TopazLover

I went into nursing and felt that was the only path I wanted. Perhaps you could say it was a calling. I loved nursing and, in general loved my patients. I was kind considerate, professional, etc. The bad part about that was I always felt I should know more. It always left me feeling somewhat inadequate, as if compassion meant that I did not have enough skills. You don't need the total passion, perhaps it is better if you don't have that degree, especially as a new nurse. Burnout will be a real issue if you don't change as you grow older. All you have done is waste years. Nursing is special, but it is not the only way to go. Now I do something totally different and love that also. Soon I will be changing again, and I will enjoy that. At this point in my life I think I have learned to enjoy many things and recognize I have many skills. Nursing is one that will remain close to my heart, but I will not return to nursing. I will gladly have someone else take responsibility and I will happily shuffle papers.

Viva, as another retired nurse I agree with all 10. Of course I am old enough to recall white uniforms, sensible white shoes, and caps. I have not stopped being a nurse. I once said to a doctor that I was formerly a nurse. He looked me straight in the eye and informed me that I would always be a nurse, retirement does not change that fact. I agree. One gift I find I appreciate is that I do not get upset by anything medical. Seize in front of me, be it a store or anyplace else, I will calmly get you safe and call 911. Blood shooting out, cover, hold and head to definitive care. I see others who dither and shrink and thank God and all those who helped me along the way to know what to do. More than that. I think, is that nursing is being, not doing. Compassion cannot be taught. Empathy is more than a term on a test. The art of nursing is alive and well, even if the practice of nursing is no longer in play.

Did something change in the pt. condition to lead to having an RN on day shift? I agree that at this point it is time to change assignments and your manager needs to discuss with the family what the rules are for your company. If they want the services, they have to know the limits. I am not blaming you for the haziness of limits. Night shift nursing in the home is very different than day shift. They are in new territory, also. The parents need to hear from a supervisor that you were doing per policy and that the next nurse would be held to the same standards. If the company takes the side of the parents in a way that is not supportive of you, the employee, start a job search. You will see the same behaviors from the company over and over again.

Merry Christmas, a bit late, but I figure I still can say it until Jan. 6th. This is great. So on target for all nurses. Thanks.

This is my doctor. He told me not to get a tattoo because I could get an infection. I said most infections come from hospitals. I want a tattoo of a cup of coffee. I always need more for those 12 hour shifts.

"I don't care that you were up studying for the pharmacology test all night. Students still cannot bring coffee to clinical floors."

We cannot give legal advice. Get to that lawyer. Ask those same questions and many more. Domestic violence in any form is taken very seriously by any prospective employer (and I will not touch how any BON treats it). Also clarify what it would mean if your case were dismissed after following court ordered anything. A good lawyer is worth a lot in any case.

To me this is close to violating TOS, as it is almost medical advice. Read about what the test actually means. I do understand the fear you have, even if unfounded. There are many reasons for positive skin tests. It may mean exposure to TB. It may be response to some vaccinations you may have received. Try to stay in today. If it were bad news I am sure that you would have gotten an immediate response. One of my favorite pieces of advice from Al-Anon: For today only, I will not live in fear.

I agree a meeting is necessary. I am flabbergasted that the school would suggest a retake of the course without even suggesting how to improve the relationship. I have seen this type of behavior exhibited in one case that landed on my lawyer's desk when the instructor accused the student of illegal activity. The student won but the cost to do so was very high. She had to change schools, the original school would not release her transcript until the court system was involved. I have a very low opinion of private schools not affiliated with colleges as a result of this encounter. It may not be a fair assessment but... they are a for profit place. If you are not fighting back they could easily have you repeat a term (at big bucks). Respectfully ask to discuss as other posters have suggested. if there is no resolution be prepared to stand up for yourself and either repeat the term or find another solution.

A union would immediately file hostile work environment charges to management. They would support staff not being injured and would show the difference under new management. I suspect you might be in a "right to work" state. As can easily be seen "Right to Work" is a euphemism for "right to be abused". Document, Document, and more papers! Contact previous workers and ask them to write letters expressing the love of their job while working there and the flip side of that coin of love of quality of life that was endangered to the point where they had to leave. Create a committee to take copies of these letters and your documentation to all involved. If nothing is done call OSHA. Ask for an immediate inspection to include interviewing both workers on and off shift when they do the inspection. As much as management has the ability to hide the facts some of the time if good documentation is in place they will have to change or be fined. I suspect there may be whistle blower status available if progressive reporting is needed.

