PeacenJoy

In the hospital where I used to work, we had a nurse who called in sick. The manager said he did not believe her and she needed to come in and threatened her job. During her shift, she fainted and fell. She ended up being admitted in the same hospital for head trauma and laceration. I am told the she and her husband settled out of court.

I love this site and I am usually a silent stalker of articles and posts on this site. However, this time, I cannot believe the amount of bad advice for this new nurse that I am reading. Let me give you my advice, which might be bad, but in my 10 years experience (2 as LPN, 8 as RN), is the right advice. You owe your loyalty to the hospital completely from the time of 7am to 7:30pm or whenever you clock in and clock out. When you're in the hospital, tell patients how lucky they are to be in that hospital, how you and your coworkers will take the best care of them. Then work hard, work your booty off, clock out and go home. Then your loyalty is only to yourself (and family). Evaluate if there are any better offers out there. Then jump ship so fast, they can only see your dust (after two weeks notice). I have seen misplaced loyalty to a hospital to be the downfall of many a nurse. First of all, do you think they have any loyalty to you? They only hired you because they could not find an experience nurse. Now that you've been hired, you are learning a lot, which is good, but they will get their money's worth by working you to the bone. They will make sure you work off all your learnin'. If they lose some new grads in the mean time, that is just the price of gambling with a new grad. They will write it off. If you come back in a couple of years as an experienced superstar nurse from the big hospital down the street, they will hire you before you walk through the door. So you need to evaluate the pay, the traffic to work, the retirement plan, the potential for growth and advancement before you think about some misguided loyalty to some hospital. Do not go down with any ships. I was a traveling nurse for a few years and I happened to work for this tiny hospital because most of their staff left. That is because the hospital filed for bankruptcy and could not pay their staff anymore. Also, the nurses that had been their for years lost all their retirement money and paycheck for the last couple of weeks. It was a big mess, but rumors of financial instability had been around for years, but nurses stayed because they loved the hospital and their coworkers. Now their futures and retirement capabilities have been compromised due to loyalty to a corporation. One thing though, do not tell any coworker about the offer from the big hospital. When you give your two weeks notice, site family reasons. State your regret that you cannot continue with them, while thanking them profusely. No one needs to know anything other than that. Do not go down with this ship.

This is more about me than the patient. When I started working as a new nurse, maybe 8-10 years ago, I called the doctor for a patient who was very nauseous. She said to given the patient promethazine PR. I had no idea what PR meant, but I didn't want to look stupid to the doctor, so I said OK. I asked others, but nobody know what it meant. So I wrote the order as IV and gave the medication via IV. The patient had a reaction and basically went bananas. The calm, lovely patient at the beginning of my shift who told me she like my flower-patterned scrubs became a yelling maniac who told me I stole her shirt and I need to take it off and give it back to her. I shamefully called the doctor back who asked why I didn't given the medication 'per rectum' as she asked. Oh, so that's what PR meant! Now I know. Thankfully, the patient came down towards the end of my shift and became more of herself again. From then on, I ask questions about things I don't understand. I don't care if I look stupid. Nothing can be worse than a misunderstanding that put a patient in danger. Just recently, one of the doctors asked me to gather things for a para. "What's a para?" I asked immediately. "A paracentesis, so I can draw fluid from her stomach," she told me, rather condescendingly. That's fine with me.

Let me give you some advice that has worked for me: overwhelm them with your knowledge. When a patient looks uncomfortable with me due to something or other, I overwhelm them with knowledge. When they ask a simple question, I answer in such detail they tune me out. When I watch their eyes glaze over, I know my work is done. From then on, they know that I know what I'm doing and they relax. For example, I'm giving you Metoprolol because it's a beta blocker that reduces the workload of your heart. Because of your congestive heart failure, we want minimize the impact on your heart. So it also decreases your blood pressure and slows down your heart rate so that we can prevent arrhythmias. It increases the ejection fraction of the left ventricle so that we can maintain cardiac output so it can pump blood to the rest of your body. I'm drawing your blood because we want to test for troponin, an enzyme released into the blood when some of the heart muscle dies. It dies when it's not getting enough blood flow, usually caused by accumulation of plaque in the arteries. We can sometimes treat it by opening up the arteries and restoring blood flow through catheterization. Do you have any more questions? Believe me, they never do. The bad part is that you will have to memorize this on every medication and procedure you do. However, the patients will relax and understand that they are in great hands. Good luck.

