JBizzleRN

I am currently finishing up on an assigment that I took with a friend of mine. Both of us are ICU nurses. We didn't have a problem getting a job because of being a "team", we had trouble because she had traveled before and this was my first run. We already have our next assignment ready and waiting in January.

Fair? Lets talk fair. I put in a transfer to the ICU from my med/surg floor. Well to start with my manager offered me a day PCC position, I refused and told her I just wanted to transfer. Two days later I call HR to see if they ever got my transfer paperwork. They say no. I call my manager and she tells me that she didn't see any paperwork, even though I had slid it under her door the night before. So I go up to the hospital, fill it out, and hand it to her this time. 3 days later I get a call from HR that my file has no information in it. Apparently my CPR card, skills checklist, all my education stuff, even my nursing liscense could not be found. Strange to say the least. SO after spending 20 minutes on the phone asking them how they lost my folder, they gave me no reasonable explanation. Well I keep copies of EVERYTHING I turn in (ecuation, tests, dr. excuses, EVERYTHING). So I go to HR with a new file and plop it on the manager's desk along with a copy of my transfer paperwork. Three days later I get a call that I can interview with the manger of the ICU. Well it's schedule for a Tuesday @ 8:30. I get up and am getting ready at 8:00 HR calls and says it needs to be pushed back to 1:00. I'm cool with that. At 12:00 they call and tell me it will have to be moved to the following Monday. Ok. That Monday I get a call that says the interview will have to be cancled and that they really don't know when I'll get to interview for the 4 spots that are open in ICU. Seriously? Two weeks go by and I call the ICU manager myself and we set an appointment up. I interview, she says I have a job to tell my manager that I am putting in my 30 day transfer notice. I do. My manager is NOT very happy about it. I tell her, sorry, but I'll be leaving this unit in 30 days. New schedule comes out and I'm still on the schedule...seriously? I approach my manager about it and she says that she can't let me go right now. I tell her she doesn't really have too much of a choice, she then shows me a letter from administration she got that gives her permission to hold me on the floor until such time as she is fully staffed. The floor I work on has the highest turnover rate of any floor in the hospital...it will never be fully staffed (mainly because fully staffed is still very understaffed. Fully staffed is taking 8-9 pts with one CNA and no secretary) that's fully staffed. So three months later I get to go to the ICU. . .

Nurses get paid more. Nurses have more responsibilities Nursing is more demanding Nurses can do respiratory therapy's job Nursing is always in high demand. Don't get me wrong I love and appreciate every one of my respiratory therapist. However they do only come around once or twice a night to see a patient. They don't have 8 pts to pass 200 meds to, no worries about vital signs, surgical incisions, titrating medicines, ect. I mean sure they have their own set of responsiblities, but when it comes down to it Nurses can adminster breathing treatments, ambu, draw blood gases, and get EKGs....so....you decide :)

In our hospital we cannont disconnect an iv w/o a drs order. . even to go down for tests.

Really? Every 7 days? Our hospital is still on the every 96 (every 4 days) protocool.

In southern Mississippi at a public hospital. Yeah it does suck more than I can even say..

Nobody is ready to come out orientation. It's a scary place, but remember you have people there you can ask for help and ask questions. When in doubt call the doctor :) that's what he gets paid for! Just stick it out. :nuke:

My usual routine: 1) Make walking rounds and see if they need anything then. Also if I got a good report from the previous nurse I go ahead and do my shift assessments. If I got a crappy report I'll go check the chart and then come back to do my assessment. Be sure to tell them you are going to check their chart and look over their meds and that you will be back shortly but to call out if they need anything before you come back. 2) Go check my charts. 3)Make a sheet of what time each pt has meds so I don't miss a 2am IVPB or IVP. Also I have a misc. colum to see who gets dressing changes, needs to be turned, ect. I also write down who has AM labs (nurses draw labs). 4) I then go to the supply room and get IV fluids for every patient (unless the fluid is going at KVO) so I have the fluid ready when I see it running low and I don't have to run down the hall to get it. 5) Pass out meds Of course if something happens such as an admission or a patient goes bad..this all goes out the window

HAHA...and get a free wax job if you aren't careful

Oh it's not like that in every hospital I wouldn't think, just ours :) They don't use travel nurses because that's what they have the "float pool" for. But when you only have 6 nurses in the float pool trying to cover the hospital's staffing shortage...it leaves a lot to be desired.

Yes, Mississippi...LPNs? I WISH....CNA'S we are lucky to have one for all 33 patients on the floor.

IV teams! Oh my that would be a dream.. With our 8-9 pts we start or own IVs and we have to draw our morning labs..so needless to say we get plenty of that experience.

Did you take it manually or was it with a machine? Either way if it was truly 40 that is considered a critical blood pressure...So you could have called the MD or put the dynamap on the patient set it to every 5 minutes and see if the blood pressure was trending up...Could you trend the blood pressure, had the DBP been running low? Which I have been told by MDs before they really don't mind about a low DBP is the SBP they truly care about.

