feisty

Apparently our "Hilton" is strugglig due to economic hardship because the bottomline demands a skeleton crew. Sadly, the staff look like the walking dead due to exhaustion and fatigue. Maybe we should refer to ourselves as the Hotel California. lol In all seriousness, I worry about the future of our healthcare system and our nation. This entitlement mentality is destroying our country.

I hate having to triage a patient who has placed their dirty clothing on the bedside table where I place my test supplies. I often go in prior to their arrival and arrange my things to prevent them from using it. LOL I cannot stand having drawers or doors left open. If one of my babies (okay, their not my babies, but they are assigned to me so...) if one of my babies arrive in the nursery with dirty clothing or blankets I clean them up and put clean clothing on them. Likewise, if their crib is messy I will change the linens and put any unnecessary items away. The crew I work with is very OCD :) I fit in well. lol When we have a new nurse to orient, it drives me crazy if they continuously move from one charting spot to another. It is all I can do to keep quiet if they have charts in more than one area. Dirty cows (computer on wheels). Enough said! I have a problem with doing just one surgical scrub if we have more than one c-section. I fight the compulsion to scrub before each case. The only thing that prevents it is knowing that my skin will crack and bleed with too many scrubs. It is like my germ-a-phobia tendencies battle one another here. Scrub vs. intact integument. I struggle to say that I work a 12 hour shift. I often find myself stating that I work 12.5 hour shifts. The nature of my workplace dictates my availability to my patients at all times. I know it is required by law that I receive my break, but there is always a loophole. grrr

Remember to maintain balance in life. Nursing can consume your every waking moment and even your dreams if you allow it. Work should be balanced with play, family, relaxation, etc. Holistic care of ones self is vital. The stress of the healthcare environment brings out the worst in our co-workers at times. Remember, you neither have to tolerate abuse nor does the negativity from others define you and your worth. Be prepared; to the best of your abilities always be prepared. I love having multiple pockets on my scrubs and filling them with items I constantly use throughout my shift.

We just had a couple of deliveries and both babies are in the nursery in respiratory distress. Could you go relieve their nurses? Could you take over the patient heading to c-section. Oh...you got room xxx....sorry, she is a druggie and the baby is starting to show signs of withdrawl. There is an ambulance in route with a 25 wk gestation bleeder. Dr. xxx is on tonight and he is in a ****** mood. By the way, he has several triage patients here who are drop ins. Your charge tonight and we couldn't find anyone willing to take OR call in the event of a c section. There are only two nurses and a secretary tonight. You have a labor, 6 couplets, and remember there are 4 admits in the morning and one is a c section. But the worse and most terrifying of all.....you are being floated to med-surg. They have 2 nurses and 31 patients. (Most of us have never been cross-trained and our poor med-surg nurses are so overworked that they are experiencing burnout=cranky).

I had a procedure recently which required sedation. I must say it was the best sleep I have had in a long time. All joking aside, I would definitely address my concerns with my dentist if I were you. Since they perform these procedures regularly, they are prepared to assist you with your concerns.

Thanks for the responses. I am excited about the opportunity and want to prepare as much as possible. Apparently there are alot of applicants who are interviewing and I want to do my best to increase my chances.

I have an interview for a position with another healthcare system. I decided to seek employment elsewhere due to the large amount of call time we are required to take. I was wondering if those of you who are responsible for interviewing applicants frown on this as a reason for leaving a position. It is the only factor that is bad enough to make me look for another job. I like my job, the work, and my manager. I would love to keep this job, but the call will not change and it is excessive (up to 36 hrs. every pay period). Should I be honest or just say the job isn't a good fit? What if they ask why I have decided it isn't a good fit after almost 4 years? Should I mention that the call makes it difficult to complete my classwork by the due dates (I am going for a higher degree). I don't want to seem so closed off that they feel I am avoiding the questions, but I don't want to say too much either.

It is your career and you should decide what is in your best interest. If you have not signed a legal contract then you are not bound to the offer. I understand the conflict you feel with verbally accepting a job though. The agency knows that a contract must be in writing and that you have the right to change your mind until you sign. I would certainly give them notice of your decision to decline the position.

I really like my current job, but the call time is a deal breaker. The original amount was one call a pay period which I agreed to without hesitation. They now require 2 or 3 a pay period. Sounds like you may need to start looking elsewhere. I hate to start over in a new clinical area, but the call is so disruptive to my life and distructive to my health. You need to take care of yourself. Your employer will not do it for you. You can try to discuss the job description and recent changes with your employer, but they can make decisions for their business which results in changes in your job description. It is all very frustrating. I hope things work out in your favor.

