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Dayray RN

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  1. Dayray

    Cognative disfunction

    I have MS, probobly have for 15-20 years but just found out last year. I had some bad issues with confusing the ceiling with the floor and not being able to get up off of the later. That got me diagnosed i have over the years had struggles with changing vision, unexplained pain and fatigue. It is actually kinda surprising I didn’t get dx along time ago. Anyway several years before my dx I went threw several crisis. My daughter died, I was run out of work (partially unfairly but partially due to cognitive deficit) and my marriage almost ended. During this time I began to have sever cognitive issues with memory attention and well just not being too swift. Over the last 4 years I things have slowly been improving but still are far off from what they used to be. Weather it is due to MS or just emotional overload I’m not sure. I mentioned this to my nero and she sent my to a cognitive psychologist. 2 months after the testing I finally got the results back. I am mildly cognitively impaired in exactly the areas I thought I was. My IQ in high school was 128 it is now 109 (doesn’t seem terrible but believe me its hard to learn to live without those 19 points). My problems are memory which kind of scares me but not horribly because I can write things down and I have been doing my job long enough that remembering what to do isn’t that hard. Most of the problems I have in this area are just embarrassing but manageable (I think). I also have issues with processing speed, multitasking, CRITICAL THINKING, strength and motor skills. I can still act appropriately to problems but much slower I can see this in my charting. It take a long time because I have to remember how the computer program works and then process that, then remember what I want to say and process that and then review the whole thing. It takes way to long. I can manage the slower charting although I really hate it and its frustrating. However, The worry that I’m going to miss something is terrifying. I work OB and things happen very quickly one part of me says "I have been around a while and have seen situations over and over again" so I know how to react like most people know their way home. Experience also helps with assessment and although I cant add things up as fast as I used to, I just have that feeling about things and am usually right or at least close. Also the strength and motor skills thing is worrisome. I can’t start IVs anymore and I used to be really good at that. I mentioned this to my charge and asked to get remedial training but the hospital doesn’t have anything along that line to offer. It’s embarrassing to be orienting a new grad, teaching her and then have to have her start an Iv, which is the simplest of nursing skills. I think I could get by with the IV thing but what scare's me is babies. I have never ever ever even come close to hurting anyone and would not be able to return to work if I did. For the last few years even before the IVs became an issue I just felt weird when I was cutting umbilical cords. Sense my dx I have been ultra careful when holding babies or putting bands on and exhaustingly careful cutting cords. I think I can manage this too but I don’t know that I can and thats making me think I shouldn’t be doing this anymore. Even worse I absolutely love what I do. I am still passionate and still get happy when I know I get to take care of someone today. I can not imagine doing anything else sure I could work in an office or sell something but well it would just be for the money. I have thought of being a midwife and the doctor says I have the capacity for college but I worry about suturing and god forbid someone made me assist with surgery (which most midwives do). Money would be a huge issue if I tried for disability my policy covers 60% of my base pay and differentials make up 25-30% of my income so that like a 50% pay cut. So thoughts?
  2. Dayray

    Lesbian L and D nurse

    WOW!!!! I tried to read threw the posts after writeing mine I have to tip my hat to the Op for reamaining so positive and polite. I won't say anymore becuase i dont want to hyjack this post with a flame fest.
  3. Dayray