Does it every aggravate you that someone on your unit answers the call light, and one of your patients wants to "see the nurse." You get there and they want pain medicine, or nausea medicine or a pillow or a blanket...so you have to make more trips and use more time than you would have it the person over the call light would have just asked the patient if you could bring something to them. But yeah, the confused patient that pushes the call light and you ask "how may I help you" and they reply "a burger and fries." classic stuff.

If I can just tough it out for a few more months I'll be fine. I look at it this way, if I can survive here I can probably survive at any hospital haha. And then I just think about moving off the Med/Surg floor to a telemetry floor or the ICU. All of the float nurses I work with tell us that our floor is the worst to work on in the hospital anyway.

I feel you on the tear in the front of the pants! I was pulling a patient up in bed and had my stance just a little too wide, and up went the patient and rip went the pants. Well went to the bathroom on my lunch break and used some sutures to repair the whole in my pants....would have worked if I really knew how to sew...didn't last...the first bend...rip again. And this might be a weird question, but seriously were you going commando? How did your boys fall out?

Why yes, I am still working there. Mainly that I am under contract with them until June of next year. It's the same situation all over again... had 8 patients... had to give six units of FFP, two units of PRBCs, trach patient that had to be suctions every hour, pt in 4 point restraints, pt going through DTs...all fun times I assure you. All of this while working with a restricted nurse so I was having to give all of my narcotics on top of hers too. We had no secretary, so we were having to put our own orders in. So that was just fun let me tell you.. I mean seriously I expect to have bad nights, but bad nights...every freaking night, seriously? So I have called the HR to see how much I would owe if I quit. They would not tell me. They said I have to put in my resignation before they would give me an amount I owe. I mean I really would like to know how much I would owe before I quit.

Bluffing? Maybe, however the same situation happened on the Telemetry floor. The nurse took the 8th patient, then put in her resignation that next day. They didn't let her work her notice out just told her not to come back.

So for 4 months now I've had a monkey on my back about our hospitals Blood Consent form. On the form is states that you can contract AIDS from a blood transfusion. This really burns my biscuits as this is a falsehood on an informed consent. You cannon contract AIDS from a blood transfusion, any nurse should know this, yet somehow no one had ever said anything about it being on there. Well after several meetings with administrators, I finally got the forms changed to state that you can contract HIV from a blood transfusion. I mean it's 2008 and misleading stuff like this is still showing up in the hospital. Not only does it add to the misconception about HIV/AIDS it also gives the patient false information on an informed consent. So whoo! Goes to show what you can change if you try...now I gotta work on getting our nurse patient ratio away from 8 &9 / rn.........

I was the charge nurse, our charge nurse has full patient loads here..

Wow, you people make me jealous. Myself and another nurse rotate weeks of being the charge nurse and we still get full patient loads when we are in charge. And I mean FULL patient loads 8-9pts/rn on a 33 Med/Surg floor.

Thanks. That was my thinking but I wasn't for certain so I did not want to leave. I mean I've had bad nights before, but this takes the caked, the frosting, the pan, and the serving knife. I have never teared up on the job before...but haha...had some "allergy" eyes that morning.

Okay here is a senario: On our Med/Surg floor it is normal to have 7-9 patients (yeah crazy), but whatever. So let's say you have eight patients...it's you and a nurse RIGHT out of orientation on the floor. You have no tech, you have no secretary. Your have many a nursing home patients that have to be turned, changed, ect. You are basically having to help the new nurse with all of her duties, ect. You have a patient's vital signs that are acutely changing for the worse. ER calls and is trying to send you a 9th patient. There is literally no way you can take the patient at the moment. You tell ER they will have to call back in an hour or so until you get a chance to settle down. Well ER calls the house supervisor. The house supervisor comes up and tells you to take the patient or he will take your badge, you will go home, and you will not work at the hospital anymore. A) You take the patient knowing that you are never going to be able to do an assessment in an hour, your 10pm meds are now over 4 hours late. You haven't even begun to think of taking your 12am vital signs and everyone else is needing pain meds, nausea meds, dressing changes, colosotomy changes, ect. B.) You don't take the patient. The H.S. takes your badge and makes you leave the hospital. Is this considered patient abadonment if you are forced to leave? It was a bad night, I ended up taking the 9th patient (pancreatitis with pain meds q 2 hours...). I was 1120am leaving that morning, and THAT was pushing some of my work off on the day shift (which I refuse to do under normal circumstances because I don't like it being done to me.). So what would you have done?

So the other night I had this lady who kept calling out for Phenergan, however when I went into her room she was chowing down on doughnuts and chips, so I refused to give her the Phenergan until she threw that stuff away. Anyway, came back out to the station and sat down. . . and this popped in my head.... It goes to the tune of "Just a Spoonful of Sugar" from the Marry Poppins Soundtrack.... Just a syringe full of Phenergan Helps the doughnuts go down. The doughtnuts go down, The doughnuts go down. Just a syringe full of Phenergan Helps the doughnuts go down, In a most delicious way....

The first was 26.7 and the repeat was 29.1 I believe was the numbers. But no it was not drawn incorrectly. I drew it from the arm opposite the IV. One doctor told me that it's actually normal for H&H's to vary like this...even drawn a few minutes apart.