Nurs0706

This is just a random thought.. I don't smoke, I don't do drugs, I don't take any illegal substances, and I drink maybe about once every two months.. But, when I have a bad day or just need to relax, I always find myself going for food, ESPECIALLY sweets. I see patients all the time with different addictions and try to help them with their cravings.. but it's funny because I kinda have one of my own. My thought through the day is: "What's for dinner, and more importantly, what's for dessert??!?!?"

I noticed your post and it reminded me alot of myself. I've been a nurse for three years, and too often come home more than not upset, exhausted, and truly unhappy regarding my day... And I have far more bad days than I do good days. I find nursing very frustrating. My roots do hold a strong foundation of why I chose nursing, which was to help others and make an impact. However, I think that sometimes in this caregiver role, we are made to feel guilty - from management, co-workers, patients, and even ourselves. That we should "hold on" to those roots, and that if for some reason we are unhappy it's because we aren't being focused on what's important: the patient. However, that doesn't hold true if every day you are one hundred percent devoted and giving to your patients, that all you want is to truly take care of them and help them heal, but it is nearly impossible related to all of the other factors within the job. Those factors, ie: insane patient loads, toxic family members/physicians/etc, reduced time with each patient, no breaks or lunch breaks or pressure to not take your full break, physical demands without proper assistance, etc (the list could probably go on for quite some time), are the realities of the profession. I am not saying that nursing is not at times rewarding.. Just that those times are often outshined by the myriad of burdens and physical/emotional turmoil that nursing often involves. My roots, as well as the profound responsibility and professionalism that inhabits being a nurse, are what drew me in, and keep me in the field. But, they are no longer the reality of nursing, which is disappointing and frustrating to people that really do want to make an impact but is becoming less of a tangible possibility. This is draining, annoying, and overall disheartening, and I think it can lead to burnout very rapidly.

Hi Everyone! I recently accepted a new position within Home Health! I'm so excited about this opportunity - It is something I have wanted to try for some time, and now am being given the chance! I really wanna do things right! What do you encourage to bring with you in the car (other than the basics) to make the day go smoother or easier? What would you find in your car on a typical day? What tips do you have? I'm gonna make a "shopping list" for helpful items to have for my new job. Any feedback is appreciated! :loveya: Thanks guys!!!

Hi! I work on a surgical service line floor at my hospital and have been there about two years. I really enjoy how diverse the patients are and the multitude of issues they come in with. Our specialities include major abdominal surgery, ENT surgeries, urology surgeries, mastectomies, and sometimes major wound debridements or amputations and occassionally gynecologic procedures. However, we also do receive many medical patients, and also persons with reports of abdominal pain, bowel obstructions, etc from the ED. We both receive patients from the recovery room after surgery, and often end up sending our patients to the OR. There is a huge mix which makes every day interesting. It's also neat because each patient is different. I may have someone who has had an emergency open appendectomy who eventually gets a bowel obstruction and then is diagnosed with an abscess and so on and so forth, but then have someone else with an appendectomy who is well within a day or two to go home. We have an extremely high turn-over in that most of our patients only stay 1-3 days, and even have had people leave the same day as their surgery, but we've also had people come and have to stay for months. It's extremely busy, and when you come on the floor you might discharge six patients and then admit another six throughout the day. All people of all ages and backgrounds often have surgery, so you are faced with challenges regarding each age group. It's neat because you get to basically do everything! Having good assessment skills is extremely important because each person's body reacts different to surgery. I've admitted a person directly from the recovery room sent with flying colors and basically stable, only to have them fade within an hour of being on the floor due to complications from the surgery or in regards to their medical history. My typical day is receiving report in the morning @ 0645, usually ending around 0715 with a patient load from anywhere from four to six patients depending on staffing and assignments. From there, I often discharge anywhere from 1 to all of the patients throughout the day depending on how far along they are on their surgeries and so on and so forth. Sometimes discharges are extremely simple, and other times very involved depending on what all needs to occur at discharge and reaching all of the medical, GI, nephrology doctors etc involved in their care. It also may involve working with care management and social services if, for example, you have a homeless man with a brand new colostomy who will definitely need outside help or a 96 confused man being sent to a nursing home for the first time. Or it can include teaching the patient and family about how to empty the JP drain they are going home with or how to care for their foley catheter or wound at home. After discharges and rooms clear out I often have to get report from the recovery room on the patients I am receiving, whether they are a cataract surgery, exploratory lap, mastectomy, wound debridement, etc. Once the patient arrives to the floor I am responsible for admitting that patient into their room, do a primary assessment and work on comfort and pain control etc. I also often have to speak with the family and so on. Between these admissions and discharges is caring for my other patients, whether that includes their assessments, medication administration, documentation, sending them off to CT scans or other medical tests, working with respiratory or cardiology for pre-op clearances,administrating nutrition needs like TPN or PPN, etc etc. The day ends with giving report to the next shift. I think that if you want experience that surgical nursing would be a great opportunity. However, what I just explained may be completely different than how your facility works, but I saw your post and wanted to try to give some info from what I've experienced. Let me know if you have any questions or anything I can help you with. Hopefully my post makes sense! Take care, goodluck!

