dnnc52

OK: I think you made the right decision to change your unit that you worked as a PCT. There is a big transition from PCT to RN. It is hard to be in control of your coworkers that you were once " one of the guys" You now have much more responsibility. You would find that although they may have liked you as a PCT, they may not respect you as a RN. Especially if you have discipline one of the old gang. I am in noway wanting to imply that as a RN you are more important or better than the old coworkers. But you have cross the line to the otherside, and it's not always greener. Also you have to be accepted and respected by the other nurses who you worked with and that is not always an welcoming party as well. OK as far as changing you current position. Nursing is a lifetime career with TNC opportunities. Learning what you don't like is a valuable lesson as well in your journey. Sometimes as a nurse you may end up fitting in where you least expected. One last Comment: Try to stay in a specialty for at least a year. It's an opportunity to learn and will in the long run benefit your future a RN...Sorry I get too winded at times.

Could not remember in my last posting. But the "Gumpco" suction units.

Hyperstat for hypertensive crisis ACLS: When you were lost for a intervention you could always "Give an amp of bicarb" Sublingual Procardia-cut or pierce the capsule and squeeze it under pt. tongue OH BTW: you had patients instead of customers/clients The Bedpan versus Bedside commode for acute MI pts This may have been local, but a bottle of Jolt Cola for nightshift. IBVP resp treatments ? the units look like ET on wheels Them little green "Bird" Ventilators? The first time we converted to "Baylor Shifts" or what they call working 12hrs Treating PVC'S with lidocaine drip for > 20/min I worked a small community hospital and we had no ER doctors at nights, the ER was covered by the local MD regardless if they were the General surgeon or the orthopedic, and they were on call. So if you worked the first floor you worked the medical unit and ER, if you worked 2nd floor you worked surg and Ob-Gyn. Being a male RN I only worked the first floor. I will have to say that many of my assessment skills from them old no MD days followed me through my entire career. OH BTW lawyers were more busy with Divorces than mal-practice in them days..

Nursing is and always will be a fascination of new ideas, studies and theory. I have a 40yr hx of CCU,ER, Geri-care, Med-Surg and many certs and took a lot of classes. My 93 old Mother is in a NH, and was called by the DON and her case worker. To be informed that my Mother had developed a Kennedy Ulcer. I will always admit when I have no idea of a subject, especially something nursing related, and this stage of decubiti I was not aware of. Yes I have worked with StgIV ulcers in my past. But I never heard of this Kennedy Ulcer. I can remember times when we had pts who were turned and repositioned and still developed an ulcer. In those days I even recall nurses blaming the NA or other shifts for these progressive and devastating wounds. So after speaking with the nurses I went to All Nurse and the internet to seek more info. Like any other medical mystery there was many lawyers and such who actually denied the existence of this ulcer. But with my prior knowledge and basic A&P I knew there had to be some intrinsic factor involved R/T to ischemia in a debilitated pt that could cause rapid and extreme skin breakdown. So now we have a name for this syndrome and it all make sense to me. I will now be on my way to see my Mother with more acceptance of her condition and the inevitable outcome. Along with sympathy for my Mother but also empathy towards her care takers and the medical staff. I am thankful for the All Nurses site and all the participation of the other nurses. I am retired but still feel like a nurse, and as always it tends to be true that as long as we try to stay humble. There is always something new to learn....

You can be in a crowd and everyone can be talking with about hundred different conversations and regardless how much you try to ignore all the talk. If there is just a faint smidge of a conversation related around healthcare or illness you unconsciously zoom in on it. Be it Starbucks, or a train station...

No doubt finger injuries especially amputations. 40 some years ago as a new ER nurse in a small county hospital where the physicians took tune being on call. I mean you actually had to call them at their home to come it to see pts or we were just given orders based on our assessment and pts history. No internet, no fax machines. Just nurse and MD working/phone. Of course in really bad or suspicious cases they came in. This night we had a surgeon on call and a guy or was intoxicated slammed his hand a car door. The doctor came in a few shots of lidocaine then off with his finger. I was pale, sweating, nauseated and the room was spinning. I think it has a lot to do with the love of playing guitar. But I have never done finger injuries without a queasy feeling. In fact most of my co-workers would tease me but then we would swap assignments. Because every nurse I met always had some kind of Kryptonite weakness..

We all go through this in our career. Its the time when we try to completely disengage our job and profession on our time off. No talking about it, no reading about it, if you are pursuing an opportunity related like in class ,or studying for a cert, working on your ladder. Perhaps its the time to take a break. Most of all get a hobby non related and immerse yourself for a while. This is a very demanding job, physical, spiritually and emotionally and so easy to get burn our or worse empathetically challenged . Its hard to relate to other folks unless they are in the same field. We change lives, We save lives, thats a real heavy responsibility. We should never take our special gifts lightly.

