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Morettia2 BSN, RN

CTICU, Interventional Cardiology, CCU
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Morettia2 is a BSN, RN and specializes in CTICU, Interventional Cardiology, CCU.

Cardiothoracic ICU-now, Interventional Cardiology Unit-4 years

Morettia2's Latest Activity

  1. See the thing is....I didn't become cocky, I was sick of being verbally beat down. One can only handle so much insult. You reach a breaking point. And I broke. I had enough, and I wasn't about to be treated like a child. Yes I was there to learn, but how can you learn when the person teaching you constantly berates you. It's been almost 2 years since I posted this and the "hazing" just started to subside. I am proud to be a CTICU nurse and I can say that I learned more when I was unchained from my preceptor. Yes, she was very intelligent, but I am a person and I deserve to be spoken to like a human being. But that's in the past and I have moved on.
  2. I have worked at the same hospital for about 5 years. I started out as an Interventional Cardiology RN right out of school. I became one of the Night Shift Charge Nurses and was offered a position as Nurse Manager in the Interventional Unit. At the same time I was offered the ANM position I had applied for a job in the CTICU in my hosp. I have a great working relationship with the MD's and RN's on the night shift in the CTICU from being pulled to the CTICU SD over the years. Let's just get one thing straight, my ultimate goal as an RN was to be hired into the CTICU. Not the CTICU SD but the CTICU. It was my dream. I got the interview, and when I was offered the position in the CTICU I started crying. I knew what job I wanted right away. I had burned out on the Interventional floor. I had precepted, had been one of the charge Nurses and I felt I wasn't being challanged anymore. My co-workers were so excited for me and said they would miss me and we cried ALOT. I reminded them I would only be 2 floors away. I start my orientation in the CTICU and meet my preceptor....my first thought was, I am so excited to be here and I can't wait to learn and build on my knowledge base from the Interventional unit. But I had also went from working 4 and a half years on night shift and suddenly was being oriented on day shift. No big deal I can adjust. Plus the position was for night shift, so I would go back into my routine in no time...so I thought.... So it starts......the one thing I said to my husband was, "I hope that this orientation goes well and isn't like the nightmare orientation I experienced years ago." He said, "You know what you are doing this time around, and you know you are a great nurse, or you wouldn't have been offered 2 jobs." Yea welcome to my nightmare....but this time around I had experience under my belt. So I start in the CTICU, my preceptor came across very excited to teach me. Great that's what I wanted.... So my first week I was bounced to another preceptor who was amazing, she knew who I was and let me work and was an amazing teacher. But week 2 came and I was bounced back to my original preceptor. Then my decent into the abuse abyss began. I was scoulded like a child, I am 31 years old. I was told that I didn't know how to properly put a BP cuff on the pt, ahhh excuse me.....I do believe I just taught you how to use the new monitors and how to activate the screens to be able to read the BP...and I did pick up a thing or two when I was IN CHARGE of the Interventional Cardiac Unit for the last few years. I basically bit my tongue and grinn and beared it for a few weeks. I wanted to learn, but when you are constantly belittled and placed in a position of being treated like a child you tend to shut down. I would ask questions and be spoken to like a 3rd grade student. I would come into work in the morning, now remember I worked nights for years, it would take me a few to adjust in the AM. I was told I don't care, I am irresponsible, and that I should realize that it is a privlidge to work in the CTICU. That this was the most prestegous job in the hospital and how I didn't appreciate that........UMM yea you crazy beast This was my life dream working in the CTICU, I know b/c I cried when I got the job, but now you are making it a living nightmare. I finally came to my breaking point. I had a pt. who told me, "don't let that woman following you into my room. She is mean and she talks to you like you are not human. She yells at you for nothing and you are running around in circles while she sits on her hide, how are you susposed to learn when you are being yelled at for every minute thing." The next day I went to my educator, I explained what was going on, and had a meeting. I thought things would change and for a few days they did then........I had enough, I was being told how I wasn't putting an IV in right, I have put in countless lines over the years in fact they don't know how to put in lines in the CTICU b/c everyone has a TLC, I just turned and walked out of the pt's room and said "this isn't my first time on the playground, I was offered an ANM position, I was runner up for employee of the month, a night shift preceptor, and one of the founders of the TCAB program. I am not a new nurse that you can beat down, I want to learn and you just keep grinding me into the ground, and by the way the pt. has 2 fresh lines I just put in while you walked out of the room, so don't ever tell me how to insert and IV ever again." Standing there was one of the MD's who I have been friends with for years, he turned to her and said, "Ang can get a line in anyone, and she is a great nurse that's why I reccomended her for this floor, but you don't let her speak or give her a chance." I think daggers may have been shooting out of her eyes at this point. And the worst part was all of my friends on nights in the CTICU were like, "Just get through it then you will be with us....we know how upset you are.." Infact some of the day shift and the night shift RN's and CNA's went to my director about the way I was being treated.... LESSON LEARNED for the second time in my nursing career "Note to self, no more preceptors..", ....my orientation was 3 months......I have beeen off orientation for almost 6 months, but have been a cardiac nurse for 5 years. I swear I attract crazy. I have no hard feelings toward her. I know Karma is a witch!!
  3. Morettia2

    What have other nurses done that have freaked you out?