    Lesbian L and D nurse

    I have not read the many of the responses but can guess that they are variable and some valid others not. I have known several lesbian L&D nurses. Some were great and others not. One of them was one of the best nurses I have ever known and took allot of extra care with her patients. the point being that as with so many things in life sexual orientation has very little to do with nursing. I don't know if these nurses choose to discuss their orientation with patients I would think that in most cases it wont come up and would be an issue that could cost you more energy then it is worth but in a case that it did come up I don't think you should feel the need to lie or cover up your life. As for how staff would treat you I do think geography would have allot to do with that as well as the kinds of nurses working there. Where I currently work we have at least 2 female nurses that are openly gay and in long term relationships. they talk about their partners and sometimes make jokes about being gay and I don't think they take much flack for any of it. I know that they go on social events with other "strait" staff members so for the most part are excepted into the community of L&D nurses. I am pretty sure that over the years there have been other lesbian nurses that have chosen to keep their orientation to themselves and I never knew the difference. I am a male L&D nurse. I don't have many problems with patients although it occasionally does come up. I am not gay but I know that many patients assume that I am. I used to always play along with this as i thought "if it makes them feel better then who cares" as of late I have begin to mention my wife and kids when opportunity / conversation lends its self to that. I really don't care if people think I am gay but just like I said you shouldn't feel the need to hide your life from patients I stated to feel i was doing this and felt it was somehow wrong. It hasn't seemed to affect things but I am also allot more experienced in L&D and I know this is evident to my patients and perhaps this is part of the equation. Anyway I can tell you that you and I have some issues in common and that well people will not react the same to a lesbian women as they would a strait man working as a nurse in L&D, there are some similarities. My biggest problem comes not from patients but from staff. I used to accept this as a given fact and approached things with the thinking that i had to live with this because i was different. I have changed my view mostly because i have been threw the ringer many many times and have decided that I don't have to take crap or prove myself to anyone just because i am a man. I don't know which is the right way to approach it. i just know that I am tired of the same old questions, issues and situations that I have to deal with every few years because i was forced to leave another job and start all over due to the "male thing" again. So this last time I have turned in every person that has made a comment or treated me differently. I don't let people slide when they treat me differently but instead call them out and resolve the issue and let my managers know about the conversation. I would much rather take the time to show those people that their ideas about me are wrong and gain their trust but I think that in doing that I somehow made people feel that they were justified in having a opinion about me based only on my gender/orientation and this lead to later problems. I did not read the post by the person about being abused but i did read your response and thought it a good one. I would like to make the comment that while this may be the way some abuse victims feel it is not the only view held by abuse victims. nurses tend to carry stronger bias against men/lesbians then the general public so don't take one view point as the only representation of people in that category. I have heard different statistics but somewhere in the range of 33% of women have been sexually assaulted (to varying degrees in their life). I have cared for thousands of patients so I know that many of them have at some point been assaulted. patients refuse my care based on gender (this is the only reason i have ever been fired) about 2-3 times a year so I know that a history of sexual assault is not an automatic indicator that a person is uncomfortable with me (or you). Also i have had 3 patients with strong documented histories of assault that would ask for me when ever they came in. That was long and I am sure some of the info will help you and other parts will not. The message i want to convey is that you should not let this be an issue that keeps you out of L&D. If you truly love this area then go for it. I think there is a good chance you may encounter some problems but for the most part patients will sense your dedication and either never know or not care about your personal life. Once you are comfortable with your new skills and role as an L&D nurse I don't think you should hide who you are to your coworkers. in the beginning with all the things you will be learning you may want to postpone the added stress of dealing with "coming out " to them. eventually though it would be more pressure for you to keep it from them then not too and let the cards fall where they may. good luck!
  4. Dayray

    Punitive Computer Documentation?

    yes, computer documentation has turned into the standard by which you are measured ie. bad at computer charting = bad nurse. when computer charting was being developed i looked forward to it but its entierly too cumbersome now, there is so much more to chart on becuse it all fits together so neatly for admistraiters add to that most hospitals still require the same amount of paper charting they used to i dont like it , dont think its good for pateints but it seems to be the way nursing is headed. if you want to be successful in nursing dont rock the boat , dont make doctors mad and make sure you keep the computer happy. who cares if your pateints die from neglect? i mean it was charted correctly right?
  5. Dayray

    Refusing "Hospital Protocal"

