shape0fmyheart

I was just wondering if anyone could tell me how often they like to check quantitative hcg levels in the first trimester, specifically in the first few weeks of finding out? Thanks!

I just saw that and deleted a bunch. Thanks.

I have been searching the internet for answers to my situation but finally decided who better to ask. I have had 5 positive hpt's... 3 were with the double lines and the 2nd line was always very faint, and 2 were digital which very clearly read "pregnant". I got my blood drawn and my hcg level is only 6. LMP was first or second week in Nov. I can't really remember because it is always irregular. I'll be getting another one drawn on Monday but what does it seem like is happening? I stopped taking birth control in September. This is my first pregnancy... if that's even what it is.

Well I'd sure like to find one of those hospitals then.

CHS is a monster corporation that owns something like 78 hospitals throughout the country. I am just getting ready to quit my job at a hospital owned by CHS, mostly because of my manager but also because I have just been fed up with the way they run this hospital for months now. At the end of last year we ran out of tons of supplies but were not allowed to order more because the "budget" was done until the new year came. We did not have tissues, urinals, graduated cylinders, thermometer probes, etc. The list grew and grew. We are constantly understaffed. They actually SAID that they couldn't hire any staff for our hospital because it "wasn't making them enough money". They have a "rule" that anyone that walks into the ER that is over 70 is automatically admitted, and people that come in just complaining of abd. pain ALWAYS get admitted and get the full work up. They care about top dollar, and that's it. Patients and employees, what do they matter? The CEO rarely even looks in the nurses' direction but if he sees a doctor he's immediately got a brown nose. I know it's a sad fact that most hospitals are run this way today but in comparing stories to other nurses I know, theirs don't sound quite as bad.

I work in Med/Surg but we are also the hospital's Oncology and inpatient Hospice floor. I have dealt with quite a bit of hospice/DNR/"comfort care" patients since I started last July and those are the patients that have truly made me feel important as a nurse. I have considered making the switch to hospice nursing but I am weary of making that change. Questions such as what if I end up not liking it? What if I can't handle it? etc. I find that the hardest part is handling family members, but that is also the most fulfilling as well... depends on the situation. I know that I definately do not want to stay in Med/Surg forever and I'm just trying to find my "calling". It's not easy...

Our normal load is 6-7, lately 7. A few nights some nurses have had to take 8 patients each. I have not been faced with that yet but I have said that I will refuse. It's MY license on the line and our patients are usually high maintenance, I barely feel safe with 6. I am on Med-Surg with Oncology and Hospice thrown in the mix.

Actually the patients that have driven me near insane have been nurses themselves, retired, but nurses nontheless. One of them kept ringing alllll night because her gas was painful. Meanwhile I have post-ops with low urine output and BPs crashing and 2 or 3 dependent cares, but she wants me to call doctors all night and be in her room all night long talking about this gas. The other one was a postop knee, OMG, no one has ever driven me so nuts in my entire 10 month career. She rang, every 5 minutes, ALL NIGHT LONG. And then had the nerve to say that no one was answering her bell!! I am sure that the Dilaudid PCA had something to do with that but come on, I can't stand when people accuse me of that when I actually DO go in there for every stupid request. She would tell me she had an itch, or she needed ice, or just tell me that "Nursing is not what it used to be!" Yeah, she worked in OB and tells me "This is why i never worked med-surg". Yeah, so stop with the $(%# call bell! ahhhh :smackingf

The other night at work I had a NP and the supervisor of our heart station as a patient. I have been in nursing for about 10 months so I was extremely nervous, especially when her IV went bad and I had to start a new one. Well, that task went ok and she actually told me I did a good job... she had just had a lap chole done so I wanted to assess bowel sounds. I told her I would be right back, I had to get my stethoscope. Along the way I got her a new pitcher of water, somewhere along the line placing my stethoscope around my neck but not really realizing that I did I guess. I walked in and said "Ah, I forgot my stethoscope!" and she was like "It's around your neck". I felt like any amount of trust she might have had in me she just lost lol. My excuse... "It's been a bad night". Which it very much WAS. I felt like a ditz.

Unfortunately, every night I go to work I feel the same exact way, and I can tell you that a good majority of my coworkers do as well... even ones who have been there for a long time. We have too many patients, too much work, and not enough staff.

