Abishag

I'm starting to think my experience and training have only set me up to keep me opressed. Hmm. Maybe I need to take that course on abuse in the workplace. I wonder if I'm just getting old school info from old school nursing instructors who mean well. I'm not one to ever let someone abuse me. I wouldn't have any issues having someone charged with assault/battery if they so much as slapped me or shoved me and were A&Ox3. I don't tolerate physical abuse of any sort (with the only exception of the dementia patient...and even then it would be case by case I think...since I've seen my own grandfather with alzheimers with not a mean or violent bone in his body punch my aunt and wet himself...I can't imagine arresting my own grandfather - may he rest in peace- much less someone elses for something they had no idea they did in their final years on this earth). As for the men that are having issues with their sexual function and getting penile implants saying things they shouldn't to the staff, I guess when you step back and look at it...well you make some very valid points. That is all I will say.

Hello, I'm a fairly new grad and have been working the last 6 months in Med-Surg. It is so fast-paced that I don't sit down AT ALL. We're not supposed to sit anyways but if we were allowed to, I still wouldn't have time to. I sometimes don't get my lunch until 5pm and have a 6pt workload. I am totally type A so I don't feel overwhelmed to the point of tears but tears are the norm on our floor it seems. Even for nurses that have been working for over a decade we still have them going home in tears. I do feel like its just too busy for me despite hating to have nothing to do. I'd rather be busy and stressed then slow and bored but I don't want to get burned out (I know I know...I've only been here 6 months and I'm already complaining). ADDED: I have to add that we are sort of a rural hospital and have no progressive unit. So when the patient leaves ICU they come to our floor and we basically function has a step-down AND med-surg. Sometimes we have cardizem drips, heparin titration, CBI, and most are remote telemetry). We've had complaints from floaters about how unsafe our floor is and I'm starting to see why. My question is, I'm extremely interested in the CCU. I precepted there during my final semester and loved it. But with having just 1-2 patients a person, do you find it fast paced at all? Or do you find yourself spacing out your work so you don't get bored? I'm sure in situations where someone is going downhill or coding its all the fast paced you can handle but for the rest of the time, what is it like? Are you sitting a lot? When I was precepting I only had one patient and so I found myself becoming the ancillary staff doing accucheks and helping turn, bathe, etc pt's. I kind of wonder if that is why I got the precept position - free help. It seemed like all the other staff was busy but I'm not exactly sure with what since I wasn't permitted to chart in the ICU setting. Is there more charting involved?? I know assessments were more frequent. I get fresh post ops now that we have to do q1hr assessments/neuro checks and I believe in the ICU its q15mins or something?? I feel like an idiot that I actually precepted there and now I totally question what exactly nurses there do.

I won't argue that my perception or how I react will or won't change. I am new to nursing and thanks for saying I'm young. I still feel young lol. But after 8 years in telephone customer service and a job depending on how I respond to angry verbally abusive clients, this seems like a cup of tea I guess. Maybe I'm jaded and don't put my foot down enough. I'll blame it on corporate america! :)