    My pat response is, "I cant and wont do anythign to you that you tell me not to, all I ask is that you let my explain the reasons behind it before you make a desiction". I tell them the reasons and explain the downsides to the procedure and tell them my opinion then wait for them to tell me what to do. Most ppl calm down after that and listen, all but the most unreasonable of ppl want to be safe and are willing to accept small discomfort for lage amount of safety. When they are havign a hard time makeing up their mind I remind them that the 2 reasons ppl come to the hospital to have a baby are 1 safty and 2 pain medicine and then explain why the intervention is related to one of those. Ive only had 1 pateint refuse an IV after a calm explaination. She told me she had done this 8 times and how could I possibly know anything sense i had never given birth myself (she was G8 P0 ) She later chose to get one when she had been in "labor" for hours, refused all vag exams and monitoring but was requesting an AROM and the midwife refused to do it until she had an IV in place.
  6. Dayray

    You know you're a male RN when......

    When you can look at a nakid girl and think " I woner how quickly i can get this assessment over so I can eat lunch" When you dont bat an eye at being included in that greating of "hi girls". when a messy bathroom scares the crap out of you becuse you know your goign to take the rap for it. when you kno way too much about jonny depp or jesica and nick when you are constantly asked "so do you have kids"
  7. Dayray

    how to manage multiple patients on L & D

    We often have 2 labor patients and many time's newer nurses need help as well as the unforeseen things that come up. The best advise I can offer is to constantly keep a mental list of things that you have to do and how important each is. It's like triage you address the most important things first. When something new turns up add it to you list and reorder your priorities. Always try to plan it so you knock out multiple tasks in one trip. I.e. If one of your tasks takes you past the med room stop there grab your meds while your in the med room try to think of supplies you might need and grab them on the way to ice machine, breeze by the nurses station and then deliver your meds while your in the room if nothing else is pressing think of things you need to do there before leaving. Instead of looking at each thing as one task try to make your movements a sweep that knock out multiple task's in one trip. Picture in your mind where you will be going and what task's you can accomplish on the way to the most important one and on the way back. Everytime you are in room assess your patient as you are doing other things. You can ask them how they are and if they need anything while hanging/pushing meds. If you can make it so you address problems while in the room then call lights don't go off after you have left. You can easily palpate contx while asking your patient question while your other hand does something else. You must learn to do more then one thing at a time. I constantly run threw my patients needs and align priorities a good time for this is while you are walking. Charting is the bane of my existence. I can easily provide good care to several patients at the same time but charting hangs me quite often. I need to practice what I preach because often I don't do this but. If you are able to carry your paper charting with you or able to do computer charting at bedside. Try to chart things you have done and your Q15 or Q30 stuff in the room just safer or as you do them. As for your student. Her best learning is from watching you. Think of things she can do on your trip's to the room. While you are charting she can hang the meds or vise versa. Ask her questions and provide experiences for the questions she can't answer. Whenever you do something ask yourself what other tanks you can accomplish at the same time. I.e. check a cervix change the lines at the same time and turn the patient check her foly as you finish. Always make sure you are accomplishing at least 2 tings at once (did I say that already? lol). If you cant do things in one trip evaluate how important the task you are planning is and ask if it can be put off until you have another reason to go in that direction. I feel like I'm wasting time/energy if I'm not accomplishing more then one thing at a time. While you are swirling around make sure your patients know you are paying attention to them sit down while you talk to them. If you have extra time spend it in the room (hopefully you can watch central monitoring in rooms). Also if you can chart in the room at least you are present while you are doing this.
  8. Dayray

    Foley Balloons for cervical ripening?

