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AngBthatsme

AngBthatsme

telemetry, med-surg and hospice
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AngBthatsme specializes in telemetry, med-surg and hospice.

I am originally from Maine. Moved to Florida in 2004. I have one grown daughter. The best dog in the world Molly and Im living and loving life.

AngBthatsme's Latest Activity

  1. AngBthatsme

    Dad's trip to ED

    OK call me crazy but if you are a nurse and watching this go down, well certainly you can be proactive in getting this situation under control. I would have addressed the primary nurse and if that didn't work I would have asked for the charge nurse. Chain of command can be a useful way to go.
  2. AngBthatsme

    Er Nurses

    Ahhh the ER nurses vs. Floor nurses. Ya know the thing that gets me about the ER. Antecubital IV starts. You start them there, they come to the floor and if they need IV fluids, people sleep with their arms bent and the darn things beep all night and I usually have to resite them. Understandable that sometimes depending on the patients status when they arrive they may need quick access and the AC is usually the best place to go. That is not the case most times. Floor nurses have a hard time appreciating the incredibly hard job that the ER faces in trying to get patients to the floor and free up beds. ER nurses have a hard time appreciating the position of the floor nurses and that they are not sitting around waiting for ER report. It is important for us to all realize that we are a team and we should work together. I always take report when ER calls, unless Im in a room gowned up or in the middle of a task that I can't drop. Remember we have to pick our battles. Im lucky that I have run into very few ER nurses that demand that I take report right then and there when they call. It also doesnt bother me if another nurse takes report for me, either way I will have to look up that patients information and assess them. A positive attitude and an appreciation for what all nurses are faced with will help all of us.
  3. AngBthatsme

    Florida nursing salaries - seriously????

    Hi Just wanted add to this post. I have worked at LRMC for 3.5 years and I have been a nurse for almost 6 years. I make $27.41 base rate. My night differential is approximately $4.50. SO YES I do make over $30 an hour at LRMC. They no longer are offering the weekender position, so those that have it are grandfathered. The weekender position was that the differential was an additional 1/3 of your base rate of pay, plus the night differential if you worked nights. Sweet deal it was, but you gave up every weekend. We used to get raises twice a year. Our contract was renegotiated last fall and we get a raise once a year now and the percentage is tied into our performance evaluations. I do hear that the new graduates are being hired on at about $20.00 and hour. As far as nursing homes paying more than hospitals. I dont find that this is true. LPNs are making more money at nursing homes, but I dont know about RNs. :) Happy nursing all.
  4. AngBthatsme

    Florida nursing salaries - seriously????

    Sorry so late to post, but just saw this post. I work at LRMC, so here is what I have to add. I started working at LRMC about 3.5 years ago when I had just 2 years experience and I started at about $22 an hour. I work 7p to 7a so there is a night differential. OK here is the skinny on the differentials. Evenings from 7p to 11p is about $3.50 and 11p to 7a is about $5 and change. We get raises twice a year. They do have a weekender program that gives you a nice differential if you work weekends, but you work every weekend. It used to be base plus a third. For awhile I worked weekends so I had $22. plus my weekender diff of a third $7. plus my night diff of approx $4.50. So three years later my base rate has increased to $27 and change. I believe there are also diffs for working ER and units, but you'd have to check Im not sure. SOOOO can you make $30. and hour at LRMC, yes but you will probably be working every weekend and at night. Good luck to you. Angela
  5. AngBthatsme

    Can I get a situation review from experienced nurses?

    You did great! There is no way to predict and his O2sats were significant. People go when they are ready. Like the other posts said, think of the alternative.........if he had gone and you hadn't called you would have felt terrible. Always better to call and update the family and let them make the decision to come or not.
  6. AngBthatsme

    Nursing Rounds

    We do walking rounds on the cardiac floor that I work on. I like it. Of course when we started it there was resistance to the change, there always will be when change happens. Doing walking rounds is good for a number of reasons. If my patient has gone down for a cardiac cath, we are going to look at the groin site, so I will know later if there has been a change. Im looking at the IV and checking the date while Im in there. Im immediately finding out if that patient is in any distress. Of course there needs to be good communication and you need to remember hippa. Basically we do alot of the report before we walk into the room and then we walk in, introductions are done and if the patient or family members start to ask alot of questions, we simply and politely tell them that after report the oncoming nurse will come back and address their questions. I find that it makes the outgoing nurse more accountable. If you know that the nurse is going to be looking at the date of the IV and its outdated or if the person is in pain and you "got busy" or any other number of things I just feel it makes the outgoing staff more accountable. Patients seem to like it to. Give it a chance...its not so bad :)
  7. AngBthatsme

    I thought I'd heard them all.......

