Tiiki

That RN to patient ratio is frightening. Do you have the ability to put in a "work-load grievance?" We do that soon as we feel that the RN to patient ratio on our med floor (acute medecine, with ventillators) is unsafe. If we have one unstable patient that requires one on one nursing we immediately call for another RN. We also do not have RPN's on nights with us because on nights we get 8 patients and everyone must be vent trained. Anyhow, we call the co-ordinator, and even the nurse manager to say that the floor is unsafe, and if another nurse is not provided a work load grievance is going to be submitted. This looks bad for the nurse manager. It says that she left her floor unsafe. It's our protection, should something horrid happen, at least they know that we attempted to right the situation. I would never put myself in a situation where my licence was at risk, or my patients more importantly. Something needs to be done where you are!! GOOD LUCK JO-ANNE

rude..hmmmmmmm i was a floor nurse, now i am in er. so i can finally speak from both sides. you will surely (spel) hear that floor nurses are rude, but you'll also hear that er nurses are equally rude. i have come to the conclusion that the big issue is commucation on all sides. yes, the floors get crazy hectic, yes the er get nutso too. if there is a code happening on the floor where we're about to transfer a pt, well, that transfer is gonna go on hold. but...on the other hand, if they are sitting on their butts not gettng a room cleaned cause it's close to change of shift & they don't want to start an admission...well!!! too flipping bad! we have a co-ordinator who gets on the tl's backs to get the rooms cleaned. floor nurses get especially pissed if they don't get a proper report. i don't mean little things, i am talking things like...forgetting to mention a chest tube to intermittent suction. you like to be able to prepare the room. am i rambling?? probably!! lol. i think the rudness goes in both directions. a harried er nurse can be pariticulariy snippy, as well as a stressed floor nurse. depends on who you are dealing with and the circumstances. [/coljor] jo-anne

I work in the ER. My last name is whited out. Everyone covers their last name one way or another. It's a safety issue. I cannot imagine forcing people to have full names on. Years ago I worked in Legal Aide as a councellor. I used my maiden name so I wouldn't be stalked. What would happen if you just went ahead and covered your name? Aren't most doing it at this time? And..are you unionized? If so, can they help? Lastly, and I know I am rambling, how supportive is your manager with regard to this. :) JO-ANNE

I work in the ER, and I've also worked the floor. It has always been the Dr's responsibility to deal with code status. They are the ones who appoach the family and patient. We can update the family on the pt's condition, but it is beyond our relm to bring forward DNR orders. We also call the family if the condition of the pt changes, but if the pt dies, again it's the MD who deals with it. Jo-Anne

Hi, I finished my ER orientation a bit back. Regardless of your past history (skills, education) we all orientated together. The first day was a brutal exam, covering all sorts of things like hemodynamics, MI, CVA, etc. From their the nurse educators knew your strong and week points. From there we had 4-6 weeks of classes. If you weren't in class, you were doing a buddy shift. After all the classes have finished you start 6 weeks of buddy shifts, with the flexibility of extending it, depending on your success, your feelings of comfort. I felt pretty secure after going thru this. I cannot imagine a 2 day orientation. Far too much to know, to learn. That seems awfully dangerous!! JO-ANNE

I have found that if a patient is concerned about addiction, they will queery their meds. I think the most impotant thing with pts is eduation, what they are getting, why they are getting it, how often they can get it, and all possible side effects. I find that once they are knowledgable they can make an informed decision, and if that decision is to refuse the med, then I respect it. As for myself, I'm no hero. I'm a migraine sufferer. The first sign of headach I hit the analgesics in hope of abatting it. :) JO-ANNE

Geeze Pebbles I am completely impressed with your knowledge! Didn't leave much for me to say. :) Tiffany, I too work in Ontario, I schooled here as well. My last year of schooing (which wasn't that long ago) I was approached by so many U.S hospitals it would make your head spin. I asked why they were so gung-ho on Cdn nurses...now I am not here to insult anyone, nor their education, the the message I received was that Cdn nurses were better trained. I have never worked in the U.S so I cannot verify this, nor can I say it wasn't a ploy to get us down south. U.S nurses write the exam for the province for which they want to be employed. Just like the NCLEX in some states. I wish you luck with your decision. It's not an easy one, when a family will be seaparted. I am sure you'r husband will support you, but miss you as well. JO-ANNE