    I have one...this wasn't a Nurse but a DOCTOR who did this......Here it goes, you guys are going to love this one, it was about 4 years ago..I was probably about 1 year into my nursing career as an RN, I used to work on an Interventional Cardiology unit. So the pt. was a case from the cath Lab s/p AICD insertion. The nurse manager recieved report from the cath lab at our change of shift at 7pm, which was normal to get report from the cath lab before the case came to the floor during change of shift. Ok the pt had AICD insertion...blah blah blah blah....Any drips? No but the pt will recieve Ancef 1gm but we will hang it when we bring the pt up( Ancef with in 30 min of AICD insertion for profaltic ATBX which is pretty much universal protocall in our hosp)....any allergies....NKDA....pt. is spanish speaking only but our Anestiaologist speaks spanish so he did the H&P and so on and so forth....So the ANM said ok the room is ready bring the pt. up....so about 5 min later the pt. arrives on the floor. We get the pt. situated in the room, Myself and a few others are doing EKG's putting on the monitor ect, and getting the CXR and I have always done this, ALWAYS, I First check the orders and the H&P and the procedure notes as we are getting the pt. settled... and the one RN from the cath Lab spikes the Ancef and the IV is going and all of a sudden the pt. is in respiratory distress....The other RN's first thought was a pneumothorax from AICD placement..... OK I am anaphalatic alleric to PCN, so as soon as I saw the ANCEF was actually running I yell TURN OFF THE IV and get EPI NOW (I mean this was seconds from when the cath lab RN spiked and hung the bag) ....The family had come up with the pt. and they only spoke spanish too...I ran out of the room, and I speak enough broken spanish to find out that the pt is Allergic to PCN. And the family had told the Doctor that did the H&P and intake form that he was allergic to PCN. But he put on the chart NKDA. I called a code and the Anastesiaologist who was on the case in the cath lab and who TOOK the H&P came stomping in the room and was so miffed. He said while intubating the pt, yea he may have mentioned something about a PCN allergy but Ancef should have not caused the anaphalyxis. I turned to him and said are you serious? If the pt is allergic to PCN that should have been a red flag not to give ANCEF...he tried telling me that Ancef can be tolerated in pt's allergic to PCN. I said what you thought maybe some flushing and hives?? And why is there NKDA on the H&P and Intake form if you knew about his PCN allergy? He just yelled a bunch of curse words... I know the nurse doing the med rec asked the pt. if he had any allergies and the pt. said no, and the nurse spoke fluent spanish, but this was right before the cath, so most people are so nervous that they forget but she should have asked in depth medication allergies, food, ect...then most people respond....but the initial H&P by the MD was critical....and the family wasn't with the pt. when the RN was doing the med rec. in the cat lab holding area..and by the way this pt. had no past medical HX that we were aware of, and no primary MD that they could have referred.... Anyway to make a long story short the pt lived but let me tell you...from that day on any pt. with a PCN allergy, or any allergy, I had my nurses check the ATBX the pts were going to recieve. We were and still are very strict on allergies, but I made sure of that. And one reason is because, me who was a new nurse at the time, made sure that all of the RN's knew what drugs were associated with different allergies the Reason being I have quite a few med and food allergies myself and I just wanted my RN's to be very diligent and proactive no matter what the MD says!! Lesson learned!
  4. OMG I haven't been on this site in a very very long time...I can't believe this post is still a sticky...I can only say, one year ago I posted this...since then it's been well...i am not going to go on a tangent..I have to be up in a few hours for work...but when I get the time, I will update you and well I am so overwhelmed by all the nurses I touched with this post!!! KEEP ON DOING IT, WE ARE NURSES!!!!!!!!!!
  5. Morettia2

    Weaker nurses at night?

    I work nights, I am far from weak. If I heard a Doc say that, I would fire back with, "well, since youthink we are weak, I would be prepared to expect an increase in pages b/t the hours of 12am-5am. And when you call back I will say, Oh I am sorry I must have paged the wrong Doctor." Night time in the hosp. does not mean that it's lights out and everyone sleeps. Half the time my pt's have no idea what time it is, and for some reason we have had a major influx of geri-tele pt.'s who are BAD sundowners. And for some reason our pt's always wait till late at night to tell us that they have a problem that had been going on all day, but didn't want to bother anyone during the day, so they tell us at odd times to say, "I have been having this chest pain all day but I figured I would tell you, b/c it's night and your not as busy as the day nurses..." ERRRRRRRRR...."No I just have double the pt. load at night. Day shift has 3 pt's, I have 6. I am not busy running all over the unit, not at all. And you know, at 2am I have access to a whole slew of MD's to help you (the house MD and the tele resident)....unlike the day shift. Oh and did you bother telling any of the 10 MD's that saw you all day long bout this chest pain you have?" No matter what shift u work, you are never weak. Hey nursing is 24/7...and if doc's wanna think night shift is weak, then they should remember if it wasn't for night shift then they would never know what happens in a 24hour period. We don't sleep, we work, period, no matter what shift you work.
  6. Morettia2

    Worst night ever

    haha thanks..I know it was a long post. And I thank you for reading it!!
  7. Morettia2