    I agree ignorant and sexist in the workplace. Women have been feeling it for years. At least you are paid at least comparitively or more. :)
  8. AngBthatsme

    Anyone ever try working 60 hours a week?

    I alternate 52 hours (four 12 hour shifts) and 62 hours (five 12 hour shifts), every other week. Thats three overtime shifts per pay period. It's not bad at all. Im tired and look forward to my days off, but I find that working just three days a week, I have four days a week off and I spend to much money......haha!!
  9. AngBthatsme

    I am being too anal?

    Dont give. What a lame excuse for the doctor to give you. I just want them to be quiet. Whatever!!!!!!!!
  10. AngBthatsme

    Really hate this nurse

    There definately needs to be some communication here. Keep a journal of examples and go talk to the charge nurse. Ask for a meeting to discuss these issues. Try to explain that you are trying to do the best for all 18 of your patients and are open to suggestions on how this can best be done. Obviously prioritizing and organizing are crucial. I find it best to try to approach the person that you are having the issue with first and if that is not successful then ask for a meeting with the charge nurse. Even then if you feel it continues to be unresolved speak to your manager. Good luck.
  11. AngBthatsme

    transferring pts. from ED to floor

    i have worked at many hospitals as a traveler in the er, and i have to say, this seems to be a universal problem. the following are my pet peeves about transferring pt's from the er to the floor/icu: 1. it is very irritating to be told a nurse from the floor or icu can't take report because the bed is dirty, he/she's on break, in the bathroom, busy, etc.... there are other nurses on the floor, someone must be able to spare 2 minutes to take report. i dont think the bed being dirty is a good excuse and neither is that the nurse is on break, someone is covering her/him. it is reasonable that we may not be able to stop what we are doing to come and take report for many reason. i'm starting an iv, im doing a dressing change, im with an unstable patient, the list goes on and there are many valid reasons. however i think the person that is supposed to be getting report should call back within 10-15 minutes and if that is not an option for a valid reason then my charge nurse should take report. 2. being asked to wait 30 minutes to bring someone up because "we just got another admission." um, yeah, let me sit on this patient for another 30 minutes while my hallways & waiting room fill up so that you and your co-workers can check in one patient that has been nicely pre-packaged for you by the er (iv started, foley in, ng in, etc.....). i wish we could tell ems- "please drive around the block a few more times, we just got another ambulance in....." i dont understand this one either.......what would be the purpose in waiting. the patient will rest better on a bed in a room rather than in a stetcher in the ed. however the pre-packaged comment, out of line we have lots of paper work to do when the patient hits the floor so your iv stick (which by the way is always in the ac and beeps all night), labwork and foley is only a minute beginning to the admission process. 3. being asked things that do not pertain to the patient's condition. example: being asked about bowel sounds in someone being admitted with pneumonia, etc.... you know what? if my patient is in the er for respiratory issues, i don't listen to their bowels! does that mean i'm a bad nurse? no- it means i'm an effecient er nurse- we do focused assessments in the er, don't ask me about my patient's ingrown toenails when they are here for pancreatitis. flip side of that is the ed nurse who wants to tell me about the ingrown toenail on my chest pain patient, but when i ask what the second troponin was ......"oh ill try to get that before i send him up", thanks since the first one from 6 hours ago was elevated. 4. getting phone calls from the floor 2 hours later wondering why i didn't do this or that from the admission orders. they are admission orders- if it doesn't say "stat" or "now," it is to be done on the floor, not in the er. i agree. 5. nurses refusing to take report at shift change. you know how badly you want to give report to the next shift so you can go home? well guess what? so do i! i have no control over admissions waiting until 10 minutes before shift change to give me a bed, but now that i have it, just let me call report so i can go home. my report will only take 2-3 minutes, so it would be common courtesy to not make me stay 30-45 minutes late just to give it. so this one just burns me. i come on shift and i have to get report on five patients and ed is on the phone ten minutes into my report wanting to give report. i tell them, im getting report i will call you back in 15 minutes. oh ed nurse if you were standing beside me and i was talking to someone getting report, would you interrupt me and cut off the other nurse so that you could give your report to get out sooner than the other nurse you just interrupted????? if you did that would be very rude, just like it is rude to call up to the floor and insist that we take report so you can go home. give report to your oncoming staff and she can call it later. 6. floor/icu nurses who have a problem with the admission orders, and give me grief about them. know what??? i didn't write them! if you have a problem with the orders, call the doctor. most of the orders that i have seen have been taken by the nurse and written for the doctor, those can sometimes be cleared up by the nurse that took the verbal order, otherwise yes the nurse needs to call the doctor. 7. nurses refusing to take a patient because "they need to go to icu, ccu, telemetry, another hospital......". the physician specified what type of bed he/she wanted. if you have a problem with this, take it up with the doctor- it is not up to me what type of bed the patient goes to, it is decided by the doctor & by what's available in the hospital. just the other night i took report on a patient and told the nurse that i wasnt so sure that the patient needed to come to our floor. i took the reporting nurses name and extension. normally i work on a cardiac floor, but i had picked up a shift on the observation unit. they called me a 50 year old female that was transported via ems with a heart rate 180s, adenosine 6,12,12 was given by ems. in the ed she got 6 more of adenosine and then a cardizem bolus. the carotid massage brought her down to 110. first troponin was 0.046after receiving this report i was not so sure that the woman did not need to be on a cardiac floor. im a cardiac nurse i could have cared for her........but the placement was not appropriate. house super sent her to a cardiac floor. thanks for the chance to vent..... admitted a lot of patients last night, had to deal with a lot of the above........ glad you vented, i appreciate your perils in the ed. we know that you are busy down there. personally i try to be courteous to the ed nurses. my best friend up home is an ed nurse. she's funny she tries to appreciate the floor nurses too. whenever she can, because i crab about it:idea:, she tries to not start ivs in the ac haha. happy nursing everyone!!
  12. AngBthatsme

