cmo421

Any management job is difficult with very little satisfaction. Hard work and many hours complicate the many requirements made. It helps if you have a assistant to buffer the many needs of heading a unit. If you are talking of shift supervisor,thats much easer. The shifts are long and demanding,but when you go home ,that is it,you are done. I am not trying to discourage you at all,just being realistic. One has to really want to progress up the ladder to assume this role on a unit. Many times once you start,you can make it your own and establish protocols that will assist not only your employees,but you in management. Be kind,open minded,see the Grey areas,not just black and white. Remember everyone is different and their nursing style is their own,as long as safety is met,kindness is a priority and patience come first,it should not matter. Not everyone has to go A-Z the same way. I hope that you have a great boss yourself to guide you and mentor you in the transition. Good Luck!

Burn out,unfullfilled dreams and lives. Poor working conditions and so much more contribute to this state of mind in some. So many go into health care to fill a hole that is inside of them. It never fills but with anger and bitterness. It is these indivisuals that become mean and fresh. The opposite pole is the majority that love what they do, realise the pitfalls and adjust accordingly. My new way is to smile at all my co workers no matter what, my mind might be saying what I want, but my mouth is in happy,tolerant gear. Does not always work, but it will remain a work in progress!

I resolve this year to: 1) Try and quit smoking 2) Overcome my PTSD and be able to look those in the eye who facilitated it ,without crying. To be able to look them in the eye,and tell them,in a strong ,steady voice, that they will never again affect my world. Then, to move on and grow strong again. 3) To take my physical pain and learn how to make it less of a disability and more of a facilitator to change. 4) To be more thankful each day for the partner,children,family and friends , I am so lucky to have in my world!

Good luck! Life is great after divorce. I always say, I gave up men for lent 12 years ago and lent myself to living!

How I wish there was a way for evey medical person, especially ER personnel, to experience one day of chronic like pain. If they had to, or family had to, I bet my bottom dollar, that pain control would become a priority and tolerance for those in it, would soar. In practice I must say to myself, "There, but for the grace of God , go I ". Always someone worse off then myself ,and it helps to remember that daily.

Just stating what I have learnt in recent months from personnal experience. I am also a huge advocate for pt privacy,and have been way before it became vogue. I think it is mostly common sence and ethical values that will encourage the profession to maintain our pt's rights. The powers that be in hospital certification have made this a vogue issue and now it is all the thing. Funny thing is,hospitals and such pay these organizations to certfiy them ,and pay them well. It is all a public image thing basically.

HIPPA is actually a joke. Pt confidentiality and respect is more the answer. Hospitals and such are throwing HIPPA at us all the time ,when actually they,and insurance companies are the greatest rule breakers. One chart and all its information is seen in detail by so many people ,it should just be published. If one researches pt privacy and all that is published and sold out there in the info world, u would be astonded. As medical professionals, it is our duty to protect our pts rights and privacy,the best we can. In speaking of them in the third person,or using them as an example in discussion,just be smart and use very limited info. I have never seen anyone step over the boundaries here myself. This forum is a wonderful site for learning from others. Do not take rules to the extreame.Utilize them in your practice and encourage them in others. If you really have an issue with HIPPA and such. Advocate for a change in pt privacy laws.Think about this.Pharmacies sell your information all the time. Your social security number is actually public information. If only once, you have put that number on a public document,it is considered fair game.

Mass emailing allnurses for help, is not the way to go. (I received two) While always willing to lend a hand, much of what you need is already in this forum. Try doing a search here and also google. Good luck!

I try to do the best I can when typing here, or anywhere. I also try and proof read. But, I am not very maticulous all the time. Like most nurses and people today, I seem always to be in a hurry. I notice that I am improving over time. Now that I know that there are rules to follow to get something read, I will be more careful. Maybe a pre-req. to joining this site, should be a few years of typing, grammer, and of course English and writing. All nurses brings in people of ALL levels, backrounds and areas of the world. Maybe it should restrict it's members , so that not to offend anyone. Just my two cents ! Merry Christmas All and may yours Holidays be safe and tolerant of others !