Got out of the service. Played a few years on the road, not the glamorous life so many think. With a bit of road wisdom I decided time to get a back up plan. Always enjoyed helping folks and healthcare always fascinated me. So went to Nursing school. Not being a sexist but in my days we had 3 males in the program, and it was one heck of a challenge. Still played local clubs on weekends to make some $$. After school was over I had my first job,with a steady income with health insurance, paid Holidays and vacation. I was instantly spoiled. Told my band mates I was out of the business because I became addicted to Food, Clothing and Shelter. But after several years the desire returned. Now that I had a steady income ,own a house married with a family. The equipment that I could never afford was now in my clenches. Started playing again at small gigs and open mics. three back surgeries later, much older. Retirement came quicker than I thought. But now I am a full time writer, with some success. No big hits, but some publishing. I feel like perhaps my love for nursing a 40 yr fling did keep me from achieving my musical goals. I simply was not hungry enough, and got complacent. Can't cry over spilled milk. I chose my profession as a nurse, it became my primary occupation. I had an opportunity to work at Vanderbilt in Nashvegas (ha ha) which now I wished I would had done. So if you are really into the music bizz I would suggest work close to a viable scene. The Kool thing is wherever there is a lot of folks, then there is a hospital. So keep Rocking!! and Long May you ride!!!

So it seems we have took a sedgeway into a side discussion on the rewards of certs by our employer. In the early days at a small hospital I was given .30/hr for my CCRN, then got my CEN, and another .30/hr. So a total of 60cents/hr. Plus they actually help me keep my CEUs. So later I went to a much larger system, was still bi-certified now offered .25/hr for certs. But only one cert, according to your area of specialty. I was always a fanatic about my certs. What ever specialty I worked I made it a challenge to be certified. I dropped my CCRN and CEN, when I left the hospital, went into correctional healthcare this CCHP actually gave me a pay raise and a higher position in the company. Went back later into the hospital the largest system cert in Ned-surg , then Geri, got 2 roses on nurse week. I always enjoyed the certs may have been just to improve my self image. But it does make you keep up to continue with the requirements. I did noticed that the larger hospital who encouraged us to get certs were also the ones that gave us the least rewards.

In order for the big greed factor to take over our hospitals. They have to get rid of the vintage nurses who have seen the drastic downfall of healthcare. There is still a great deal of older nurse in the workforce who still remember the days of healthcare service as opposed to healthcare business. Its not the fault of the new nurses. They just never had the glory days. That many of us miss. We still share the tales of those days and it causes distress at times to us older nurses who adapted to the transition but still knows deep down that very good patient care is less important, and the appearance of Very Good healthcare is the selling point. So to make it easier they need to get an abundance of nurses in the batting cage and ready to run on the field, while slowly letting the older nurses go. So this shortage has been in the making for a long time. Its the supply and demand factor. The more nurses they have looking for jobs, then the less money and amenities they need to use to recruit. Also they can handpick the nurse that seem to fit their agenda.. How many new nurses to you see not being able to find jobs? Around here much more than expected. But while they are waiting in the wings the older nurses must move out. just my opinion.....

Okay folks I am a retired RN and always feel the best place to come for true facts and education is to the nurse who specialize. I have a 20 yr old nephew who has been on Depakote for about a year maintain levels WNL. About 2-3 weeks ago he C/O visual and auditory hallucinations. When my sister mentioned to her GP. The GP wanted to have him seen by his neuro that day. The neuro did not feel a need to see him. Saying that side effects are? either visual or auditory but not both?. According to his parents he "has not been himself" since being placed on Depakote. I know that any drug can just about be the culprit of any Sx. But any of you folks ever heard of these type side effects? The seizure disorder was dx are parietal lobe, which only occurs in sleep. thanks

That was the hardest thing in my career. was getting sleep while working and then re-regulating sleep on days off. I was so adamant about not sleeping my entire day off that I would come home have my wife wake me up in 4hrs. Drink a big Sundrop or Jolt Cola. Then drag but all day, and have her to all the driving. I lived like a zombie. This went on for 15years. Until I had a 3p-3A ER job and that was the best hours. Require no turn around. Got up between 10-11 everyday. In fact now that I am retired I still mostly live on this time schedule. If you get the opportunity to land a 3A-3P time goes fast, cause you are busy as can be in an ER at these times. But it worked great for me. In fact later in my career I went into a executive position on the road and I missed the old 3-3 shift...

