Cutandstitch

As a murse who works inpatient OB/GYN, I am used to getting told by my patients that they would prefer a female nurse. It is a good opportunity to take ego out of the equation and recognize that it really is about the patient. Something to consider: maybe you lucked out that this specific patient can keep his nasty attitude saved for someone else. I used to be frustrated that some patients on my unit would be put off just because I was a guy. But the reality is that the assignment will be shifted to accommodate and you will get another patient who doesn't care and you can have positive experiences with these ones. Patients come from all backgrounds, with every conceivable (if sometimes easily falsifiable) viewpoint. You do yourself a disservice by letting this one dude get to you so much.

Hi there everyone! My unit is in full Joint Commission prep mode and nothing regarding that bothers me so much. I am slightly concerned because I am currently on my fifth nurse manager in less than 2 years. None of our unit's policies have been updated since 2013 with best practice research. I am greatly concerned that hospital policies provide conflicting guidance in many different aspects of my job (medication disposal procedures, fall risk avoidance policies, no obvious performance improvement projects, etc). Additionally, this is my first job as an LPN (about 2 years here,) but not my first inpatient position with more than 10 years in healthcare in one form or another. In the midst of all of the above, I get so frustrated with what I am told is normal for care systems in my environment. Getting pain medications for a fresh PACU transfer can take more than an hour because the order to transfer has to be activated in one system, then an RN has to acknowledge the new orders for the patient once the Pt arrives in another system, then the pharmacy has to review the orders but usually this requires at least one phone call to notify them of the transfer and usually three or four more because the pharmacist has yet to acknowledge them, then the orders are rewritten by the clinical pharmacist and then reacknowledged by an RN, and then there aren't always loaded into the Pt profile in the Pyxis without repeat phone calls to pharmacy. On several occasions I have had to have the Docs call the pharmacy as my Pt is howling in pain following the transfer. And nothing on my end can expedite this process. Pretty severe example, but this type of issue extends to other ancillary service interactions and often even the mundane tasks like getting ice chips becomes a six step process because this ice machine is broken, or the substitute ice box is empty, or visibly contaminated and has to be cleaned. I came to the conclusion that nursing is to some extent coordinating all care for an inpatient and that there will always be unforeseen speed bumps in that road, but is it always and everywhere a case where even simple tasks are unbelievably convoluted and waste valuable time? Is this how inpatient nursing is now and I need to resolve myself to this? Thanks for reading the novel if you made it this far!

So I figured that enough time has passed for me to be able to reply with some confidence. I appreciate everyone's input tremendously. Bar none, everything that was offered was accurate. One thing I was not prepared for was the level with which I empathized with the patients and families who were/are uncomfortable with a male nurse in this specialty. I think it's strange how a male OB seems ok but a male OB nurse seems odd to some people. I imagine much of my unease going in to this specialty was because I didn't think I had any place being there. I know that my future most likely will not center around OB care. However, it's been wonderful expanding my knowledge and comfort zone. I've learned how fulfilling a therapeutic relationship can be for a nervous hi risk first time mom as she struggles to maintain the pregnancy just one more day for her baby. I've met some outstanding nurses who are masters of their craft and have learned so many technical things from them that I never deemed interesting before this. Ive learned that new dad's can have a comical (to me) leer sometimes when doing peri are or helping with breastfeeding. I've shared some of the happiest times of people's lives and helped them navigate the drastic changes that tiny people can bring. And I've gotten to hold the hand of grieving parents that will never get to take heir little boy home. No, OB may not be my career, but I'm damn proud of what I have learned and accomplished since I got here. Thank you for the support and advice!

I JUST discharged you so no I cannot give you pain meds!

Sadly the world isn't split up into good, competent people and insane people. Does he have what it takes? Probably not. Does his personality leave much to be desired? Of course. But that doesn't mean he has some psychosis that needs medicating. Four weeks will be over soon!

At my facility we have an antepartum unit and an MBU. Antepartum takes overflow couplets. Ratios are four couplets per nurse. Babies room in 24/7. No designated nursery. Nicu moms generally go to the antepartum ward. That charting gets out of hand sometimes lol.