    Cool thanks for the info. I wont be so resistant to peopel useing them now that I have seen some studies on them. the only point I still argue is that they do in fact hurt =) but prostin placment is no picnic either. Also ty for the link to web MD, I had no idea that site was so in depth with its explainations.
  9. Dayray

    Mom on Antidepressants during pregnancy

    good info thanks
  10. Dayray

    Tips for New Grad Male Nurse Transitioning

    Congratulations! We have talked before and as I have told you before there is a place for men in OB nursing. That being said, I have to say that I would be wary of a job as a both a new grad and the first male on the floor. I say that because I did that and it turned out badly. Perhaps you can succeed where I failed. I won't share the story again because I think I've told you before. Because of my experiences when I interviewed for my current position I asked about opposition of the current staff and got the answer I wanted. My manager told me "I don't think there will be any and I won't tolerate it" that was the answer I needed because I knew that mistreatment based on my gender was not seen as acceptable to her and that I had her support. I also was not the first male on this floor. However I will offer what advice I can in regards to your current situation. Stay clear of the common "male nurse" stereotypes. 1 male nurses are lazy - work your behind off offer to help everyone, be the first one there in the morning and be ready to work 2 male nurses get better treatment from doctors - don't pal around with the doctors or engage in "guy talk" if a physician makes a disparaging comment about women to you even in private (which they will) find a way to non offensively let them know you don't share their views. A confused response like "why would you say that?" has worked for me. 3- male nurses don't respect their female coworkers - go out of your way to show your respect, don't kiss up or be fake but make sure you look them in the eye and be sure to express your appreciation of their help and suggestion's. 4- men are messy and expect women to clean up after them - clean up after yourself, keep your rooms tidy and don't leave the junk in the break room and please please don't leave the toilet seat up. In fact try not to use the same restroom as everyone else or all the messes will be blamed on you. Also as a the only man in a female environment you have to be very careful of your interactions with your coworkers. Never ever "check out coworkers or visitors"; don't engage in flirting this will ruin your relationship with the staff. It could easily be seen as harassment and even if the flirtie is willing others will see this as a bad thing. Don't talk about girls you date or like or even actresses or singers (until you get to know people better on the floor). Don't interfere with the "pecking order" of the floor. Women interact differently then men do in this regards I'm not going to get into specifics as I despise generalizations and don't want to perpetuate them but I will say that you need to keep yourself outside of this or you will quickly find yourself at the bottom. If someone tells you a piece of gossip about another coworker do not engage in it. Simply say "really?" and either find a way to change the subject or get away. This will burn you faster then anything be careful. Erase the words "I know" from your vocabulary, if anyone offers you a piece of information (even if you already know it or don't agree) listen to them, thank them and then consider it. I'm not saying that you should take every piece of advice offered to you but you must at least offer the courtesy of considering it. If you ignore them or blow them off they are going to think you don't respect them and write you off. Figure out who the leaders on the floor are and learn everything about nursing you can from them and let them know you are eager to learn from them. If you show that you are willing they will gladly teach you and hopefully except you as well as encouraging others to accept you. Realize that everyone IS watching you and making judgments about you. Never let down your guard or forget that you are an outsider and in many respects an oddity. You have to prove your self to them as a good nurse and as a safe person to have on their floor. Your goal is to eventually overcome this but only by realizing it can you actually do that. When people make disparaging comments about men (which they will) don't blow up and don't voice opposition instead look like you are listening and neither show approval or disapproval. The best way out of this trap is too not to take a stand eitherway. Don't allow yourself to be used as the muscle. Yes help where you can but don't allow your self to be seen as the guy who carries the heavy stuff. This is hard to do because your should help out and I always tend to pick up the heavy stuff but if you are seen as the muscle your are falling into a generalization and then others are automatically applied to you. Take the best care of your patients you can. Everyone is going to think the patients are uncomfortable with you. You can deny this all you want but the only way to change their mind is to have patients tell them how much they love you. I could write forever on this subject so I'm going to cut it short and say the very best way to get the focus off of "men in Ob" is to shift the focus to patient care. Make everyone see that you take great care of your patients and that they are infact better off for having had your care despite your gender. I have seen many men come and go from my current job. I can only shake my head as I see them make stupid mistakes and lose the respect of coworkers. I've been here for almost 4 years and I can honestly say I many times forget that I am different and that I'm not always thinking about "the male nurse thing".
  11. Dayray

    Foley Balloons for cervical ripening?

