Ann RN

And once again, I am just trying to help new nurses understand how we sometimes feel. And why. Believe me, it is not a personal affront. It is not an attack. And if you think a seasoned nurse's humble opinion on who the hospital should hire matters, you're kidding yourself.

We do not "trudge along". We are still learning, even after 30 years. We have to - things change. So please do not make the argument that we fall into a pattern. We take responsibility for our own education. And we do well. In no way do I believe that a new nurse getting experience on a med-surg floor is merely "putting in time". I applaud him/her for having the forethought to hone their time management & assessment skills while getting exposure to various treatments & procedures.

I'm trying to do this without being personally critical. I do not want to put all new nurses in the same basket, so to speak. You have been blessed to work in a unit where all the seasoned nurses are happy, no one is burned out & all is well. This is a rarity. Believe me, it's not that we do not want to teach or help new nurses - far from it. Nothing makes us happier than when we see a new nurse "get it". But there have been far too many times when we have seen a pt.'s care compromised because of a new nurse who did not "get it" & did not know enough to ask for help. We have seen critical labs missed & subtle clues that were not picked up. We have seen new nurses who had no critical thinking skills. And while we're precepting, it's OUR licenses on the line. Precepting is not easy - it's not just being there if the new nurse asks for help. It's anticipating, proactively teaching, monitoring, constructively critisizing, teaching more, evaluating, etc. So please try to understand our point of view. We're tired. And sometimes we just want to take care of our own patients.

Do you have any idea what you are REALLY getting into? A year as a nurse apprentice is not the same as a year as a graduate nurse on a general peds floor. And I hate to tell you, but you WILL be working with adults - parents. They can be harder to deal with than adult patients. Orienting new grads has absolutely burned out the majority of the seasoned nurses where I work. It is extremely hard to do. You will not have the assessment skills you need to pick up subtle changes when your preceptorship is done, & IMHO that is not safe - for both children & adults. I believe a patient deserves the safest & highest quality care possible. And I'm sorry, but that is just not from a new grad in a specialty area.

OK, here goes - 1. Decreased tissue perfusion R/T decreased cardiac output & AEB periods of confusion. 2. Knowledge deficit R/T disease process. 3. Altered nutritional status AEB nausea & poor appetite. Hope this helps.

You set yourself up for this. If you cannot do your job, you should not be there. Those of us who are not pregnant do not want to take MRSA home, either, whether or not we have children. Those of us without children also have families that are important to us. We deserve to spend holidays with them just as much as a nurse with children. I am so tired of nurses thinking that just because they have children they deserve holidays off more than me. Don't tell me I'm mean just because I, too, want time with my family or because I believe a pregnant nurse should not use her pregnancy as an excuse.

1. Ryka sneakers - made by women, for women. They have nitrogen shock absorbancy. Great stuff!

"I work Mon-Frid 8-4 days, and the company is very good to me, I mainly do paper work and only clinical things like Medi port meds that LPNs can't access. I get little perks like gifts and game tickets an hr for lunch, pretty much do my own thing. " Sorry, but I'm going to play devil's advocate. I hope what I say is wrong. It sounds like you are getting adequately compensated for the duties you have described. Maybe a higher salary is used on your "perks". I absolutely hate when an employer, or more often a pharmaceutical company, does this. That is why our salaries are low and are prescriptions costs are so high. I cannot be bought with tickets to a game.

Sorry, but - if you drop the pt. off in the hall of their new unit and a nurse does not accept the pt., that is patient abandonment. OR am I missing something?

Properly go up the chain of command with written communication. Keep it factual; no opinions. The fact that she is using a hospital computer for "personal" business may be cause for termination - review your hospital policy. Keep a copy of all written communication.

First, let me say that these two issues should be covered in your initial hospital orientation. I cannot believe they were not better covered when you were in school. Anyway - Observe IV insertion site at least once/hour. Look for signs of infection - reddness, swelling and drainage. Look for signs of phlebitis - edema, red streak along vessel, warm to touch, pain. Look for signs of infiltration - swelling, leakage at site, no blood return, pain. If any of the above signs are present - D/C IV catheter, elevate extremity, apply warm soaks. Follow your hospital's policy on infiiltrated IV's. Reinsert IV in a different site, preferably in the opposite extremity. As for body mechanics - Find your center of gravity and maintain it. Do not bend over from the waist; bend from the knees (squat). Hold a heavy object close to you - not at arm's length. Never lift a patient by yourself, no matter how small the pt. Never be afraid to ask for help. Hope this helps. Good luck with your career!

Need other labs - Bun/Cr? Lytes? Serum osmo? If you cannot rule out a head bleed, DO NOT give dextrose!

Since when does your nurse manager think you have the time to read emails AND do your job?

I am so glad I went to nursing school when I did. I graduated from a 3-year diploma school in the late 1970's. We had 6-week rotations in every area. Six weeks in the ICU with very much hands-on care. Six weeks in the OR with hands-on circulating & scrub experience ( I even got a chance to put in a few simple sutures with MD supervision). Team leader experience, evening & night experience, multiple procedures. I firmly believe this has made me a good nurse.

Best - Someone holding my hand & talking to me when I was scared to death. Worst - Post op day 1 (abd. surgery), BP in 60's, tachy in 120's, no u.o. & lethargic. IVF @ 125/hr. I asked for more IVF. Nurse said "we'll just wait until the doctor comes in later." She refused when I asked her to call a doctor. Thankfully, all was OK, but - CRITICAL THINKING guys!