In the army, they will offer you options to specialize. If crna is your goal, you can come in and do a few years as a med surg nurse and then take the 8A course for critical care nursing. After a few years in critical care you could be competitive for the crna course which is taught at USUHS in Maryland and maybe another location. I'm not entirely sure what the situation with accession is like today, or how it varies if at all from day to day. However, the fiscal year ends at the end of this month and that can open many doors. It is definitely worth talking to the AMEDD recruiters to find out what they currently are offering. Student loan repayment is a normal incentive. Additionally, you'll get experience to remove the "new grad" stigma if you decide to not continue in the military..

Classmate informed his clinical group he got to administer milk of amnesia (magnesia) to a patient.

I find it appalling that someone got that nasty thought into your head. At best, it shows a narrow view of an environment in which your classmate has no solid information. At worst, it could mean he himself had a bad experience. Either way, don't let it influence you negatively! You bring more to the profession if you have a genuine interest in the area in which you work. While I was in nursing school during my mom baby rotation, I got to go to a c section. I got to catch the baby. We NRP'd that baby for four hours. Because of that experience and my interest in critical care, I did my capstone in the PICU. Now, through an odd twist of fate, courtesy of Uncle Sam, I'm working on a Medsurg floor that gets overflow MomBaby couplets. Not my idea of a perfect environment. Some parents are uncomfortable with me helping with breastfeeding or assessing lochia or lady partsl lacerations. But that's not everyone. It's not even a sizeable percentage of everyone. My silver lining is that I get to help transition and care for neonates. There are always going to be people who disagree with something you want regardless of your reasons. This is why it's important to identify and pursue goals that help you achieve fulfillment and happiness. Good luck with your studies. Let us know how things pan out for you.

Some places call it a saline lock, others call it hep locked. In colorado, they continue to be buff capped. Pigtails for extension tubing VS machines I heard called dynamaps (brand maybe) for most of time time as a cna. I still slip that into conversations and am now unsurprised by the looks I get in return.

I feel the need to clarify something that is increasingly bothersome for me recently. Yes, Ebola traditionally has a 90% mortality rate. This current outbreak strain is currently being recorded as a 55% mortality rate. Social media, traditional media, and individuals are failing to recognize that that is a large difference in mortality rates.

Thank you for your reply. That's essentially how things boiled down for me as well. I sat down with the other nurse this AM because she asked to talk to me. I was happy to oblige. She went through her version of the timeline and I told her where I was coming from on this. I think we're finally on some solid ground. I made it a point to let the nurse know that I appreciated her questioning because it makes me think, but that in this situation, turning it into vocal blame game didn't seem constructive. Hopefully this will set the tone for the future!

Ever get the feeling that the nurse you're giving report to feels underwhelmed by what you managed to complete before handoff? I had a patient that I prepared to discharge, even went so far as to have the husband pick up meds and did the teaching with the patient because we didn't have an order yet. Because of past experience with this nurse while I was on orientation, I called to see if there was anything I missed that could have made for a smoother transition. The charge told me that nurse was discharging the patient but that the nurse complained that the order came through during report. I'm a new grad lpn and I work inpatient in a hospital. I'm fresh off of orientation. I try to learn from this nurse as much as possible because she's also an lpn and she has extensive knowledge of this area and years of experience that I appreciate. My goal is to do right by my patients and I fail to see rushing a patient out the door before report as proper. Is it possible this nurse is just seeking to minimize her task list and becoming vocal about my supposed shortcomings because it's convenient and I'm new? How can I approach this situation without sounding like a whiney new kid?

About two years ago?

Two nights stand out, both with their own distinct flavor of suck. Forgive my writing, this is being completed on my phone. I had been a LTC cna for a couple of years and made the switch to critical care a few months earlier. I was working telemetry overnight and around 0300 I was talking with the nurses on my floor and I said that I thought this floor was quiet and that it was three months since I'd started and there hadn't been an RRT or a code or anything. (I claim youth and ignorance for even voicing those...) needless to say, 15 minutes later, this sweet LOL who spent a week dithering over whether she wanted a mechanical valve or a porcine valve replacement decided that would be the right time to code. I tempted the fates and blamed myself for awhile because I'm superstitious. The other night that stands out was on the same floor. We had three GI bleeds on a golytely prep overnight. All three were older, all three were max assist. All three required a bedside commode. All three required extensive encouragement to drink their golytely. I spent the night going round robin for all of them going from one to the next repeating the same task for the three of them back I back. To this day, golytely holds a special place in my black flabby heart for its ability to cause misery for so many people.