Nenja

I'm a floor nurse, no ED experience beyond floating a few shifts. I honestly don't think anything either party does will entirely "stop" it. Y'all think we get snarky, we think y'all get snarky...and both do. We all have rough, demanding jobs and want the best for our patients but unless we are experiencing both situations *at that time*, we can't get what the other is dealing with. My typical beef is - shift change. I have to get report on my other patients, I don't know if there is a surface to put the kid on in the room, if safety supplies are in there. We don't always have secs/techs to help with that and ED will call immediately after we are paged - no time. It is such a bad first impression for a family to roll up in the middle of report, be left on a stretcher and then sometime, someone will lay eyes and start an admission. We've gotten in report a kid is fine and they're dusky on arrival...but if we hadn't been able to get there right away? We have our own kind of busy and even emergencies at shift change...it's just a terrible time. And - if I'm getting an ortho/trauma and they can't tell me what's broken. Good to know for transfer from stretcher to bed. We've been told they aren't even the nurse taking care of the patient, just giving report...which should just never happen except in extreme circumstances. This is a constant dialogue at my facility and both sides are working on it...but this is very common and I think there will always be some issue. Communication is key - "I know this is a bad time, but we are slammed and have a trauma coming in...I need to open up this bed"...same for us "I'm in an isolation room and trying to give meds to a squirmy toddler. Can I call you back in five?" I don't really care if you've given antibiotics and made them pretty. I've never gotten a foley from the ED. Labs don't really need to be dealt with unless it's emergent...because that's why they're coming to the floor. If they're screaming in pain, yeah throw them some Morphine before transfer because if you're slammed, my docs are slammed too and it might be a bit before I can get some orders. We're all trying to do the best that we can.

You may find yourself surprised. Nursing is so varied that even similar units at different facilities can bring an entirely different experience. I went through school hating the areas of my clinicals. I wanted nothing to do with adults. Ever. I knew that going in and it maintained to the end. I love the (bedside) job I'm in now - Peds on a busy Ortho/Trauma/Med/Surg/Neuro/everythingbutthekitchensink unit. Do I LIKE it every shift? Gosh no. It's HARD on so many levels. Nursing school is just trying to keep your head above water. Try out something bedside that you think might sort of maybe interest you. Get some experience in and go from there. You don't have to - and probably will not - stay at bedside forever. I'd hate to see you waste all that hard work. You went to nursing school for a reason - remember that and hold onto whatever that is.

I'm in Peds and we don't have that policy. If it ain't broke...don't fix it! :) Rarely would it last that long anyway though for a lot of our kiddos.

One place I worked we did team A and B and we worked whatever holidays were for that team...next year it switched. We were typically able to swap around and even sometimes split the shift in half to make it work for whatever we had going on with our families. That was a really small unit. Where I am now, we get the list of holidays and we rank them how we'd prefer to work. I *think* if there are too many on/off a day seniority gets priority, but I don't think it happens too much. If census is low day of the holiday, most senior is called off. I choose to work all of a major holiday and request to have all of the other off (talking Thanksgiving and Christmas) because my family isn't local so I travel home for one...the next year I switch it the other way around because I think it's most fair to my coworkers. We can still swap between each other as plans change...I don't think we have too many issues with doing it this way.

I'm in the same boat, but as an RN. I graduated in May...I can pass my meds but woah they never had us do any of the million pages of paperwork and orders in school. I'm clueless.

I graduated in May and got an RN job at an LTACH where I had been working as an aide for just over a year. Thrilled about it, no, but it was the only offer I had and I knew the facility, patients and coworkers. It has always been explained to me as much like an ICU (a lot of the patients are s/p MVA with multiple injuries, respiratory failure with trachs and vents, wound vacs, dialysis...I gather few have a single fully functioning organ in their body). So here I am exactly 4 weeks into orientation and the DON was ready to put me on my own starting tomorrow. I talked to her about the fact that I haven't had much experience interacting with doctors because my shift is 7p-7a and asked if I could get a few shifts on days with the charge nurse for that, which she agreed to and buys me just one more week of orientation. My patient load has been 7ish throughout my orientation and for the most part I LOVE my coworkers. These are the same I worked with as an aide and they have been very supportive and helpful. I thought that 7 was a bit much for these types of patients and then I go in this weekend and have 10! Granted, we do have LPNs and they are awesome and do so much...but I cannot just walk into a room and know that something is going wrong with the patient and needs attended to NOW like an experienced nurse because I've never SEEN anything go wrong. They aren't ALL on vents and brain injuries, but I still feel like it is a lot of unstable patients to be responsible for. The RNs I have been orienting with are great but they know how the unit REALLY works and at this point have pretty much left me on my own and they are for backup because they don't want me to sink my first day on my own. So with our census of 19 this weekend there were 2 RNs actually working the floor plus the RN orienting me. The other RN was agency and didn't know how to do orders so I had to do the entire unit's worth of orders as the NP stayed well past midnight continuing to write them to cover the weekend. Unless they were getting an IV med or their vent alarm went off, I honestly did not see a patient after their assessment at the beginning of the shift. I then gave report for all 10 patients to a new grad agency RN who has never set foot in an LTACH, touched a PICC, trach, vent, wound vac...day shift had a charge nurse to help, but they had their own work to do too. I just don't understand how they are thinking this is at all safe or acceptable??