    Worst night ever

    Ok so I have been posting on here for quite a while, and alot of you have read my stickie...it get's better I PROMISE....and I thank you and I hope I have helped or encouraged you to keep up the good work. But I have to share this one, and the only reason I am doing it is because experience and my wit were the only things I had going for me. Let me tell you a little story about the other night. Saturday night I get to work, fine it's my 2nd night in a row, I got back the majority of the pt's I had the night before. No problem.... OK PROBLEM...I go to make my rounds. One of the pt's I had the night before, I went to say hello and to assess him. He tells ME, "ohh god I have been having this terrible headache and double vision for the last hour." I ask was the double vision new, he says yes. He said it's killing me...I take his pressure, its 180/110.....OK...he's already on a heparin gtt, and I am about to give coumadin 20mg...Holy crap that's alot of coumadin...I automatically called the cardiac MD service,call the tele resident, and the house MD for the night. I automatically gave him his procardia 60mg, Clonidine 0.1mg and tylenol 650mg at 8pm insted of 10pm. My fear was the pt. was going to stroke out. I get zero calls from any MD's. I begin my round of paging agian..finally I get the cardio MD on the phone. I tell him the s/s the pt. is having and what meds I gave. He told me to put in for a STAT head CT w/o contrast and to tell the tele resident to call himwith the results..I finally get a hold of tele resident to tell them what going on...the primary cardiac md said I did the right thing giving all the meds...ok...I put in for the CT of the head, and take the pt. down. ASAP..... yea.... I get back to the floor to call the tele resident to tell them that CT was done and to call the cardiac MD with the results asap...In the mean time the headache was gone, the pressure stableized and ok.... NEXT PROBLEM.... I am going to the next pt. room to say hi to the pt. and the over head page is going crazy with my name. I can't do one thing with out being paged....it's security asking if family can come up to see a pt, it's the nursing supervisor, it's god asking me if I am sane.... Finally I begin to assess my pt. and have to give a gravity peg tube feeding. I said to the UC to call the room if it is urgent b/c I am about to give a gravity feeding. I begin the feeeding, toomby and jevity, 200cc gravity bolus. I had the door shut while giving it, b/c I knew better then to be distracted while doing it and told people not to burst into the room....welll...hahahah...yea... As I am on the 3rd 30cc round of the feeding, I am paged in the room. It's the tele resident, I told her I would be out in a few min. and to stay there b/c I am giving a gravity peg feeding. NOOOOOO...the tele resident comes busting into the room startling me and making the pt. cough at the same time....JEVITY GOES EVERYWHERE...ALL OVER ME, THE PT, THE FLOOR...GROSSSSSS........ OK at this point I am covered in jevity and probably part of the pt's stomach contents.....i flush the tube...go out of the room and talk to the tele resident.... AT THE SAME TIME I am being called by the raidologist MD about results from a CT scan of the abd. that was done during day shift on the pt. with the peg. He tells me the results...I said, "Umm, you need to call the MD with the results" HE basically told me NO and blah blah blah blah and how I had to do it...I said very firmly "YOU are the on call raidologist MD, and YOU ned to call the MD. So pick up the phone call the operator and get the # of the MD who ordered the CT of the abd. if it's this urgent" and I hung up. Well...I know the MD who ordered the CT so I called him anyway. He called back asking why I was the one calling him with CT results...I said, "B/c the raidologist MD on call won't call you. SO here's what he told me, and here's his name." So about 20 min. later the same blastin raidologist called me agian with the results of the CT of the head my pt. with the uncontrolled HTN had...I said , " CALL THE TELE RESIDENT, here's the #"....I called the tele resident anyway to CYA....OMG....the resident was telling to me call the cardiac MD to tell him the results, I said, " I am not the MD, you are, I told you that you had to call him back with the results of the CT scan of the head., SO CALL HIM, he won't bite", but I put a page out to the cardiac MD to CYA.... IT GET's MUCH BETTER.... SOOOOO I have 4 pt's and I have to admitt 2 more...no problem I never got the ER report for my first admitt b/c of all of the chaos.... The pt. arrives...she passed out at the airport, came to the ER, was in the ER wnt outside to the ambulance bay to have a smoke and passed out agian...38 y.o. female...has a basilar skull frx, stitches to the back of the head and on the back. Comes with a EEG monitor to my floor.... UPON ARRIVAL...she begins freaking out....climbing the walls literally. Speaking both perfect english and chinese...I call the resident for a 1:1 order and an auto psych consult as per policy.... I asked if she was speaking manderin or cantonese?? she said something then cantonese... SHE THEN GRABBS ME, AND CLAWS ME IN THE POSTERIOR PART OF MY RIBS in my back ON THE LEFT SIDE. She gives me a GOOD JAB. I just lost it... I began screaming for help...she was out of controll... The resident calls me back telling me that they won't sign the 1:1 order...the pt. was a service pt. so it was their resp. to sign the order...the resident and her senior resident begin telling me how they won't do it b/c if something happens to the the pt. it's their