Hello! The hospital I work at has been implementing the new care model Relationship Based Care with Primary Nursing being the center. The hospital is also reaching for Magnet Status. We recently had the surveyors come to the hospital, and our document has passed with flying colors. Personally, I loathe both processes. I am a fairly new RN, only about two years out of school, naive in the idea that I would be caring for patients instead of working on committees and completing paperwork and being a "foot-licker" to outside surveyors and administration. I think Magnet is a complete parody. I believe the true issues in nursing involve not having the time needed to do our jobs, low staffing, sometimes inadequate pay, and little to no respect from other healthcare professionals/administration and often disrespect and dislike from the public and our own patients. I am so disappointed that so much money and effort goes into a process that I believe to be a fallacy. It, so far, has not improved anything within my work. Instead, it has made me feel like a toy utilized to gain the "company" of the hospital a status that will bring them more revenue and allow administrators to boast to others. I work more hours on committees while maintaining my regular 40hr work week on the floor, and am expected to be the perfect, non-complaining employee to individuals who come and inspect our hospital to decide if we deserve this so-called Magnet Status. The process has gained nothing for me personally, the floor RN, the person whom it is supposed to make the most benefit for. I also find RBC or primary nursing to be irrelevant to my practice. It was presented to our Unit Practice Council not as a choice, but rather as a requirement. I'll never forget our Patient Services director stating "No one has a choice in this, you all have to do this, it's going hospital wide. There is no choice." When the hired outside company came to address us personally, I was so surprised when they stated to the RN's "This is what you wanted." I was surprised because no one actually asked us what we wanted to do for our caring model. It was decided by the higher-up's that this is what was going to happen for the hospital. The entire process is lengthy, with meeting conducted with this outside company and participating in embarrassing processes that I personally felt were ridiculous and demeaned my so-called "healthcare professional" status as a registered nurse. However, I do think that the behind principles are important - creating a relationship with your patient, continuity of care, and working more towards your patient's individual requests and needs. But, I believe that my floor was already doing these things. We worked hard on continuity and all took our relationships with our patients seriously. With the RBC process all I find is that we're doing more paperwork, no increase (for me, at least) for my satisfaction, and finding myself almost having to lie in order to maintain my job status. I have addressed my issues to my nurse manager as well as the hired outside company, and all I have received back is "You're not being positive enough" or " You're a new nurse, you'll see how this will help" which all make me feel once again, not appreciated nor involved in the decision-making process for my care, which becomes linked into the Magnet process. How am I supposed to feel excited for processes that supposedly help with my "satisfaction" when things are just becoming harder and harder for me to actually care and apply my expertise in health promotion to my patients whom I am there for in the first place? I'm sorry I wrote a book. I could probably go on forever on these topics. Thanks for anyone who actually read all of this. I would love any feedback.