If someone is found in a post mortum state,dead, no chance of bringing them back, it is unethical and poor judgement to go pounding on their chest.You might not agree, and cya is always the safe way to go, but I am just saying what is ethical and within our licence. We can not legally "pronounce", but we certainly know when rigor has set in and someone has been gone for more then a few minutes. Ask someone on an ethics committee what they say. I am betting they will agree. It costs money and time to code someone, and we have to do it,even when we do not want to. But there are limits to expectations. Documentation is key, and will hold up in a court of law. Now , if one chooses to jump on a cold chest and do cpr, go for it. Not me. I have had this happen before and never had any backlash.

If u walk in and they are dead,dead,dead, then let them be dead in peace. A full code is done on a warm body,not one in rigor. No family member or ME is going to tag u for making a judgement that is in the best interest for all. Document what u found, how the body was, lack of VS and move on. Codes are expensive and even in the ACLS protocol, they say dead is dead. I would not be breaking ribs on a body that lacked spirit for a time. JMO!

Actually, a DNR order can and should be written on admit, no matter what the diag, if the pt request it and has a document. An elderly person of 90 ,might come in for a scope and code on the table. It is what it is. When nature takes its course, a pt's rights should pervail. I know there is much controversy here, but come on, do u wanna be breaking ribs on a 80 year old, no matter why they came in?

Merrick Manual will fill u in on all of this and lippincott can help also. Google is also a great idea.

I gave the last dose to my Mom before she died. Ratty resp. ,comatose, but obviously in the last moments of her life. Cried for months over that , but will never regret the fact that my mother died without pain and that her grandchildren,holding her hands in death ,did not see their grandmother suffer in her last moments.

I agree! It worked for the dirty dozen,,,lol.

Well I have never seen one either, but we need one. Betadine is really, really outdated now also. Unless we let it totally air dry, it is useless and also it inhibits new tissue healing. This is fairly new in the literature,but going into practice over the last year. It is just getting the betadine off the units. It's been a standard for so long,it is hard. Thanks for replying!

Read about Toxic bowel syndrome and its incidence in the critical care areas. With high use of antibiotics and opiates, bowel problems should be a high priority,but sadly they are not. High temp,sedate elder person? Possibly just ***. I so remember getting a terminal middle age woman from a LTC,chronic abd pain,high temp, high WC. Turned her over to assess her backside,and her rectum was dilated no less then 4 inches around, no kidding. Since then, I always think of the bowel regeme as high priority.

"rampant unprofessional behavior" seems to be more acceptable these days ,then not. Witch hunts against those who tire of such and report to the powers that be, is also more the norm. But , ethically, and morally,one does what one has to do. Agree with documentation and CYA ,statements. Sadly, those that are willing to go the road ,are those that are "punished"

Thanks for the reply. In my research and in speaking to IC people, betadine is now frowned on post op and really anytime. Unless it is let completely dry when used,it can actually become a medium for growth. It also inhibits healing in open wounds . I am learning somethng new each day. Thanks again!

Actually the cloraprep people just left my office. They r going to send me what they have on it. Right now they say it has limitations with certain incisions. Thanks!

Never take the role of giving meds lightly. Too often after passing meds for years,nurses become complasent. Mistakes are most often made when we think things are routine. Distractions play a huge part in errors. Stop what u r doing and switch gears until u can completely concentrate on the MAR and meds. We multitask so often,put this is one area that requires 100% attention. Consequences often depend on the error and pt condition,etc,,,, They vary and are too munerous to mention. Avoid the consequences by valuing the importance of med giving. ( we all have made mistakes, most of us are just lucky that no one died or became gravely ill because of it) Christine

Looking for some feedback in this area. We have a rate increase in post op cardiac harvest site infections. High thigh wounds,close to peri area. Any standards out there ? I have looked on so many site and can not find what I am looking for. Evidence based practice would be great. Thanks in advance! Christine

http://www.medscape.com/viewarticle/566561 Great article on back pain and the MD perspective and recommendations for treatment inicially.

From someone who has been there, and done that, I say get legal help. Now. Look up your state's comp laws and regulations. Do not count on ur employer to do the right thing. Therapy should not be given without some type of xray to rule out cord issues. I waited two months before getting a lawyer,and regret it now. I am back to work on permanent light duty and in school to move on to bigger and better things! Hope u feel better and good luck! Feel free to email me if u have any questions. Christine