I worked in a very busy ER. After wheeling the last of my four patients to the parking lot, I always return to the ER with four brand-new patients who need IVs, labs, urine, EKG, not to mention history and assessments with documentation. Then we get a diagnosis and treatment within two hours, discharge and then four new patients. On twelve hour shifts, I walked about 12,000 steps according to my phone, and never have time to go to the bathroom. I eat a bite of food while documenting at the computer and dare anybody to say anything to me. That ER offer a $10,000 bonus EVERY YEAR in order to keep staff. I had one man whose heart rate was in the 180s. I went to give him the medication. He refused to give me his arm with the IV and said he will not let me give him the medication until I get him a sandwich and a diet coke. I said, "I understand. I will document that you refused and I will let the doctor know, too. I am going to given the person next door their medication. Let me know if you change your mind, sir." And I walked out. I don't even argue anymore. Aint nobody got time for that. Yes, I am trying to keep him from going into cardiac arrest, but I aint God. I can only do what a human woman can do. I think he called me back in 10 minutes and I gave the medication. Aint nobody got time for that. They call me the crazy whisperer because all the crazies settle down because I don't engage. LOL.

The most recent annoyance was several weeks ago when the physical therapist called me and said that the patient's BP and pulse went up when she was trying to get the patient up. Should she put the patient back in bed and what was my name so she can put it in her notes that the nurse said not to get the patient up. First of all, I told her, the patient has been laying in bed for the past three days because PT does not come on the weekends. Of course her blood pressure and pulse will go up. Secondly, getting the patient up or not is her decision because she is the physical therapy consult.

You know what, there are a lot of techs where I work who said that they dropped out of nursing school because the teacher hated them. Always thought this was bull because I had a teacher who did not like me. I actually thought that she's gonna fail me out of nursing school but she had no ammunition. I always got to clinicals on time, I always did what I was supposed to do and I did everything by the book. Before I give any medication I research the medication, I know all the side effects and what it does, I always ask my patients their name and their birthday, and always check your ID band before giving the medication. Because I did this other people in my group started getting in trouble because they never did that. I passed and I went on. It was such a stressful time for me but now this woman has no chapter in my life. I will not let a hater have a chapter in my life. So I told the techs that They should've done everything possible to take away the weapons from that teacher. If you get it right there's no way she can say you got it wrong. You can get out of there and you will forget even her name. If you let haters damn you, you will remember their names every day and that is the worst thing that can happen.

"My father ran out of his BP pills, so he hasn't taken it in two months." I understand, I said, as the Doctor told you, his troponin is high, which is indicative of some cardiac damage. I was thinking to myself, you didn't bother to refill your father's (who lives with you) medication for two months, and caused him to have a heart attack, you jack a--.

Actually, I am trying for an internal transfer right now. I want to move from med-tele to ER. If it doesn't come through, I would have to quit. Of 8 the people they hired in Aug 2011 for my unit, I am the only one left. Everybody else went to another hospital that has a higher acuity and is paying them $6 more per hour. When I applied to that hospital, they hired me for med/surg. I decided that even with the higher pay, I can't start over again paying my dues in med/surg.

I had a blind patient a couple of weeks ago. I gave him the nurse's call button and told him not to get up without calling me. I moved his finger to the big red button on the control. He said, "Oh I see, this one said nurse, this one said TV." He could read Braille!! I had forgotten there were braille letters on the button. I was so exited, I almost peed on myself! I had never met someone who can read braille before. I think it was because he was blind from birth. Most people get blinded because of diabetes and other things in adulthood.

Wow, 8 times?!! Obviously, you are not unintelligent, judging by your work history and your long paragraphs. What I can attribute it to, I'm thinking, is the fact that you didn't learn how to think like a nurse. Your nursing school or teachers presumably did not prepare you or you just did not grasp it. It is nothing to be ashamed of, I myself did not understand the nursing thought until my last semester of nursing school, which thankfully, was just in time. Before that time, I passed my tests by sheer memorization and regurgitation. Grasping the nursing thought is like wearing glasses: it makes everything clearer. Therefore, you can look at a question on a topic you know nothing about and at least eliminate most of the wrong answers. Someone once told me that you go to school not to learn facts, but to learn how to think. That is especially true for nursing. I've been to three nursing programs (one for LPN, one for RN and another for BSN) and I have noticed that there is a uniform way of thinking that they are trying to teach you and can be quite difficult to grasp. So good luck on your next endeavors. Do not, under any circumstances, tell any of your employers, employees or patients that you passed the NCLEX after 8 times.

Broadway, I think you need to find someone to take a look at your resume. I am surprise that not one out of 500 resumes had a bite. With as much experience as you have, intuitive knowledge that you accumulated does not just go away, and the practical knowledge comes back pretty quickly after a period of orientation. I think the problem could be something as simple as your resume.

Maybe I'm doing it wrong, but this thread is hilarious.

oooo I got one: Why do you want to know how much the jobs pays? You shouldn't be a nurse for the money. You should work just because you love it...

Congratulations!! Great job. Austin looks like such a great place to live. I know you will enjoy living there and working there for more than two years. I didn't apply for the NICU because neonatals scared of the beejesus out of me. I know you'll do well because you have a passion for it.