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brownbook has 36 years experience.

brownbook's Latest Activity

  1. Exactly what you say. Let it slide depending on the acuity of the patient. An ICU transfer involve the ICU relief or charge nurse. If that doesn't work involve your charge nurse. It's "nice" to have something written, a policy, to cover every urgent to annoying situation. But in over 30 years of nursing I've realized policies are specifically vague, thus unhelpful most of the time. I did have one ER nurse at the end of her shift bring me a copy of our policy that said two weeks notice was not required and to take her off the schedule as of now.
  2. brownbook

    Unprofessional Conduct Online

    I would unfriend them. I know nice, harmless, reasonably intelligent people, who have diametrically opposite views from me. Yet we can be, are, civil towards each other when in each others company. I wouldn't hesitate to recieve care from them.
  3. brownbook

    Future Nurses are Brighter Than Ever

    Now you're changing your question. Yes it is hard to get into nursing school now because there are a lot of applicants and not a lot of teachers, among other reasons. Yes it's hard to get a job after you graduate because the nursing market is saturated. Yes until around 2000 it was easier to find a job and go right into the speciality you wanted. My friend persevered. Got her LVN degree, ADN degree and BSN degree. Has a great job now. It was hard and frustrating but she refused to give up. My "generation" of nurses had it easier. But not because the educational requirements were less rigid.
  4. brownbook

    I’m a new grad in medsurg and I’m struggling

    As a new grad you cannot be expected to read all the clinical notes, study"and see the "big picture" on every patient you have. Get a basic organized routine, via a brain sheet, and stick to it. Put "brain sheet" into Allnurses search box. Find a routine, a brain sheet, that works for you. You will get better and faster. THEN after you get a good routing down, you'll have time to "study" and read clinical notes on more complex cases. Focus on basic safety you KNOW from nursing school. A diabetic's glucose/finger stick before insulin, a patients baseline blood pressure before routine antihypertensives, a patient's level of consciousness before pain meds, pertinent allergies.
  5. brownbook

    Trying to get more experience. Help

    All good advice. Many nursing schools do not teach IV skills. Hospitals don't expect, or require, new grads or newish nurses like you, to have this skill. Youtube is a great resource.
  6. brownbook

    Nursing Is No Longer Worth It

    All you down on nursing as a job posters are such deep thinkers, very eloquent, verbose and have such high expectations from a job. I wish some of you would learn to use paragraphs....I didn't read the long posts with no paragraphs. I got a job as a nurse because science is interesting to study, there will always be a need for nurses (until the robots take over 😁). The pay is more than adequate. (Earning a big paycheck was never something I aspired to.) I didn't feel nursing was a calling, I'm not a martyr. No one would ever enter any profession if they expected whatever it is you expect. Hospitals have to be run somewhat as a business. You have to have enough income to pay the bills. We could all become ultra socialists, be taxed a lot, so somehow all the hospitals income would go towards payroll. Go Bernie! I do agree waterfalls in the fancy lobby are inappropriate 😂.
  7. brownbook

    Nursing Is No Longer Worth It

    I did bedside care for 17 years. The more confident and competent I became the more I loved it. Moved into ambulatory surgery. It's like Disneyland. I was mid management for five years. Never was offered a bonus. Was nominated by my staff for nurse of the year. I'm sorry you chose the wrong profession. Don't curse the darkness, light a candle. Tell the nursing students what wonderful, perfect, profession they should be persuing. I guess you believe there is some perfect company, job, profession out there? We'd all love to know what it is?
  8. brownbook

    Nursing Is No Longer Worth It

    I'm glad I became a nurse. Good pay, job security, some shifts were nightmares, most were average, some were so slow it was boring. I think my expectations of what I am owed from any type of job are very simple.
  9. Common sense says any worker in any job shouldn't have a lot of downtime every day, or shift. Especially when co-workers are obviously busy. Maybe some workers are super efficient? Personally if I'm all caught up I seek out something work related to do. I hate sitting around doing nothing, watching the clock.
  10. One nurses glimpse of the front lines, is actually just one nurses assessment/opinion. They may be, are, to close to the action to see the big picture. I didn't learn anything I didn't already know. If you have comorbidities you have a bigger chance of dying. Healthy people with no comorbidities can die. Many, (how many, I hate math but I know the percentages of deaths per population make the numbers high). This virus won't go away. HCW will get sick and die. I think we already knew all this "important information". I do like the posters style of writing. "My friends, the danger is very real.....You are the author of your destiny." Very impressive, they should write a book. I can "imagine", I know, the "military is sent out without adequate protection". Being married to a front line, saw action in Vietnam, Marine I hear ad nauseam how bad some of the equipment was. During inspections they had to be wearing it or be reprimanded, only to discard it as soon as inspection was over. And he makes the same comments watching current war news or talking to newly returned troops from the front lines.
  11. brownbook

    Pregnant new grad...need advice please!