I disagree with that a whole lot. I graduated Friday from BGSU and will be an RN after my boards...the UT/BGSU consortium is now graduating nurses three times a year, plus there is Lourdes, Owens, Mercy, Terra, Firelands, etc. all in the area. Our area is cranking out nurses - there is no shortage...hospitals just cannot afford to hire at this time. I know two people in my entire graduating class that have jobs lined up and they are going into the service...none that had to search, apply and interview.

I am a nursing student doing my psych rotation. A partner and I have to lead a group session on an inpatient unit next week. We've been rotating through our clinical group and we are running out of ideas (I know, there are tons out there). Any suggestions that you've seen? Thanks!

I was hired at a Long-Term Acute Care Hospital in June. I am in my last year of my BSN but this is my first aide job. It is basically an ICU...most on vents, many with tube feeds. It has been a great learning tool in that and just more patient and staff interaction. When I was training we had as little as three patients and just this week have we gotten up to 18. So while I was trained, very rarely, if ever, was I left to do something completely on my own (they were training 2 others at the same time as well). Not that big of a deal with most things. Since our census has been so low I don't even remember the last time I had another aide on the floor with me. Where opinions come in is...I am a small girl and these patients are hooked up to a lot of things and many of them are quite large and can't help turn themselves, lift their bottoms, etc. I can't really be expected to turn some of them or do full bed changes for the more difficult ones on my own, am I? Typically, especially since we have had so few patients, I have started my rounds on the ones I know I can do on my own and then go back and have an LPN or RN assist me with the others. Is this what I should be doing? I don't want to come across incapable to my coworkers but don't want to be unsafe either. Nobody has expressed this isn't okay and when they are easy turns some of the LPNs just turn the patient themselves when they give meds to save waking the patient up again, being third shift. I'm a little unsure/worried about when our census increases.

Question about the melatonin. I will only be working overnight Fri & Sat nights...if I take the melatonin to help me sleep for those shifts, is my body still going to hate me the rest of the week when I try to have a normal life?

Ah thank you, I was wondering too. I will be starting a third-shift soon at a Long-Term Acute Care Hospital and my interviewer said that it is mostly like an ICU...lots of vents and such. Anyone with night experience - any tips for sleep schedules? It sounds as if they are going to schedule me Fri & Sat nights so that I'm on that schedule when school starts back up but I can pick up other shifts as I can/want.

I don't know anything about working at Toledo Hospital because I'm still a student and don't intend on working in this area. As for looking where to live - like the other reply said, South Toledo is pretty good, East is bad. The area around the hospital itself *I* would not live in, especially being a third shifter. I lived in Maumee this year, which is pretty nice, and my commute to clinical at TH was about 25 minutes, I think.

I am a 3rd year nursing student (U of Toledo) and currently live in Maumee (ever need a sitter? lol). I just completed my women's health clinical at St Luke's and it is my favorite hospital I've been at for clinical so far (others are Toledo Children's & UT Medical Center). I've heard nurses that have worked at a handful of other area hospitals and they like Luke's the best. That being said...it is a small hospital and like someone else said, the staff likes it there so they aren't leaving. From my apartment in Maumee it takes about 15 minutes to get to UTMC, and about 25 to get to Toledo Hospital and St. V's. Its not a horrible commute. Of course only about 5 minutes to St. Lukes. There are a lot of nursing students graduating in the area and UT is also changing its program. They will have rolling admission and graduate three times a year (this is from memory, I think it is accurate) so that will pump out even more nurses. Just some things to consider. I know you're already moving so you're going to have to get a job somewhere...I just wanted to tell you what I know about the area. Good luck!

I just started my OB rotation. (LOVE it, BTW) We are to look up (purpose, route, dosage, etc...) the most commonly used meds on the floor and I was able to find most in the drug books I purchased for Pharm & Peds except things like Tucks, Americaine Spray/Dermoplast & Mammol Ointment/Lansinoh Cream. I assume hydrocortisone works just fine for Tucks, but are there any reliable places online to find info for the others? Thank you!

I know I've seen topics about this a while ago, but nothing came up in the search. I'm in Peds this semester and for half the semester I am in a preschool classroom with typical and atypical developing kids. We are to do a little teaching project for the kids related to health. The teacher said that hand washing is always good and so would be nutrition since Valentine's Day and Easter are coming...but I'm not sure how to make these things fun and interactive - especially handwashing. If anyone has done this and has tips or ideas, please share!