responsibility..... I LOST IT.....I SAID, 'I AM LOOKING OUT FOR THE SAFETY OF THE PT., THAT'S MY RESPONSIBILITY, SO GET YOU BUTTS(didn't use that word), AND SIGN THE FLIPPIN ORDER. I already called in a psych consult so JUST SIGN IT" I just went into super nurse mode...I began calling the nursing supervisor, the house MD, the psych MD again...the ER nurse manager who sent the pt. to me.... I got the night shift nursing supervisor on the phone and well...let the fury loose......told her about the resident, the raidologist who won't call MD's, how the pt. assaulted me, how NOT A SINGLE MD WAS doing anything..... Well with in 2 min I had 5 MD's on the floor. and the psych md called back..I got an order for thorazine STAT.... Funny b/c the EDP(emotionally dis. person)'s IV was blown so on top of it all I had to put a new IV in. That's when the pt. told me, "you have NOOO Idea how I used to hurt my self when I was younger..." I saw all the cut marks all over her.... And I got the psych md at 1:30am the psych MD came in and eval. that pt. only to tell me to d/c the 1:1 order.....I said , "are you kidding me...LOOK AT THIS!!!!!!!!!!" I lifted up my shirt and showed him the giant bruise the pt. gave me.....she mayhave hit her head but she didn't forget how to fight..PLUS she told me how she used to hurt herself" I convinced him to keep the 1:1 order.... After all the chaos I begn going through the orders from the ER...I saw in the notes howw she assaulted a nurse, had a 1:1 in the ER....I was never told....I was soooooo MAD.... SOOO I GET MY NEXT ADMITT...I was told, actually promised, that this one was ok...WRONG...CONFUSED, with a 1:1..... needless to say in hindsite...if i was a brand new nurse I probably would have really flipped...but I know now that my exp. is making me stronger..I fillled out multiple incident reports, didn't back down to the MD's and did my job... you will come a long way I promise...
  8. god-is-love, when you start out as a new nurse it's like being on mars, kind of. My story is this...I am from the philly burbs. I went to the University of Scranton in 98-2002 and graduated with a B.S. in Criminal Justice and a minor in Sociology. When I graduated I couldn't find a job, I wanted to be a police officer or go back and get y masters in criminology. But the job market was horrible in 2002, I had taken numerous law enforcement exams, federal, state and local. But nothing.... So I ended up working at my parents hair salon, being the salon manager. I hated the fact I was working for my parents but was grateful to have a job. I looked day and night for a job, any job. I found a job in T.V. production. It was for a traffic coordinator for Infomercials. I went for the interview and got the job on the spot. OK, I had a love hate relationship with this job. It was a family owned business, ok I know what that's like from my parents hair salon. It's a family atmosphere.... I began working and realized I was making NO money but I was getting awesome exp. in broadcast and marketing, which I knew nothing about, other than the fact I used to watch infomercials all the time in college when we would be up late or all night...drinking and 4am infomercials...hahaha..anyway. The company that hired me was well known and respected, but the owner was a cheap shister. He drove a porshe, blew money on the most rid. stuff and payed his employees terrible. He was around about 20% of the time, and a total train wreck, he would make us start projects that were the most pointless things I have ever seen, like making me reprogram all of his cell phone numbers from his old phone into his new phone...YEA...theycan do that at the cell store.. But the only good thing was the people who worked there. It was a family owned business. The owners wife was actually co-owner and like a 2nd mom to me. There were 2 daughters, around my age at the time, which was 22, and their brother, who actually ran our west coast company untill they made the decision to shut it down. The brother, after he came back from Cali., became my boss, and he used to say I was like their adopted sister. He was also the big brother I never had. I was the one who told him to marry his, now wife, who is a cardiac nurse, after their 2nd date. Anyway I worked there for 2 years. I learned alot, I mean alot, how to deal with pushy clients and media buyers. I learned the business of TV and broadcast and became traffic manager, which I should have been paid 3 times what I was being paid according to some of our clients. After being WAY WAY underpaid for about 2 years, I found a job through one of our clients. In the meantime my boyfriend, who is now my fiance, became a police officer for the NYPD. My turning point to becomming a nurse was this, if anything happed to my fiance while he was on the job I would want to be the one to take care of him, and then there was this...my fiance and I were in Atlantic City for a weekend. We went to one of the clubs, and after drinking and dancinbg all night we sat down on a couch and there was this girl passed out next to me, but had noticed her earlier in the night with some friends and the friends left her b/c she was taking to some guys and she was drinking water. Now some shady dudes were trying to get her to leave with them. I just turned my head, asked her name, she told me, although she was semi-conscious. I asked the shady guys what her name was, they had no clue. I acted like she was my friend, and they eventually left. But in the mean time, she was getting worse by the minuite. It wasn't like a drunk semi-conscious but like a drugged semi-conscious..I know know but that instinct