    I've seen foleys used. I personaly dont like them for several reasons. #1 they hurt #2 if it not okay to manualy dialate a cervix with your fingers, then whey weould it be okay to do it with a peice of rubber? - what kind of damge is it cuseing? #3 yes it dilates the cervix but it does not put the patient in labor (labor = cervical change + regular contactions) #4 if your gunna have to pit them anyway what good does the ballon do? it does not ripen (soften or thin) it only dilates. I think people get excited by the cervical dilation achived with this method but i dont see any real benifit to it. Our residents offten sugest a ballon but I have never allowed one on my patients. sure it changes their cervix but it doesnt put them into labor or ripen the cervix so why do it?
  12. I had a rather nasty confrontaion with a post partum nurse last night. She was upset becuse when my patient asked if she could take a bath later that night after delivering I said that she shoudl shower for 6 weeks except for sits baths. The postpartum nurse told me that she had 35 years of expeance and that I should not be tellign my patients not to bath. I was always taught that post partum bathing (other then sitz or running water soaks) place the patient at risk for infection so i told her that i would continue to teach patients not to do it. She said that she is goimg to report me so I am looking for some evidance based research on the subject. Does anyone know of an article or a study that addresses this subject? Ive looked on he internet and all i can find are opinions from other nurses but I need soemthign solid. At the very least Id like peice of mind that I'm teachign the right things or information that would make me comfortable changing my taching.
  13. Dayray

    Discrimination Against Men in Nursing

    Yes it happens. Some times though it's hard to decide what is discrimination and what is just a reflection of the cultural norm. The simple sad fact is that it is currently "cool" for women to be man haters. My wife was talking about this, the other day. She was with a bunch of other women talking about how men are dogs and so on. She didn't join in and someone said, "oh I forgot, you love men and think they are great". She doesn't think all men are great but we have a very good marriage and she knows that ALL men are not dogs and doesn't give in to the peer pressure to join in on the man hating so thus, she is made to feel not a part of the group. To make the situation more complicated, In many cases the man haters have good reason to hate individual men. Now I'm not saying that their attitudes should be extended to all men but I can see why they have a hard time not generalizing. The things other men do to women continually astonish me. We live in a confusing time where shifting gender roles have left men floundering and having difficulty finding a mold to fit. Back in the old days men were strong, domineering and providers for their family. It wasn't seen as politically incorrect to boss women around or to play knight in shining armor to their damsel in distress. Now its wrong to be domineering yet it is even worse to be sissy or XXXXX whipped so this leaves guys with a very thin line to walk and honestly it is impossible to fit everyone's expectation of what men should be in today's world. I think this is what leads to so many men letting women down. Still I find comments made by many women offensive now I don't go running to file a complaint and I can't even fault them because I also hear them talking about the awful, awful things men have done to them. It makes me sad for both men and women. I have also seen real discrimination and been subject to it on both racial and gender basis. The problem here is that most of the discriminators are not evil villains that set out to make all men pay (although sometimes they are). They instead are otherwise perfectly nice people compelled by (many times repressed) feelings of resentment toward men or by stereotypical views (unrealistic) of what is proper for one gender or the other. It is therefore impossible to verbally convince these people that they are doing something wrong. It is however possible with lots and lots of patients to prove yourself to some (not all) of them. Yet the price for this is often too high. I mean how much abuse do you want to take to prove yourself to someone that hates you? I used to work at a place where I was the continual butt of jokes. Where I was always suspected of not working or of stealing or hiding ...etc...Etc. I know that some of the accusations made toward me were out and out attempts to get me fired but I also know that some people actually believed them and that I never had these problems before I went into nursing. My manager knew that the reason I was being harassed was because I was the only male on the unit and she made it clear in her comment to me. "...(Sigh) this is the price you have to pay for choosing to work with all women and remember you made that choice" Now I work in place with a great staff that judges me based on my performance and personality rather then my gender. Still I recently experienced a situation where my gender was brought under scrutiny. It was in attempt to protect me from some harassing comments and actions made by 1 staff member and was not meant to make me feel out of place but to keep that from happening. Still I have been made to feel even more uncomfortable by this situation then I was by the one fool that choose to harass me. So is that discrimination? Or is it just "the price I pay for choosing to work with all women?" The problem is that things are made even harder to deal with because society does not see me as normal for choosing to be a nurse. My choice of profession is the subject of jokes and whispers. Hell, my mom doesn't even talk to me about work and other family members have openly expressed strong disapproval about men being nurses. I don't know the answer all I know is that I have a feeling of awkwardness that I can't seem to shake and that it is effecting my performance and attitude toward work. I've always dealt pretty well with crappy comments made by people but now I'm having a hard time seeing there comments or inquires as innocent questions/observations and just seeing judgment and condemnation in their eyes. It would be simple if my choice to become a nurse was only based on the income and working hours, I however really love being a nurse and don't have a desire to leave it. So am I right and society wrong? Or the opposite? Lol I'm not sure? All I know is that it's frecken hard to be different
  14. Dayray

