CareteamRN70

Damn Leslie, you must be a ball at funerals and wakes. After reading a few of the post that started to border and the "aggressive" with a distinct undercurrent of "Yes, you are a freak by the normal standards for not having teeth, life sucks, etc etc" I decide to lighten the mood of the post with abit of humor and I get you prophesying my dismissal and or demotion? Aside from the fact that I really do not like wearing them, they did cost me over $1k after all fittings (and yes refittings for those who kept telling me to get them refit). They are not something I absently keep in my pockets which can't even hold inkpens very well more or less a set of dentures.. Also I believe I stated I did not think it was discrimination nor came anywhere close to rising to that level, I just consider the whole incident unfortunate. I actually take all advice I get on AN to heart and weigh it all for what it's worth..you offered no advice just a little venom tinged text..or hey..maybe your a better humorist then i am and I dont get your sense of humor.

More background to fill in the blanks: My DON found out I didnt have teeth because she was complaining about her dentures and I joined in the conversation stating I don't wear any and don't seem to have any problems. At this time she stated she would have never known if I had not said anything. I am a bit put off by all the post that keep equating me not having teeth with dressing scuzzy, unkept hair, pimple outbreaks etc. As I mentioned before I take great care with my "general" appearance. My dentures do not hurt me, I am just not used to them and that causes my "grimace", I "know" they are forgeign objects in my mouth and I think I mentally rebel against that. Also, I did not lose my teeth to bad oral hygeine. Up until I lost my teeth I took rather good care of them. I lost some of teeth due to the mishaps of youth that normally started with the redneck battlecry "Hey Ya'll watch me do this" BUT what killed my teeth was a rather nasty URI I got that required a lot of IV antibiotics...I swear before I even left the hospital my teeth had started to crumble like candle wax. A year of this and frequent gum/tooth/jaw infections took it's toll and I conceded my mouth to the dentist. As for discrimination...I do not feel discriminated against. To me stupidity is stupidity...no need to glorify it to the level of "discrimination". My original post I will admit came from a bruised ego...not over my lack of teeth..but that my skill as a damn good floor nurse (if I say so myself) was not the mitigating factor in me landing the position. As for those that railed against my post and any offering me moral support I offer this...yea life is life..reality is reality and what a drab boring reality it is for some when they stop questioning and the word Why? drops from their vocabulary. For those that did offer support fear not...as I said I took the job..to which they may soon regret, I've become quite adept at popping my dentures out soon as the higherups leave and I am now embarking on a quest to see how much "fun" my dentures can bring... Last night I walked up to an aide and showed her my dentures in hand and said "See what one of the residents gave me as a gift?' She blanched and stated "Why would you even take them?!?!" at which point I popped em in my mouth and said "Because they fit great!" She covered her mouth in shock and ran to another unit...good times..good times.

SMILE? Background: I am a fairly new RN who has been working LTC for about a year. We have been in need of a unit manager for close to the entire time I have been there. I figured being so new it was out of reach, and I wanted to cut my teeth on the floor as much as possible. A few weeks ago the DON approached me and encouraged me to apply for the unit manager position. I applied, interviewed, and waited. Week or so later I was informed that the higher ups wanted me to get more experience on the floor. I really couldn't argue with that. Then I found out the UM they did hire is a new grad...but with a BSN (I have an ASN). I felt some sour grapes but in this economy was happy to have a job period. Few days ago the DON calls me up and with a few other managers in attendance tells me that if I was willing to wear dentures I would be promoted to Unit Manager....I thought at first they were joking and this was just a creative way to offer me the position after all.. They weren't joking. I asked them was the only reason I was denied a promotion was because I didnt wear dentures and they spoke in the affirmative. Now, I don't have teeth, and unless I told you, you would never know. My face hasn't fallen in on itself, my speech is perfectly clear, and I don't tend to give "toothy" smiles. I own dentures, but never took to them. I lisp when I wear them, grimace a lot, and drinking anything hot really is a pain with them in. So, I took the promotion but feel a little let down by my company that "teeth" are a pre-req for management. I know all about "professional" appearances and all...I keep my hair short, press and starch my scrub creases (Former Marine), cover my tattoos (again, former Marine) with a long sleeve scrub jacket, and try to keep compose myself as a medical professional. Maybe I am making too much out of this but makes me wonder what else could have been asked...I have streaks of grey and white in my hair...hair dye?, I wear reading glasses sometimes..contacts?...I wear my laugh lines and crows feet proudly...botox?..I'm overweight...bariatric surgery? Guess Im just confused and disappointed

Facility where I work (LTC/Subacute/Rehab) has been on a big push to hire RN's. When LPN's quit they are not replaced with LPN's, but RN's instead. There has been a growing rumor that LPN's will be phased out here which I think is a terrible mistake due to the years of experience our LPN's have. I have been told that when the LTC/Subacute/Rehab units are ranked that RN hours are heavily weighted in factoring ratings. Key problem we have are that most RN's -least the ones I know, do not want to work LTC..they want to work in hospitals or other specialty areas. I always wanted to be a geriatric nurse so I feel right at home, but many of my fellow RN's just work LTC to get that golden year of experience then leave, or more often then not, they make it through orientation then promptly quit as LTC is not what they want to do. So this big transition to RN's only is rather haphazard and doesn't really endorse continueity of care.

