fetch33

I have been a RN for 23 years...I have NEVER called a tech or nursing assistant to clean up a patient while I walk away. In fact, where I have worked for the last 10 years, we rarely have a tech on the night shift... nurses to it all.

I always say... 'women pay good money for this'

I had a patient last night. She had MRSA back in 2002. Had no open wounds of any kind, except her fresh incision. The nurses on the previous shift put her in isolation when she came back from surgery because she had not had 3 recent negative swabs for MRSA. There was no mention of MRSA in the doctor's history. After gowning and gloving every 20 minutes for several hours, I finally called the nursing supervisor to discuss the situation. She said it was rediculous to isolate the patient for something that happened 7 years ago so I took her out of isolation and her care was greatly streamlined. Being a weekend, the infectious disease nurse wasn't available. Anyone have experience with this... is it really warranted to isolation a patient for something that happened years ago?

You couldn't pay me enough to work days at my hospital.... Tons of patient turnover due to a very busy ortho unit. I choose to work nights and have done so for 16 years. The shift diff is 15 % of base pay and that jumps to an extra 12% on the weekends. I can't afford to work days!

I work in the Midwest.. we still have lots of positions unfilled PLUS I know of 5 nurses I work with on nights that will be moving in the near future.... more unfilled positions. I think it just depends on where you live. There are nursing jobs out there.

I love 12 hr shifts! Right now, I am in the middle of my 14 day vacation... I only used 4 days of vacation pay. I've been a nurse for a long time now. I can easily pull in 80-88k a year, depending on how much OT I pick up. Nursing has allowed so much flexibility in my life. I worked PRN while my kids were little. Now, as a full-timer, I am enjoying perks like paid vacation and have picked up the health insurance for my family since it is better than my husband's. Yes it can be very demanding and difficult work at times... my worst shift was just a few months ago.. I went in to work at 7pm and got off work at 1pm the next day....but I wouldn't trade my job for anything... I love it. My teenage daughter is planning to go to nursing school because she has seen how beneficial my nursing career has been to our family.

Misswoosie, Right now, as an RN, I am generally responsible for 4-9 patients, depending on if I am providing primary care or working with a LPN. So can I expect my patient ratios to go up as a cost-containment effort if nationalized health care goes into effect?... also, sounds like supplies are tightly controlled or limited. Must be frustrating to work in that environment. Do you find families mad at the system or at you? I work as an orthopedic nurse. We do thousands of elective total joint procedures a year. Are elective total joint procedures rationed by the government? Is dialysis rationed by the government? I heard if you were over a certain age, you just didn't get dialysis and you died. Is $550 the amount taken out for your health care or all taxes in general? I pay a lot less than that a month for health insurance for my whole family. Also, what are the pay caps for nurses? I have been a nurse for 23 years and make about $85K/year in a midwestern city. I could make a lot more if I was disciplined enough to work OT consistantly or worked on a coast.

http://www.msnbc.msn.com/id/22184921 about medicare fraud From http://www.hhs.gov/stopmedicarefraud/ : Most health care providers are doing the right thing and providing care with integrity. But sadly, due to the illegal actions of a small but active group of heath care fraud perpetrators, billions of dollars are stolen from taxpayers each year. Medicare fraud schemes have grown bolder and more elaborate, resulting in billions of dollars in false billings and fraud schemes which are robbing Medicare and Medicaid blind and leaving our most vulnerable citizens at risk. http://www.oregonlive.com/news/index.ssf/2008/12/disability_fraud_saps_social_s.html : Cheaters cost Social Security billions by Bryan Denson and Brent Walth, The Oregonian Saturday December 06, 2008, 8:36 PM The Social Security Administration has fallen behind in reviewing the medical conditions of 1.7 million Americans on its disability rolls, potentially paying up to $11 billion in benefits to people who are no longer disabled. The agency's failure to tackle those pending disability reviews allows tens of thousands of undeserving people to bleed government funds that Americans count on when they become too sick or injured to work, The Oregonian found in an ongoing investigation of Social Security.