kicked in..I began counting her respirations, and this was in dark club. I just put my hand on her back and began counting her respirations, it was b/t 6-8 a min. I was asking her simple questions like do you know where you are? ect...I took her pulse, it was 40...now I wsn't even thinking about nursing school yet, but knew enough to see some one in trouble. I made my fiance grab a security guard and he came over and I told himand he ignoed us. I finally grabbed the head of security and told him what was going on and also told him her pulse and respirations. I said this was the water bottle she was drinking out of. He took it gave it to the ACPD that was standing out side the club. I said how the first security guard ignored us, and said she's probably just drunk. The head of security and the ACPD called the paramedics. She was unresponsive at this point. I had a pen light my aunt, who is an er nurse manager, gave me to have in my purse for when it is dark outside. The security guards and cops only had those big MAG flash lights, no good for pupil response unless you want to blind the person and yourself. While te medics were in their way I checked for pupil reaction, with my pen light, they were sluggish. The medics arrived and took her. We went back to the club the nxt night just to talk to someone to know what happened. And the cops who were there the night before were outside. I asked them what happened, they said she was roofied and ghb was put in her water. She didn't have an ounce of ETOH in her blood. They asked if I was a nurse or a paramedic. I said no I wasn't. They said if it wasn't for me they don;t know what would have happened to her. OK here's the kicker...after that night, I knew I had a calling and I began the rapid research on nursing schools in my area. I picked my local community college, which is one of the best nursing programs on the east coast. I barely made the deadlines. I had to take the NET test, most people have months to study for it, I had 2 days to study for it. The nursing recruiter said can you do this in 2 days? I said yes..2 days later I took the test. Now in the mean time I was preparingfor a job interview for one of the broadcast clients I worked with. My life was split, and it was I swear to god, or who or what ever, that fate or destiny stepped in... I got the letter 2 days after I took the NET test that I passed with a scorein the high 80's. I was given the option to choose day program or night and weekend program. I chose night and weekend so I could still keep my job. About 1 week later I had a job interview with a huge media company. It was a hughe position. It was a 3 hour interview. After the interview I got home and saw this letter from the community college. I opened it and it said I was waitlisted to the night and weekend program, it even ranked where I was waitlisted, I was #18. I was a total lunatic. Also right after I opened the letter I had a call back from the interview I just left asking me to com bcak in the next night for a 2nd interview. NOW MY FATE...the next day I was on my way to the second interview and in the car I got this chill down my spine and a little voice in my head said call the college and ask if there are any seats open for the day nursing program. I made the phone call. The nursing recruiter said, "Ang I was just going to call you, you read my mind, there is one seat opn in the day nursing program, do you want it?" I just blurted out YES YES YES...now this is as I was oulling into the parking lot of the compant I had the follow up interview for. I went in to the interview, the woman who interviewd me just grabbed me as I walked in and said, "ang you are perfect for this position, I have interviewed 100's of job applicants but you are it, here's what you will be makin a year, it is about $60000 or more. We want you to start immediatly, you will have your own team and be DRTV broadcast manager." I jut stood there and had to make the most important decision of my life. Do I go back to school, get a job that pays crap just to get me through school and that's if i make it through school and end up doing something I was meant to do, or do I take this job, and if i take this job I won't see my boyfriend, now fiance, ever b/c we live in different states, but have my first REAL job..... I said to her, "I am so sorry to tell you this but on my way here I was just accepted to nursing school. I was offered the last seat in the program. This is probably the hardest decision Ihave ever had to make, and I hope I don't regret making this decision, but I decided to go back to school and accept the nursing school seat. I am so sorry." She just stood there and said, "but you were the ONE, I called all the regional offices and told them about you. But you know what, my mom was a nurse, so I know you must be excited. So listen if nursing school dosen't work out, you just call me and tell me. Here is my card, and keep in touch. remember you have have a job waiting here for you no matter what." She gave me a hug, and said congrats and that she just lost the bes potential DRTV broadcast manager. I still keep in touch with her. She always tells me that if I want to leave nursing I still have a job waiting. I went back to school, and I worked my tail off. got a job in the library at school, making like next to nothing but it was a job, and I worked through school. When I passed my final exam I cried. cried at pinning in may of 2007. When Ipassed my boards in july of 2007, and became an R.N I cried. And when I had my hosp. job interview,after I cried. I impressed the unit director so muc with my answers, eventhough