I have one patient I really have a good relationship with, but this worries me to no end because it kind of puts me in her sights. This pt is the one that has the DON, the Facility head, the ombudsman, and state on speed dial. She will call from her room to the nurses station to report that her call light has gone unanswered for hours (her biggest complaint is having her cath bag emptied and most times she will hit her light and go back to sleep, the aides empty it, turn off the light and exit). Every morning after she is hoyer lifted into her scooter she will be up at the facility managers office with a list of complaints. She has asked me to write up aides for not performing duties (which I have seen them do as I enter her room from the shared bathroom to care for her room mate and she doesnt always see me as she berates the aides to no end as they do her care). She has gooten several aides pulled from her care, and had at least 1 nurse let go because of her accusations. My concern is right before she goes on the warpath it always seems to be her favorite aide, nurse that gets the full brunt of it.

I've used coke, but recently my facility has just started stocking these and I love them. http://www.nationalscrubs.com/feedingtubedeclogger-16-18french395cmqty10.aspx dont know if we will keep them in stock, but I really hope so as I normally have 2-6 feeding tubes to care for during my shift and I always have at least one that does not want to flush.

I hate to say it but these kind of post rarely educate. They may give us a sense of "there but for the grace of God go I" and put our own experiences in focus, but for the most part they are sensationalist. I have decided, since becomming an RN, that we folks are indeed aliens. People from the outside, including students (because i was one as well), find our more extreme experiences as both entertaining and morbidly curious. I watched countless hours of "life in the ER" and any other reality based medical shows when I was a student. Now they barely keep my attention past the intro credits. For many people our stories fill in for those tv shows. You never see many "good" stories about good nursing in the news..even in AN news section it is the sensational and extreme stories that get commented on the most. I have no problem with this, and I have no problem with nurses posting their experiences, but I don't pretend that someone asking us to spill all of our most gross/painful/strange/weird/humiliating/off beat tales is doing so from an academic point of view, they are basicly looking for all the entertainment of "Strange but true nurses tales" cue spooky music. There are countless post here that someone can search for if they really need to know what kind of experiences they may encounter. Everything from the funny, the heart warming, the heart rending, the mundane, and the outlandish.

Language can be fun. Now I admit when I'm getting report and I can't understand my co-workers pronunciation of an antibiotic, that can add a little stress, but it's not that hard to figure out that A: the pt is on an antibiotic B: I can look up type and route in the MARS without hounding on my co-worker. I have dentures..I almost never wear them..as a matter of fact I think my 14 yr old daughter has them...she likes to put them in innappropriate places around the house...in stuffed animals...using them as pencil holders, and last week I think she carved out a section of watermelon and stuck them in such a way to make the melon look like is was grinning..sick child but thats another rant... When i dont wear my dentures I mumble...think "popeye" speak. My co-workers have no problem asking me to repeat myself and I assume they will allow me the same. As for speaking native languages at work..i have no problem...some residents gets very confused (more confused then norm) and even abit afraid when our multilingual CNA's start holding native tongue conversations in their rooms while doing patient care, but we have a facility rule of not having personal conversations while providing pt care, regardless of language. And the fun in language comes in with our misunderstandings. I was giving report to a fellow nurse from Nigeria, and was trying to tell him that 2 residents had been having sexual liasons all over the facility..now it seems every CNA in the facility was huddled at the nurses station so I was trying to be delicate in my descriptions of what had been observed..which just confused the poor man more and more. I asked another Nurse who was also from Nigeria to tell him about the 2 residents...she promptly turns to him and says "Oh they have been %*%#@ all over the place" at which he smiled (blushed along with me) and said ah okay I got it now. I see the value of being multi-lingual as not coming into it's own....yet. As our culture becomes more diverse, our pt load will as well. Maybe 20 yrs down the road we will all be saying "Thank God we have a nurse that speaks [insert language] to communicate with this patient." I understand the dangers of misunderstanding one another, and I do think we need baseline levels of being able to speak and understand the language of the country we work in, but I also tend to find enjoyment in learning new phrases and words in other languages and without my day to day contact of mulitlingual medical workers..well dang it I wouldn't know how to say a code brown in 6 languages ;P