I am starting to really hate my job. Every night I have to go in I dread what disaster I will encounter this time. Even my fellow colleagues "joke" with me about how I always get the "bad" patients. Problems with BPs, pain med oversedation leading to 40% room air sats, unarousable patients and Narcan. Chest pain. Code ones have always been my patients since I have started on this floor. I have had 3 people fall. One was completely with it until he had Ambien (darn that Ambien) and I hear a crash and an "ahhh!" at 2am and find him face down on the floor in a puddle of urine. He wasn't hurt thank goodness. My most recent fall was just Friday morning at 0700 when I'm trying to finish and leave after my 12 hours of suffering through patients going into CHF and dealing with a woman who was oversedated on Versed at noon still feeling the effects. I heard someone yell "Can someone help, I have a fall in 17" and my heart just dropped. I knew it was that little old woman I just helped get up. She wanted to go in and clean her teeth and "try and pee" (I just took her foley out). She wanted to pee on her own so she could go home. I go in and she's yelling ow my head, I broke my leg. We all lifted her into the chair and then into bed and wouldn't you know, her left leg is externally rotated and about 3/4 of an inch shorter than the right. She had a big blue egg on her forehead and cut her left shoulder. She is nearly in tears and so am I. I feel HORRIBLE for what happened and I have not been able to sleep for the past few nights. I was afraid for my license but I have been assured by the other nurses at work that it will be fine. "People fall" they say. Yeah well why do MY patients always have the disasters?? I feel like a HORRIBLE nurse. They tell me "But you're a good nurse". I have to go in tomorrow night and I begin to cry just thinking of it. I know this woman will still be there, waiting to get surgery on her hip. I have wanted to call and ask about her but at the same time I don't want to know. She was the sweetest thing, telling me I did so much to help her last night and not blaming me at all. She wasn't on fall precautions, her score was only 6 and it has to be 10 to initiate that. She says she thinks she passed out. She has some kind of problem where she gets "whoozy" in the head as she puts it, but that had not happened all night. I just don't know what to do. I really, really hate this job lately and I feel like I just suffer through the nights I have to work and then dread going back on the nights I have off. No matter what I do, something horrible happens.

You will have to let me know how you like home health when you start, I've been considering that in the back of my mind but I also have a lot of fears about it as well. I will keep an eye out for your posts. When do you start?

I need to post a semi-rant here and see if this happens in any other hospitals between shifts. It seems as though dayshift thinks night shift nurses are lazy and sit on their butts all night long. When I don't know something in report and they ask me about it and I say, oh I didn't have time to look at the chart, it's as if they don't believe me. They come in miserable and with attitudes when and if they are left with something to do that, oh my gosh, wasn't done by me. They act like night shift does nothing when we are not ONLY the nurse, we are the aide, we're housekeeping, we're maintenance men, we're unit clerks, we're chart checking, MAR checking, rechecking things from the day before making sure THEY didn't miss anything. We do our own vitals on 6-7 patients. Assessments. Meds. Q2 hour turns. Incontinent checks. I&Os. Waitress and get new ice water and snacks and this and that. Honestly, there are some nights when my butt hits the chair barely long enough to do chart checks and MARs and then I am not starting to chart until 0730 when I am supposed to be out the door. I have more nights than not like that. I had a nurse follow me this morning who had a hissy fit because SHE had to do an accu check. It was my misunderstanding that this man was written down for 07-11-16-21 accu checks and he was really 06-12-18-24. I had done it at 0200 because he was a new admit. The aide was already done the morning accu checks so this nurse says oh I need her to do another. She couldn't find the aide so then came out and proceeded to stomp and throw the accu check machine and say "I guess I'M doing an accu check". Well I am so sorry I did not know that dayshift nurses are so precious they just can't dirty their hands doing a little old accu check. We do them at night, but I guess we are below dayshift. Oh and this is good too, our morning aides complain that they have too much work to do. Well labs and accu checks and vitals ARE in their job description. But now, night shift nurses need to start doing AM labs. Granted I do the picc lines and the hard sticks already and the 0600s, but doing all of the 0700 labs was not in our job description. We are already ripped off at night being short a nurse pretty much every night, and then most nights we don't even have a unit clerk. And we NEVER, have an aide. I really can't stand this hospital drama. I am not trying to offend anyone on dayshift I am just wondering is it like this everywhere? Sorry this was so long, wow I needed to rant. :angryfire p.s. My hospital is owned by CHS (Community Health Systems). It is my understanding that they own about 75 hospitals in the US, anyone else work at one? They are so CHEAP and only care about money, not patient care. I can't stand it.

