pRNss808

I like to keep my patients' glucose levels above 100 over night. Anything lower can put them at risk of hypoglycemia by the time breakfast rolls along.

Here's what happened during my night. 20-something year old male. Status post femur fracture with ORIF post op day #3. History of multiple drug use. Complains of pain throughout the night. But requesting for Morphine IV and Tylox or Tramadol PO at the same time. States that nurses are giving them together. Checked the eMAR and noticed that nurses weren't giving them together. But were administering narcotics within less than an hour of each other, as close as less than 30 minutes. I was totally against administering the patient's pain medication in this way. I explained side effects of administering multiple narcs at the same time and explained the hospital protocol. What would you have done? And what is your hospital's protocol for pain management?

I wish our CNAs could at least do blood glucose checks. But then the problem would be reporting abnormal values to the RNs. No excuse not notifying the RNs because we all have iPhones using the Voalte system.

The CNAs would NEVER get 18 patients each. Nowadays, anything more than 9 they're already ******** and complaining. I had one literally looked in their union contract. There are several nurses on my shift that are very notorious for not helping out their aides and other nurses. Regardless of how busy I am, I try to help out. Even though they are not my patient. Because if it were me laying in that bed, I would want someone to help me out. If that patient were my own mother, I would want them to care for her as soon as they can. And hey...what goes around, comes around. There will be many times when I myself may need help. Sometimes we can't help it if we're short-staffed or we get slammed with admissions. Two big hospitals closed down a little over a year ago. Many times Med-Surg patients are being held in ER, waiting for a bed to open up on our unit. If 12 was managable at one point. 6, 7, 8, or even 9 (at most) are doable. I just don't understand them. I know acuity is a major factor. But at my unit, acuity gets thrown out the door (this is for another thread). Majority of out patient population are the geriatric. This is my thing: The time spent complaining could have been time used to take care of a patient.

There defintely is poor work ethic amongst majority of the staff (nurses and CNAs). I constantly hear, "I don't care," and "Whatevers." Call lights are lighting up the floor and bed alarms are going off like crazy. I even see staff walk by a call light without even peeking in because, "that's not my patient." CNAs complain when they have more than 6 when 12 was doable in the past. I'm constantly always offering to help, regardless of how busy I may be. I will answer a call light or help a patient that's not even under my care, but will do it anyways. Because no matter what, I will always be busy. There's always something that needs to be done. What if that patient was your own family member? Wouldn't you want someone to help them? I rarely take a break, although I should. My definition of a break is to actually sit down and focus on my charting. I was just curious what everyone's ratios were to sorta prove a point to my manager that most CNAs have a lot more patients to care for than what our unit is currently caring for now. That the problem to our falls and decreased patient satisfaction surveys is not the ratio but in their care (and work ethics).

To make a long story short: Had a loooong 8 hour shift on a Med Surg unit (42 bed capacity). In our last staff meeting, the manager has decided to decrease the CNA load from the previous 9-12 patients to 6 (Day & Eve)-8 (Night) patients to improve patient care and decrease the fall rates. Nurses still have 5-6 patients regardless of the shift. With that being said, I feel like I'm doing more work and working harder now than before. Don't get me wrong, but I really appreciate my CNAs and the work that they do because they do a lot better than I could ever do it (and faster). My mom is a CNA at the hospital I work at and I hear the things that she has said about her unit (Long Term Care). I seem to be answering more call lights for diaper changes, emptying urinals, refilling water, and etc. The CNAs take their "mandatory" breaks, have time to talk story with other co-workers in the hidden corners of the unit or in the kitchen having a "dinner party" while I'm running around like crazy. I have a pedometer on me and I walked almost 8000 steps on my shift. [*Sigh* There's my ranting for the day and hopefully I can sleep.] So I was just wondering what your unit's CNA to Patient ratio is and if you have had experiences similar to mine. And what have you done to minimize the situation? Maybe I could make some suggestions with my manager or something.

I know EXACTLY how you're feeling because I'm sort of going through the same thing. I get anxious and queasy before work. I have the "seasoned" nurses chewing me out. When I ask for help, their response is usually, "Oh...you're supposed to know." Work is only 5 minutes away. But I feel like the short distance is not worth this kind of stress. So you're not the only one...

My first paycheck was partially spent on a Tiffany necklace with a butterfly pendant. My next big purchase for myself is a 3 series BMW convertible that I have been saving up since I started working. It's arriving days from now, in time before my birthday. I'm excited!!

Uniforms Hawaii across from Costco on Dillingham. Drive towards HCC. You'll eventually get there. Go UH! Congrats! I know how hard it is to get in. I started in a class of 30 students in 2004.

I get the same way before I start my shift. Most of my anxiety comes from my co-workers. The hospital I work at has no new grad program. So they rarely get new grads. I think they feel threatened. So they like to "test" me. But right after change of shift, I lose all that anxiety. I absolutely hate that feeling and dreading to go to work. I've only been working as an RN for 9 months. And at one point, I never thought that I would dread my job. It's the horrible work conditions that I have to deal with. And it looks like I'm not the only one!!

The problem with the unit that I work on: everyone is out for themselves and themselves only. They're always pointing the finger at someone else. What ever happened to teamwork? Is this where nursing has come to? I didn't get into this profession for the money. I love taking care of my patients. My concern is with my colleagues. I notice that a lot of my co-workers come into work looking grumpy already. At the end of my shift, I had a resident comment how radiant I looked and asked if I were just starting my day. I told her, "No ways! I'm going home!" I never thought that I would be working under this kind of working environment. I've had non-nursing jobs in the past. And I never had a big problem with co-workers or working conditions. It hasn't been a year, but I already dread going to work because of colleagues. As soon as I'm done with receiving report, my passion for nursing and caring for patients returns.

I'm in a similar situation with majority of the staff. Asking them questions goes back on me feeling stupid. No matter how stupid, I rather ask then to do something life-threatening and potentionally injuring someone. A lot of times, they just answer, "You're supposed to know." Then I end up having to ask another nurse. I feel for you. And it's sad. Aren't we professionals? All we can do is be a good example for those newly coming in. And hopefully, there will be a little change>

I know EXACTLY how you feel! The other night, I had it so rough that everyone (including my manager) knew just by looking at me. I'm usually always smiley and cheery, despite how busy I get. So for this particular night, it was that bad. I think that the other shifts don't understand how nights can be very difficult. We don't get the back up (unit clerks, more CNAs, etc.) like they do. If I'm not busy with patients (which is hardly ever), I'm researching charts to prepare myself for questions that day shifters are going to ask. Majority of my RN brain is notes for them. I can understand if it's a patient that's been newly admitted the previous day. But when I get patients from previous days, a lot of information I have told in previous reports to RNs aren't mentioned thereafter. So when I get asked about that particular information, I don't remember the exact H&H. These nurses I give report to literally "roll their eyes" and say something passive agressively and I feel stupid, dumb, etc. If the other shifts knew how busy nights can be. As for me, I've been oriented and worked on all shifts in the past 9 months that I have only been working as an RN. So I have some understanding for other shifts. Do they?

I finally got a job, but it's only on-call. Hey, it's better than nothing right? But yeah, I'll keep trying. And thanks to everybody for the posts. At least i know that it isn't just me...

I've been there and they have some cute stuff there. The owner is/was an RN at Tripler (I think). They have a lot of the latest brands and Hello Kitty stuff (which I love).