Just heard a horror story from Canada on a talk radio show. A woman's father needed a heart bypass at age of 59. He was denied by the medical board because he smoke and drank. The doctors gave him 5 years to live and sentenced him to die. At age 64, he began feeling unwell. Because docs only work 9-5,M-F there (according to this woman), his doctor was unavailable to him. His wife took him to the ER at 9pm on a Friday. At 10am Sat, the wife drove home for a blanket because he was cold. At 4am MONDAY morning, the man DIED in the same wheelchair he'd been sitting in for 55 HOURS having never been seen by a doctor. This woman was crying on air saying the Canadian health system killed her mother also... she was unable to elaborate on that death due to lack of time. Universal care will result in rationing, longer waits in ERs than we have now and letting people die because their treatment may be deemed too costly. But hey, everyone will be covered... at least if you can find a doctor or be seen in an emergency. I also read an article by a Canadian doctor who said his opinion on the Canadian Health system was changed when , as a medical student, he took a different route through the hospital by going though the ER... he said it was a war-zone that stank of urine and sweat. Some of the patients had been laying on cots in the halls for 5 DAYS. His goal in life was to make enough money to immigrate to the US so his children wouldn't have to grow up in the Canadian health system. Even the prime minister of Sweden (I believe), had to wait 8 months until his turn to have a hip replacement. As a college student, I had the opportunity to go to England for 4 months and study the health system there during a Community heath semester in my nursing program. I remember one elderly gentleman that I visited. He had a badly fractured patella. He was was on the waiting list to get his fracture fixed... surgery was scheduled for weeks out... meanwhile, he sat in his house at risk for all kinds of complications. In the US, he'd been operated on within 24 hrs, barring medical delays. I can just see the problems that are going to happen. Patients and families expect immediate results and very timely service now... with private rooms, meals on demand and excellent nursing care. Everything is customer service driven. Imagine them being told they will have to wait weeks for their MRI or that they can take their elderly mother home with a broken bone while her wait on the list ticks down? Or maybe they'll be told that their loved one doesn't qualify for life-saving surgery... kind a bitter pill for those of us that have provided for our own needs for years to swallow. America is up for a rude awakening! Yes, something needs to be done. But name one government program that isn't full of waste and run well? I don't want the government in charge of my healthcare. The insurance companys are starting to wake up and realizing if they don't do something about covering people at a lower cost they are toast. Obama's health plan will put them out of business....

I work on a large ortho unit in a major city. There is an orthopedic practice specializing in hands that uses this hospital. They call the pinky finger a small finger or fifth finger. The fingers are designated like this: Index, middle, ring and small or they are numbered.

I had received an order to anchor a foley on an elderly man who was retaining urine. I explained the procedure to him, telling him that a male nurse was available if he felt uncomfortable with a woman doing it. He declined the offer and began telling a story of Adam and Eve, which involved a rib and birth, after which he said 'so you see why I can't have a man do it'. I told him I understood and proceeded with preparations, during which time he began talking. He told me how his wife had been dead 30 years and they always had a good sex life . Then he started talking about how he never had visited Las Vegas, but 'what happens in Vegas, stays in Vegas' (I am assuming he was talking about legalized prostitution?). Then he says..... ' be tender'....:rotfl:. I about lost it at that point. Unfortunately, the catheter insertion attempt was short-lived.... he had a severe urinary meatus stricture and the 14Fr catheter could only be passed a quarter of an inch. I high-tailed it out of there and laughed to myself as I notified his female MD. I've never had a patient equate a catheter insertion with SEX before.