I was thinking about applying at Flagler Hospital. I have family near there and they have had good experiences as patients, but you never know about the work environment. Thanks for the reply:)

I was thinking about relocating and maybe applying at flagler hospital in Florida. Can anyone give me any information on the work environment, training, pay scale, etc. Thanks!!

i understand your frustration with the whole situation. patient care is difficult and a hard assignment makes it seem overwhelming at times. remember there is always more than one side to a story or more than one perspective on a situation. having said all of that i would advise you seperate yourself as an individual employee from the whole "we" mentality. i do not mean as in teamwork. what i am trying to say is that you were hired as an individual employee to perform in a specific role. as long as your supervisor is acting within the guidelines of the facilities policies in making the assignments then she has the authority to do as she deems best regardless of whether it is "fair". "i'm over here busting my *** while this woman wants everyone to feel sorry for her because her husband is in the service and she has 3 teens at home. um hello you're not the only who has it tough other people have it worse. she is such a brown noser which is probably why the supervisor gives her better treatment ugh! :mad:" anger, name calling, and assumptions will only cause you trouble. i would suggest that you not use these tactics with your supervisor if you choose to address any issues. attempts at conflict resolution will be more effective if handled properly. if you are given a physically challenging assignment that requires 2 people to perform the care then do not hesitate to ask for assistance. if noone is available to help then i would suggest speaking to your supervisor. inform her that you are concern that patient and employee safety would be compromised if you attempted to perform a specific task alone. it is her responsibility to see that there is adequate staff to ensure safety. likewise, it is your responsibility to see that you do not endanger a patient by attempting a task without proper assistance. personally, if the other employee came to me asking for help and i was struggling with my patient load i would probably bargain with her. i would say something like, "i would be happy to help you bath her if you will first help me complete this task of bathing mr. so and so." teamwork can provide safe care and enable you to finish in a timely manner. remember, there will be days when you do not feel good and your co-workers will probably extend you the same courtesy you have extended to them. i do not know the dynamics of your unit so i say that on the premise of one built on teamwork and a patient focused environment of care. one last thing.....your passion for the care you give others is obvious. i am so glad you have chosen a career in healthcare. please don't let people rob you of the joy you find in helping others. thank you for the hard work and care you provide for our elderly population!!!!

Please don't let this make you feel stupid. Like merlee said, "hard to stop and think in the middle of an emergency." This will present the opportunity to evaluate a better process for maintaining meds. Your response time was great!!! You obviously kept your cool through the episode:yeah:

Hurricane, that is a scary situation. Glad your daughter is healthy. FLOBRN, thanks for the link. I believe it will be a wonderful asset to have. Thanks to everyone for the responses and info on PPH kits.

The article was in the December 2008/ January 2009 edition of "Nursing for Women's Health." It is entitled "Shoulder Dystocia Drills: How One Unit Prepares for Potential Obstetric Emergencies" by Kathleen Curtis, RN, MS and Lola Guillien, RNC. The article provides an algorithm to determine the responsibility of each participant. It is designed for use in a large facility, but it could be modified to meet the needs a much smaller hospital. It also gives an acronym for the steps to follow during a dystocia event.

I just read an article discussing shoulder dystocia drills which was very interesting. I am considering approaching my unit manager with information from the article and was wondering how other L&D's train for these incidents. We have many new grads who are orienting or have completed orientation and there are times when they do not even realize the event is occurring. The experienced nurses know what to do, but we do not have an algorithm to follow which sometimes results in chaos. We are a small rural hospital with no NICU. The labor nurse is also responsible for neonate/mother care and assessment after delivery. Staffing normally consist of 2-3 nurses, a tech, and a secretary. Obviously we have an MD delivering, peds on call, and respiratory available. With limited staff it is crucial that we know our roles in these situations. The article also mentioned a postpartum hemorrhage kit. Does your unit have one? What does it consist of? I know that documentation is very important. Does anyone have suggestions concerning guidelines for this? Resources that are available?

I struggle with the same issue. I have had a co-worker ask me if I wouldn't come in if I knew my co-worker needed me. I hate manipulation and guilt trips. I have finally decided that my life and happiness has a major impact on my work life. I can't live the rest of my life resenting the horrible working conditions I'm experiencing. If I allow the manipulation then the powers that be will never change the working conditions. Our patients also deserve the best care possible and they aren't receiveing that if the RN's are exhausted, angry, and burned out.

