GomerPyle

Sorry for the large font folks....my vision is a victim of too many birthdays....

i've been an rn for just over a year and still get my butt kicked. my orientation didn't go so well...my preceptor would turn me lose on my own sometimes for 2 hours without ever touching base. yes, this was my own fault for not speaking up. a good preceptor goes a long way in helping you to grasp what takes priority at this moment and what can wait. following 6 weeks of orientation at a teaching hospital in our system, i returned to my home hospital and busy med-surg floor. the first night at my hospital i was given an 8 patient assignment on the 7p-7a shift. i was in total shock the entire shift and was told by my charge nurse in so many words."this is the normal assignment" for all the nurses on this floor on this shift (it was pretty much sink or swim) i didn't think i would make it a week, but my time management skills began to improve after a few months. i concur with the sentiment that you can't really teach time management skills. find out what works for you and make tweaks when necessary.sounds to me like you're a good preceptor. maybe acute care just isn't her bag......just my

everyone has opinions and speaks from a bias....even simple rn's. i'm sure there is a nurse somewhere who can give an unbiased explanation....just not in this country!

a special thanks goes out to peter fleckstein (aka fleckman) who researched the entire healthcare bill and came up with these rather eye-opening provisions and posted them on twitter. all these are verifiable via the bill...read for yourself... pyle pg 22 of the hc bill mandates the gov't will audit books of all employers that self insure!! pg 30 sec 123 of hc bill - there will be a gov't committee that decides what treatments/benefits you get pg 29 lines 4-16 in the hc bill - your healthcare is rationed!!! pg 42 of hc bill - the health choices commissioner will choose your hc benefits for you. you have no choice! pg 50 section 152 in hc bill - hc will be provided to all non us citizens, illegal or otherwise pg 58hc bill - gov't will have real-time access to individual finances & a national id healthcard will be issued! pg 59 hc bill lines 21-24 gov't will have direct access to your bank acctounts for electronic funds transfer pg 65 sec 164 is a payoff subsidized plan for retirees and their families in unions & community orgs (acorn). pg 72 lines 8-14 gov't is creating an hc exchange to bring private hc plans under gov't control. pg 84 sec 203 hc bill - gov't mandates all benefit pkgs for private hc plans in the exchange pg 85 line 7 hc bill - specs for of benefit levels for plans = the gov't will ration your healthcare! pg 91 lines 4-7 hc bill - gov't mandates linguistic approp svcs. example - translation for illegal aliens pg 95 hc bill lines 8-18 the gov't will use groups i.e., acorn & americorps to sign up individuals. for gov't hc plan pg 85 line 7 hc bill - specs of benefit levels for plans. #aarp members - your health care will be rationed -pg 102 lines 12-18 hc bill - medicaid eligible individual will be automatically enrolled in medicaid. no choice pg 124 lines 24-25 hc no company can sue gov't on price fixing. no "judicial review" against gov't monopoly. pg 127 lines 1-16 hc bill - doctors/ #ama - the gov't will tell you what you can make. pg 145 line 15-17 an employer must auto enroll employees into public option plan. no choice pg 126 lines 22-25 employers must pay for hc for part time employees and their families. pg 149 lines 16-24 any employer with payroll 400k & above who does not provide public option pays 8% tax on all payroll pg 150 lines 9-13 biz w payroll btw 251k & 400k who doesn't provide public option pays 2-6% tax on all payroll pg 167 lines 18-23 any individual who doesn't have acceptable hc according to gov't will be taxed 2.5% of income pg 170 lines 1-3 hc bill any nonresident alien is exempt from indiv. taxes. (americans will pay) pg 195 hc bill -officers & employees of hc admin (gov't) will have access 2 all americans financial/personal records pg 203 line 14-15 hc - "the tax imposed under this section shall not be treated as tax" yes, it says that pg 239 line 14-24 hc bill gov't will reduce physician svcs for medicaid. seniors, low income, poor affected pg 241 line 6-8 hc bill - doctors, doesnt matter what specialty you have, you'll all be paid the same pg 253 line 10-18 gov't sets value of dr's time, professional judgement, etc. literally value of humans. pg 265 sec 1131 gov't mandates & controls productivity for private hc industries pg 268 sec 1141 fed gov't regulates rental & purchase of power driven wheelchairs pg 272 sec. 1145. treatment of certain cancer hospitals - cancer patients - welcome to rationing! page 280 sec 1151 the gov't will penalize hospitals for what gov't deems preventable readmissions. pg 298 lines 9-11 drs, treat a patient during initial admission that results in a readmiss-gov't will penalize you. pg 317 l 13-20 omg!! prohibition on ownership/investment. gov't tells drs. what/how much they can own. pg 317-318 lines 21-25,1-3 prohibition on expansion- gov't is mandating hospitals cannot expand pg 321 2-13 hospitals have oppt to apply for exception but community input required. can you say acorn?!! pg335 l 16-25 pg 336-339 - gov't mandates estab. of outcome based measures. hc the way they want. rationing pg 341 lines 3-9 gov't has authority 2 disqual medicare adv plans, hmos, etc. forcing peeps in2 govt plan pg 354 sec 1177 - gov't will restrict enrollment of special needs persons! ???. my sister has down syndrome!! pg 379 sec 1191 gov't creates more bureaucracy - telehealth advisory cmtte. can you say hc by phone? pg 425 lines 4-12 gov't mandates advance care planning consult. think senior citizens end of life pg 425 lines 17-19 govt will instruct & consult regarding living wills, durable powers of atty. mandatory! pg 425 lines 22-25, 426 lines 1-3 gov't provides apprv'd list of end of life resources, guiding you in death pg 427 lines 15-24 gov't mandates program for orders for end of life. the gov't has a say in how your life ends pg 429 lines 1-9 an "adv. care planning consult" will be used frequently as patients health deteriorates pg 429 lines 10-12 "adv. care consultation" may include an order for end of life plans. an order from gov pg 429 lines 13-25 - the gov't will specify which doctors can write an end of life order. pg 430 lines 11-15 the gov't will decide what level of treatment you will have at end of life pg 469 - community based home medical services=non profit orgs. hello, acorn medical svcs here!!? page 472 lines 14-17 payment to community-based org. 1 monthly payment to a community-based org. like acorn? pg 489 sec 1308 the gov't will cover marriage & family therapy. which means they will insert gov't into your marriage pg 494-498 gov't will cover mental health svcs including defining, creating, rationing those svcs

