kimmicoobug

Usually when our ac's let us know about an admit, we usually have report called from the ER within the hour. However, I have come across the day shift charge on my unit refusing admits for this, that, or whatever reason. So, night shift gets stuck with the admit at shift change. Or, we have the day shift ERnurse who wants to give report at 1915 while I am in the process of getting report on my five or six other patients. You would not believe how many times I have gotten chewed by some of the ER nurses...(or maybe you would). I love it when I hear, "This patient has been sitting here in the ER for seven hours...they need a bed...and I will be on overtime if I don't give report right now" Then when looking at the admit orders, the orders were written 4 hours earlier. I just tell the ER nurse that getting report on my five or six other patients is just as important as getting report on that one. I guess maybe we just need a better system.

I work nights 19-07. I actually choose not to take a routinely scheduled break. I do this because there is nothing for me to do on my break. It usually tends to slow down around 01-04 which is when I will sit down to do chart checks, read progress notes, catch up on charting, etc. etc. So, I will usually pull up my coffee and my food and work and eat throughout the night. This is what I choose to do and it works for me. Now, I do take mental breaks as much as I can, such as surfing the net for this or that.

What our union contract says is that we have to work 2 holidays a year. However, our director seems to play favorites and gives certain people holidays off every year. Our Christmas is considered the 24th going into the 25th. Last year, I worked both the 24th into the 25th even though I was sick with a terrible head cold. My supervisor took me off for the 25th going into the 26th. Now, mind you, I would normally call in when super sick, but of course my director takes people off and doesn't bother to find replacements, so we were working short, so I felt obligated to be there. So, this year she has me scheduled to work, even though technically it isn't my turn...Oh did I mention that I also worked Thanksgiving, and New year's and every single Easter since I was hired. The other units in my hospital are a bit more fair and rotate.

My personel pet peeve is when you follow a nurse and you clean up their messes. Or a nurse gets an admit 4 hours ago and leaves it for you to do all the paperwork....this actually has only happened following only one nurse in particular. Also, I get really irritated when the aides do not pass waters at the end of their shift (one of assigned duties), yet they find time to socialize...I also get irritated at nurses who calls an aide to take a patient a soda or a juice so they can sit.

We need to get rid of ALL our dynamaps. One of our machines, we had to wrap silk tape around it to keep it on the pole. Do you think our director is sympathetic...well, we still have them. Also, I think we need to do away with the Polaroid cameras for documenting decubs or any other skin condition. A good digital camera would be more accurate in showing detail if taken to court, IMO. We also need new rooms. Our sinks drip, light switches don't work, TV's are fuzzy. Our chairs in the nurses station have rips and tears. We look so ghetto. Also, I am very tired of the old, stained pink and green wallpaper...bleh.

I am a nightshifter...so anyone ever have an Ambien weekend at work? Sweeter than pie old ladies that turn into raving lunatics...I am always just slightly hesitant when giving this to someone for the first time

We use filter needles as well. I agree with whoever posted about the vial being redesigned, not the needle.

I have been a nurse for 10 months now, and I am now a charge every Sunday. I hate it. It is two more an hour and to me not worth it. I could really care less about staffing and checking the crash cart. I still just want to learn my job as a nurse. I still have to carry a patient load of up to eight patients, and since I work with floats very frequently, still take the admits. I got no orientation and the first three times I did charge, it seemed hell broke loose on the unit.

Nope, no crushes on an MD, but do flirt with them on occasion. Now, I do have a mild crush on one of the RT's I work with. Very nice butt, and just the nicest guy in the world.

Nurses have intubated at the facility I work at. I believe our policy is MD's first, RT second, and then nurses third. However, it is very rare for RT to do it, and even rarer for nurses. I have only heard of one OB nurse to intubate a neonate in distress, and don't know the reasons behind it. Now, would I want to intubate...NO...but I think it would be neat to really learn how.

Yeah, I was just told by one of the charge RNs that we have to give notice one half hour in advance if we cannot take our break at our assigned times....So, if we have a patient crump five minutes before our assigned time, then we can not claim "no lunch"...Yeah, right!!! First of all, I am an adult, I think I can choose which time I feel is best for my patients and myself to go on break. Second, this whole stupid 30 minute deal won't fly for very long. And, she is the only one who is saying this.

I always heard carry high, and it is a boy. Carry low and it is a girl.

yep, depends on the patient and what they are there for. I always start PCA's at the lowest setting on the continuous setting. However, it can be dangerous. Recently, we had a kid on a Fent continuous and PCA and he almost didn't make it...

I would date a co-worker...Maybe not in the same unit though, or heck, even the same field. Gossip doesn't bug me. I have always been gossiped about by someone, and it is like water down my back.

well, there is a room where I had two patients in two days have problems. Day one, low BP's, ARF, delusional...she sure got quiet after 0400. I went in there at 0700, to get a BS and she was pale and unresponsive with a blood sugar of 26. She got sent to ICU for BP's, and the next lady admitted was a patient with a 0300 BS, and a BS of 32. Plus, she was going into heart failure....God, what a week that was and those were my more easier problems to deal with that week.

The experience that I had that just really shook me up was when I first came off orientation on med-surg. I had a patient on BiPap with elevated BP's. I was so focused on her BP's that I just didn't see her declining resp status. Also, they assigned me a very crusty OB nurse who floated over to be CNA. She didn't get sats on any of my patients, including this one on BiPap. At the time I felt that she must know what she was doing to not get sats. No, what it was is that they don't get sats on the PP's, so it was out of her routine. So, in the morning, the day shift RT, got a sat on her and said she was about to code. Within 15 minutes at the end of my shift, she was sent to ICU, where she lived, did not code, and eventually went home. That taught me alot. It has taught me to be so much more assertive, to use my resources, and to not become so focused on just one piece of the entire puzzle.

