Annebug

Similar situation happened on my floor the other day. Pt with family who left room 10 min earlier, very pleasant man, telemetry monitoring, A and Ox3 all day without complaints. Walking past our monitors I saw a sudden flash: Vtach/Vfib. He was a full code and we tried our best for 45 minutes, but he died. His EF was 10%. The one that haunted me was a man with some kind of CA with newly dx brain mets. He was so anxious and in so much pain all night. He died the next morning a few minutes after I left. I saw his wife on the way to my car, and we talked about what a bad night he'd had. Little did I know he would die minutes later. Hard--really hard--to deal with the emotions after my first few patient deaths. I'm not cold now, but I think I'm learning some acceptance about death. I try really hard to make folks comfortable--and their families. Of course we can save the day here and there, but most often it seems to be a matter of comfort.

there is an ongoing situation where i work. a nurse on that shift is verbally abusive to patients, cursing in front of them, talking to them like they are animals, and neglecting them. i could spend all day documenting examples of this ongoing behavior. maybe three weeks ago i reported what i have been witnessing for 6 months. until then, i guess i thought maybe a charge nurse would do something about what was going on. i didn't want to cause trouble. i knew that the charge nurse was seeing the same things i did. nothing changed. finally, i reported the situation directly to a manager. one tidbit of the whole story had to do with internet use. all night long, looking at really weird, sometimes inappropriate sites--basically, if one looked at the pattern of internet use, it would clearly show that patient care wasn't taking place. the only thing that i'm aware of that came out of my complaint was an order that the night shift was no longer allowed to use the internet. not for any purpose. but, the problem is not internet use, it's a matter of work ethic and morals. replace using the internet with reading magazines and gossiping--the problem is still there. the dehumanizing treatment and borderline neglect of patients is the big issue. the demented and confused patients are the victims. i knew somehow that complaining would come back to haunt me. i realized quickly that i would have to leave the department, and i've arranged that. what's bothering me is that this situation is going to continue and that possibly it may never be addressed. patients on that floor on certain nights will be treated and talked to like animals. my grandmother died on that floor. i made the decision to change careers on that floor. i never even considered beginning my nursing career anywhere else, and i am sad that i have to leave. i see my grandmother in every patient there, and i can't leave knowing that people are going to continue to be treated in such a way. what would you do?

The LPN who was so rude the other night (reminder--in front of a patient) told my preceptor: "I'm sorry, I know I offended her." Okay, that really doesn't cut it. That still places blame on me for being offended. The issue was hers. She was at fault. She was caring for a patient (to be general in using the word care) in the same room with my patient. She told me first that the nurse who reported off to me hadn't changed this man's dressing all day--not true! Then she told me that I needed to medicate him with morphine prior to dressing changes--also not true, and not indicated on the MD order. Then later she said that she had emptied his JP. I have no idea why she would do this since it wasn't her patient. So my preceptor and I are all set for a sterile dressing change--I'm in gloves and with sterile field, etc. She comes in and asks what we're doing, etc. Says that we're going to dislodge the drain, asks about the orders, etc. I say "you are welcome to look at the orders in my notebook, just watch out for the sterile field nearby." Mind you--I am gloved and everything at this point. She says "this isn't sterile anyway, since you're next to the air conditioner." The patient is not looking happy at this point. So I just ripped off my gloves and threw everything in the trash--I started over after she left. So now, she's sorry that I was offended? Am I too sensitive, or was this totally out-of-line on her part?

I still work a bit in my pre-nursing career. Granted, I don't do it often, but I still do human resources projects on a consultant basis. I think variety is wonderful! (And choices : )

I just graduated, and started in oncology--thinking my next job may be a nearby burn/trauma ICU. It's funny how different we all are.

Last night I read a nursing progress progress note with the following first sentence: "patient done well today." Geez...

You are right. There will be rude people wherever I go. I do realize that. I have always been able to deal with workplace issues. I worked in HR for 12 years before becoming a nurse. I CAN DO THIS! I'm just so sleep deprived--I think that's a big part of the problem. Also, our nurse manager doesn't address issues directly with people, which is a big pet-peeve of mine. Example: someone fails to answer a call bell quickly and a patient or staff member complains. Her solution is to send a berating message to the entire staff saying that we are not exhibiting teamwork. Staff members who are continuously complained about NEVER change their behavior. The assumption is that the NM isn't addressing the issues, and there are several blaring issues on my unit. I'm going to be okay!

