HazeKomp

Never tried it. Won't try it. Do NOT care if it is legal or not, feel it is terribly unprofessional and unsafe to be under the influence. I am an old nurse with many chronic aches and pains but I never, ever work with any medication stronger than Motrin/Aleve/Tylenol on board.

So basically, should age alone be a requirement for retirement? Simple answer: No. As per others' comments, ability to give safe care is not determined by age, but rather by a multitude of factors. Physically, we older nurses may need more help pushing a bed, but we are also your great resource for challenging situations as we often have "been there, done that" before. It is a trade off. Yes, I am dog-tired after a busy 12 hour shift...but so is everyone else. Yes, I will probably need hearing aides in Yes, I wear glasses...but I've been wearing them since age 9! Yes, I am aware I may not have the best memory...but I've been writing myself notes for 30 years: I LOVE post-its! Yes, my math skills are awful and I want to have med dosages double-checked with another RN...but I've done this for 30+ years of nursing for patient safety...I flunked Algebra I and barely passed my other math classes, so this is nothing new. Yes, I appreciate help turning patients and pushing beds...but so do my co-workers! Do I probably spend more time on my days off "recuperating" than my 20+ year old peers? Yup, I'm positive I do! Would I like to retire at 65? You bet! I'd love to have time to do more volunteer work, spend time with family, travel, etc. Can I retire at 65? Nope. I am the sole support of my family, as well as contributing to the expenses of my children and their children on occasion. Can I retire at 65? Nope. I have NO retirement plan, per se. And my measly 401 K won't last two years. Too many expenses raising a family kept me from major contributions to my own savings. Most teachers, police, firefighters and other service professionals have some kind of retirement plan. My friends who taught in New York have a comfortable life of retirement. I will be moving into my car! Please do NOT judge people by their age, any more than you would by their color, their religion, etc. I need my job til at least age 70!

I currently do not have a gun or a permit for Concealed Carry. I would like to learn and to eventually have both. I enjoyed target shooting in archery in college and would most likely enjoy it with guns. I don't know if I would ever "carry" but strongly would like to have the option. Why don't I have either yet? time and money! To safely & responsibly own a gun and carry one, I feel one must take all available safety courses, one must have a firearm that is suitable for themselves (ex. I have small, weak hands so a huge gun would be difficult for me to handle properly), and one must practice frequently to stay proficient. I think too many folks with hand guns buy them and never really become skilled in their use, just leaving them locked up in case of an emergency! I don't have the time or the $$ to do what I think should be done to be a responsible gun owner. Would I "carry" at work? Nope. I work Labor & Delivery and have few conflicts there. However, depending on my commute, I might "carry" in my car and elsewhere. My son, the father of two little girls, has his permit and "carries" wherever he goes with them. He would defend them at any cost! And he fits my requirements to be a responsible owner by taking courses, frequently going to the gun ranges to keep up on his skills, and keeping them safely secured in his home.

As a 30 year veteran in Labor & Delivery, I often wonder how much longer my old bones can handle the 12+ hour shifts! Where I work there is a high epidural rate which equates to a great deal of physical lifting; our charting is to be done at the bedside, standing; and there is a high C/S rate which means moving beds with patients frequently as well as standing in the ORs. On busy days towards the end of the shift, I cannot sit down for fear I could not get back up again, my knees, legs and feet hurt so much! I often contemplate where would I go when L&D is no longer an option.......... sigh.

For young nurses, nurses with families, and some others, 12's allow more time off and flexibility in scheduling. For some, working 12"s allows them to work TWO full-time jobs!! Whew! For many, that "wall at 10 hours" is a reality! Observe and listen to your peers and note how many comments are made about fatigue, difficulty concentrating, physically uncomfortable, loss of compassion, and loss of patience happens around that time. I know in my unit, admits at 6:30 are met with moans and grumbling quite frequently. Reality: We work 12's because it is cheaper for the hospitals! Proven in multiple studies: 12's are more dangerous for patients! (would YOU want YOUR elective surgery at 8am or at 6pm?? Think about it....)

Our hospital has some great male postpartum, nursery and NICU RNs!