Do you have any ancillary staff like techs or nursing assistants? I work a very busy orthopedic unit. Night staffing is usually 5 patients, primary care as we don't have techs. If you happen to be working with an LPN, you could be reponsible for 9 patients. Day staffing is 5 patients to a RN/tech team, or a team of RN/RN/tech for 8-9 or RN/LPN/Tech for 8-9. I do night charge. I can have as little as 3 patients or as many as 6. My additional responsiblities including placing new admits, doing bed assignments for the next day's surgeries, staffing assignments for the day shift, taking care of any problems on the unit and acting as a resource for the regular staff, including starting IV's and drawing blood. I also have to take report on the entire 55 bed unit and give it to the next charge nurse. Many mornings I don't leave until 8:30 or 9 am. 80-90% of the time I don't get a break. All of this for a whopping $2.00/hr, which I shouldn't complain about because we only started getting paid for charge a couple of years ago.

Ten years ago, we had programs on the EKG machines that would interpret them for you. Being an orthopedic nurse, who does EKG's maybe once a month at best, this was great. Then they took away those programs and gave all of us a basic interpretation class once a year. The theory being any nurse should be able to do basic interpretation. I usually ran them off and sent a copy to the cardiac floor for interpretation. I didn't look at enough of them to know what I was looking at. Now we have the lovely rapid response teams, so usually if someone is getting a stat EKG, they are already involved and take care of it.

I use to donate faithfully. I was turned away often for low hct and once for an elevated pulse of 104... during which time my B/P was 90/50... I can't believe THAT didn't disqualify me! Now I am banned for life because I lived for 4 months in England during the mid 1980's.

I have worked nights for 13 years, mostly 12 hr shifts. I usually don't even get off of work until 8 or 9. When I get home, I immediately pop a couple of Benadryl and then I unwind for an hour or so. I use ear plugs and an eye mask faithfully. Hopefully, I can sleep until 5. Most of the time, I am up and down all day, letting dogs out and dealing with teenagers. I skip the Benadryl if I don't have to work again that night. Needless to say, I have learned to live (and work) without lots of sleep!

I work 12 hr nights on a busy ortho unit. A couple of units in the hospital are trialing hourly/q2hr rounding. We are in the q 2 hr group. Supposedly, it will reduce call light usage. I say it may on days, but won't have any affect on nights... the reason? The patient is asleep many times when you check on them.. they don't know you have just been in 10 minutes ago, so they will push their call light. Another problem I have is that we have extra paperwork to fill out to 'prove' we are rounding. It is not a part of the patient's permanent record and it is rediculous. I say make it a part of the patient's chart and put it on the computer where I am charting already. Also, the nurse manager wants all shifts, including night shift to physically go into the room to the bulletin board at the foot of the bed and chart on the paper there. First, I am short and pens don't write uphill. Second, walking to the patient's bedside many times will awaken them and I'll need a flashlight or light to see by to chart. I always check to see that my patient's are breathing, but walking next to the bed with tennis shoes on that always squeak with the darn wax they put on the floors is just overkill. It will awaken patients and piss them off. Are there any other hospitals who insist on added paperwork just to 'prove' that they checked on the patient properly?

Gosh, I've seen so many.. I'll start with the first: A man tried to kill himself, so he shot himself in the head. He awakened to find a nasty wound to his head. He called his doctor's office, but was told it was closed for the weekend. He hung out all weekend at home with his brain exposed and called Monday for an appt. He tried hard to convince the doc he had walked into a door... doc didn't buy it, LOL. When I had him, he was just out of ICU with a drain hanging out of his head and enough skull missing that you could count his pulse with the pulsations of his brain. Amazingly, they had enough skin to cover the wound. I took care of a mental hospital patient who had an appetite for bedsprings... he had just had 15 of them removed from his stomach. This was not his first surgery for this problem. He later died from peritonitis after he did the same thing. Along the line of swallowing things... had a patient who swallowed a spoon and ink pen so he could get all of the 'good drugs' , assuming he'd be opened up to retrieve them. Nope, the docs fished them out with a scope, LOL. I still have the pictures! A railroad worker was drunk at work and ... oops.. accidently put his foot under a moving rail car. I can't believe the ER nurse actually brought me the boot... that was now missing it's front half... just like the foot. Maybe she thought the state would use it for evidence? The most recent is a child who was bored and playing with daddy's pocket knife. He cut his pinky clean off!!! The docs reattached it, but even after a week of leeching, it didnt' make it. Turns out the kid didn't go tell daddy right away, but hung out in his room for an hour or so until he could get up the nerve to show his parents what he had done. By the time he got to where I work (hours away by car), the pinky was pretty much non-viable.. but they gotta try.