I would like to follow around an MD for a couple of weeks. I think it would be give me a new understanding for their job. And yeah, I think it would be nice for an MD to shadow the nurses or maybe even RT for a few weeks. Case in point, I once got an order for Fentanyl IV over the phone, she called back 10 minutes later wanting to know how the patient tolerated it. Geez, I had to explain to her that I had pushed it just two minutes previously. She got snippy and wanted to know WHY it took so long. So, I told her that I had to sign the med out from the narc cupboard, find another nurse to watch me prepare and waste, and then push the med safely. Just little things like that the MD's have no clue about.

Well, just to post my opinion. I work at a Catholic hospital, thank God, so abortion just would NOT be an option. My sister had an abortion last year, and I really discovered the truth about myself and this very sensitive subject. Well, I encouraged her to keep it and to even move out here with me and I would help her get on her feet. Well, she did it, and I cried for two days. However, what made me feel worse for her was that she went through a very traumatic situation and she said she received no counseling and treated as if she had a very routine procedure done. I was very hurt at the time that she would do something like this, but now, I do see why she did it. Her boyfriend was abusive and beat her, even choking her...Hopefully, this A-hole will never impregnate another woman. So, no I would never put myself in a position to assist in an abortion. For those of you who would, I am certainly glad that you are able to, cause someone has to. I probably could care for a mom after the fact.

I push Fentanyl all the time on the med-surg floor. I try to use it as a last resort, but will use it for breakthrough pain when it is not yet time to administer MS or other pain meds. I always start with the lowest dose possible and work from there. I would much rather give it push, then PCA d/t one of my patients nearly coding from a Fent PCA set on the lowest settings (happened in the shift before mine). I have also seen ill effects from Dilaudid, as well. And MS...

Ohh,,,I have another pet peeve. Your charge nurse is insisting on taking a 15, and yet the other staff members have not even had a chance to sit and think straight. So, said charge nurse is ignoring her pages for beeping IV's and wants the rest of us to medicate her patients and take care of her IV's...Had this happen last night while I was in the middle of a code (yes, that is right!!!)...and taking care of one of my patient's emergencies last night (I left the code for 15 minutes to take care of this).

Oh Jeez...last night was a perfect example of this conversation. I had 8 patients...Ok, as long as nothing happens. However, last night something DID happen. Night shift has a skeleton crew, barely the minimum to keep the hospital going. I had 8 patients and was a part of the code team, so guess what code called, and I was in a code for almost 3 hours. My charge nurse was upset that I was gone for so long and the floor was short staffed because they had to carry my load (initial assessments and meds done) during the code. They needed a replacement, but on nights it just isn't there. So, I had to let things slide with my group and had to pass things on which I hate to do... Last night, was my third code this week with these kinds of ratios.

I love nights and work 8's. I will occasionally go in early and work 12's. Once I got into the rhythm of working nights, it was cake. I do have to take sleeping pills, though on occasion. I usually get around 9-10 hours of sleep per day. I schedule my sleep so that I will be home and spend time with the kids (daughter in kindergarten) before the oldest goes to school, and then I get up so I can see my kids off to bed. Either way, I probably see them the same amount of time if I were to work days. However, the biggest complaint about nights is the lack of support staff hospital wide. For some reason, everyone thinks that the patients are sleeping!!! Nope, when patients crash, they crash and less help is available.

I live in Eastern Washington in a fairly small town. I make 21.00 an hour as a new graduate. For this area, that wage is not bad at all. Decent houses range from 115,000 on up. I love the hospital I work at. Most of the staff has been so supportive and encouraging of me, which means alot. I plan on staying here for awhile. I have two kids and think this town is a pretty good place to raise them.

But, to add to my previous post... I love my job. I love the NACs that I work with and I love most of the night shift crew. I have such a good rapport with the RT's, a few of the doctors, and most of the nurses in the hospital on nights...Nights rock.

I have a lot of pet peeves!!!! 1. When I have a full code patient who is crashing and needs to be sent to ICU with falling BP's and HR in the 140's and 02 sats that won't maintain...and the doc says "sounds like he is doing fine"....careful charting with this one... 2. When you call another doctor about his patient being fluid overloaded and has developed pulmonary edema with sats at 78 % on 15 Liters NRB, and he wants to argue for twenty minutes because there is NO way that patient could be overloaded according to his math. He gets so twitterpated, that he comes in at 0200 for me to prove him wrong...I just wanted the Lasix, man. 3. When your director starts preaching the little things we could do to improve customer satisfaction...hmmm, I am all about patient care, so give me less patients than the usual 7-8 I have every night, and then maybe I could better serve my patients/customers. 4. When you have had the night from hell with little emergencies all night with all 8 of your patients, and then you get an admit, so you just can't get to everything. Then, the day shift nurse always complains that night shift never does anything. Come and work with me sometimes, and you'll see that I am usually running my tail off. I have double the day shift load...and you would think the patients would sleep at night, but that is when they seem to crash. 5. When you have a charge nurse who is a control freak and everything has to be done her way, and on top of this, she is lazy and tries to pass the buck on to others. 6. I am young and "cute", drives me crazy when certain doctors are always telling me how great my skin is, how good I look at the end of my shift, or what nice hair I have. Thanks very much, you're married, and so am I...and I am not a cheap piece of *ss. 7. Then there is the security guard who tells me how "awesome" I look, almost on a daily basis...seriously, I always divert his attention. Doesn't he worry about being slapped with sexual harassment? Well...I have some more so I will come back to this thread later....Good topic.