    Anxiety before work

    This thread made me think of this girl I went to nursing school with. She was so anxious that she would shake. At clinicals she was scared to go into the patients rooms. She cried a couple of times in post clinical conference about how she was so scared any wrong step on her part could put the patient in harms way. She had come from the medical field before nursing school, she was a CNA. Anyway third semester the nursing instructors had to let her go. It was a good decision the woman was a mess. Her patients and everyone around her knew she was scared. I agree with the previous post though. Normal for new nurses to have some anxiety, but it should subside with time as your confidence grows. Good luck.
  13. OK does anyone know any other reason than bp that we do not give beta blockers and ace inhibitors together. At our hospital the pharmacy times them two hours apart. An old cardiac nurse asked me "why the betas and aces two hours apart, why not the betas and calcium channel blockers"? OK I said because of BP and so did pharmacy. We all know that our patients take them all together and dont space them. Of course when we a patient is taking them for the first time we would want to watch the bp closely.....but does anyone else know of any reason? Thanks :)
  14. AngBthatsme

    What have I gotten myself into!!!!!!!!!!!!!!!!

    Dont quit. Change is stressful, learning new things is stressful....but it will get better as you go. It seems natural to want to go back to a place of comfort. If after your orientation is nearing an end, you still feel uncomfortable, talk to your manager and your preceptor. Im guessing if you are still feeling overwhelmed they will realize it too. It's alright if after you attempt it and it still doesnt feel right, to do something else. The beauty of our profession is that there are many avenues to explore and we definately have job security!! Good luck to you and hang in there until you have had enough time to make sure that you are making the right decision.
  15. AngBthatsme

    professional street clothes ??

    If they didnt give you a description, I would wear casual. To be on the safe side, no jeans and tshirt. Good luck in school.
  16. AngBthatsme

    Getting report from the ED

    We get phoned report from the ED. I swear sometimes I'm getting report from the tech. Half the time it is a nurse who did not take care of the patient. They pick up the chart start flipping through pages and reading. I only want the important information, Im not going to quiz you about where the IV is, I'll figure it out. I have 5 other patients to take care of so hanging out on the phone with the ED nurse is not where I want to be. One thing I do want as a night nurse though, is a list of home medications. It is our policy that the ED nurses fill out the medication reconciliation sheet. The doctors want the list when I call for orders or they need it the next morning when they round. Unfortunately many family members go home after the patient has received a bed and is going to the floor. Last week I had a nurse give me report and at the end of report I asked her to please make sure the medication reconciliation form was filled out, her response "there are orders on the chart and Im not filling it out". In a non confrontational way told her that it is important that she get that filled out before transport. Her response "Im a charge nurse and Im not filling it out". How quickly we forget why we punch in.......it is for the patients right?
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