I work at a community hospital that takes pride in "the caring tradition." What I've experienced so far has been NOT CARING! Some (not all--not even a majority) of the experienced nurses are so freaking rude--to me, to patients, etc. Last night was particularly bad. One nurse was so rude to me, and in front of my patient, who she obviously felt I was not qualified to care for. All that "caring tradition" talk is apparently just lip service. Getting into details would just make me re-live the horror. Question is: how bad would it look to another employer if I just bolt my first nursing job after 2 months? Did any of you get the cold/rude/crappy shoulder from experienced nurses in your first nursing job? If so, did you stick with it, or leave for friendlier places. I know that there are friendly nurses out there. I know there are places where ongoing behavior issues with experienced staff v. new nurses are addressed and not ignored, as they seem to be on my unit. Please send advice if you have some!

Regular cotton panties for me. Bikini style from Victoria's Secret. I've never worried about having a panty line. Now I'll look. I really don't care, though : )

You are not alone. When I read your post, I could swear that you were talking about a nurse I worked with when I was a CNA. I still chuckle thinking about him. He would walk the unit 3 times looking for me to ask me to get his patient something. He wouldn't get ice water for a patient on fire! I'm serious. He spent so much time just looking for me, he could have done most of what he asked me to do 2 or 3 times by the the time he caught up with me. The charge nurse on the unit noticed what was going on. He told me to politely tell this nurse that I was busy at the moment, but would help him as soon as I could. I was still a bit frustrated, but for the most part, it worked. You are not a slave to the nurses! You are there to provide patient care, and you must prioritize. Do the best you can, giving priority to the patients who need care the most. Be as nice as you can to this troublesome nurse, and help her when you are able. By doing this, you rise above the behavior of this nurse. Best wishes!

I decided to become a nurse because of my grandmother, who was the light of my life. She died of lung cancer (treatment) just a few months after my daughter was born. I was pretty much camping out with her in the hospital for the 7 days she spent there before she died, with my newborn in tow. I told her so many times during those days that she could make it. I wasn't a nurse then, but I coached her through the anxiety, etc, etc, -- always adamant that she would make it. She finally said to me on day 6 that "it's just my time." I fought that until day 7. When she was struggling for breath on day 7, I said/asked "they can give you medicine to make you comfortable, but you will be out of it--you may not wake up--do you want the medicine?" Only a slight nod (yes) from my grandmother, and I gave the go-ahead to give morphine/ativan/whatever they could to ease her suffering. They gave the medicine but my grandmother held on. She was barely breathing, but she held on for hours and hours. I asked other family members to leave the room and I told her: "I understand that it is your time. I will miss you so much, but I know that you have to go. I'll be alright, grandma. I'll miss you, but I'll be alright. I love you. Go peacefully. I'll always remember and love you." She died within minutes. It was totally peaceful. I would say it was a good death, if such a thing is possible. Here's the really spooky portion of this story: my daughter, 3 months old, was on the bed when she died. My daughter started screaming when my grandmother died. She was inconsolable. I'm talking about at least 20 minutes of weird crying, like the world was coming to an end. I thought: did my grandmother's spirit pass through my infant? Why did my normally happy, quiet infant start screaming at exactly that moment? After that night, and for several nights, I wondered if my grandmother's spirit was inhabiting my infant. I felt my grandma's presence for days. I felt her presence at my bedside while I was sleeping--my daughter also sleeping in her bassinet at my bedside. It was odd. The feeling faded over a few days. My daughter, now 4 years old, asks me about my grandmother often. If I miss her, if I'm sad that she's gone. She is so much like her. Odd.

These are great!! We should STICKY this thread and keep it going!!

I thought the bowel work was going too far. I'm still in orientation, and my preceptor though it was alright. I guess we should have asked for a more broad order to cover all that we had to do. Oh my god, the patient felt like a new woman when it was over. All good results!

I've been working in oncology/med surg for just over 2 months. I just graduated in May. I've had the most incredible transition. Started nursing school after/really because of my grandmother who died of lung cancer. She was closer than my mom or anyone in my life. I knew that I had to work on the unit where she was a patient, and I secured a job there. I feel like I could already write a book on my experiences on that unit. I really don't know how to describe what it's like. Helping people who need help desperately, assisting people at the end of their lives to appreciate and feel good about what they've accomplished, easing pain for patients who feel so much pain, listening, holding hands, etc, etc, I could go on for days. There are many frustrating aspects too--as in any area of nursing, I'm sure. Yes, it is hard. I've seen young people with children die, as well as old folks with grieving families, or even worse, with no family at all. I try and put the emotions away until I leave, then I cry, then I take care of my own family. Sometimes easier said than done, but overall, it works. I'm happy with my choice for now, but will likely move to critical care within a year or so. Best wishes!