That is so sad. If vaccination can save any young people and their families this kind of suffering then the incorrect worry about it making young people more sexually active seems even worse. And the cruel statements by Bachmann et al about the dangers of vaccination need to be stopped each and every time they are put forth as if true.

http://www.reuters.com/article/2013/06/19/us-usa-cancer-hpv-idUSBRE95I1AW20130619 Reuters) - The U.S. introduction of a vaccine to prevent cervical cancer in 2006 has reduced infections with the human papillomavirus or HPV - the sexually transmitted virus that causes the disease - by more than half among girls and young women, U.S. health officials said on Wednesday. The results were better than expected and may even suggest that unvaccinated individuals are benefiting because of a drop in the number of infections circulating, the team reported in the Journal of Infectious Diseases. "This report shows that HPV works well, and the report should be a wake-up call to our nation to protect the next generation by increasing HPV vaccination rates," Dr Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, said in a statement. http://maddowblog.msnbc.com/_news/2013/06/19/19043487-the-political-significance-of-hpv-rates?lite It became a hot-button issue again last year when South Carolina Gov. Nikki Haley ® vetoed an HPV bill approved by state lawmaker in her own party, despite pleas from state health officials. (South Carolina ranks ninth nationwide for cervical cancer deaths. This, alas, did not sway the governor.) As is often the case, science keeps getting in the way of far-right Republican talking points. Last fall, research helped document the fact that the HPV vaccine did not change sexual behavior among minors, and this week, new data published in the Journal of Infectious Diseases helps document the extent to which the vaccine is literally a life-saver.

I agree that nurse is abusive and negligent. That said, seeing a resident up at 3 am humming makes me wonder if she might have been having pain that she could not acknowledge. How do her late night habits work with any therapy or other day time issues? I am all for personal decision making. I also recognize that there are times when we need to enter the world of the resident and not wait until the resident inflicts her anxiety into ours. There must be a reason why there was an order, I would think. If going to bed is a real issue address it. If it is a fussy old biddy nurse then address the behavior of the nurse, which you did. Keep up the good work. Some of your best help will come from staff who have been working with these patients for a period of time. Some of the worst advice can come from others who have been working there at the facility for a period of time. There is a difference.

UTI giving stroke like symptoms that then caused fall that in term caused a rhabdo. Pneumonia from either stasis or aspiration, or both.

Juan, thank you for this really down to earth article that I really enjoyed for many reasons. Karen, that trip down memory lane with a look at the Bird was almost like a silent scream for me. We used to call Birds "the kiss of death" and worked really hard to keep away that kiss when all we had were those Birds. That was back in the early 70's. We thought we had reached a new century in vents when the MA-1 came in. When DH was on vent he was barely moved off back. His turns by staff were only a few degrees. That was one of the few things I saw where he was that I did not agree with but had not been involved in ICU for too many years to argue the point. I know it would not have made any difference in outcome but I am glad to see that the discussion continues about positioning. Thanks again.

By the end of my 12 hour shift everything is dragging.

While there is a federal law and regulations involved many places in "right to work" states seem to be able to ignore it as they will fire anyone who makes waves. As a shop steward I fought for our night nurse to be paid. My reasoning was that if the person could not "give up the keys", and leave the area, they were not free from responsibility and therefore had to be paid. We prevailed and the nurses in question had to be paid. Without a union I doubt we would have had the same outcome.

That came from the NM's office. I always knew.

Thank you all for sharing. I think some people who have some understanding of schizophrenia believe the bast a person can do is live like John Nash in a very controlled environment focused on one thing. I have to admit that even though I know better sometimes my mind drifts back to the movie "A beautiful Mind". It still is hard to imagine nurses who multitask and deal with huge stressors able to manage this disease. It is obvious you do. it is so important to get this information out to everyone. Nurses are a good place to start. Thanks again.

