nursingisworkRN

ok for a quick review this isn't bad...in case anybody else needs info like this! http://www.awesomelibrary.org/multiculturaltoolkit-patterns.html

Hello! I am hoping that somebody out there can help me! I am currently working on a powerpoint presentation on Cultural Assessment of European Americans. I need to include a section on physical assessment issues specific for this group. Any ideas? I am stumped, and most of the research I have found indicates they are the majority of people seeking health care, routine ob/gyn exams, mental health, etc... and that normal values tend to be based on this group. I also have to do a section on illnesses common for this group. I have included MS, cystic fibrosis, skin CA, hemochromatosis, IBD/ Crohn's, and spinal muscular atrophy. Can you think of any others I may be missing? Or areas to search on the web? I pulled CDC info for the top 10 causes of death and have included that in my research, so it covers the basic cardiac/ CA/ accidents/ renal etc. Any help would be appreciated. Thank you!

I recently transferred to the ER and feel that it is helping me develop "thick skin". This is not to say the negatives outweigh the positives. I have a great job with plenty of autonomy and my input is respected (for the most part). My coworkers and the environment have helped build my thick skin. I have always been sensitive to criticism and nastiness, and even if not involving me I would often get teary eyed. In the ER if there is conflict, it gets resolved on the spot. I don't mean people complaining, but rather problem pointed out and problem solved. No catiness, no backstabbing makes it so much easier to go to work and do your job. As far as just being jaded, I am not there yet and when I do it is time to move on. With some of the difficult pts I have to be nurse ratchett, but with others I am free to smile or laugh or cry and just be in the moment. It usually has to do with how busy the ER is, how sick my pts are, and of course if the pt is trying to kick me or bite me. Then come the restraints and I do laugh from time to time when I see someone trying to chew through them. For me the thick skin comes from watching my role models-aka nurse heroes- demand respect by their actions with pts, mds, etc. They are not pushovers, but they also admit when they are wrong and correct mistakes. They don't let people talk down to them and then feel bad, and really nobody ever should.

NEVER! And we use the pressure cuffs too! EEKIES! One of my nursing instructors back in the day had a bloodbag that had some type of rubber band for pressure shoot the spike tubing out and splatter her. She said the pt looked up and told her she looked like she had the measles. They BOTH had a good long laugh about it. I like the bag defect theory...too strange to get air in a blood line and then have it go bonkers when you squeezed it. SOMETHING wasn't quite right.

:lghmky:I am a dork, but thought it was pretty cute. Gonna look at the rest!

I am sure that you realize the age old saying, but it bears repeating to yourself over and over..... "It's not about me." Clearly she has issues and will likely lose some sleep over the lashing she will likely get about professional conduct. Plus, you should probably also believe that she is insanely jealous of you and has to put you down to your friends to make herself feel at least a little bit adequate. So when she is being so terrible, try to think about how terrible it must be to be in her shoes. Or not, what the heck, but you could TRY. Or of course, as a coworker told me once, it is like water off a duck's backside. Shake it off baby!! Sorry to hear about it though. Some people...YIKES :angryfire

Our ED is the same as Stardogdaisy. Oh yeah, and don't forget the dual 16g :wink2:. Last guy I had was young with a hemocue of 5, and he got 14's. He had to wait in the ED for 12 hours, and I think he liked the lavage. At least, he asked me to do it again after nightshift went home. He did have coffee ground blood. Not sure about active bleeding.

NO WAY! It takes a very special kind of person to do what we do and do it so well. Not everybody CAN do what we do. I wouldn't want just anybody caring for me or a loved one. I do not expect the world, or most of my friends and family, to understand what I do. I no longer expect them to appreciate it. They know I am a nurse, and to them it is my job. They do not realize how hard it is to tell a woman she has lost her unborn baby, or how gut wrenching to have a pt return from a sobering center with an ingestion 6 hours after discharge. Or how scary it is when a teenager comes in with status epilepticus, or a 3 year old who tried to fly off the roof of the car but somehow his cape didn't work. Or how heartbreaking when an elderly pt is found down for days at length with a broken hip. Or how terrified I am when a newborn comes in not breathing well and the line is impossible to place. Or how sometimes you do everything you can and it just isn't enough. They really only know that often I do not get home on time, and that I am exhausted when I do get home and not inclined to hear about their bad day. The bad day was reserved for the family who rolled their car off the freeway without seatbelts, and only the cranked out mother survived. My coworkers know what it is like. I have come to rely on the fact that nurses are largely misunderstood by the real world. When the rest of my life gets out of control, I can count on the fact that the minute I walk through those sliding doors I am with real friends who "get" me. Not everybody has the ability to handle what nurses do without even thinking. It becomes second nature to us. But to out pts, we are always there when it counts the most.