carolmaccas66 I was not talking about accepting abuse by individuals that are in their right mind. However, you can tell the ones that are abusive in general by how they treat their family members, and those that are just being over-protective and stressed out. I've seen patients families coddle the patient but then yell that we aren't getting results fast enough. Or "I've asked you for this 4 times and you still haven't brought XYZ to me!" Its things like that, that I start to consider "Caregiver Role Strain" and "Anxiety" and so forth before snapping back as I've seen other nurses do. However, if a patient's family member is being rude to the patient and to me, you can better believe I will say something. Also, anyone that is physically abusive that is not under the influence of dilaudid, dementia, or some other pathophys causing the behavior, will have security called and the charge nurse will be informed. For instance, I had an old man acting totally sweet and normal one day and three days later after some dilaudid and major surgery, acting out of his mind with wild eyes, ripping out IV's and talking nonsense that pulled back his fist like he would hit me. Had he hit me, I would have probably thought long and hard about whether to do anything other than letting my charge nurse know because I know he was not acting in his right mind. You see my floor is mostly elderly since I work in an elderly community. The only people that are younger than 60 are getting penile implants or having hysterectomies or prostatectomies. These individuals are known for saying some bizarre things like, "I'm totally ready for my bed bath now...OR now I can get it up honey!" I would never accept physical sexual abuse (grabbing, fondling, etc) and would be calling security right away and pressing charges if need be. But I have had men that will lay in bed completely naked just to see what my reaction is. Which I ignore it. I mean I deal with patients having penile implants so they can have sex and will have erect memberes following an implant in order to heal. Its hard for them to NOT say something because of embarassment. Or patients that have TURPS and become or can become impotent. Its kind of difficult to avoid the subject altogether. But when patients get out of line I think of my other nursing diagnoses like "Sexual Dysfunction" or "Anxiety" related to loss/change in sexual function. Trust me, no matter what is said, I don't just keep my mouth shut. But I refocus them onto healthcare subjects, like "well Penile Implants have a great success rate but if you want me to print you up some material on the procedure and the healing process after, I'd be happy to print out those instructions." I would never accept abuse if I thought it was real abuse. Some women probably couldn't accept as much as what I've mentioned above and that is fine. Everyone has different histories and predispositions and some nurses probably can't let things roll off their back. But if another nurse or CNA saw me let something roll off my back and not ask why I didn't do something then they may not know my reasoning for ignoring certain comments. I don't think the right behavior for a nurse (in the situation of the family being demanding) is to just snap back and be rude. I think the nurse needs to explain as calmly as possible why XYZ hasn't been done. I wouldn't want anyone to accept behavior that makes them uncomfortable or emotionally distraught. I hope my first message didn't come across that way. But it only explains why in certain situations I've allowed things to roll off my back.

Nick - Our final semester we had clinicals and class lectures on ICU. We rotated and took patients in the CCU, MICU an and SICU. I did my preceptorship in the CCU as well. Our instuctor had many years in the CCU so he was passionate about it.

I can tell you why I put up with behavior like that. I was taught in nursing school that patients and families are sometimes dealing with an extreme amount of stress and don't know how to handle it. Sometimes we think the patient's condition is not a big deal but the family doesn't know that. Its hard for us to think back when we had a family member hospitalized and didn't know anything about medicine but we were probably just as scared and just as frustrated with everyone. I've had families be extremely rude to me and I still treated them with respect. Later, I was (on occasion) apologized to because of how they were acting. I was taught in nursing school that many times patients would be sexually explicit but not because they were trying to be rude. The instructor explained that many times the patients feel that their dignity is robbed because they have this person that is flipping and turning them, wiping them, barging in their personal space, making them do things when they want it done not when the patient wants it done. The patient isn't used to not being in control. This acting out is sometimes their deep-rooted frustration in loss of control and privacy. Also, for those that may be frustrated with their new condition (colostomy, prostatectomy, etc) they may be scared about the future of their sexuality and ability to be intimate and so they harass because their unsure or too embarassed to ask. These patients are probably the most scared and the most frustrated. Some nurses put up with it because that is what we are trained to do. I do believe in setting boundaries but we probably let more things slide because we realize these people are in a delicate condition. If not everyone can handle it or deal with it - to each his own. I'm probably more feminist than most girls my age and believe in being respected. But I also know that sometimes we all act like self-centered children. These patients are under a great deal of stress and so I can let more things go and just vent about it later. JMHO.

As a former MSON graduate, I can tell you that we were constantly being told by nurses at the hospitals that compared to other schools we were way ahead of the game. Apparently the other schools did more shadowing and ancillary work (baths, etc) while we did total pt care (meds, dressing changes, etc). After moving out of state, I started working with other new grads from the area I moved too and my nursing director came up to me and asked if any of my other classmates would be willing to relocate to that state. She has only been impressed by how much I know and my non-slack work ethic (a requirement at MSON). MSON only sets you up to succeed. They are also one of the few schools that has a critical care semester which hones your skills. MSON is the best school in my totally biased but honest opinion. There are no other options!! At my work, I get complimented CONSTANTLY by staff members and doctors that are impressed with my skills and I was by no means at the top of my class at Mercy. I graduated with a less than 3.0 gpa. If you pass MSON, you are going to be a good nurse. The only other school I have heard great things about in that area, is Gaston Memorial. But I've only heard that through the grape vine. As for CPCC, UNCC, Queens, and so forth, I have heard bad or so-so reviews both for NCLEX and for performance in clinicals.

