ArmyMSN

neu ulm, germany ft lewis, washington nurnberg, germany croatia honduras augusta, georgia (twice) babenhausen, germany san antonio, tx bagram, afghanistan vilseck, germany its been a fun career

My first assignment was overseas (as a 2nd LT) - but that was 16 years ago (Now an LTC). Germany has a MEDCEN at Landstuhl. You might be able to get there - but I think the Army prefers that you go to a larger stateside MEDCEN to get experience before being assigned to a smaller hospital like in Korea or Heidelberg, Germany. Good luck with your career.

This is a very good idea - also on obese/overweight patients.

Try to get the arm in as dependent position as you can. Let it hang over the side of the bed, if possible. "Pop" the vein to get a histamine release - this tends to pop up the vein. Very important to continue to stabilize the vein with a non-dominant hand throughtout the IV start. Don't let go once you've attempted to enter the skin/vein. Alcohol rubbed upwards also causes veins to pop-up. Know the anatomy - know where veins should be. Approach with confidence - as if you've done hundreds. IVs sting/hurt - don't be afraid of the patient's response. You need to get an IV for a reason. Be matter-of-fact about it. Apologize if you miss. Warn them that it'll sting - but to try their best to hold still. Try not to attempt more than twice - get someone else - but this is tough when staffing is short or the others you work with aren't strong with IVs. Just know, that the more attempts you try, the better you get. Don't shy away from them. Also, try to start of with easier IV starts to build up your confidence. Trying to start on very difficulty, edematous patients with no palpable or visible veins is tough on anybody's confidence. I've seen anesthetist have difficulty on these types of patients. Oh, yeah - be comfortable over the patient when starting an IV. I've walked in on so many people and they're awkwardly hunched over the patient. Raise the bed, get a chair for yourself, etc.

Nursing is a tough career. 3 yrs and counting for me to leave - time to find something else to do.

got mine last Monday - absolutely no problems since -

I think its too premature to quit. I've had experiences like you mention where I was placed in a job where I wasn't completely oriented/prepared. Like you I thought I wouldn't be able to get through it. My recommendation is to take it one day at a time (I know that's cliche). Try to emulate those that are being successful. Try to stick with it for a year, then make a move to some other nursing that might be more your style. I can tell you that many nursing jobs spread you thin/pull you from all sides - even some clinic jobs.

Getting frequent luxury/pampering type gifts is a good deal - save the cheap trinkets for someone else, imo.

That would be an outstanding combination of degrees - I could see someone working in diabetes management/education, bariatrics, or just critical care as a consultant/educator along the lines of patient nutritional requirements/recommendations. Sounds like a CNS type of role with that expertise.

funny:balloons: :balloons: :balloons:

Last Nurse's week, all staff nurses got a cheap flashlight/key chain combo. I asked, "what the #$#@#$~~~!" is this? It doesn't even work. I swear only in our profession do these things happen. No physician would accept that crap. :angryfire

I've lost all confidence in axillary temps. Twice this last week, took axillary temps on toddlers. Got a 101.5 or something. Decided to take rectal immediately afterwards and they were 104.5 (both). I'm using axillary as a pre-screen. If its above fever level, I'm going to follow-up with a rectal temp. (My electronic thermometers from Welch-Allen are top notch and I trust their readings).

Yes, you have the right to refuse to be weighed. You also have the right to refuse to have your BP taken, to refuse to take your medications, to refuse to follow the advice of your healthcare providers. Patient rights, plain and simple. If I were you, I'd select a healthcare provider that listens and works with you regarding your special needs. I'd bet the tech is following her boss's directions. I wouldn't blame him/her for the clinic's policy.

Each manager has their way of doing things. I try to have a meeting at least once a month, and send out e-mails for urgent thing (try to limit though). Its sometimes hard to get the information to everyone - unless you use e-mail. There are a lot of staffing issues (turnover, call-in, new hiring orientation) , training requirements (JCAHO), policy and procedures, dealing with administration and physicians- that managers have to deal with and get information out to the staff -sometimes the information trail seems overwhelming and endless. In one place (without good computer access), I used a commo book that I placed in a common area. I'd try to be as supportive to your NM as possible - as she should be for you. Maybe someone could volunteer to set up a decent sized bulletin board where those important notes/post-its can be arranged more professionally.

1. Dependable staffing levels and nurse-patient ratios 2. Scheduling 3. Pay (I'd work for a lot less pay to work in a better job)

I feel for you. My nursing programs always seems to involve public speaking projects. I hated them - but somehow got through it. I still don't enjoy it - as I frequently have to give presentations in my current job. I know med-surg nightshift nurses/critical care nurses often can get through a shift with little dialogue - unless something occurs with their patients requiring coordination, discussion with other providers, family members. I wonder if your shyness is with large groups? I can see where home health nurses may get away with little discussion except teaching families and one-on-one interactions. BTW, your patients may appreciate your shyness - because it allows them to talk more - and they appreciate when people listen to them. I'd hate to see nursing lose a kind, gentle nurse just because she's shy.

Agree 100%.

I can take a guess. . . Its hard work. Its a thankless job - manually intensive. Very little thanks - or support from the healthcare organization's administration. High stress, poor staffing, high patient-to-nurse ratios, obese patients. Difficult family members who don't understand what nurses really do ("are you my waitress?"), very low control over work hours. Colleagues that can be over and needlessly critical. Rewards of job satisfaction are few - maybe a thanks from a family or patient, or a doctor. Maybe a physician will come to you for advice (and actually follow it). Lets not even talk about JCAHO and the constant last second changes the week before their survey. Hey if you find that special job, let me in on it - I may follow you.https://allnurses.com/forums/f195/why-do-nurses-leave-icu-168740.html

Got to agree. Get out. That organization is kooky. You deserve better.

Nothing like teamwork. I'm curious. Have you ever left her hanging in need of assistance? Maybe she's reciprocating. I've seen it where nurses help those who have helped them. Just one of those things some nurses do (not that I agree with it).

The funny thing is that we nurses are part waiters/waitresses (especially with primary care nursing and not having CNAs to assist). In one minute I can be serving a patient a tray of food, assisting them with their meals, getting coffee, etc - then a second later I can be attaching a defribillator to them, doing CPR, and pushing Vasopressin. What a career.

Avoidance. Time to schedule a heart-to-heart with the educator behind closed doors. Just becuase you're a new graduate, doesn't mean you can't speak up when you're being abused. The educator may find that you're an easy target. Sounds like someone needs to back you up, too. This is definitely a case of "nurses eating their young"-

http://www.rnceus.com/triage/triageframe.html Telephone triage is a good gig - and being used by outpatient clinics- doesn't require physical/manual labor. Requires computer use and someone who is personable.