Lol I'd be scr*wed either way. I quit smoking cigarettes but now use e-cigarettes which still have a healthy (pun) dose of nicotine. No tar, no 400+ other chemicals, but still nicotine. My facility went non-smoking on the grounds which is par for the course, but we had 1 resident that was grandfathered in as being allowed to still smoke since they had come to us long before the no-smoking rules came into effect. She used to get smoked 6x a day out on the edge of the property. Just this week they took that from her and slapped a patch on her which is driving her crazy (along with withdrawl). As for obesity, I am a very large guy. You've heard of functional alcoholics..well Im functionally fat. I don't even know what the chairs feel like in my facility because my @ss never gets to sit in them. Im on the floor humping along my entire shift, plus being regarded as my units spare hoyer lift. I even chart standing up. The day I get judged by my waistline vs my work output and attendance record for illness (normally 1 day in a 12 month period for flu, cold, or a planned MH day which I havent taken yet) is the day I hang up my exl scrubs, say my good byes to my favorite residents, and take up the mantle of grandpa extraordinaire.

I'll up the ante on the OP's tale. I have a friend who just started at a LTC as an RN. She was a very friendly outgoing nurse who befriended her fellow nurses and all of her CNA's. She shared her facebook page with them as well as her email address. Few weeks later she calls me very upset because she was fired... One her "friends" walked into a patients room where a very very large code brown was sitting on the floor. She snapped a photo of it with her cell phone and promptly emailed it to several others, my friend included. One of the recipients, another nurse, took the image to the DON of the facility who called in the offending aide and asked who all she had sent the photo to... All the recipients, my friend included, were fired. The original aide was fired for abuse of patient dignity..even tho no pt could be identified in the picture. The others were fired for not coming forward to the DON when they had received the image. I felt bad for my friend (we went to NS together) but it just went to prove how correct someof our instructors were about living in this day and age of cell phone cameras, facebook, email etc. It can all be turned against you over the littlest thing. I have a FB page but if you were privy enough to see it you couldn't even tell I was a nurse or were I work. I don't post about work on it, I don't mention work, and I refuse to own a cell phone even tho my facility has offered to get me one so they can hit me up for OT easier. The only place I even let my guard down slightly, is well...here on AN...and even then when I post I imagine my DON or Facility manager is reading every post I make...

When I started at my facility we had one nurse that would put the "new" nurses through the ringer. I was very new, a new grad RN in fact. This didn't help as my facility was touting how they were going to be hiring RN's in liu of LPN's. Talk about walking into a hostile environment. I was not about to get into an LPN vs RN war...in no way was I going to flout my 2 yr degree so new the ink wasn't dry vs in most cases 15+ years of floor experience. The one nurse who seemed to single out new nurses was an LPN, but to her credit her attitude was spread evenly among new LPN's and RN's alike. For two months I put up with it. I found out she counted meds and tx supplies to see if they were being giving and used. I was accused of not giving a tx because her supply count was over (I had used supplies from a tx cart from another unit) and showed her my documentation and the dated dressings (which I retrieved from the trash just to show her). She seemed to relish chart checks to make notes on med errors for the managers to see, not just flag them so the nurs ein question could make corrections if it was just a missed initials. Giving report to her was like pulling teeth. She would ask me questions about patients that was common knowledge and I felt like i was always being tested. I put up with snide comments, being cut off in report with "whatever, if you don't know you don't know, next patient"... One night after a very hard shift I was short tempered, discouraged, and not looking forward to reporting off to her. I was giving report and didnt pronounce a pt's name correctly and she corrected me and said how she couldn't stand how some nurses don't pronounce names right...I lost it. I asked her what in the hell did I do to her or anyone else in the facility to deserve the crap i was having to put up with. One shocked look later, and an uncomfortable silence, I resumed report and she didnt say a word. Since then we have become good collegues. I respect her for her knowledge and have learned a lot from her. She is one of my go to people when I have a question about procedures. Recently, she actually came to me and asked for my opinion about a pt wound issue. I thought it was a trap, another chance to show me how new I was, but she honetly wanted my opinion...and she used it, then the MD on call verified it was right. One of my best nights ever. After I had my blow up the other nurses started treating me better as well. They let me in on the fact that dealing with that particular nurse was a right of passage for new nurses and once you had your say with her you were accepted. We still conk heads sometimes, but it's as fellow nurses, not newbie vs experienced nurse. I am not encouraging "blowing up" at rude co-workers, it can backfire, but what I do encourage is standing up for yourself and expecting others to give the same amount of respect you do.

