Charity

You did the right thing. Just can't take it personally, as some people can never "be wrong." At my teaching hospital, we don't hesitate to follow the chain of command. In the past, it has had to be taken to the doctor's department head, and even to a hospital administrator!

"Why, of course, ma'am. If you would please take over performing chest compressions, I'll get right to your mother. Don't worry about that odd feeling as you compress. Those are just his broken ribs."

Your manager can't require a doctor's excuse just because. That should be in policy under what circumstances, or when. Usually it is after a set number of days calling in. Don't answer texts or calls. My manager and supervisor have their own ringtone on my phone ("suspense" on the iphone!). Many years ago, my sister would explain to her manager that she could not come in because she just had a nice alcoholic beverage! But there is no need to give any explanation. No is sufficient. Giving in just enables them. It is sad, but if they have enough troubles with staffing/workloads, then perhaps they will change something.

We have some folks who work that shift. To be honest, it is a very difficult one to work, because one has no private life with "regular" people, as you will be working every evening. But it is always a good way to get your feet in the door. One of our 3-11 people is first up to transfer to days when that position comes open in a month or two. As far as the difficulty of work, it will vary according to PACU. Will you be the only nurse there after a certain time? (NOT GOOD and not according to national standards!) What will the parking situation be? Can you get a spot in the morning without arriving an hour early and how safe is it returning to your car at 11pm? Assuming you drive to work that is. Otherwise, make the move! PACU is great.

Until this month, we (PACU nurses) thought we could not give Ketamine as it is classed as an anesthetic. The hospital just okayed Ketamine in PCA pumps, to be ordered by our Pain Service only. So I suppose we can, in low doses. I suppose it is similar to our epidural policies. We can't give the test dose, but can initiate the infusion later.

The best resource that I used was Perianesthesia Nursing: A Critical Care Approach, by Cecil B. Drain and Jan Odom-Forren. (I used an earlier edition by Drain alone, but its the same book)

Short answer: We PACU nurses take care of the entire patient, not just what got operated on!

It depends on your state's Nurse Practice Act. Nurses in my state can start art lines if trained by their hospital. (all policy/procedure written, naturally) I don't know of any that do, however. We have hospitals here (not mine, thank God!) that don't allow RNs to do any arterial sticks, even for gases. Our docs would love for us to, I know. But the little residents have to learn something while they are here!

As a junior in nursing school, I had clinicals on a pediatric surgery floor. I loved it. The last day of clinicals, I knocked on the nurse manager's door and asked for a job. I was working there as an SNA less than a month later. I did my externship in the peds house, and started as a graduate nurse on my floor two days after graduation. My second job was similar. I called a nurse recruiter at another hospital, got some appointments with nurse managers, and was offered the job on the spot at my first interview.

Does anybody know how we are differentiating between H1N1 and the "regular" flu? If they have stopping doing confirmatory tests, do they do a prelim that can tell what kind? I seem to remember a friend whose daughter had it. They told her they could not give her an official diagnosis with the test they did, but that it was the same class (or something) as the H1N1, which differs from the current "regular" one going around. Do the symptoms differ?

Thanks everyone for their replies.

As an acute care nurse, I read "residents" as physicians! You know- intern-resident-fellow-staff. Was I confused!

What type of scrubs/uniforms do you wear in PACU? Hospital issued or personal? Are you physically attached to your OR, or separate. What type of PACU is it? We are looking at our dress codes, but can find little in the literature.

With all the nursing schools in the area, I would contact a nurse recruiter at Forrest General as soon as possible.

Well, since we have well over a dozen OR nurses of the male persuasion, it never occurred to me that a guy would have any problem. This is not counting our techs and perfusionists. As far as I know, I doubt a chaperone would be needed as the OR suite is such a public place, with the other team members present. BTW, it isn't only males who need to consider a chaperone these days, for certain procedures. Want to be an OR nurse? Great! Get to it!

I had to check to make sure that I hadn't written this post! Except for the years of experience (have a few more on ya there), you could be describing me. I taught for a few years, and enjoyed it. Yet I missed bedside nursing. It has taken years for my family, even the nurses in the family, to stop asking if I ever plan to go back to teaching. They just don't seem to get that I love bedside nursing. I still love to teach as well, and get the opportunity to with students doing externships or management clinicals or with orientees. Nursing provides so many opportunities. I always say, "If you don't like what you are doing, do something else." That is what you have done. Why apologize for this?

We staff 2 RNs past 1900 every night and on weekends. If we need a 3rd (and it happens, one stays late or is pulled from another unit). Our other PACUs keep 1 nurse at night, with the OR nurse as the second nurse. Only our Day Surgery OR closes at 1900. As I type this, I am at work. It is 0300. We just sent our last case up. Of course, the ER is very busy, so who knows what will happen in the next hour... C

our facility uses two forms. er and outpatient services both use a form that a nurse or someone similar will complete. if the patient is later admitted, a separate inpatient form must be complete by the physician. if it is a direct admit, admit day of surgery or such, just the inpatient form is completed by the physician. c

It does vary from place to place. At my hospital "Code White" is for a combative person, whereas "Code Gray" goes to our neuro team for someone having a stroke.

If this is "nurse mode" then keep me in it 24/7. I call it being a decent human being.

I often got my ideas from nursing journals or "current topics." We discussed family presence at codes. New advances in pain management they would be seeing. My clinicals were at a Catholic hospital whose written policy prohibited not only abortions but elective sterilization procedures. I had my students find the policy and discuss. We talked about end of life care. Joint commission. OSHA. My group rotated through 5 to 6 different units with me, so we were able to compare how different units functioned at one conference. I tried to use the conferences to get to some things they could use, but may not find written into the curriculum. And always low-key and informal.

Actually a 3L bag of irrigant weighs 6.6 pounds.

I just watched his show tonight. I have not read anything he wrote. On his show, he praised the nurses. "With the exception of one," I think the phrase was. One could tell that he was embarrassed about the youtube video (which I did see). He indirectly blamed the drugs.

Reading that made me ill. I wonder how "descriptive" her charting was to validate her lack of medication. Your doc should have ordered the pain meds q1hr, or an infusion. No PRN. One of my docs calls PRN doses "per RN." He says too often patients are at the mercy of nurses who don't "like" pain meds or don't think they need them. BTW, I love teaching hospitals. When one encounters an ill-informed doc, one simply goes over his/her head! (after an appropriate Q and A session with them. After all, they are here to learn from us too).

I wander in all the time, and I think I may have posted as well. Do I need to be chaperoned?