Have you looked into their training programs, both for new grads and for experienced nurses? I would say to stick with the ER that has the most comprehensive training program and offers the most education. Also consider the importance of teamwork in the ER you are choosing. The pace and variety for trauma pts as well as non-trauma pts can be insane in a high volume ED (probably also in a low volume one). Are your coworkers going to be working together well? What is the nurse/pt ratio? Do you have EMTs/care techs/etc working with you and how many? What can and can't they do (LEGALLY in your policy and procedure LOL-they can and will do just about anything when needed to). Will you have a resource who can help you when you get 10 ambulances back to back and can't place a line or have a concern but no md because they are intubating or otherwise incapacitated with the 9 other ambulances? Are the doctors working hand and hand with you and will they value your input? I couldn't make it without the help of my coworkers, and the ED docs are just amazing. The transition from tele to ER is HUGE. Good luck! I am sure you will make the right choice for you!

Am I wrong to assume that when the pt md was rounding she should have seen the pt? If she hadn't yet, then you gave her a heads up. If so, then she was already exposed and probably should have done a better pt assessment the first time. Either way, she is the doctor and any risks she takes in her occupation are 100% her risk. So ugly it makes me shudder.

To answer your question: 1. Yes 2. Year round, depending on dates of new grad orientations which are every 8-12 weeks. All new grads will start in new grad orientation, the ED has I believe 4-6 months of training for new grads, 10 weeks for experienced nurses. 3. I have not heard of more than two new grads hired at the same time, but it is totally dependent on department needs, available preceptors, and length of orientation. 4. New grads are required to have ACLS, PALS, and dysrhythmias. Experienced nurses get TNCC, ENPC, and any other recerts. I have 11 weeks of orientation, with TNCC and ENPC, and still need PALS. I already had ACLS and dysrhythmias/12 lead interpretation, so that helped. 5. We are a level 2 trauma center (no affiliation to university) Personally, I was not prepared as a new grad to work in the ED. My year and a half of telemetry was invaluable experience, but I do tend to think that experience is experience and you have to get it some where. Best of luck!

In my house, we really only worry about shoes and hands. Shoes off (and on) at the doorstep, and hands washed immediately. I will go grocery shopping or on a quick errand in my scrubs, mainly because by the time I go home and change I am not going back across town. I would not be likely to visit a friend in my scrubs unless we worked together and then went for breakfast or coffee (I don't like my scrubs as much as jeans and I kind of stick out). One of my roommates who is a nurse will not go anywhere without showering, which is her preference. On a particularly bad day I might know that my clothing is dirty or have that smell that I just can't shake, even with three showers, and then I will not go anywhere until I am sure I am clean. Funny though, nobody else seems to smell it. Must be in my head!

IMHO, now is as good a time as any to begin college. Meet with a guidance counsellor, talk to the nursing department staff/students, and work on those nursing pre-reqs. The only way to really know if it is for you is to go for it and find out. As far as your fears go, there are plenty of tutorials and resources available to help you with the math-type stuff. Nursing school is TONS of work, but look at how many people have completed it! The emotions are a bit trickier. I guarantee you will encounter situations where your emotions come into play (it happens everyday in different ways). How you deal with them is up to you, and you will learn along the way what does and doesn't work for you and what is and isn't healthy. Good luck! I am sure you will be a great nurse if you put your mind to it!

CONGRATS! And Happy Thanksgiving! Enjoy your new career and, of course, spending holiday time with the family!

In our hospital, we are not paired with the techs. RNs can have 4 pts at at time, but the techs are assigned by rooms and have more than 4 pts. On a busy day when we are full++, I don't want to know how many pts the tech's are assigned to. Of course, we all work together and work hard but our techs are just AMAZING and I am always grateful for the help!

Good for you for recognizing your discontent and having the courage to move on. My suggestion: write a list of qualities you want in your job and find a place that will work with those. Be extremely PICKY...work is hard enough without the dread. I am undergoing the transition to ER and absolutely love it. My tele experience is very useful, and I can only imagine how many areas a peds background would be useful in. Good luck...you will find your home in nursing! One of the greatest beauties of the profession is the flexibility.

Welcome to CA! It is my understanding that to re-license you pay a fee to the BON. And the pay for nurses is northern CA is great! If I didn't love the southern california sun (born and raised here) I would go up north and double my paycheck.

You may also look for a foot store that makes custom orthotics. They are not too expensive, and many swear by them! To point out the obvious, that is too many hours on your feet! YIKES!