I thought i blew the interview b/c I had an asthma attack in the middle of it, I recievd a phone call an hour after the interviw was over to tell me I got the job, Interventional Cardiac R.N. and started a month later. In that month I moved from Philly to NYC to live with my fiance. We found a great townhouse to live in. I started my new job in NJ, I didn't know a soul. I met a girl in orientation that had moved fom indinana to statan island, and we both worked in NJ at the hosp. bvut on different units. Well, she is one of my best friends. She left the hosp. last year though and moved VA. b/c she hated our hosp, as did I at the time. But I can say, like I have said a million times before on this site. It was awful at first. I was a TOTAL outsider when I started, I was from Philly, I was a new RN starting on an Interventional Cardiac/CCU step down/ pre and post heart transplant floor. I was abused with awful, pt. assignments, didn't know how to stand up for my self as a nurse yet. MD were intimidating, my co-workers were down right rude and ignored me. Also I didn't have a great orientation at all. I learned ALOT, and I MEAN ALOT on my own. I was pulled to the ER my 2nd week off of orientation, which has never happened ever, to any new grad off orientation at the hosp, you are not susposed to be pulled untill you are 6 weeks off orientation.. I even got an award for that one, literally. I was verbally threatened by a Doctor like my 2 or 3rd night off orientation, who wanted to "have my license", b/c I called him 20 min. after he evaluated the pt. to tell him the pt. was having chest pain. It was like 2140 or 2220 at night, and was right after he did the H&P, like 30 min. after the MD had left the pt. began to have crushing chest pain. YEA that MD went to the HEAD of the HOSP and tried to have my license taken, the head of the hosp. said, "Hey doc, it's your pt. and your responsibility. She is the nurse and she did her job, and she did it well, you are the primary physician." I always say karma is a bit@#. I ended up having that MD, who "wanted my license" as a patient a few months ago. He was admitted to my floor and of all the blastin nurses, they picked me to take cae of him b/c they all said, "it's payback time, ang, it's been a year since he did that to you" I just said ,"he's just another pt. to me, and he's sick so that's why I am here I am his nurse, yea karma def. bit him in the butt and took a huge chuck out, but I am his nurse an he needs me." When I walked into his room for the first time, and said "hi dr.XYZ, I am going to be your nurse tonight" He just looked up and had this blank expression. HAHAHA..I took care of him a few nights in a row. But in the end he ended up sharing some wired fruit from his country with me and now every time he sees me he always says what a great nurse I am... I mean you grow into your own, you find a voice and develop your style of nursing. I started out timid, yea I was NEW, what new nurse isn't intimidated by the 3 ring circus at the hosp. I developed my style of nursing and my nursing persona. I am the go getter, the one every one comes to for advice or pt. evaluation, but when I frist started I was always told I was over reacting untill they began to notice that my over reacting was for a reason, it's called being a nurse. I have delt with my fair share of rude and piehole MD's, that try and intimidate me. At first I was, but now I just say, "hey I am the nurse I report s/s and objective observation, you are the MD, you diagnose." I had one MD bark in my face abou how I didn't see the pt. was in pulmonary edema. I said, "yes I did KNOW, b/c the pt. sounded like he was drowning. I calld the RESIDENT to eval the pt. And I suggested differnt meds and tx to YOUR resident, but was ignored. and I am sorry, a CXR was done as per my idea, but ordered by the redident only after I suggested it. The resident read the CXR and said the pt. ws fine. I am a NURSE, i know Pul. edema looks like a butterfly on a CXR, I said that, but your resident didn't agree. I do my job and I do it well. It's not my fault that the night MD's and DO's don't know what they are doing, but it's all we have to work with at night for objective eval." I mean I have had MD's rant and yell on the phone, I said to one who went on a 5 min tiraide, "OK are you done yet? did you get it all out? b/c I need this order now"...everyone just looked at me like i can't believe you just said that to him...I say, "he/she is not god, they are human, people like you and me, they just like to yell at the nurse. They have that MD or DO after their name for a reason they chose to be a doctor, and if they don't like 3am phone calls for orders then that's tehir problem, and as nurses we are only doing our job... TAKING CARE OF THE PT., so when that pt. wants tylenol or mayloxx at 3am and house staff dosen't cover their servce, then you better believe I am going to call and wake their butt up. I am here for the pt., hence the reason I am a nurse and as an pt. advocate I want what's best for the pt." Nursing is stressful, but very rewarding. It seems like you ma have more bad days then good days, but there is always one pt. who thnks you for everything you have done. An even on the bad days or nights, always do you job to the best of your ability. It will only make you stronger. Ok enough typing...but if could make it through my first year and survive, so can you. I am comming up on 2 years. I am a good nurse, and as long as you remeber why you became a nurse, you can make it. Smiles, hugs, handshakes or een jut a look from a pt. can make all the difference.
  9. Morettia2