How about giving a fleet's enema that the doc ordered (after he was called asking for this order) -- having no success and deciding to go ahead with a soapsuds enema without an order? Oh and manual disimpaction after the soapsuds... Then a mineral oil fleet's for good luck... Is that practicing medicine??? I'm seriously asking.....

Last night a patient told me that she has "sleep anapia." So cute because apnea IS kind of anapia when you think about it : ) This is a great discussion--lots of chuckles.

Should baseline ABGs be measured when patients are admitted with chronic lung disease? I guess it wouldn't really reflect their normal baseline if they're being admitted in respiratory distress anyway. I ask because I've cared for several folks w/COPD who are being maintained on 5 or more LPM of O2 with sats at 99-100%, and I've heard how dangerous this can be. Docs in my hosp. tend to write orders like "O2 PRN to maintain sats greater than 90%." Many nurses crank it up to get "normal" sats. What do you think?

Hi Junebug, I just graduated from the PVCC program in May. I passed the NCLEX and am now working Med/Surg and Oncology at MJH. There were some great things about PVCC's program. Clinicals at UVa were wonderful. Many new nurses I've met from other areas didn't get to experience the kind of patient care we did at UVa. I've heard folks describe clinicals as boring, and my clinicals were definitely not boring. The program was really challenging. I feel it prepared me well for the NCLEX and for my current job. There were not-so-nice aspects of the program as well. The workload was incredible. The organization not always so great. The tone from the instructors to students not always so great. The dreaded "U" day policy was horrific and terrifying. I'm still amazed that I got through it all. But it was worth it! Feel free to reply with specific questions if you have any. Good luck! Anne

Now that I'm done with school and working, it's hard for me to say that I would have waited. In the thick of it--and oh yes, it is so much work--I cried, sulked, etc, and felt horrible that I had chosen such a bad time to become a nurse. There were also times when it felt quite manageable. I did't have support other than from my husband and my daughter's preschool. That said, the experience will be different or each person. Best of luck to you with your decision and experience!

We do have a palliative care team, but I don't know if they were consulted. Again, I wasn't the primary nurse for this patient, so I don't have all the details. All I know is that it was a horrific scene. I'm not sure what meds (other than morphine) she was being given. But I'm still confused about the difference between palliative care and comfort care. Can anyone explain this to me?

Remember that you'll be in orientation at first, and will not be eligible to pick up extra shifts. One you "count" as a staff person (when you're finished orientation) I think the sky's the limit, depending on policies at your facility. Good luck!

I would buy "chemistry for dummies" if such a thing exists, or borrow a basic textbook and just familiarize yourself with the basics. It will probably help you in A&P, definitely in micro--I didn't have any straight-up chemistry questions on the NCLEX, but of course you have to understand so much, like big picture stuff. They will not ask anything as straight-forward as a basic chemistry question : ) Good luck!

Same here. I look forward to putting on my Danskos. I rarely have any foot pain when I wear them. I'm wearing my new balance running shoes now and wishing I was wearing the Danskos. The clog style that so many folks wear didn't work for me, so I bought a mary jane style. They're expensive, but they are so totally worth it. I'd pay double if I had to. Make sure you are fitted properly for them--you should be able to place a finger behind your heel when wearing them.

I still have moments but I'm feeling so much better now. Thanks so much to everyone who responded. I knew this would be hard, and I signed up for it anyway. Also, I am going to stop smoking. I can't be an oncology nurse and smoke. Morphine, ativan, scopalomine--these will be used generously (as allowed) by this nurse in these types of situations. I get that we are not ending life by using them. Some of your stories were really incredible--I hope that you all feel some peace in telling them. Getting on this board and writing it all out was so so helpful for me. THANK YOU!

Exactly the same experience here. I had 75 questions, so many priority questions it was scary, and about 5 select all that apply questions. Felt like there were only a handful of questions I know I got right. I was so sure I had failed that I cried 2 1/2 hours on my drive home. BUT I DID PASS!! Remember that they ask you questions they feel you have a 50% chance of getting right. If you get half right at the right difficulty level, you pass. Don't freak out! I've been there, and just a few weeks ago.