I think I choose "Poor management" which I feel is the result of many of the other options 1. Overworked 1. Overworked- This is a result of the hospital administration trying to save money ,clearly as nurses we see all the waste in other depts. and other features. Example is how these mega system are more involved in making the buildings and rooms like 5 star hotels, and the major very costly TV commercial productions. Money wasted on PR instead of improved care. 2. Underpaid- Hospitals know that we as nurses are just wired to put our desire to care over everything. They take advantage of our nature and get away with all healthcare workers being underpaid. 3. Treated badly by patients- This evolves around the business aspect of the customer is always right! 4. Treated badly by families-This evolves around the business aspect of the customer is always right! 5. Treated badly by managers- Too many managers are in position by popularity of administration and not their accomplishments. So they become very insecure and sorry "suck up" to authority. 6. Treated badly by other nurses- As long as management can keep discord and bickering within the staff. They know that as we are divided and less powerful. 7. Treated badly by other members of the interdisciplinary team (physicians, PT, OT, ST, social workers, case managers, dieticians)- The other team members see how we are treated by management, simple they see us as sub-servant and tx us that way as well 8. Too much responsibility-Management has always been so quick to put more task on the nurses and then lie under the cloak of "this improves care" example years ago we had techs, EKG tech, Lab Techs, Resp techs, and a lot more NAs. So they cut back on the assist for nurses and saved money. 9. Not enough authority- Wow perhaps not enough Effective Authority would be closer. We have too many (sorry old saying) Too many chiefs and not enough Indians". Seems everyone who does not wear a nursing uniform or scrubs have mega authority. But very little responsibility. 10. Administration treats us like we are as replaceable as the roll of toilet paper in the restroom-"We here how we are a dime a dozen" They don't care , this is a pysch technique to make us feel a state of worthlessness. I remember when we use to be consider an honorable team member with seniority, as opposed to now the more vintage nurse are considered as obstructionist. 11. Mentality that the patient is always right-This evolves around the business aspect of the customer is always right! 12. Increased focus on patient satisfaction scores-They cant come up with a viable Acuity system to distribute equal and fair work assignments. But Bingo! did not take long to develop satisfaction scores. Once again in some hospitals the nurse are the ones who while attending to you loved ones is making the phone calls and follow-ups. Part of my evaluation for my 2% raise was based on my quota of follow-ups! 13. Decreased focus on proper patient care- Proved time and time again. The nurse/patient ratio has a direct effect on the pt outcomes. Put this simple proof seems to be swept under the carpet. 14. Dangerous nurse/patient ratios- See above#13 15. Feeling trapped in a lose/lose situation- This is the making of the zombie nurse. Yes boss whatever you say So I blame much of our problems on the high end of management, the administration. The folks who while they are getting Million dollar bonus and raises have the balls to have meeting to tell us the healthcare workers how much money we are losing, and how we will need to cut staff, be willing to work outside your unit and discipline. and oh BTW Wage freezes. We as nurses are not a dime a dozen, and a nurse takes care of patients, not customers. I encourage my friends when the go to the hospital for tx to always ask the nurse"How many other patients to you have?. Since the administrators don't give a rats behind about how we feel. perhaps eventually their "Customers will get more educated and say" You can have my fancy flat screen TV,and Solid oak crown molding,. I prefer more nurse and healthcare people taking care of me. Then the word of mouth will once again be the best PR..... Sorry very long!

I am wondering while these nurse are wearing the Extreme(but necessary ) PPE. Seems that charting would be very difficult. Are they able to use a dictation device or something?. I could not imagine wearing that PPE for 4 hrs. I know I would be claustrophobic and would feel very surreal. I would not be on top of my game. Just being honest and no need to worry because I am retired. But still in the corner praying and doing what I can to support our family of Health Care Workers..

Try and find a hobby you love as much as nursing, let them compete, then let the hobby win on your time off!

[ I just found the terminology "highest regard" a little florid. Highest regard is earned by showing an example others should repeat. Okay When we go to War. We always have "High regard" for the 1st charge,the 1 st injured and the 1st fallen. This is the 1st time this enemy has entered the arena of a General Hospital. The 1st situations the facility had days to prepare and abundance of staff to directly care for the Ebola pt. This was the first ambulatory Ebola case that ever came through the door of an ER. Most likely these nurses perform their duties and task appropriately according to the policy and procedures, providing they were available. They did not turn away and refuse to care for this patient, cant say for sure how I would have acted in the situation. Who would ever think we would be so concerned about the difference between 99.2-100.5 degrees. When you consider the margin of error with out basic thermometers. Seriously how often have you got the same reading twice in a row?. Okay Amber notified the authority of the temp and they instructed her to follow through with her plans. How can we expect this nurse who has never worked with this type patient,or had no training with this type disease to not trust and be comforted by the authority's directions.