Our ER nurses have recently gotten a kick-start (incentive pay) for getting pts out in a certain amount of time. It is GUARANTEED that we will get a call at 2300 with an admission. The ER will call at least 3 times from 2300-2330 to give report, despite you repeatedly telling them that that nurse is in listening to report on the 6 patients she already has up here. If you dare tell them she will have to call back, you will get threatened that they will just send the pt up without report. Ok, I will just put my other 6 patients on hold while I go down MYSELF to get this pt (we do not have aides, LPNs, and we "share" a unit clerk between floors but we rarely see one on our floor), do the admission myself, get them settled, then finally roll around to the poor people that have been there, at 0200. I love when their excuse is they are "so swamped" and you walk down to get the pt and everyone is hanging around the nurses station doing nothing. And the pts are always mad at US as to why there was a delay getting upstairs. Last night it was a juggle between post-op surgical, ortho, confused combative alzheimers pt with fx hip fighting everything you have to do, an "oops I pulled my iv out" with Morphine PCA running all over room , 2400 meds, and a new admit at 2400. Oh I love the rare few that just want an Ambien and the door shut. Gotta love this job.

He didn't ring the bell (this time) but I was in the room with bed 1 when bed 2 decides to yell out "Hello?!". I look around the curtain and say "Yes?" and he says "Oh, hi. I just wanted to say hi."

Hey there. I work 11p-7a 5 nights a week (big mistake there) on a very busy med-surg/oncology/hospice floor. I honestly feel like the stress that I get from this job is not worth having the job itself. I have been a nurse since July. Granted, I am starting to feel more comfortable, but it seems as if the nights where I think "I have never had a night this bad", always seem to get their match. The past few weeks have been horrible and yes I was warned it'd be bad for the holidays, but come on. Honestly, all I can say is I am sick of the sick people. I got someone to work for me tonight because I just needed a night off. I don't even care about losing money anymore. I have become so secluded, miserable and depressed since starting this job. I have always hated public places (dx with social anxiety a few years back) but now I completely avoid them. Our grocery store is open 24/7 and I find it perfectly normal to go shopping at 1am on a night that I have off, to avoid people. I am so worn down and "burn out" already but I feel like I don't have a right to be because I just started. I am working with nurses who have been on this floor for 20+ years. It seems as though the patient load and acuteness just seems to be getting heavier. Last night we had 32 patients on our floor. I was one of the lucky ones who only got 6 patients, not 7. One has been having blood glucose problems for 2 days. She starts acting VERY WEIRD. I do an accu check and its 527, wow ok. Do another and its 208. Wait 15 minutes do another and its 68. Send down a STAT blood glucose draw, which takes a freaking half hour to come back, and its 36. She got 1/2 an amp of D50 only to be back at 50 by 6am (she got the d50 at 2). One completely dependent who keeps making me call his wife at ungodly hours. One who needs assist to BSC and takes what seems like hours to shuffle over to it. Pain meds after pain meds after pain meds. Some nights I think that's all I do. 32 year old male accidentally pulls out IV at 3am, very pleasant, completely oriented "got it caught on his bed". Ok, I like this patient, I don't let it bother me too much. Get the IV back in and he gets his prescribed 4mg Dilaudid at 0415. 0700 he is found unresponsive when someone goes in to get him into a wc to go down to ultrasound. I am in completely dependent man's room on the phone with his wife when I hear "Code One room 520". I am like WHAT IN THE WORLD IS GOING ON!?!?! 32 year old completely normal man all night long. They are blaming the Dilaudid. He had it twice before that and was fine, plus it was 3 hours after he had it, but ok. Most days I'm just glad that everyone's alive when I leave in the AM (if they are). I have seen so many horrible things in these past few months, felt so stressed, so broken down, so wanting to just quit, that I am wondering how in the world anyone does this for so long. This is such a love/hate job for me. Is this how it will always be? It's like it's either really good, or REALLY BAD. I seem to have more of the REALLY BAD. The other nurses on nights have even made comments before that "wow you always get the patients with issues". By the way, that guy was alright. I was helping to wheel him down to the ICU at 0720 (and yes I'm supposed to be leaving at 0730). Oh the joys of nursing.

