately, he really wasn't aware that I was a student because he didn't really recognize me everytime I came in the room. I think he would have thrown the "you'll never be a good nurse" comments at me!

The guy was admited at midnight the night before from a psych hospital. His chart indicated a long history of psych issues so the feeling I got was the md was not very familiar with his case. They did give him tylenol, not much relief from it though.

why do you stay?

patient was admitted to the floor at midnight from a psych hospital. I guess the md was not feeling generous about giving any pain meds because of his history. they did give him tylenol but not much of a change in him

oh, I have tears reading this story! Thank you!! It sounds so similar to the day I had yesterday...I just really wanted to hear "it will get better..." I really do plan to hang in there, I just needed a little encouragment.

Would anyone like to share their worst clinical story? I just survived my very first 3 days of med surg clinical (no nursing experience whatsoever!) and my patient on the second day was a 300 pound, dimented, confused, dependent, biligerant man. No pain meds b/c of the dimentia. Had to clean up a big messy bm (lots of digging!) while he yelled at us. It got to the point where I didn't want to go in the room...He would yell, "I need a bedpan" and then when two people came in to help him he would yell at us asking why we were trying to move him "I don't need to go!!" Anyway, I survived with my ego intact but keep asking myself, "does it actually get worse?" I hope that was my worst patient and if I can deal with it, then I'll be okay going forward. Any thoughts??

wow,thanks for all the info and the encouraging words--very helpful! can you stand a few more questions? did you know what kind of nursing you wanted to do before you started the program? what kind of floor are you on and why did you choose it? thanks!

As a future Curry ACCEL student (and a mother trying to balance it all) could you give me an idea of your schedule while you were a student? How are you doing in your job search? Any feedback and/or advice about the program would be greatly appreciated!