    1st day male in L&D

    Well I kind of am and kinda not. I worked with a volnteer ambulance company when I was 17 and had my preques for nursing done at 19 to the nursing program but worked out of health care for a few years and then got a paramedic certificate at 21 (have to be 21 to get it) I then worked for a few years in the ER, ICU, EMS and med surge. The hospital I worked at let me work in a similer capacity to an LPN. Then I worked in the finaclial word and finaly made enough money to go back to nursing school and then finaly became an RN about 3 years ago. So I've worked in allot of differnt areas and capacites over the the years in tottal about 11 years but only about 3 1/2 in L&D/PP.
  15. Dayray

    1st day male in L&D

    wow I was surprized to see this post back on the board, its pretty old. Anyway Like blueeyes said I have been doing L&D for a few years now. I don't have many problems with my gender although I can't say that i dont think about it offten. I have come to accept the fact that their are some poeple who will always judge me and see me as doing something wrong by working where I do. I however would like for you to know that most of them are nurses. Very very rarely do I have a patient that is uncomfortable with my gender for more then a few minutes. It has everything to do with how you treat people and the "vibes" you give off. People (especialy women) will pick up on a persons intentions pretty easily. A patient turning down a male care providor generaly has more to do with the way that care providor presents themselves and less to do with past expeance (except of course when it has to do with religion/culture). I had a very nice delevery with a pataint tonight that told me how she had kicked male resident out becuse of the way he acted, so I of course asked her if she wanted a female nurse and she emfaticaly stated that she wanted me to stay. People are always talking about how victoms of sexual abuse would likely be uncomfortable with male care providors, I can tell you from experance that this is in fact opposite of the truth. Patients who have been victoms of abuse need compasionate and patient care providors and the gender is much much less of an issue then you might think. If you are having that much truble with female patients I sugest you alter the way you present your self and evaluate your own preconceptions and attitudes toward women. It is most likely something they are sensing about you rather then the fact that you are a man.
  16. Dayray

    Obsessed ? or Justified?

    Heck no not obsessed. In fact this woman would have been maged and induced where i work. pre-eclampsia doesnt always have all the S/S. Elevated presure + prot in urine + epigastric pain = Mag and induce. This lady was on her way to getting very sick and term so why keep her pregnant? I am really surprized that no one cought this before she was transfered to ER and I dont see her LFT's or coags I'm sure that some hospitals dont see as much of this so I guess thats why you missed it in your initial assessment. I work on a high risk unit and we see allot of things so mabey thats why I'm really haveing a hard time understanding why someone would have missed this and transfered her to the ER for a medical work up. Prot in urine should have bought her a PIH profile add the increased BP and you have sufficant reason to induce throw in the epigastric pain (which is a late sigh in PIH and comes from swelling in the liver) and you need to mag and deliver her ASAP. I hope I don't sound mean or rude but this woman might as well have had "Pre eclampsia" tattoed on her head or a sighn that said "please induce me" around her neck.