Lady_Bing

I have observed that most RNs on our floor do clean drsng when packing wounds or doing WD drsng. I asked about that and the thought was - well, when the pt goes home they will not be doing strerile drsngs anyway. However, I still use a sterile technique, because even if the pt will be utilizing a clean technique at home, they are HOME, not at a hospital. When they are at a hospital, we should be going an extra step to protect their immune system.

To update everyone who has been so helpful and encouraging :) I am slowly getting better with practice. Yesterday another nurse had a patient who had really bad veins, she asked a senior nurse whom I was following to help her out. The senior nurse grabbed me and we looked together for veins, when we found a good one, she said - go ahead, you can't do it and I did it :) Thank you all once again for the positive feedback.

I am a new nurse and I actually had sassy attitude coming from colleagues who have been a nurse for 5-6 years and who are relatively young ladies in their late 20s, early 30s. We do have several nurses who have been on the unit for 15-20 years and they are just wonderful. They don't partake in any gossip or drama. I am serious, whenever the conversation turns to a specific person or specific personal situation; they just get up and leave the nursing station. I have witnessed that on many occasions. They are also very helpful and kind to newbies and to everyone on the team. Other nurses seek them out for help and you could tell that everyone respects them. You should see these nurses handling a crisis situation - there's no panic, they never raise their voice, they get everyone organized and you become calmer and more focused in their presence. I consider them to be the pillars of our profession. I think it's safe of me to assume that there's nothing about new grads that could intimidate these nurses. Now here's my two cents about being a brand new nurse and a relatively young nurse (I am 25 y.o). #1 In nursing you come across different personalities and it is important to get along professionally with everyone - with your patients, their families, doctors, nurses, nursing assistants, nursing managers, environmental support. It comes down to respect. If you show respect to the other person, they are more likely to respect you back. However being respectful doesn't mean that you have to compromise your professional integrity and do whatever the other person says you have to do, there's a little technique called assertiveness JJJ it really works J #2 When it comes to sassy attitude from co-workers - I try to focus on the message that is being delivered, rather at how it was delivered. Bottom line - if you are a new nurse there's so much to learn and you have to embrace the criticism and learn from it, without making it into a personal statement against you or the kind of nurse/person you are. Some nurses are more diplomatic when delivering criticism, some are not so much. Regardless of how diplomatic they are, they are still sharing their knowledge and their experience with you and I am grateful for that. I would rather have a more experienced nurse point out that I am doing something wrong, albeit in a snappy attitude, than have her say nothing at all because she is worried about hurting my feelings. In the end, I have to ask myself, what benefits my patients?

I had a patient last week who had terminal lung cancer (he looked like he was losing the battle) but sadly he seemed to be in the "anger" and "denial" stage of grieving process. He was admitted for nausea/vomitting. Doctors suspected that it was due to his chemotherapy so it was stopped for a week. Predictably, the chemotherapy agent was still in his body after a week and he was still having emesis. He refused Zofran and other anti-emetics because he felt that they there were not doing anything and he "felt like sh*t". During rounds with the doctor (I was present at bedside) - the patient stated "I hate this hospital! And the nurses! Everytime I ring the bell, they come in 10 minutes later and ask me how I am doing and offer me Zofran!" I was surprised by that statement. I thought we were doing our best :/ I also had a lady one time who when being asked if she in pain, looked away from me and said "I am fine!". i should have realized that she wasn't "fine", but it was my first day on the floor after orientation and I had 5 other pts. Later she complained to her daughter and the doctor that she was in pain the whole morning and no one did anything. The doctor pretty much yelled this info at me. I walked back into the room and asked the pt to clarify what's going on, she explained "well, I was being ****** to you, you should have realized that I am in pain!!!!" I just told her that "pain management is an important part of nursing care. that is why we ask our patients frequently if they are in pain and ask them to rate their pain. please share this information with your nurse, as it helps us take better care of your needs. The fact is I don't want to see any of my patients suffering, but I can't also make any assumptions about people's characters. if you are in pain, let me know and when I ask you if you are in pain, let me know, I will be here as soon as possible to help you out." After we established that we had no problems, family was very nice to me for the next 5 days. Sometimes there's lines of communication are not clear, don't take it personally... p.s. I have also seen a lot of families exaggerate their stories when the doctor was in, as in "he IV was bleeding all over the bed" - when really it was a couple of drops when the tech put an iv in. Or "the nurse took an hour to bring pain medication" - and it was more like 20 minutes - because guess what - you stand in line to get your meds out, and it takes time to count narcotics, and if you have lab calling you about a critical value, yes you have to fill out that sheet right away.

