NurseNature

Plus, a lot of the time the ER or EMT's put their IV's in the AC or wrist so they are not in good spots for inpatients. The machines will beep at you nonstop until you change sites or splint the extremity.

I just learned that word, pagopica, which describes the craving for chewing ice. I have recently, within the last three months or so, become a pagopicic.?. I love word play. Anyhow, I was wondering if anyone has heard of this or had experiences with chewing ice as a symptom of anemia. I was told by a coworker that I should have my iron levels checked out so I looked it up online, and, sure enough, chewing ice is a symptom of iron deficiency anemia. Who knew.

They usually start to fall asleep about the time I am giving report to the day nurse. And, on my floor, the pt's are usually sick enough that there is not much change from day to night shift and sleep patterns are not patterns at all. I really want to learn from this situation. I guess I should probably pull that dusty mental health book off the shelf for a quick review.

Thanks for the tips. It is a hospital setting. MD's are all fed up with the situation as well, and since I work nights, it's usually a resident that I am calling every hour for some issue with this pt and they don't even want to bother with it anymore. Pt has been at several different hopitals, continually for a few months, and is a young ADULT with possiblities of older family member keeping this pt sick- get my drift? I hate to even use the term Munch.... well, you know, but it is very hard not to at least consider it in this crazy case. I suppose my main question, before I go in for next shift, is this - is it what the pt says, or the DPOA says when it comes to refusing meds/treatment? The pt seems capable to me, but not according to dpoa who claims this is absolutely not the pt's right frame of mind since they are on narcs. I did call for a patient advocate to come and speak with the duo, now I just need to find a nurse advocate for me.

Pt agreed to have DPOA make all decisions no matter what, verbally, to me. But, then, they argue about decisions, every single decision, including such small things as stool softener refusal, and if I follow the pt's wishes the family member gets raging mad at me and the pt. then gets mad and says I should only do what the family says and that's the way it is because he/she is not in her right mind b/c the pt is taking opiods. Please. One or the other is always really mad at me or kissing up to me, sometimes at the same time, sometimes not. They are all over the place and it is way overwhelming for me, but I do not want to request not to have them anymore as I would like to be able to learn something from this as I'm sure I will have many more manipulative people to deal with in the future. (that was one heck of a run-on sentence- I just couldn't stop =) This just may happen to be the most extreme. Hopefully. :)

I don't feel like going into detail about the patient and family member right now, but I know I need some helpful advice on how in the world to handle these two insanely manipulative people. This pt is very sick and whilst he/she and the family member are seriously impeding his/her chances of getting better, which shoud easily be happening, instead, they are speeding down the road of self-inflicted complication after complication. I was excited at the chance to educate. They will not let me say two words, literally, before ranting and raving about nonsensical theories and constant attempts at manipulating me- the nonconfrontational can't we all just get along- brand new nurse. There are definitely some very abnormal mental health issues going on between the two, but I want to keep this as short as possible. Yes, the word "sue" has come up several times so documenting is obviously important. I really need advice on how to care for this pt w/o letting this pair of lunatics drive me to tears every night and seriously impede my ability to care for my other patients. I was at work for three extra hours catching up and my pt load was normal, except for this unbelievably abnormal duo.

Christopher Reeves died of a pressure ulcer and he had the best care money could buy. So... if we fall at work, as nurses, or get hurt in any way for that matter, our insurance shouldn't pay for it because it was most likely preventable. Same with every single injury or illness out there folks!!! Duh... every event is caused by something so why not just stop paying alltogether???

Yeah... I just don't understand how they can categorize some of these complications as "never ever should happen if proper care is administered" type of events. Falls, whatever, not possible. Infections??? Come on now, really? Are you going to tell me the patient that refused his/her bath all week and then scratches his/her butt and then picks at their scabs shouldn't be expected to get a raging infection no matter how many times I clean my hands and tell him/her the risks/benefits of them not adhering to the plan of care... and proper hygiene??? I have yet to see any newspapers, or even nursing mags for that matter, yet defend the health care workers on this issue. It is not all to improve care, but rather it seems, to save the government and insurance companies more money. Whatever.

I've come up with two questions while reading the posts. One, does the hyperosmolarity of the blood put these patients at an increased risk for CVA's? It seems as though it would. And, two, Why would insulin ever work for type two diabetics if it is a problem of cell acceptance of insulin? Oh, and a third question... this is probably a dumb question, but is there a blood test or something that tests for circulating insulin?

You sound just like me! Exactly. I end up second guessing myself just like you did and then I get upset for not speaking up for myself and then I go back and forth and back and forth. I am just out of orientation and this has actually been one of the biggest issues for me. I guess I just expected that everyone would be professional and looking out for the patient's best interest at all times and that everyone could just be civil with one another and share knowledge freely and politely when the opportunity arises. No Doctor, I realize I am not an M.D., and no, I do not want to be one, and no I am not trying to second guess you, necessarily. Many times I just do not know why you are doing what you are doing and it would be helpful for me to know. I have been just finding a random Dr. in the hall or calling a resident to ask a question, or even pharmacy, in order to seek the knowledge I am trying to obtain if no other nurses know and the Dr. is a butthead. Then at least I am a little bit armed when I call him or speak with him.

Not in FL, but HCA is many places, and they are no good from what I"ve heard and seen. They are for profit. I know where I live the majority of the hospitals are HCA; but nobody wants to work for them, or get care from them, unless they have no other choices. They do pay better than others; however, you will likely have the workload of at least two nurses.

I think I made the right decision starting on a med-surg floor b/c I still feel pretty overwhelmed just trying to learn about the hospital's P and P's, let alone all the other obvious stuff a new grad has to become familiar with. As you can see, I am already trying to stress out, or maybe just thinking ahead, a little bit about a transfer to the ICU that I am not planning on even making for at least one year from now. I will forever be asking questions. I have always been a very inquisitive one. I want to know a reason for eveything, so I don't think that will be an issue for me. I suppose I just want to make sure I get a proper orientation.

All I know is that I would be scared to let any loved ones recieve care there simply b/c we get several pt's from them who have been neglected. One pt had a stage four ulcer the circumference of a grapefruit and apparantly select services had not even realized it was there until it was a stage four. Just one example for ya.

I just don't know. I had a pt for three shifts in a row and on the third night he had a pretty significant change in LOC. The pt's son was at the bedside and thought his father had a small seizure just prior to the change, as he had seen this before because his dad had a seizure disorder. I really felt something was wrong. It's the first time I have really had the gut feeling everyone talks about getting as a nurse. I got my preceptor immediately and she told me he was fine and that it was just age and medication related. I still felt uneasy so I called an ICU nurse to come up and take a look. She agreed that it was simply age and medication related. I just saw the pt's son in the hallway and it seems his father has been in ICU ever since that night, which was one full week ago. Darn it anyway... why didn't I advocate better for him??? The doc on call was a first year resident and I felt the ICU nurse was a far better resource, but now I am so mad at myself for not doing more or for not calling another doc. Would it have mattered? I don't know the details of what happened after my shift and only found out he was in ICU b/c I saw the son in the hallway and he spoke to me. I cannot stop thinking about it.

I am interested in ICU; however, I felt starting in medsurg would give me some time to learn a few basics first, as I just graduated in May. So, my question is this: If I want to transfer to ICU after just one year of medsurg... will I get a good, long orientation to the ICU unit, or will I have a shortened one and be expected to know a lot more than a new grad orienting to the ICU unit? I am in my last week of medsurg orientation right now and I feel like I don't know anything - kind of like most new grads on here have stated as well.