I work 11-7 and the other night one of the experienced day nurses, the one who thinks she "knows it all" and is always questioning everyone else, calls at 0330 to say she forgot to chart something on one of her pts. We all enjoyed that, saying, hey she forgets things as well. :chuckle

Thanks everyone for the positive words! Good luck to those of you feeling the same way I am right now, I realize I am not alone. :)

LOL, I just realized that I meant to title this "More BAD days than GOOD". See what this job does to me?? :imbar

Thanks for the replies. I'm sorry that I posted that twice, my computer was telling me that the website timed out and I didn't even think it posted once! I work on med-surg/oncology/hospice. We get a LOT of surgical patients, and have had a lot of hospice people that seem to be dying every other night (they did tell me they seem to come in spurts). Whenever I have a good night it shocks me, and I hate to say anything outloud about how it was a good night because I really fear that when I return the next night, that night will be from hell. Superstitious I guess. Funny how I've never been real superstitious before but about this I REALLY am. I don't think the assignments are split up fairly but at the same time I'm not sure the other nurses realize that most of the time. Like the other night I had 7 patients, 5 were surgical and almost all 5 were having issues. I had to call the on call surgical doc about 3 of them. And the surgical docs are NOT NICE . But before I have noticed that I've been assigned patients just for someone elses convenience. One night I had the low even numbers and another woman who works 5 8's a week that always stays at the high evens, decided to give me room 20 (the hospice room with a dying patient, wow thanks), because he was on isolation and she had some surgical patients and we're not supposed to mix them. Guess what, I have surgical mixed with isolations every other night probably, it's unavoidable. The night she handed me off this hospice patient on iso, I also had surgical patients, more than one! That night was HORRIBLE, and wouldn't you know that the hospice patient died around 3am so I had to deal with that as well. She was my preceptor and I never thought she would do something like that to me, but I guess you never know. I just don't know what to do. Our nurse manager even knows it's been bad seeing as the other day she handed out cards for money for the cafeteria saying "thanks for putting up with the high census" on them. Oh and another thing, our floor seems to stock the entire hospital. They overschedule us on nights so 1 or 2 of us can be pulled to another floor; I am just waiting for my day. I do feel at times that my license is at risk because I feel like I can't provide the care that I should be providing to my patients. Sometimes I don't even get in to see someone until 2am, or I'll go most of the night basically ignoring some patients because I have others with such high demands. I just leave those mornings thankful that everyone is alive. This is such a big weight to hold on your shoulders, having a license and a life that's in jeopardy to be taken away or be sued or whatever. *sigh*. I don't know... I really don't know what I expected nursing to be, but this isn't it.

I'm writing this at 10:15 and I have to be at work at 11, and I am dreading it. The past few weeks I have had more than double the amount of BAD nights than I have had good nights. It's horrible. I am on the verge of tears many nights and I leave never wanting to come back. I hate my job most of the time. I get the horrible patients all the time. My co-workers are wonderful, they help me a LOT, but it still is enough to send me off the edge. I just graduated in May and started in July and I am already wanting to quit, go back to school for a bachelors or masters so I can get AWAY from bedside nursing, far away. I really wonder if this stress is worth it...

I'm writing this at 10:15 and I have to be at work at 11, and I am dreading it. The past few weeks I have had more than double the amount of BAD nights than I have had good nights. It's horrible. I am on the verge of tears many nights and I leave never wanting to come back. I hate my job most of the time. I get the horrible patients all the time. My co-workers are wonderful, they help me a LOT, but it still is enough to send me off the edge. I just graduated in May and started in July and I am already wanting to quit, go back to school for a bachelors or masters so I can get AWAY from bedside nursing, far away. I really wonder if this stress is worth it...

I just got done my 8 week orientation and passed boards that I took on July 9th. I really wish I could volunteer my time to go down there but I don't know if I would have my job when I came back... this company that owns the hospital is just all about money.

Oh I just had one of those last night . She came in on the 14th of August for rule out meningitis, which was ruled out but for some reason she stayed until the 23rd anyway. She was back in the ER at 2345 on the 23rd c/o "intractable nausea and vomiting". Intractable, yet when I read the ER report the pt states that the symptoms were sudden and began just before she came to the ER. Who says "Oh my gosh I'm throwing up, I have to go to the ER!!" as soon as they start? :icon_roll

I live in the suburbs of Philadelphia and my base rate is $24, $1.50 for evenings and $2.00 for nights. Not sure about weekends. Time and a half for holidays. That's pretty much average around here though I did interview at a hospital that I would have started out at $30/hr if they hired me.