    VENT!! Called off and labeled "No Call No Show" LOOONG...

    HAHAHAHA you don't know how many times I wish I could have said that...hahaha..
  10. Morettia2

    VENT!! Called off and labeled "No Call No Show" LOOONG...

    I am glad to hear that everything worked out... I am an RN working in an innercity hosp. Every so often we get called off when our census is low. Last week, I was called at about 5:45pm by the day shift charge nurse, to tell me I had PTO for the night. I was just getting up anyway to shower and get ready but since I was given PTO I wanted to wake up, have a cup of coffee and talk to my finace and my future inlaws...I was thrilled. My fiance just had major surgery and I was taking care of him so it was very conveinent. I was also at my finace parents house, I slept there in b/t shifts b/c he was staying there, rather than our townhouse. So I went down stairs, told my fiance and my future in-laws I had PTO for the night... About 20 min later I get a phone call from the staffing office at work...stupid me Ipick up the phone and they tell me it's no longer PTO but conditional PTO, so I am on call untill 11pm. Ok fine..about 3 min later I get another phone call from the staffing office telling me I have to come in for my regular scheduled shift 7p-7a. OK.... Now I call my floor b/c I was annoyed at this point and it was almost 6:30pm and my shift is susposed to start at 7pm. I taked to the charge nurse, she had no idea staffing was calling me telling me to come in and my PTO was cancelled and that I had to work.... I said, "thank god I am at my fiance's parents house which is only 20 min away from the hosp, and not our townhouse, which is 50 min away. but I am going to be late b/c I have been playing musical phone calls with staffing...so sorry but it's not my fault that I was told I have the night off then told I am on call then told I have to come in. So I will be there by 7:30pm...." I got to work and well what a waste...it trns out they didn't need me at all but I said, " I am here, I already had 2 huge cups of coffee, I am going to work so figure out my assignment and no worries. " But this sort of thing happens all the time on my floor. I can't tell you how many phone calls I have gotten telling me I have PTO for the night, then with in 10-30 min later I get another phone call telling me I am on call, then another phone call telling me to either come in or stay home... It's fine if I am being told I am on call, b/c I can be ready...but when they mess around making 3 or 4 different ohone calls teling me different things I get mad b/c I live about an hour away from the hosp. I have gotten to the point when I say, "you know I live about an hour from the hosp, so when you do this last min. come in nonesene, after being told I have off, I am going to be late. When I am on call everyone knows I will be there ASAP, BECAUSE I AM ON CALL. But this calling me and telling me 3 or 4 different things has to stop." It will never stop, but hey I became a nurse for a reason so I guess I am just happy to have a job.
  11. I just wated to tell you, your story sound similiar to mine..I will post more later gotaa go back to work in a few hours but if you ever need to talk just send me a message
  12. Hey guys just got my evaluation for the year, last year I was new so it was a prewritten evaluation..this year I got to score my self, self evaluation before my night shift Nurse Manager gave me what she evaluated about me. Well, let's just say that we use a scale of 1-5...I scored a ton of 4's and 3's on the evaluation from my Nurse Manager at night. She said she has never given so many 4's on an evaluation for a new nurse, meaning under 2 years exp. She also said she is trying to nominate me for a junior registered nurse of the year award. She said that I have improved and excelled more then any other new nurse she has ever seen. She said that I still get frustrated with certain things, I made her name an example(s), she did, and then she also said that no matter how much exp. nurses have they still get frustrated with things. I also pointed out the situations in her examples and why I get so frustrated and no matter how much exp. you have as a nurse theses situations will make you frusrated, she agreed that I got and still do get heavy pt. loads but for a reason, and it may be intentional and unintentional, but she felt that challengeling me as a nurse with certain pt's makes me a better nurse. She also told me that my patient relation skills are amazing, and my objective and subjective assessment is incredible. I was floored that I scored 4's on my evaluation. She also told me that my aggresiveness and advotacy for the pt with the MD's has changed our floor at night. She said, "you used to be timid with the MD's last year and in you eval from last year in january of 2008, you were telling me how hard itwas to talk and make a point across to the MD's b/c you had only been a nurse for 6 months at that time. BUT NOW you make sure some MD, will listen and if they don't you keep calling, no matter what time it is and who you wake up in the middle of the night. You have no fear of MD's yelling at you b/c you fire back at them and you make sure your pt. is taken care of no matter what. She said that I am comming up on my second year of being an R.N. and she is very proud of me. She said that she's very proud of me... After that eval. I got home in the morning and called my mom, my aunt(who is an ER nurse manager, and my mentor in nursing) and told them. My aunt was so happy, she said, "just keep excelling, and I can't believe you scored 4's on your eval. I am proud of you.." Comming from her that means the world to me.... So new grads you can do it! It takes alot of literal blood, sweat and tears but being a nurse is something we choose. And well it's a love/hate job, but those little moments change our lives!!
  13. Morettia2

    Having a hard time with less hygienic patients

    OMG I work in Newark, NJ and we get the worst of the worst. Low income area where my hosp. is located. The pt's that are admitted to my floor with cardiac problems are so unbearable at times. There was one pt. in particular last week. Great guy, young guy but heary transplant rejection and morbidly obese, but very friendly but had the worst aroma. YOu could smell it as soon as you walked into the back part of the unit. I would walk into his room and I had that gagging sensation from the smell. But I maintained being a professional and didn't make a face. He was for TEE on the following day, so Iwas determined to strongly encourage him to was himself very well before I left in the AM...well the CNA was not so professional, she kept telling me, "HE stinks so bad that the other pt's are complaining, and I askd him if he washes and he told me he does, he's a liar..." I just said" calm down this is what you do, when you start your AM care at 4:30am, offer him a hot basin of H20 with lots of soap insted of just asking him to go into the bathroom and wash up b/c he may be too SOB to stand at the sink and do it, soo and as you offer him the hot soapy H20 in a basin ,start to fill the basin up with the hot H20 and soap and give him lots of wash cloths and towls and a big boy gown and just place it at his bedside table, even if he says he can do it him self in the bathroom, fill the basin anyway and I bet he will wash...and make sure you change all of his linens that will also help and I will get you some magic spray for the room, but if the hot soapy water is in the basin right in front of him and he has enought wash cloths and towls to dry it encourages him to washup, insted of just assuming since he can walk into the bathroom he can wash himself," I go into the room at 5:45am to give him his meds and what do you know he washed himself. The basin H20 was so dirty it was dark brown. The pt. said to me, "I overheard what you said earlier to the nursing assistant, I appreciate that you didn't talk about how I smell, I know I do and I apologize but it's hard for me to wash up but what you told the Nursing assistant to do this morning is the first time I have had a nurse care about me. And I thank you for the deodorant you gave me. I feel much better, and you are the only nurse that I have had since I was admitted that didn't say that I stink up the unit." I just said, "well, sometimes a good wash makes you feel better, and if you just have the right way to do it you can really clean your self up, but from now on, just tell them in the morning that you want a hot basin of soapy H20 with lots of wash cloths and to put it at the bedside. But as long as you feel better, I feel better."
  14. Morettia2

    Starting PIV = bane of my existance. Any advice?