-This dinosaur doesn't bite, but I make alot of noise when I walk. -Everyone is expected to participate in atleast one code brown. -Don't be critical about how I look because you too will sport this ragged, worn look in a few short years. -I know you hate developing those long care plans, but you should look on the bright side. After you graduate you will be well equipped to survive all those hours of double and triple charting that is required EVERY SINGLE DAY. -You think your school assignment isn't fair just wait until you have to deal with unfair patient assignments, schedules, and administrative antics EVERY SINGLE DAY. -Some say nursing is "a calling", but I am here to tell you that the MD is a callin', management is a callin', the patient is a callin', and the family is a callin' the entire time you are on the floor. It is a never-ending "calling" that will drive you to insanity unless you find appropriate coping methods (illegal substances and ETOH is not considered appropriate coping methods). The most important thing I would say is "welcome aboard and I am so glad you are here. If there is anything I can do to assist you in reaching your clinical goals please don't hesitate to ask."

This is a great post. I must say that my favorite patients are elderly men and women with grit and spunk. They are tough as nails and never whine. When I float to the med-surg floor I tend to gravitate toward these patients.

I was going to write a long post on my observations, but I have decided against it. I will say that each couplet is different and one broad approach is not always baby friendly. Will be interested in the longterm results of this. Will there be an increase in incidents when the mother is suffering from extreme fatigue? Will a positive result occur? Will we see larger numbers of successful breastfeeding? I guess time will tell.

This has only happened to one of my patients. It was SROM and I still remember looking at the monitor and watching the baby's heart rate actively decel for just a moment before springing into action. The other thing I remember is the look on the couples face as she is being wisked off to the OR. I am always concerned when the MD's AROM someone whose fetus is still high. I stand by with my gloves on just in case. Very frustrating to say the least.

I think I will have a will drawn up that states my children will lose their inheritance if they do not honor my living will. lol Seriously, everytime I work in the ICU (float there sometimes) I threaten my family with all manners of hauntings. Let me die peacefully or I will NOT let you live peacefully.

If she is a former nurse can you imagine what she was like to work with?!?!

Our facility does the same thing but we are required to be on call the entire shift that we are cut back. Their reasoning is we were scheduled to work and therefore required to be available because it is OUR shift. No on call pay for those hours. We are also required to take scheduled on-call days. Personally, they can keep their measley two bucks per hour and give me my life back. My floor is the only one in the hospital that requires the nurses/techs to take call. We are also required to float to other floors, but the other floors refuse to float to ours. I love my job, but burnout for myself and others on our floor is starting to take its toll.

Have you and your classmates analyzed your performance on the last test to determine what might have contributed to the large number who failed? Really evaluate why you missed the questions. Was it lack of knowledge on the subject? Was it difficulty with the type of questions (many students are shocked to learn that all the answers correctly apply to the question but one is the "best" correct answer). Did the questions come from material that was assigned? Remember, all assigned reading is fair game even if the material isn't covered in class. There isn't enough instruction time to cover all you need to learn. This advice is the result of my own experience as a nursing student and as a nurse. I am sure you will also receive some very good advice from other students, nurses, and instructors. Try not to develop a we verses them mentality as this is very unprofessional and will only result in trouble. Did the faculty really "pull this out of their butts"? I can understand becoming frustrated with the situation, but remember to respond in a constructive manner. As an adult you can now examine the issue and evaluate what you can do that will help you accomplish your goal of becoming a nurse. One of the most valuable lessons you will learn in life is the fact that you can teach yourself. As a nurse you will constantly be required to educate yourself on a subject such as Advanced Life Support, show up for a brief class, perform the skill in a mock situation, and take a written exam. Certification will be impossible if you do not educate yourself prior to the class. Remember, keeping a job will depend on you and your ability to educate yourself when certifications are required. At my place of employment, new hires are required to take a test similar to the nclex and the new hire must pass. No instruction time is given. The new hire must "know their stuff" so to speak. I hear this is becoming the norm at many places now. It is a wise person who doesn't become dependent upon others for their knowledge. Its wonderful to find an instructor who brings a subject to life and makes learning fun, but try not to allow yourself to become dependent on others for knowledge. Be thankful when it occurs and enjoy it, but always show up to class as though that will be the exception and not the rule. Its very empowering to educate yourself and to also share your knowledge with others (study groups or class presentations). If you find that you are having difficulty with the test when you know the material then request a meeting with your assigned faculty advisor and request assistance with assessing the problem. The nursing process can be applied in this situation and ultimately help you achieve your goals of passing the tests, class, program, nclex, and becoming a nurse. Develop a pattern of meeting challenges with a constructive plan and you will become a successful individual. :yelclap: