jrsmrs

Come to my hospital lol! No such thing as low census.... We're in constant gridlock :/

I do part time 8s, but I imagine it would completely depend on your place of work. I don't do strictly 3 8s a week, though. My schedule is more sporadic, so I might work 4 or 5 shifts one week, and then have a week or so off. I normally do 11 days a month. I much prefer it to 12s or full time.

Yep, same here. Also in Ontario, and each nurse here (whether RN or RPN) has their own load of pts, no help. If you're one of the 4-5 (days) or 6-8 (evenings/nights) pts assigned to me on my shift, I do it all. Vitals, glucs, physical assessments, meds, baths, toileting, attends changes, linen changes, feeding, communicating with docs or others, arranging for services, discharge planning/discharges, admissions, managing crises, etc, etc, it's all on one person. It's a lot, but we get it done. In fact, I kinda wonder if I might actually like this job if I worked somewhere that I didn't always feel pulled in 100 different directions.

I'm just under the 1 year mark since I started working. I've not had a chance to do compressions myself, but have been otherwise involved in 2 code situations at work, one of them being my patient who I had just rushed up to ICU cause he was going downhill fast from the moment I got him. STEMI, diabetic, renal, severe PVD, R AKA and gangrenous L foot; hadn't been keeping up his sugars all day apparently, and SBP in the 80s for the most part, according to the report I got at 19:30. By 20:10 I had called our rapid response team on this guy. ICU was full so we had to wait til 22:55 to transfer him after they cleared out a bed (to me, incidentally) with this guy circling the drain the whole time. Portable tele battery died in the elevator on the run up to ICU, tho he was still speaking to us on the way. Ran the whole way and when we plugged him back in, boom! VFib. Unsuccessful code that time. I have, however, looked after 2 pts who were successful codes in the past few months. Both made it out of ICU and seemed to be back at baseline for the most part, aside from the broken ribs.

I'm in Ontario, Canada. As students we were not allowed to do any IVP meds. We had to minibag everything or have the RN do it.

Wow, it sounds like things very different where I work! We are not a teeny hospital by any means, and actually a smallish regional center, with lots of pts coming from outlying areas.My floor is not so bad, as we do get more break time than our CBA allows (assuming you can get to them, which the majority of nurses do the majority of the time), however that is not at all true on other floors. I worked a surgical floor for awhile, and the majority there come early, but still only get their union-allotted breaks. If anyone should be complaining, it's them. As it works out for me personally, unless I have an especially heavy pt load, I certainly don't put in more hours on the floor than I'm getting paid for. This is only because the manager allows these longer break times... And because we don't have a clock-in/out system. Unless you call in sick, or put in for OT for missed breaks or staying late, you simply get paid for the shift you're scheduled for.

Also, since there is no overlap of shifts, at 0730 (or whenever my shift starts), it is me and only me who is responsible for those pts. If I don't know anything about them, what if the doo-doo hits the fan? I wouldn't know anything about their dx, code status, hx, nothing. Last night for example, I picked up a pt at 1930 after someone called in sick, and literally as I was printing off his tele strip at 1930, his tele cut out. Went to check on him, he was hunched over the end of his bed, hard to rouse etc. Had I not already done my research on this guy and knew his story, I would have been working in the dark. I wouldn't want to walk into that with no background. As an aside, the guy went down the shiitter fast. Had to call rapid response, portable tele battery died on the run upstairs to icu. Plugged it in when we got there and he was in vfib. Literally, the guy had been talking to us just seconds before. Bad night

Do you all have overlap of shifts, or....? We don't have any overlap, so even if I only wanted to get report, I'd still have to go in a few mins early or else the previous shift would have to stay late to give me report.For those that don't do chart checks at start of shift, when do you do them?

Just to be clear, a good 90% of the nurses where I work come in early. The ones who don't are more or less skipping chart checks from what I can tell (although I'm usually too busy to really pay a lot of attention), but i think i can only name maybe 3 nurses that i know of that don't come in til right on time. And I never do patient care before shift, just prep work going over charts, etc. This really is the status quo here, so I'm surprised to hear otherwise. And no, we do not have any aids here. I work in Canada, on a cardiac unit, and I've got 5 pts all to myself during the day. Sometimes a pick-up as well so I end up with 6. We also do get our assignments way ahead. We don't do assignments based on acuity, they are based on room #. Schedules are done a good week in advance so we all know what section we are in ahead of time.

Reading another thread got me thinking about this...I always get to work at least a half hour before my shift starts. Do I want to or like to work for free? Hell no! But I really don't know how else I would ever get out on the floor in time to get everything done. If I start at 0730, I've got glucs to do before breakfast, probably at least a few 0800 meds to give, etc. never mind getting vitals on 5 pts, doing assessments on all, washes as needed, putting out any fires that spark, etc.How do you adequately prep for your shift if you get there at the beginning of shift and not early? Reading kardexes & shift summaries, checking meds on MARS vs charts, etc takes me minimum half an hour for 5 pts. Usually quite a bit longer if the pt has a thick chart that takes forever to get through (which is many of the pts). There is no way if I spent a half hour-45 mins prepping after start of shift that I would ever get all my stuff done on time and get out for breaks. I hate going in early, in practice and in principle, but just in order to meet expectations and also to avoid the stress of constantly being behind and trying to play catch-up, I do it. If there is some other way, I'd love to hear it. The only nurses I've noticed who don't come in early really don't seem to be double-checking their med orders vs MARS, which is a policy at our hospital q shift. That's the biggest time eater, really.

In my limited experience, it's all about perspective. You can choose to focus on all the things that are wrong with people- chronic illnesses, cancer, addictions, terminal illness, loneliness in LTC, etc- or you can choose to focus on how you're working to provide excellent care, thereby making their day or their life a bit better. Of course it's sad when bad things happen to good people, but if you focus on your job, and your contribution to their life, you realize that you can be a positive influence, even if it is in a small way. Giving someone comfort (physical or otherwise) in their last days, supporting people who are going through a difficult time, having a conversation and showing interest in a person who is separated from their loved ones- these are all ways that we help people in bad situations, and give them something positive to remember or feel or look forward to. Perspective, baby.

Can you feel your own? My submandibular nodes are always palpable, but just slightly. When I'm fighting some kind of infection, they're quite swollen and often tender.

I've heard of similar things happening to a few people in my program. If you know you're prone to this kind of thing, you need to take care of yourself and make sure you've had something to eat and drink before watching anything that might bother you.

MRSA really shouldn't be a concern for you as long as you're healthy and not immune-compromised. Lots of health care workers are carriers. MRSA precautions aren't really for you as the nurse, but so you aren't transferring it from the infected patient to another pt with compromised immunity.

Empty the bag into a graduated cylinder.