greetings jopacurn, here is a link to the entire healthcare bill that is currently in the house for a vote..it's long but detailed... pyle http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

wow, 4.5 hrs and no replies:no:

i have spent many hours reading the numerous posts on this board regarding the many challenges and/or opportunities that we nurses face on a daily basis. it would be interesting to note how many of you out there feel that the current proposed healthcare legislation would either help or hurt our profession? this is not meant to start a flame war, a political tit-for-tat, or "let's bash our president" discussion. simple..... help or hurt? peace gomer

don't beat yourself up. i felt like s#**t after taking the test...i got all the questions. every nurse i've spoken too concerning nclex had similar reactions. i think it's only natural to question your outcome. btw, i passed the first time around and i was a c student. good luck and keep us posted....

no low census down here in gods waiting room....plenty of orifs...knee's...copd exsacerbation...non-compliant diabetics...etoh..and the list goes on. btw..has anyone noticed a sharp increase in the weight of patient's charts lately? i counted 12 out of 32 patients on my m/s floor last night with hospital stays exceeding 3+ weeks.

In terms of quantity, we dispense dilaudid by the gallons on my busy med/surg floor here in florida. I surmise that this may have a direct correlation to the number of frequent flyers on my floor.:cheers: again, just my

i dig the incorporated bed alarms on the new hill rom beds. working from 7p-7a, i activate the alarm on all eight of my patients, whether they're 20 years old and able to leap tall buildings in a single bound, or 85, demented with a broken hip. only drawback is when the tech or another nurse turns down the volume on the alarm. those bed alarms are a great tool in helping to provide for patient safety and reducing stress levels for the caregivers. just my

you walk into the room to introduce yourself to the new admit...and before you can say "hi, i'm _____ , they say " is it time for my dilaudid yet?":uhoh3:

from what i've seen in my organization, you better comply with said scripting or risk finding yourself unemployed any noncompliance or perceived "bad attitudes" will flag you as being a "non-team player" so to speak. being the "free thinker" rebel that i am, i refuse to comply with such policy. i have received numerous compliments on my bedside manner...my patients dig me ! :kiss just my

i'm hoping there will be a government bailout of all healthcare worker student loan debt. how much could it cost? a few billion? that's chump change when we're currently spending trillions :smackingf i think i'll send a letter to obama:idea:

what keeps me in nursing? let me give you 3 reasons...... bills, bills....and more bills:cheers:

ah, the infamous "care and comfort" rounds...brought to you by press ganey. we have been using these "care and comfort" round sheets for a little over a year now at my hospital. what a waste of time!:barf01: our nurse manager goes over these sheets religiously on a daily basis....looking for any discrepancies for which to leave you a "motivational voice mail" :nono:the stack of sheets in her office must be approaching 3 ft by now. fortunately, the press ganey scores have been above average for our hospital making all the administration happy. they even gave us a mouse pad as a token of their appreciation just my