Hi Everyone! I just had the unfortunate experience of a contaminated needlestick. The patient is low-risk with a small history, luckily, and fortunately the stick was moderate in puncture-length and without much blood. It happened after I had given an abdominal heparin injection, and as I was re-capping the dirty needle I was distracted by a patient's question and missed the cap. Needless to say it went into my finger. I had blood drawn and notified our employee-health office. Thankfully the rapid HIV test from both of our blood samples (patient and nurse) is negative. However I am waiting the results on the other tests. My question is if anyone has had a smiliar experience, and what your outcomes and thoughts were. Any comments are helpful. Thanks so much!

I've thought about this myself. Often when I find nurses being so berated nothing is ever really done. I think, in part, it is because nursing as a profession has been berated for so long. I also think that other individuals, not nurses, have power over the nursing staff and make many of their working decisions for them. One of my favorite books is Suzanne Gordon's Nursing Against the Odds. She puts so perfectly the challenges facing nurses today. It really motivates me to want to change the profession, however I always run into the roadblock of exactly how to make this happen. One thing I think would really help, however, would be a united front. It would be interesting to see what would happen if nurses country-wide could, for one day, strike and not go into work. However, I know the impact of this would be disastrous for patients' wellbeings..... but it would definitely show others how important nurses are and their impact in healthcare and that things need to be changed to stop/help the nursing shortage.

Hi Everyone! I am a RN on a med-surg (primarily surgical) floor at a large teaching hospital. Our floor is one of four floors designated to be the first "wave" into the relationship-based care (RBC) implementation. We had our kick-off date with our recent changes on May 12th, and are currently utilizing the changes we created during the preparation process. My questions and concerns are if anyone has had a negative impact with RBC? To be honest, I find myself very cynical about the entire deal. Not that the idea behind it is bad, but instead the process that it entails and the influnce from the administrators. The first meeting I attended the administrators and individuals from RBC said that it was "Exactly what we (as nurses) wanted." That sentence still fascinates me, especially because we as nurses had no say in who the hospital hired as consultants to change the care model. In addition, we were never really asked if this RBC thing was what we wanted it all. They basically said it was our choice to what we wanted to do, however if we say anything negative or want to make any changes that we really think would be good for the floor, they say that we aren't "postive" enough and basically get our ideas shot down. I am on the RBC board and although some employees seem to be enthusiastic I find myself boiling inside from my frustrations with the process. The changes that are being implemented often include more paperwork and tasks which are taking away the idea that primary nursing is supposed to ensue - and by that I mean a relationship with the patient and the care and attention provided to them. Plus I hate going to meetings where people read me "motivational" poems (which I feel are a lack of time and make me feel like a child) and tell us that we need to take care of ourselves, yet at the same time say everything must be patient-focused. This is not a bad thing, but when it starts to influence the schedule, employee's lives at home, health, and overall well-being, then you will start to lose staff due to unhappiness. I think staff needs to be kept happy too because if the staff begins to leave and there is limited to no staff to take care of the patient, then RBC wouldn't even be possible. I honestly can say that I feel like this is all being forced upon us by administrators that do not even work on the floor, and is a huge driving force for them because it will probably help to get the hospital magnet status, which means that the hospital will "look good" most likely at the nurse's expense. The concept is a good one. That the patient will be well-cared for. However, I think RBC nursing also avoids so much in what is really important. Nurses are skilled in so many aspects, not just "care" in the sense of sitting with the patient or providing comforts. Nurses are knowledgeable, address life-threatening conditions and necessary treatments, administer sometimes dangerous medications and monitor their effects, utililze technological competence, and participate with so much more in the holistic few of the patient. I believe in order for nurses to gain social acceptance and increased respect that these skills should be showcased and made aware of to the public. I feel that RBC sometimes makes the profession of nursing look like fluff. Does anyone else feel this way about RBC nursing or am I just nuts? Thanks!!! :)