northshore08

I so appreciated this article! I left ED nursing in 2012 after 27 years, and now am orienting as a hospice nurse. Next month I join the peds hospice side. In all my years of ED nursing I felt like the ED nurses that posted in the article, that if I internalized the grief and pain I saw, that made it about me and not about caring for and supporting patients and families. Now I find that on the hospice side, you really are closer to the family dynamic and grieve with them for their loss, not so much for the passing of the patient. I'm busy watching the hospice teams support each other and seeing how they work with the families. The peds team meetings are full of tears and support; I am grateful for the peds nurses in the article sharing their experience. Thanks!

Three weeks into orientation, I really appreciate tips like these. After over 25 years as a nurse, I feel like a newbie again. I am alternately challenged and overwhelmed. I find the case management part is quite overwhelming, but looking forward to getting it right. I'm learning the phraseology and the documentation is unparalleled in my experience. Newfound respect for those who can do all that AND provide tender care for the dying and their families.

Thanks so much for your responses! In my experience, choices concerning patient care for those who are not able to consent for themselves rests with their health care proxies or with the next of kin. Is that not the case in LTC facilities? I can't see how consent can be implied for dementia/Alzheimer's patients who cannot consent for themselves.

I have a lot of questions about this issue, and I am probably wrong about a lot of my thoughts, so I came here for clarification. My experience is hospital based, ED and OP. If residents are in the nursing home because they are demented and cannot care for themselves, how can they go farther than hand-holding or hugs? I understand the need for close human contact, but we don't allow minors to have intercourse (unless I am wrong) and aren't demented patients in that same category? Are dementia patients considered consenting adults? I think about surgical consents, where these patients cannot consent for themselves, their POA or family has to be present and consent for them. I learned Maslow just like you all did, but I don't see that sexual intercourse is the same as nutrition or cleanliness. Help me understand all this. I like the idea of the decisions being made in conference with the HCP family members. I know if my mom had wanted to be with someone it would have been okay with me, but maybe not with my brother or dad.

aloha, LL! Keep on trying; and sign up for multiple agencies if you need to. I used Altres and Island Nurses with success a couple of years ago; they both kept me busy and I could pick my own schedule. Keep in close touch with the schedulers and they are great!

"Unprofessional" is how your manager is acting. You are not the problem, and your manager is taking out frustrations on you. Make sure your departure date is okay with your union and enjoy your new job! Huzzah! ps...bet that manager won't be there long. shedding good staff is a symptom of a larger problem....

Now that one gets my vote.

I've never seen a patient fake nystagmus. Is it something to do with heavy nicotine?

From what I've read, this is not considered acceptable labeling. In my book it is, but according to JCAHO, this method is not what they want. A good example of what they want is posted on the last premixed med your inpt pharmacy delivered to your department. I can't see writing all that information on every syringe of Zofran I have to administer. I really believe all these med standards (current and future) will never be met until every medication is prepared and labeled by a pharmacist on site before it is delivered to the staff nurse on site for administration. From what I have read about the pharmacy world, they are less than prepared to fulfill this role. In the last 50 years or more, I am surprised nurses have not killed off more of the population. I'm sorry, but IMHO these "national patient safety goals" continue to be someone's way to keep their administrative position. Requiring increasing mandates of every move workers make will not ensure the safety of patients. More staff and the time/freedom to do the work results in less safety problems. I feel a little bit of environment change could help with many of these safety issues. If you are so concerned with handwashing, install sinks in my rooms; the sanitizer you have so nicely provided doesn't clean pee, poo or the C. Dificile off my hands. If you want all specimens labeled at the bedside, provide pre-printed labels for me to use; the lab has them, why can't we? Just a few ideas....Okay, I'm better now, and ready to follow my scripting for phone calls and patient contacts!

Network with other nurses, do a little travel nursing on the side, see other hospitals with their work environment and types of patients. It's not all like you are experiencing, and you know the old saying that whatever doesn't kill you makes you stronger. Sometimes you just know it's not right for you. Your experience there at that place can only be beneficial (experience-wise), but don't get sucked into the idea that this is the only place for you. Unless you are contracted to stay at this facility, keep your options and your eyes open for a change if you really need it. Your career is more important than this one job. And I have a feeling the staff argues with one another because they have no control/say over how the patients treat them.

It's all kinda fishy. I even called ENA to make sure the email was authentic (that the sender really DID work for them.) Bad business to have no other shipping options but their choice (UPS ground.) Give me some other choices! Also REALLY bad business to try to get more money on the back end of an order instead of keeping up with your website. I cancelled the order. That's it for me. Ah, well. Another day in paradise.:icon_roll

Perfect! Someone finally understands the silliness of the pain scales/descriptions we have to use. And he didn't even get to the domestic violence screening or the tetorifice shot! The moaning had me ROTFLMAO! Love it! He had it right on about the parking/validation scenario. No, honey, the valet parking is in outpatient with the folks with insurance, not in the ED where it needs to be.

:redbeathe You are a great nurse. And a wonderful writer. God bless you, Scrappy!

I ordered a CEN review manual the other day from ENA, 50.00 (for ENA member) plus 12.50 shipping. Okay, expected all that. So today (two days later) I get an email requesting permission to INCREASE the s/h charges to $29.50! Dang! Another 17.00? And for a BOOK? That's 30.00 shipping for a 50.00 book! Anyone else see the sense in this? I refused and asked them just to send it by USPS in a flat rate box for 11.95, or even book rate; the response was, "we are raising all our rates as of 2009, sorry!" Well, my calendar says February, and I don't see why you didn't already take care of your needs for rate increases, or at least post a one-sentence disclaimer on the website. :angryfire I don't mind paying for the book, but that will be the last thing I order from the ENA! That's outrageous. Okay, done venting now. Thanks, you guys. :redpinkhe

Sorry for assumptions, but you could have clarified sooner than 4 pages into the posting. It's not what satisfies you. The hospital has to satisfy the feds.