all i can say is wow! how can one care for 52 patients? how can one care for 30 patients? how can one care for 20 patients?:icon_roll i've been an rn for not quite a year yet and struggle with 8-10 patients on a busy med/surge floor. i cannot imagine a nurse/patient ratio of these numbers. am i missing something here? is this typical of ltc and alf's? i guess i need to get out more:rolleyes:. btw, i fail to see how single payer universal health care will solve these problems of nurse/patient ratio's...maybe i need to be enlightened to that... just my .

as a side note... it's not taken this new nurse long to figure out that unless nurses put their foot down, nothing will change in this industry. sad that these working conditions and/or the possibility they exist, were never mentioned in school. i was sooo naive !

tampa area....6-7:1 (days), 8-10:1 (evenings)...at a magnet hosp. no less.:icon_roll right-to-work states just blow!!!!

eight patients is the norm on my floor. last night was one of the worst nights in my short nursing career. two rn's called off...leaving 3 rn's to care for 32 patients on a busy med/surg floor. needless to say, we each had 10 patients. i struggle with 8 patients...10 just absolutely buried me. charge nurse says " this ain't so bad, we were getting 11-12 patients just two years ago, staffing is getting better!"

i need some feedback regarding the stress levels of icu as compared to a med/surge floor? likes and dislikes? i'm getting burned out already in med/surge after only 9 mos the 8-9 pt assignments from 7p-7a are starting to wear on this noob rn. i know in my heart that i'm no where near ready to move into the unit with my limited knowledge, however, that time will come eventually.

i believe my hospital plays a big role in this "dilaudid shortage". we have happy hour...2 for 1 on all dilaudid from 7p-7a..7 days a week.:cheers: we go through so much dilaudid, we keep it in a gallon jug with a pump handle in our pyxis room.:chuckle

maybe i'm wrong, but it's my understanding that the nurses in ca. have many more duties to perform than does the nurses in non-mandated states? i had a girlfriend that moved to sacramento from miami to continue her nursing. she told me that her duties other than nursing consisted of unit secretary, social worker (all the duties that goes along with it), lab technician, and transporter. although she only has a 5 pt. assignment, she has to perform the work of 5 other people as well. she's not very happy although her workload has gone from 8-9 pts per shift to 5 pts per shift. maybe the grass is not necessarily greener in the "other state". at a recent staff meeting, we were asked to provide input to a recent employee survey concerning the work conditions and/or environment and what could be done to make our place a better place to work. nurse manager says, " i would like to say before we get started, that the common complaints of staffing and nurse/patient ratios will not be addressed at this meeting, only those items listed on the board will considered!" this is the problem with nursing period! nobody listens or cares what the bedside nurse has to say........... gomer

physically .....no mentally and emotionally.....absolutely the hardest!

i would give anything for a 5 pt. assignment! i work on a neuro/ortho/spine/med/surg floor from 7p-7a. on average i get at least an 8 pt. assignment (lately it's been 9 pts) on a 32 bed floor while sharing 2 pct's between 3rn's and 1 lpn. btw, i work for one of the largest healthcare providers on the west coast of florida in the tampa area.in my hospital, i was told in so many words that only recently, nurses were commonly given 11 pts and i would have to find what works best for me because the nurse/pt. ratio's weren't going to change. "uh oh, what have i got myself into this time?":cry: i hear your frustration rt. i am a new rn (8 mos) and still having a hard time getting my "gameplan" together. even the best gameplans often fail:wink2:. dont despair rt, you will eventually formulate a gameplan that will work for you in most situations. here's a brief gameplan that works for me: 1. arrive 20 mins prior to receiving report...get cardex's for your assignment. 2. quick chart scan...current orders, mars, docs progress notes, imaging and lab results. i take no more than 2 mins at each chart max. 3. after getting report, hitting every room briefly with an introduction, quick visual scan of the pt. (fluids, dressings, drains, pca's, cpm's etc.) 4. pull all my meds, giving a quick 5 min assessmnt of my pt. after passing his/her meds. 5. chart my assessments. as you know by now, this is all subject to change at any given moment as conditions warrant ( like getting 3 admits the first 1.5 hrs of your shift:banghead:. as a side note, i'm not sure how much longer i can last at this pace. with the economy the way it is, i feel like i'm trapped with few options. maybe i can write my senators and congressman and request a bailout:idea: anyways...just my