    This question has been asked many times on Allnurses. I don't like, or can't figure out, the Allnurses search function. Maybe you'll do better than I do. I think the responses are no you don't have to tell them and they can't ask during an interview and common decency and common sense is to tell them sometime after you get hired .....before you deliver....before it becomes obvious.....??? Nursing is "traditionally" top heavy with females so they are, should be, used to, accepting of, the fact that nurses are going to become pregnant.
  12. brownbook

    Thoughts on Charge RN

    In my humble opinion a good charge nurse does not have to be an expert in Critical Care. I assume you could step in and help out when the *** hits the fan, I assume you could take over the care of a stable patient to free up a nurse when another patient starts crashing. I assume you could help do an admission assessment, enter orders in the computer, etc. A good charge nurse stays calm, handles staff disputes. Pitches in to help out. A good charge nurse know who on her staff is the go to "expert" nurse. A good charge nurse says..."Bed 7 needs help, I will watch your (hopefully stable patient) for you so you can help bed 7" . Anyway go ahead and apply. Emphasize your all around general nursing experience and knowledge. Emphasize you ability to get along and problem solve, but can be "tough" when the situation calls for it. I'm sure they'll ask for an example of a difficult situation involving staff or patient's families and how you handled it
  13. brownbook

    COVID-19 and extinction of human species

    The Earth Abides was realistic, not a "thriller" about a global pandemic. Left all the politics out of the equation. Mostly about how the few survivors coped in the aftermath. No crazy cults, no zombies, no Mad Max, just people doing the best they could. Shocking I know, how could that be?
  14. brownbook

    COVID-19 and extinction of human species

    An OVER REACTIVE immune system is what mainly kills people with covid 19. Many diseases, illnesses, are DUE TO an over reactive immune system. They are called "autoimmune diseases". I've said this ad nauseam....studies, after the fact, of WW II concentration camps, suggested that the better fed, warmly dressed, etc., concentration camp guards were more adversely affected by measle epidemics than the obviously underfed, poorly dressed, etc., inmates! You're correct, the immune system is very complex. It is not so simple as eat well and boost your immune system. If you even want it "boosted".
  15. brownbook

    ECG help

    It is confusing! Is there a picture of the "strip"? ANY EKG is measuring electrical activity of the heart. It doesn't mean it has to be a 12 lead EKG. It can be a 3 or 5 lead EKG. When I see the world "strip" that indicates a 3 or 5 lead EKG that "only" prints out a " strip" of paper. The "strip" of paper is similar in size and to a receipt from a store. A 12 lead prints out on an approximately 8 1/2 by 12 inch sheet of paper. It's to bad it's so confusing 😢. Try to focus on what the heart rhythm is showing on the "strip" or even the 8 1/2 by 12 paper. Try to not get hung up on confusing terminology. Unless you're working 32 to 40 hours a week where 12 lead EKG 's are done several times on each patient, (so you're looking at 12 or so 12 lead EKG' S every day), I wouldn't spend to much time dealing with the minutia of 12 lead, 8 1/2 by 12 inch EKG printouts. Yes some of the basics can be learned about 12 leads. But "usually" there is an MD, even a cardiologist right there. It's usually not up to the bedside/floor nurse to interpret a 12 lead for rule out MI. Unless the nurse has been working with 12 leads on a regular basis. The three and five lead "strips" are more the expected responsibility of the nurse. These strips aren't too difficult to learn. Relate PQRST to what the heart is doing. Count the tiny squares, know how many squares are normal between each spike, etc. Learn what a normal EKG looks like. Then you'll see, understand, what an abnormal EKG strip looks like and learn what that abnormality may mean........the patient is brushing his teeth, it's not v/fib 😂. Or the electrodes fell off it's not asystole. Always look at what the patient is doing when you see a sudden change in rhythm.
  16. brownbook

    ECG help

    There are 3, 5 and 12 lead EKG's. The basic is the 3 lead, the 5 and 12 give a more three dimensional look at the heart's electrical activity. Youtube has excellent videos on all of them. Knowing proper lead placement is AS important, even more important, than knowing how to interpret one. If you're new to learning about EKG's having a good understanding of the 3 lead is a must. A cardiologist told me you can ask ten cardiologist to interpret one 12 lead EKG and you'll get 20 answers. And I've heard the EKG machine interpretation of the EKG was more accurate than the cardiologists 😂. Don't get to obsessed with, hung up on, the details. A good basic understanding of the 3 or 5 lead will suffice in most areas of nursing.