I have shaky hands naturally as well. I'm a first year RN. I can tell you...shaky hands is the least of your worries. Catching rolling veins and not blowing crappy ones on the other hand...sigh. I'm in a hospital that is mainly geriatric (worst veins) and I'm probably around 30 for 50 (in other words I get about 3 out of 5 iv's haha).

What kind of insulin was it? If it was Lantus I probably wouldn't have given it unless they were over 120 just out of habit. Even if there was no rule or perameters saying to hold if Even when there are no parameters given, I usually hold insulin when its less than around 140 unless they get their tray directly after the accuchek. Our perameters on sliding scales at our hospital start at 151. No insulin is ever given if its less than that unless its Lantus or something. But for long time diabetics, if there are no parameters, I'll just ask - "Do you want me to hold your insulin?" Insulin is too dangerous IMHO to give if my gut tells me not too. What if they get nauseous and decide not to eat and I've already covered them???

Hey, I'm a new grad here. When I did my clinical rotations they were at the CMC-Pineville maternity center in Charlotte, NC. They have a level III NICU I believe. I know that the RNs in that maternity center can also scrub. I know the CNM's have been first assists and I believe I asked once and I think they said the other RN's can be first assist as well. Anyhow, $31 does seem steep around here. I'm guessing you'll be in the mid $20's. I know differential in all of Carolinas healthcare System is $3 for weekends and $4 for nights (or vice versa I get them confused). So you get $7 if you do weekend/nights.

You know I just don't even understand why we have to wait 48 hours when they know the results almost instantly. But God forbid I lived in CA!!! I can't imagine waiting longer than 48 hours for my results!!! I feel sorry for you. I felt like projectile vomiting! But if you got the good pop up, then fear not my nurse friend! You passed!! It worked for me.

Do you know what your pass rate is for you school? The reason I ask, is because if you guys have 100% pass rate, then try not to worry so much. Your faculty prepared you well for the NCLEX-RN. Don't sell them short. My school has a 100% pass rate for the last five semesters and so I did about 800 questions combined of the NCLEX 3500 and 4000. I took a few ATI exams that I had taken in the past too. Which you can get the log in ID's and passwords online by just googling them. Once you start taking the questions and getting the majority right, you will do well. I absolutely refused to take a Kaplan/ATI course or buy another book. I knew my teachers taught us well so I relied on that and I passed (81 questions). Most of my class passed with 75 questions. If your class has a decent pass rate (like in the 90's) I would say stick with what you already have. But if your class has a bad pass rate (below 90%) I'd say check out Saunders review. I've heard good things about it. I don't know from personal experience but all of my classmates that passed that used additional study material used Saunders. There are several of us though that just relied on 3500 and 4000 questions and did fine! Our test taking motto is: ABC's and Maslow first.

It is true! I just checked and I passed! The pearson trick worked for me. :) Also, for any that are concerned that their questions were getting easier at the end. Mine definitely got easier. Almost like the computer had forgotten to give me easy ones (cause I don't remember too many easy ones). I had about 6 extra questions and they were all fundamentals type questions at the very end! I thought I would die! So just because they get easier in the end doesn't mean you will fail!

I received a phone call from a recruiter this week wanting me to send in my goals & objectives for the new grad position along with clinical references. I've been applying since October and this is the first real interest I've been shown. So now of course I'm afraid to screw it up. My question is, do they want it to sound ultra-professional (bordering bland) or do they want to hear your voice? For instance, which of these sounds better to you? original: Of the various areas I worked in, tertiary care, especially critical care, was the most interesting to me. I enjoy the critical thinking and fast-paced environments in the intensive-care units. Therefore, a short-term goal is to find a position that will allow me to gain experience learning about the various body systems and the effects a disease or trauma can have on each one. or more professional: My short-term goals include obtaining a position that will allow me to gain knowledge and experience working with the various body systems and the effects a disease or trauma can cause. I would use this position to develop and exhibit my critical thinking and the most advanced nursing skills that I can gain toward becoming a Critical Care Nurse If any recruiters or hiring managers have input too that would be great! Which do you think the recruiter would be more interested in reading??

I took it today. Had 81 questions. Mostly drugs I had never heard of and tons of priority questions. I had 8 SATA. I tried the Pearsonvue trick and so far I have the good pop up that I can not register and to contact my member board services or whatever its called. So I will update on thursday.