I hope it's just not nurses and Healthcare workers praying for these comrades. I like to think that everyone is praying for them. I think it's well over due for a National Day of Prayer for our Healthcare Workers. Other folks read these post as well. I hope that they realize when we make positive comments or though some of these post seem directed to nurses. That we include all Healthcare Workers as well. I see folks on these post make reference to working with HIV/AIDS pts. Yes I was on the forefront of working with these pts. There was anxiety, as in all isolation cases that we worked with and had risks involved. But regardless of exposure and even needle sticks. We knew we had years to deal with the disease process in worse case scenario. This Ebola is very new to our land. But I cant think of any disease I worked with that could lead to such devastation. But an old saying rings true. When we start pointing our finger, there is always 4 others fingers pointing back at us. .....I hope Nina and Amber are following this site. If not may be someone could let them know. We could be very therapeutic to them and give them the emotional support that only family and friends can provide...

darn I was on pg 10 hope it was not me. But sounds like.

So we are not stopping or restricting folks from these high risk regions. But some of the major airports are going to have increased screening. At which time they will place those who are suspicious in quarantine. Then if they develop Ebola they get transferred to a US Hospital, where they can receive the best treatment and care?. So if I am sick and I can get to the USA then I have a better chance of tx. As well as not being a financial burden to my Motherland. Time to close travel. . Seems to me that is a hard call. So just monitoring air-travel is not going to be the answer. We must restrict all travel from these high risk regions? We always hear about terrorism that if we don't defeat them over there we will be fighting them here. Well Ebola is the same concept lets defeat over there...

OK WE HAD 1 pt and 2 nurses so far infected,and Africa has had about 8000 cases and Bout 405 Health Care Workers infected. I did not address the the level of tx. My target of comment was based upon the safety of the Health Care Workers made considering the amt of cases and years of working in these conditions they learn to do a lot with a little workforce and equipment so I think, and still beleive that when considering the amt of cases the Doctors without Borders and Samaritan Purse, have dealt with that they have a better system in place and better protocols. Its a matter projecting the math at our rate. Also the WHO feels that the cases of Health Care Workers who do contract the disease is due to improper use of protective equipment and the exhausting demand on the limitted workers. I do not feel that the CDC is giving us the real story. BTW there is a great article and info on the New York Times web site with all the stats and facts....

"Evidently, some people don't understand the meaning of "voluntary quarantine". I know - I would HATE it; I'd have to be led kicking and screaming to wherever the designated quarantine facility was but I would do it, to protect my family" The way I feel is yes offer or Put all these folks in a really nice quarantine. Like a nice hotel give them free food, drinks and PTO. $$$ should not be an option. In fact let the Hospital Administrator pay for it. Then if these administrators cant provide the equipment and support out of their empathetic nature. Perhaps the consequences of them losing some $$$ might make them get with the program. The administrator is the captain of the ship!

Simple question but as nurses you may understand where I am coming from. What type of thermometer are they using. We all know that its rare that we can get the same reading back to back. If it oral then I could just drink some water while in the line waiting for my temp ,and get through the screening. For these "70" other healthcare workers should be quarantine. In the finest hotel, free food,a drink, and PTO at the expense of the hospital.... Then no contact and help prevent the spread. These nurses and other Health Care Workers have got to be on pins and needles, along with their families. Sure they could use our prayers and some debriefing as well..

Okay the Doctor's without Borders and the Samaritans Purse seem to have this care to an art and have a much more better safety record than the US hospitals. So who would you trust them or the CDC?. They don't seem to have the equipment and supplies available and still are having a better safety record. Why re-invent the wheel? Let examine their protocols and get this under control. Again if the administration what our Healthcare workers to work in these questionable conditions. I say have them come into the zone right beside the nurses. Its well over time for these hospital administrators to stop treating us like "were a dime a dozen".

OKay Nurses: What do we do when we don't have Unions to speak for us?. I hope out of all of this we learn and realize just how much danger and how important we are. I mean to include all our Brothers and Sisters who are working in the Health Care Workers.

Seems like when it comes to the rationale to combat terrorist. They always say" we need to fight them over there before then can get here". So perhaps we should take the same advice with Ebola. "We need to fight it over there as well. But as soon as a high profile individual catches this infection then we will see more aggressive actions taken. I am also very concern that most of our PPEs are made outside the USA. So in the event of an all out plague that the US would just be a part of the market of supply and demand, and our demand will greater than the supply. We need to at least when it comes to medical supplies. Start manufacturing them here. We are already sleeping with the devil to get our gas needs covered!