Hi CareBayer! Hang in there, darling. I know how you feel. I finished my 8 week orientation two weeks ago and I have been on my own for 2 weeks. It’s a hard transition from being a student to being a nurse in real world. No matter how well you did in school (I graduated with a 4.0 and did excellent in clinicals) , you can’t go from a novice to an expert in a very short time. It takes time to learn how to manage your time and your patient load, how to deal with doctors (who don’t always collaborate and consider you a part of the team), how to deal with patients who don’t respect you as a professional, how to deal with families who are anxious and don’t understand why you have to divide your time between 6 people and not focus on their loved ones (because it is not their job to prioritize getting their mom a cup of coffee or choosing to hang blood on the patient next door, it is yours!). Try to get the most out of your orientation experience – learn from the best and also learn from the worst (learn what not to do J !) Some preceptors prefer to step back and kind of let you figure out things on your own – a good preceptor will still be there to answer questions and make sure you are providing safe care, but they will stand aside, giving you a chance to practice your critical thinking skills and allowing you to become more confident in your abilities. Others believe that teaching you a solid routine will help you succeed. Of course there will always be some nurses who don’t like to teach and feel frustrated by newbies, hopefully they are not functioning as preceptors. Like I said before, don’t despair – ask anybody and they will tell you that it takes time to get the hang of things. I think the fact that we are feeling anxious is a good sign - we are concerned about making mistakes, we are concerned for our patients, we are thrust into an unfamiliar hectic environment and we realize that we have shortcomings that can harm someone – just the fact that we are aware that we don’t know everything and we ask questions and get help when we are in doubt, sets us apart from new nurses who assume they know everything and don’t get help/ask questions, thereby compromising their patient care. I’d like to think that hopefully in a year our brains and our hands will catch up with our heart and we will be able to manage time/problem solve/start IVs just as well we love and care for our patients. Stay strong, take good care of yourself, and find a good support system at work and at home. p.s. do you have a clinical nurse specialist on your floor who kind of oversees your orientation and meets with you to evaluate your progress? If you do, you should be able to share any concerns about your orientation with that person (as I understand, that’s a part of their job J) p.p.s. try to find nice senior nurses – you won’t believe how many good nurses there are out there who are wonderful teachers without being put officially into that role. They are endless reservoirs of knowledge and experience. Watch what they do and how they do it!

Heya. I am also a new nurse and I wear "nurse mates". I have to say that I liked them when I was in nursing school when my hospital experience was limited to a few clinicals. Now that I work full time, I come home in pain. I am exploring different options at this point - I need something better than what I have.

Hi guys! Does anyone own orthotebb shoes or knows anyone who does? I would love to know if they are comfortable. I wear Nurse Mates right now and my feet burn like the hottest fires of hell at the end of the day I also tried cheapy immitation of Crocs - feet hurt less, but I kept tripping thw whole day ... Thanks in advance.

quote=julesar;2638149]i worked on same day sx for 17 years and it is a great place to get practice. couple of hints: if possible, tie the touniquet tight- makes a huge difference. also, if it is an elderly patient with very small veins, try to use the smallest gauge catheter possible b/c sometimes the vein just won't hold even a 22 g- and it will do fine with a 24 g. i learned early on that if i advance the cath. just a little more than when you get a blood return, the vein doesn't blow as much- i think the cath is sometimes not all the way in. don't feel badly about your ability- i work with many long-time rn's who cannot start iv's and i think it is entirely due to lack of practice. when you only have one or two a wk compared to ods having 20/day, you just don't get practice. one more thing- do not fall into the trap of leaving the iv in after it is sore and/or infiltrated b/c you feel inadequate in restarting. for the patient's sake, try once or twice and then get the best iv nurse on your unit and don't feel badly about it. hang in there, it will get better! thank you for all the encouragement and advice. iv is such a sensitive topic to me - i end up being sort of fixated on them and if i see any sign of phlebitis and/or the pt complains - that sucker is out of there in a sec. i can't imagine someone ignoring a bad/infiltrated iv for any reason, that's just goes against every principle of good nursing. i always try to start an iv myself - and if i don't get it on a second try - i ask another nurse to help me (and i try to do something for her/him later in the day to kind of make up for the time they spend on helping me). but i feel bad for the patient that they are getting poked multiple times on account of my incompetence. then again if i see someone has really bad veins, i call a stat nurse - there's no need to torture someone just for practice. for example, if i know that a senior nurse (who is really good at ivs) couldn't get an iv into my pt yesterday and had to poke her 2 times, i call the stat nurse for help. the thing is we only have two size catheters #20 and #22. and of course smaller veins would call for a #22, but if i know that my pts hgb is dropping and he had transfusions yesterday - makes me realize that the next logical step for this pt would be having a #20 in case he will need more blood.

Thank you, guys! I will be taking your advice and asking management if I can spend a day just doing IVs and improving my technique.

Hi everyone, I am a new nurse on a busy medical floor and I am just two weeks off orientation. I am having a really hard time starting IVs, I did not get an opportunity to start many IVs in nursing school and now when I am on the floor I find myself feeling handicapped in that department. I read a number of posts on the boards and found really useful tips, and I am now able to see and touch the vein, but I am having a hard time finding the vein with my needle/catheter. And even when I get the blood return, I am having a hard time advancing the catheter into the vein without blowing it. I realize that there is an art/techinique/ to starting IVs and I need experience, but I am feeling very frustrated because despite getting practice, I am not really improving. Please help.

i am a new nurse and i just started on a busy med-surg floor. i find myself perpetually overwhelmed by the pt's acuity levels and the number of patients that i get (typically 6, but has been higher on several occasions). i am constantly running from one room to another, i am lucky if i get 15 minutes of break (management believes that if you schedule your lunch at a specific time and you didn't go, that it is your problem, not theirs). there's really no time to sit down and read the pt's history/chart to get a clear idea of what's going on with your patients, it's also hard to stay on top of all the labs/procedures/new orders. i do my very best to listen to the patient's fears/anxieties/concerns and advocating for them, but most of the time i feel that my patients deserve more. before getting this position, i did my externship on oncology floor and i loved being able to sit down, talk to my patients, get to know them, provide comfort and support. i walked away every day from that oncology floor feeling like a made a difference, i built bonds with my patients, they remembered my name and missed me if they didn't see me for a couple of days. to this day, i remember most of their names and their medical diagnoses! and that was almost a year ago. the patients were more acute than the pts i have right now, but i only had 3 and i had ample time to stay on top of the labs and new orders, i was even present for doctors' rounds every morning so i had a clear idea what the plan of care was. on this floor, i have to look on my sheets to remember the pt's name and medical history. at the end of the day i feel tired and mediocre. i think this floor provides a good learning experience and a solid med-surg background, but i don't think i will be staying past my 1 year commitment.