Absolutely NOT! Having care providers attend comforts the families and manifests your level of caring for their family member!

My father was on a Med-Surg floor for two weeks, with terminal lung cancer. By the time I was able to get off work and fly to his location, he had fallen twice trying to get out of bed to the bathroom and had developed pressure ulcers on his sacrum and lateral ankles. My father was a very quiet man, who would never complain, never want to bother anyone. I found the staff's attitude was pretty much the "he's gonna die, so if he doesn't ask for anything he must not need anything." Needless to say, he was moved to a hospice care shortly thereafter where he was kept clean, comfortable, and pain-free until his death a week later. I do not see a terminal diagnosis as an acceptable excuse for patient neglect. I am a Labor & Delivery nurse of 30 years. When I have babies born that have "incompatible with sustained life" diagnosis, my babies are bathed, dressed, kept warm, held, and loved until they die. They are not left lying in a crib in a corner waiting for the inevitable. A terminal diagnosis is not permission to neglect basic human needs and the right to high quality nursing care.

#1 any notes/journals/papers you may have at home or in a locker will be called in as evidence! Period. #2 any notes/journals/papers you may have at home or in a locker are indeed a HIPPA violation. Period. #3 denying the existence of such notes would be perjury, jail-time... let alone unethical! #4 most likely against hospital policy and you could loose your job if they find out.... could also be against your state's Board of Nursing regulations and you could loose your license! So............ two suggestions: #1: become a charting professional, putting details into your notes and charting! Remember, not charted=not done. Also, most cases do NOT come to court for many years, hundreds of patients later! #2: IF you DO indeed have a special case, situation that you are concerned will come to court in later years, put the "special" documentation into your hospital system's occurrence/incident reporting system! The hospital can legally keep the info for reference and you are remaining professional, ethical. ex. the litiginous patient who keeps threatening to sue everyone ex. non-chartable information about sentinel events like low staffing, missing equipment, poor response times from support crews, etc. ex. doctor problems like "don't tell the patient but I'm not ordering that because I think it is a waste of money on them" "I have a hot date, so don't let her deliver the baby between 6pm and 10pm" I am known for my detailed charting... it has come in VERY handy on several court depositions! I am known as the "Occurrence Report Queen" because I insist on patient safety and quality care! If someone or something puts MY patients in jeopardy, I'm reporting it! Examples: frayed cords engineering are slow to fix; unsafe staffing levels; doctors who are either unsafe or just stupid, etc Do not keep notes at home.

And kudos to the patient-advocate nurses who refuse to check patients just because the clock says it has been two hours!! If they are early in an induction and not contracting well, why check them? If they have prolonged ruptured membranes, minimize lady partsl exams! If the doctor insists on an unnecessary exam, I chart it as an order on his/her order sheet, chart it in the record as a VE ordered by the MD, and tell the patient the VE is one ordered by the MD! (I know, sorta ****** of me I suppose) I started in L&D with a group of midwives and OBs who were trained where they were only allowed FIVE lady partsl exams of a patient in the entire labor! Those folks were very, very conservative about doing exams, saving them for time when the info is more important. With induction patients, when I am left on my own to decide, typically I do a VE on arrival, prior to IV pain meds, after epidural placement, and every 2-3 hours in active labor, and as needed during transition. In the early stages of an induction I will go hours & hours without doing a VE, if the contractions are mild or irregular or the patient is only cramping. Patients sometimes ask "Aren't you gonna check me soon?" I tell them I do VE upon MD order, upon medically indications like before pain meds or with decelerations, or as appropriate for their stage of labor. (IF I have a good rapport with them, and they are already used to my somewhat perverted* sense of humor, I'll tell them I won't check them to satisfy THEIR curiosity or their mother's curiosity about their labor progress!) Haze *perverted sense of humor: after 30 years in lady partss, I can get a little silly and twisted in my language. Example: trying to get a patient to get their knees apart to let me do a lady partsl exam "Honey, you've gotta get those legs apart like you did when you GOT pregnant!" Perhaps not ideally professional, but sometimes humor works best with some patients!)