I have a friend who was just diagnosed with Meniere's. She doing better and can actually do her work now. She has young children and is still learning her boundaries. I have tinnitus. I can appreciate that part what you go through. Sometimes the noise is so loud and intrusive I can't sleep, even with my sound machine and a touch of Ativan, and Melatonin, and my normal pain meds. I do better with distracting noises. TV, radio, music, anything that gets the focus off the noise. So many diseases are hidden diseases. We can't see the heart disease that makes the person concerned about bleeding and bruising. We have no idea of Crohn's or other GI ailments. People are quick to judge. Bruising: wonder if they drink too much and fall down drunk. Thin and hitting the BR often: Must be bulimic. Age has given me a bit of patience with the person who does not respond the way I anticipate. I have never set foot in their moccasins, let alone walked that proverbial mile. Life gave me that lesson because I also have hidden things.

Someone did not do the 24 hr urine correctly.

We all know that CA has issues. As least there nurses tried to support each other and have some say. In a right to work state it is worse, believe me.

This is probably where the pressure can be applied. If doctors refuse to send patients there they can not get reimbursements. Eventually they will become only able to fill beds from ER. So many of these admits have no insurance and will be treated for little return... The other thing that may make a difference is to get word to the board that the CEO is responsible and should not get any incentive pay or perks. If there is enough noise perhaps it will be heard. Union in CA got mandatory staffing levels. In right to work states you are up the creek without the paddle.

I think I would go to your boss and discuss it with her. Show her the materials and be prepared to give an opinion about using it. When you meet with her i think you should have your boss present. Instead of including it in the eval I think the boss needs to discuss social media and how it can and will negatively impact her life. Show her the writings and explain that it is an open site and could be seen by her patients and other staff members. It reflects negatively and even though it is not part of the evaluation you have created the boss may have other ideas. Your job is to eval performance. Your boss has the job of protecting the institution's reputation and you are taking the material to her for her input in that regard

Substance abuse by itself is a psychiatric diagnosis. I believe a sort of monster was created when the term dual diagnosis came into vogue. Do we say that someone with diabetes and CHF are "dual diagnosis" patients? These are co-morbidities. I believe it matters when the greater piece of drug addiction is denial. It is important that the patient be instructed with correct information. This disease of drug addiction is the disease being treated. The person may or may not have co-morbidity of other mental illnesses. Depression is the most likely. One has to be sober and clean in order to properly if this disease is present. Those individuals with mental illnesses of Bipolar, Schizophrenia, etc. must be screened for the co-morbidity factor of addiction. If none exists we are looking at different treatments and potential outcomes. For example: A schizophrenic who has hallucinations not caused by drugs or other external things will need medication to control these. Someone who is Bi-P may require a life time of medications to smooth out the mood swings that wreck a life. Without the existence of the other diseases an addict needs to use talk therapy in some form such as a psychologist, or other mental health professional or attendance in a recovery program such as AA/NA or other programs that not not always 12 step programs. When you put addicts with MI patients it is much easier for them to continue the denial as they "are not like those people". It seems logical to say that the MI might have it easier - except there is resentment that addicts tend to be frequent fliers with limited desire for a lifetime of clean living. Most MI people wish for an end to the symptoms and are frequent fliers as the meds cause so many side effects that they are frequently stopped. They also believe that once the symptoms stop they will not return, a form a magical thinking. Patients are all different. MI is like other illness. We see many of the same symptoms in many diseases, that is why residents carry their differential diagnoses books in some form. The symptom of belly pain tells you no more than the symptom of self neglect. A specific diagnosis will lead to appropriate treatment. The belly pain diagnosed by a HCP as an ulcer and treated differently than if it were a hot appendix. So, self neglect is diagnosed as a specific form of MI, perhaps schizophrenia as a result of intrusive voices. Perhaps it is post postpartum depression. The treatments are not the same. To place the two people with different diagnoses together will have issues. The person with an H.pylori ulcer will be taking meds that are very harsh. The person with the hot appendix will be cured with a small surgery. There is a resentment likely if you fail to do proper education for both patients. The patient with the ulcer is more likely to stop taking those meds that cause discomfort, and the person with the scar will tend to be more upset by the needs of the ulcer patient. It does not mean we cannot teat our patients effectively. We may have to step into the reasoning of patients on a mental health unit and see what they see rather than what our education about the diseases tells us.