Law enforcement personel are the only ones permitted to carry weapons into the hospital. However, in my 21 years of experience, I have had two incidents happen. One night all was quiet at the nurses station. We suddenly heard a noise like a locker door slamming. Since we didn't have lockers anywhere, we all jumped up to look for the patient that hit the floor with an IV pole.... the only thing that made sense. While frantically running around looking for the patient on the floor, a code was called. Turns out a patient on our sister unit around the corner had just commited suicide. He was a dialysis patient who had decided he'd had enough and wanted to kill himself in the hospital so his family wouldn't have to find his body. He announced this to his roommate who was frantically pushing the call button while the patient was getting his gun out of the closet. Poor roommate actually flipped himself over the bedrails and got under the bed thinking the guy might want to take someone out with him (fresh appy too). The next incident involved a paranoid paraplegic. His nurse came out of the room and called security. She had seen the patient slip a pearl-handled knife under the mattress as she was walking into the room. Security was called and we waited in the nurses station while they searched the room. Imagine our surprise when the guard came into the station and laid a GUN on the desk. We about fell out of our chairs. The kicker was THEY NEVER FOUND THE KNIFE!!!!!!

We have Liko brand of lifts installed in the hospital where I work. On my unit we have 16 rooms with lifts and also various portable units. Honestly, the portable units hardly ever get used, so I don't think those were a good investment. We've had lifts for a year. Staff still have to be reminded to use them. They are a real back saver.

I get paid $2 an hour for orienting. We have only one assignment between us. Many times however, I will get charge duty in addition to orienting.

This is something we already have to do. It is the level of pain that the patient states is tolerable to them.

You know, I have been a nurse for over 20 years. I rely a lot on my physical assessments and experience for my patient care. To be told I have to count respiratory rate and get and oximeter reading on a healthy, few day post-op patient at 1 am is rediculous. It takes up time that doesn't need to be taken up. And no, we don't have CNA's or techs on the night shift where I work. It is all primary care. Do you count respirations and do an O2 sat check when you give a pain pill? Do you do it when you reassess pain in 1 hr? That is what is being asked.

We just got a new pain documentaion protocol. Supposedly, it is required by JCAHO for our total joint patients, therefore, it is going to be used on all of our patients on ortho. You have to document resp, O2 saturation, any O2 the patient is on, current pain level, negotiated pain level, location, description of pain, LOC, and behavior every time pain is addressed. So I am assuming that just running in and handing pain pills to a patient, on whose pain you have assessed is a thing of the past. Now we have to stop and document O2 saturation and resp rate amongst other things. Oh, and even if the patient states their pain is a 0 out of 10, we still have to address each of these things. Isn't this overkill? There are some patients whom I give pain meds to up to 8 or more times a shift....... when I am going to find the time? Perhaps we can just surgically implant an O2 sat monitor on admission

I know of one HIV positive nurse in the hospital where I work. He couldn't keep it a secret from management because he was admitted with complications. He was still in direct patient care last I heard.

I have retrieved a hospital cell phone from a needle box. Here is the story. A worker that replaces code carts was pushing a new one down the hall while talking on her phone. The phone slipped out from under her ear and straight into the needle box. After swearing her to secrecy (and in a secluded hallway), I placed a disposable chux on the floor and shook the contents onto it. Luckily, it wasn't that full. She got her phone back and I used hemostats to replace all of the sharps.