Also on the write ups I would probably attach an addendum with my side of the incident and that signature implies receipt of report only and not agreement of events. Refer to addendum. And yes, ALWAYS have a witness.

Frustrations understood. I think that as nurses, we are encouraged to be supportive and understanding, and that we are frowned upon if we speak up about certain pts. If you find that this situation has become a daily thing and it is starting to affect you adversely, I would probably suggest a change. Have you considered another area of nursing? I have had similar experiences with "difficult" pts. I have found that the combination of being understaffed, overworked, scheduling problems, rotating back and forth between days and nights, no resources/preceptors available, lack of team work, and high level of acuity has started to affect me poorly. I stay late at work, don't sleep well or enough, have not been running/exercising, and cancel plans with my friends b/c I am so tired, and as you stated, my back HURTS! I have a change of venue next month, and am so excited for just something DIFFERENT. Plus, I lack the patience and tolerance for the folks who feel it is okay to throw a tray at me because of???? never ok to throw things at me, unless the pt is demented/ can't help it and then anything goes. And yes, having a pt back who was discharged the day before who fluid overloaded themselves AGAIN b/c they ate a bag of potato chips?? And has the nerve to tell you who completed their chf core measures with them that "I didn't know I couldn't eat that. You never told me." Zero accountability. ALWAYS FRUSTRATING. LOL-I also think a gentle swift kick to the rear that is well meant and well placed is effective. Many pts push the limits b/c they can. Sometimes it is necessary to remind someone that they are in the hospital, not a hotel, and some of their freedoms are limited here because they have direct adverse effects on their health. CHF/DM/PE is not getting a donut and a smoke break. And no, I am not sorry it hurts when you breathe if you take your heparin gtt into the bathroom to smoke. GIMME A BREAK!

I was having lower back and calf pain after 13 hours in my dansko professionals. Chucked them and started wearing my asics running shoes. They are mostly mesh so no hot feet, and I put some powder in my socks just in case. At the end of the day, I am pain free and my feet don't stink like they did with the danskos.

Two (maybe 3) things to learn from your experience. 1. Do not work in that department. The conditions must be terrible if the staff is behaving in that manner. No nurse wakes up and wants to do a bad job, treat people poorly, and make work any harder than it already is. Think of how overworked/ under-resourced they must be and try to be empathetic. You saw how bad their work environment is. 2. Treat students kindly. It is guaranteed that the day will come when you are the nurse who is working with the students and some students will make quite a bit of extra work for you (not doing tasks stated they would do, failure to perform interventions, not notify until after 8 hours and leaving that pt had no urine output, breaking hospital infection control, dishonesty,telling your cna how to do their job, correcting staff nurses on their interventions....so many things are possible). Remember how you felt and be kind and patient with them. You are a role model to them for how they want to be someday. Some days it will be a challenge to be a role model. Be one anyway. 3. If you ever find yourself in that position as a nurse, it is time for a change. Maybe a new department, a new facility, or another area of nursing entirely. Burn out can happen to anyone. PS-I love working with the students. Some nurses really do love to teach. The best advice:keep your smile on your face, do the best that you can, and leave work each day with one thing you did well. So often we focus on what needs improvement rather than what was done well.

Hi everyone! I just wanted to announce that I am interviewing in the ED next week. I have been contemplating it for some time, and decided that my heart is there and I need to find out if the rest of me has what it takes. I am very nervous, but also extremely excited. I am concerned that 1 yr of telemetry experience might not be enough, but from what I have heard from other emergency nurses, emergency seems to be in a different league from med-surg floors anyways. If anyone has any advice, suggestions, or helpful tips, it would be greatly appreciated! Wish me luck!

I know that here in SoCal there are many different options for a new grad RN. You may consider an outpt clinic, county health facility, rehabilition facility, long term care/ SNF, dialysis center, private md offices, psychiatric facilities, and I think that some of the private care agencies are now willing to train new nurses for private duty. There are probably many many more places. I work in the hospital, so my ideas are limited. Keep your eyes open and good luck!

You might discuss your interest from the get-go with your instructor for ob/maternal newborn. They would probably have suggestions or know of positions opening up before others as they are working on the floors frequently. One of the students in my nursing program signed on as a pt care tech in l&d. She worked for 2 years while in school and then when she graduated she accepted a full time night position. Maybe you would consider working as a CNA on the floor. If you are not a cna, maybe you could take the test after your first semester of nursing school when the units are completed and get your license. That way you could get to know the facility, the manager, and the staff. Usually a unit will hire a current employee as long as they are a good worker and a good fit to the floor. GOOD LUCK!