"Not documented, not done," is our mantra. We use integrated progress notes, which mean that all the documentation on a patient is in one place, so you may chart after the RT, or after the MD, etc. That cuts down on looking for individual notes. It also makes the MD more responsible in that he/she can no longer say.."was such and such done." Our charting is supposed to be by exception, but during nights, it's an hourly thing, even if you write, "pt sleeping soundly, IV insitu & running well, no signs of distress." It shows you did your rounds, you are aware of goings on. I had on MD actually correct my charting. It was a horrendous day, and I charted on one pt the following.."pt in pain, breakthru given." I figured since there was only one narcotic break thru PRN med I was clear. NOPE! The MD wrote in RED!!! "WHAT MED? WHAT DOSE?" That taught me to be very specific about everything, from am to hs care. I have found it also covers your ass if a family member or patient for that matter starts complaining of the quality of care given. Cheers! Jo-Anne :)

we usually have a table or counter. I have a pencil case for odds and ends, I collect funky pens. In my pocket, I use an empty 50cc I.V bag for my pens, the ones with 4 colours in em, a pencil, sissors..and what ever else I pick up. Rolls of tape go around my stethescope. My pockets still get pen marks, ripped, etc....ohhh well..all part of the job! Cheers! :) Jo-Anne

Our hospital policy (& that of I.D) is that droplet procautions always for any MRSA pt. Gown, gloves, mask. I know there has been some controversy in the past, but our I.D. dept stands tough on the masking/gloves/gown and we have never had a major outbreak. (touch wood) ) My advice? Be save, err on the side of caution. Mask! ciao JO

could someone please explain what a CRNA is??? thanks :) JO

Some sounded oh so familiar, all made me chuckle! Some of the gags we played were filling 10cc syringes with water and having water fights, we had a homophobic male nurse with us. He was excellent, never showed predjudice. One night he was coming in for his shift...we told him of a new admission he was getting. He was a male, 37yrs old, cross-dresser in fishnet stocking and stilletto's, frilly dress, who's given name was Bruce, but would only respond to the name "Phyllis." The look on Josh's face was priceless. He did everything he could to pass off this "Phyllis." The icing was when "Phyllis" requested and suppository. Josh had no choice but to go check out his new admission. The look of relief on his face when the bed was empty was priceless. Another gag we pulled was on a nurse who had just purchased a new vehicle. We called one of the girls (she was new) called him up and said "do you have a green jeep with licence plate..blah blah blah" Josh (yes same guy) goes yes...she replied.."well I just hit your car in the parking garage. I don't have insurance, I want to pay cash..and they are trying to extridite my car from underneath yours." Josh was white...he stood up..screamed.."omg its one day old!! " well we couldn't contain our laughter. An end-note, we had a newbie nurse on night shift. He liked to think of himself as superior, so the designated T.L told Brian to take over for a while. Then we took a morgue gurney, put a nurse from another ward on it. We told brian there was a dead body in the hall, and as T.L he would have to deal with it. He was shaking. He kept asking one of us to do it. No one would, we told him.."you wanted the responsibility, you got it." He asked who the body belonged to. We told him we didn't know, that he'd have to uncover the body and find out. He tentitively walked up to the gurney..he stood beside it ..until Heather sat up! Brian let out a shreak and fell to the floor! It took him a long time to forgive us for that one! I've really enjoyed your stories. The things we do to relieve stress! :) ciao JO

How awful, sad. I am speachless. You go to work to save lives..and one brief moment..yours is gone. I have never been frightened of going to work. Hope I never am. My prayers are with those nurses and their families. Blessing. JO

My grandmother was a nurse who loved her job and was so proud of the R.N. that went with her name. We used to laugh when she told us that in her obit she wanted "R.N." to be listed with her name. Out of 7 grandchildren she hoped that one of us would catch the "nursing bug." But at the time none did. I felt so pressured to enter nursing I rebelled. I went for a criminology/law degree. I don't feel i was mature enough or competent enough at the time to complete the nursing program. My grandmother died 12yrs ago. It was such a blow, she died at work, doing the job she has loved. She became a nurse at 17, lying about her age. She is so amazing I could write a book. Anyway, shortly after her death, on a whim I applied to nursing school. I was accepted, met with the most amazing professors and received my degree. I often pine for my grandmother, there is so much to say, so much to ask...but I often say to relatives who comment.."your grandmother would be so proud of you." that I finally know why my Nana was so proud of her profession. She is with me, every time I am in a crisis situation...every time I seek guidance..I see her, I feel her. She is still nursing! Ciao! JO