1 year out from school and I can't even remember my previous life before nursing. My only regret is that I waited until my late 30's to do it. I went to a two year school, where only 2/3 of my class made it to graduation, put out over 70+ applications and went to 8 interviews before I landed my first job. I have suffered the confusion of orientation, the fury of experienced nurses taking me to task, and the realization that my family has to share me with 127 residents at my LTC facility. I would do it all again without a moment of hesitation just to be called "Nurse"

I work in a subacute/rehab wing in my LTC and needy family members are par for the course. I have had them follow me and I refuse to answer questions at the nurse station, in the halls, or throught the bathroom door (yes I had a family member follow me to the bathroom and knock on the door to ask me a question about their mother's labs) My ace up the sleeve is HIPAA. I always educate the family that I, by law, can not discuss any facet of their family members dx or tx in a public place and that I will round back to the room to answer questions after x amount of time. The only time this has caused trouble is when other nurses "will" discuss pt's in public placed with family and the family throws that back at me. I always stand firm, I may not be the "favorite" nurse they remember but I hopefully I will be the nurse that get's remembered for being able to round "all" their pt's. Also for the family that want magic nurses (appears 2 seconds after family request pain meds, a pillow, a soda etc) I have lost mytemper a few times and it amazes me some family member's are immune to sarcasm. I chalk this up to concern about the ill family member, but some days I have to wonder. Family: What took you so long in coming back with that sandwich, new batteries for his remote, different color gown because he doesn't like blue, four additional sandwiches for me and his nephews..don't you nurses care at all about other people!?! I would also like a complete copy of his chart, he needs pain meds, and do you think you can bring me some tylenol I have a headache from waiting! Me: I am sorry you had to wait, I was on another unit and got stuck with one of "those" families...no consideration for any one else in the world and loaded me down with a bunch of silly request that ate up a ton of time I could be helping all my patients. Family member: Oh I am sorry to hear that, I hate people like that, now about those sandwiches, we don't like white bread withe crust not cut off.

Just had a pt do this a week ago in middle of the night....twice..pulled out his Foley with balloon intact and also managed to pull out his g-tube, bulb defalted (he did chew on syringe port of g-tube). Order I received was I/O cath Q4Hrs, then it went to Q6Hrs, then twice a shift, now its is Qshift. Wish we had a bladder scanner to better time the I/O cath to make the best of it. And yes he bled...alot. Pt was hospice for cancer, was A&Ox2, and was having his pain maintained fairly well which may explain how he could pull the foley out balloon intact.

I was given 7 days of Orientation at the second job I took (my first job gave me 1 day following a medcart then that night I was by myself with 60 pts). There are not what I would call short cuts but prioritization skills you can develop (or learn from good nurses) that will help you ten fold. Some examples I learned from some experienced nurses: We have a 1 hour before and after med window. When I started I passed my 4AM meds at 4AM, my 5AM's at 5AM, my 6 AM's at 6AM....it never occured to me to pass my AM med pass at 5AM and cover all 3 passes within the facility defined window. This did take some reserach on my part to make sure that I was not passing any medications that may be contraindicated in a same pass time frame. I learned which pt's in my hall took a bit longer to pass too..either they woke up slowly, wanted to talk, or my more alert ones that wanted me to asses them every pass to see if they were needing any of their PRN's (Got one every AM that wants imodium, mylanta, milk of mag, a suppository, 2 tylenol, a neb tx, and insist that the previous shift did not change her 30 minute to do dressings for cellulitis and wants them done now - even tho the dressings are c/d/i and are dated and initialed by previous shift nurse) I tend to pass her meds first just as she is waking up as she often wants to go back to sleep..otherwise I am doing an hour of assesing to document that she had a BM my shift, regular not loose, Dressings are c/d/i and dated properly, O2SATS are 99% on RA with no labored breathing, 2 tylenol given for pain with a mylanta chaser. One wonderful OCD nurse I work with taught me to lay out all my blood sugar supplies out before the med pass. She always has them neatly lined up on top her cart 1 lancet, one accucheck stick, one alcohol swab per pt..all on top one another..she even goes as far as to write inmarker on the swab the pts name..I used to just fill my pockets with lancets, swabs etc....I just don't wash my hands 16 times and check the faucet 16 more times afterword. As for pt names..at first it is daunting, use the advice given of asking aides at first, but what I did was every morning once I verified a pt I used their name several times ie "Good morning Mrs pt" "I'll be back in 15 minutes Mrs Pt" etc after a week or two you will be amazed that you can remember over 127 pt names like they are family..(because in a way they do become that). Right after report make yourself an action plan even if it is just a scribbled page of quick notes..I need to do this this and this..and if at all possible try to alot yourself 20-30 minutes for "Ah sh*t" moments...that fall that happens 10 minutes before your your relief shows up, the one time your pt that wants all her prns actually does need them because she has loose stools, hypoactive bowel sounds, and has O2SATS below 85%, or my favorite time killer...when a visiting MD from the wound team leaves three pages of orders...then hides them in the chart no where near the orders section..and you find them one hour before shift end. Last note, good CNA's are angels sent from heavan to protect us time challanged nurses..I never finish a shift without thanking my CNA's for their contribution to the shift.