    ok had a pt. last night who needed a new PIV. The day shift RN told me he pulled it out by accident around 5pm...I asked her why she didn't put in a new one..she said no one could get a vein, even the MD. I said wel there is a STAT dose of vanco that should have been given at 5:30pm according the ID MD's orders, and the 6pm dose of zosyn was also not given, it's now 7pm, we are changing shift and are all the MD's aware that the IV ATBX weren't given due to no PIV access..the RN said yes...little background on the pt, he's a renal transplant in rejection and ended up on my floor (which is interventional cardiology) due to a hypertensive crisis during a TMA operation. Now, the BP is undercontroll and the MD wrote for the pt. to d/c tele, but because he's been through so much medically his veins were all sclerosed... So I went into the room, introduced my self tld the pt. I was going to try and put a new IV in...he said ok like a good sport... I looked at both arms to see if he had an old A/V fistula or shunt due to the fact that he had a kidney transplant...no A/V on either arm.... So I brought in 2 22g and 2 24g angiocaths... I tried the left arm first, got a great vein to pop after tapping for a while, I made the skin taunght and went to stick a 22g, and nothing, I was in the vein b/c th guywas so pale this veins were bright blue but no flash but I looked at the vein and tried to figure out why I had no flash and began to palpate further up the vein and felt this hard lumps all up and down the arm...so I retracted and went for the right arm...the pt. said to me, "that vein you just stuck, everyone always thinks it's great untill nothing happens, everyone get's that vein and then they are upset b/c it dosen't work" I said no problems, no worries we still have the right arm to try...he said, "one this guy stuck me and I never felt it and he was the only one who actually was the only one who could find a vein" I said, "gimme a chance you will be suprised" So I put the tuniquite on the right arm, and NOTHING, I began tapping away, and nothing, tap tap tap, then finally I saw something, plapated the vien up and down, grabbed the 24g and stuck the pt, BOOM huge flash, I said don't move, he said to me, "you are in the vein?, I didn't even feel it, let me see I don't believe it." I said look...he said "back flush it I can't belive it, that you found a good vein and you didn't hurt me and you got it on the 2nd try, the MD couldn't get a vein to save his life and he was the best..and those 3 nurses that stuck me today just made me have a bunch of holes in my arms wth no success. And now they wanna put a PICC in b/c they can't get a line ever, but you did thanks, and you did it and I felt no pain" I hung the vanco watched the IV ATBX run for about 5 min to make sure it didn't infiltrate and it was all good no blown vein, called the ID MD told him I got a 24g in the right wrist hung the vanco and will hang the zosyn later, he said, "you DID get a vein? How? This guy has no venous access b/c of sclerotic veins, I can't believe you got one on the 2nd stick." I just said, "well I just sat there and waited for something to pop, and got a great vein but put a small gague b/c I didn't want to blow the vein with a large gague while the 250mls of Vanco runs in and have it blow, I also noticed that the vein looks big but when I stuck him it would shrink so that's why I also used a small gague. I know we can't do much with a 24g PIV but run fluids but he now has venous access." The doc said thanks...and this morning before I left the MD actually came in early to see, I had the 6am dose of zosyn running it was susposed to be given q6 hrs so the day shift didn't give him him 6pm dose the night before, but he got the 12am dose and 6am dose ...he just said " I can't believe you found a vein that works"...the pt said, "she stuck me and I didn't even feel it, I like her alot" It's just pratice and patience, and you find your own technique of inserting PIV's. I tend to talk to the pt. and distract them while I stick them, it seems to relax them and they are less likely to flinch when you are taking to them about something. I hate when a pt. pulls back or flinches b/c you end up with a mess and you are more likely to stick your self..so what I found useful, I strike up conversation, get my stuff lined up as I am taking to the pt, and before they know it they have a working IV, and it also makes you the nurse more relaxed when you talk to the pt. insted of saying.."ok, I am going to insert the IV now..." I find that when I say that the pt. squirrms and moves and you blow the vein plus it makes you a little more on the spot b/c the pt is watching you every move... Some pt's like when you explain what you are doing, and are really into watching you which can be fun for you and the pt. b/c they are fasinicated and it's like Q&A time but is a learning exp. for the pt. and you as the nurse are teacching them.. but you also have to read the pt. before you stick them...I usually ask if they are going to flinch or squirm or pull away. Good luck, every nurse finds their PIV niche.
  15. Morettia2

    Starting PIV = bane of my existance. Any advice?

    My fav. place is the hand...you just put that tourniquite on and tap away at the veins in the hand untill you find something. The pinky and the thumb work well for pt's that have crappy veins....but patience is key...just wait, and you can always use warm compresses to make that puppy pop..I also come with an arsenal of gagues in pairs...18, 20, 22, 24...so when that vein does pop you can look at it and det. the gague you need...once you stick just make sure the vein dosen;t roll before you stick...some people LOOK like they have good veins till you mmake the skin taunt then magically it disappers...just keep praticing..
  16. I can stick the worst veins, start IV's on anyone, code a pt. , pull femoral sheaths, tell you about medications even hae MD's come to me about meds, can read rhythms when other people can't..but if you ask me to park my suv in a tight spot forget about it..I can parallel park like a pro which I am a total pro, but pulling into parking spots I am a total spaz.