Early labor/Cervidil placement lady partsl exams are uncomfortable. The cervix is typically very posterior, up high, and difficult to reach for even nurses with LONG fingers. There are, however, several things you can do to make it less traumatic for the patient and for you. First is patient education. Explain why you are doing the exam, that it will be very uncomfortable but you will do your best to do it quickly and as gently as possible. Explain that sometimes medical/nursing procedures require you to be "a good nurse not a nice nurse" and do things that hurt. (another OB example of "good nurse vs nice nurse" is fundal massage after delivery. It hurts but if NOT done, patient may have retained clots and unnecessary heavy blood loss) Another is developing a rapport with your patient. Do not walk in, announce to your patient your name and that you are going to do a VE that "is gonna hurt" and dive into her lady parts from the door!!! (we have all seen doctors and nurses who use THAT technique!) Help her to relax a bit and get comfortable with your caregiving skills and her environment. Protect her modesty, minimize her exposure. Many very painful exams are on primigravidas who still are modest. Be sure unnecessary family/visitors/staff exit the room. Be sure the door to the room is closed. Keep her covered as much as possible. Position her optimally for the exam. I know nurses who have their patients make fists of their hands and have the patient put their fists behind the sacrum to make the exam easier-- I don't like this one personally. On VE where I anticipate the cervix being very posterior and high, like for Cervidil placement or the first VE prior to induction, I prefer a different position. I have them lying flat with the HOB down, pillow under their head is OK but not under their back. I have them bring their knees up, grab their knees and pull their knees back towards their armpits in a curled up position. This tilts their pelvis and makes it easier to reach the cervix. You could almost compare the position to a "McRobert's Maneuver" position. I'm right-handed, so I often push gently on their right foot and have a coach helping them hold their left leg. (By touching their foot, I can feel them starting to move before they kick me, so I have time to get out of the way! hehehe) Use a lot of lubricant. (lady partss are best visited when moist) Go in very slowly. First touch the perineum and wait a second to let them adapt to the initial touch. Then slowly enter the introitus and stop again to allow time for them to adapt and cope. Then do what you have to do, reach the cervix, and get the heck outta there! Have a washcloth ready to wipe her perineum afterwards. No one likes that post-GYN-visit K-Y jelly slime left on them! Cover her up. Apologize if it was traumatic/uncomfortable. Tell her she did a good job getting through the difficult exam. and position her for comfort afterwards. I hope this will help you. Again, many times in L&D, and in nursing in general, one must choose to be a GOOD nurse not a NICE, gentle, "oh, poor baby" wimpy nurse! L&D nurse of many, many years who still loves her job and her patients, Haze

As a L&D nurse, I get body fluids on my skin daily DESPITE wearing gloves. It's a messy job. That being said, wear gloves when you can. But I've done CPR out in public, exposed to complete unknowns, because it was an emergency. I would have applied pressure gloveless if it was a true emergency. (cut artery stuff) But not if alternatives available, like cloths, garbage bag or a pocketful of gloves. In the hospital setting there are very few times when the emergency is such that not using gloves can be condoned. but I must agree with the "old nurse" (like me) who mentioned that some people seem to think that gloves will always magically protect them from pathogens. Wash your hands, folks!

I want replies! I am 30+ years in OB/L&D and the 12 hr shifts are getting very difficult physically!

:yeah:I appreciate this thread, and the comments from both faculty and students! I work full time in L&D. I do clinical instruction one day a week. I only get the students for 6 hours (seems short time to both them and me) so it is a PACKED day! We have brief pre-clinical conference: give out pt assignments, discuss goals, gather paperwork, etc. On the floors from 7a, report time, until 11:30. Off to post-conference x 1 hour. Our post-conference covers brief description of "their day", Examples of "good nursing" and "bad nursing" observed by the students, discussing areas of questions/concerns,a 5" oral presentation w/ Q&A period per one student a week. I then discuss in detail a pathophysiology area that students seem to be weak in, or something high risk that they may not be able to experience. I do NOT start late, waiting for tardy students. I do make a conscientious effort to be out on time or 5" early. Hopefuly MY students find this a proper use of their time!

Ta Da! Karleena is now an employed RN!!!