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eriksoln BSN, RN

M/S, Travel Nursing, Pulmonary

Content by eriksoln

  1. eriksoln

    LTC vs. Hospital, good move or not?

    I see a lot of posts by LTC nurses about how bad the conditions are. I see some too who say they are happy with where they are, but not nearly as many. I've come to the conclusion that I don't get along with night shift. In my current position at a hospital, not much opportunity to change to days and/or evenings. Day shift nurses are being called off a lot due to census still and every position that posts internally is for nights. So, unless I am willing to move on, I'm stuck with nights here. I am considering doing LTC nursing because I already know of two places I could basically be hired at right off the bat if I wanted. And, they are days. I've always said I would never do nursing home but............to get away from nights I might. Good move or no? More importantly: What do I look for as I go to places to see where I might get hired? Any tell tale signs of a good vs. a bad situation at a nursing home? It'd be a big move for me, but I think a lot of things would improve for me if I go to nights.
  2. eriksoln

    Time to call a duck a duck, part II

    OK. I had an infamous thread going that challenged the notion that nursing is a profession. If you are REALLY BORED, go ahead and read it. Since then, I've had a bit of an epiphany. I couldn't help but wonder "What was the bug up my butt about it anyway?" and "Why is it so important to convince others of this?" Well, you ever get that wonderful brain fart syndrome going after working a night shift? The next day, you are trying to recall a well known relatives phone number or someone's name you should remember, but you don't. Then, out of the blue, a little while after you stop thinking about it, it comes to you. Thats what happened to me. I stopped stressing over it, and I was all of a sudden able to put my finger on it. The orig. thread touched on it a bit, but in an indirect manner. In the orig. thread, I rambled a lot about the personality types who "Consider nursing an image instead of a career/job" and all the lovely nurses who preempt every statement with "Well, I'm a nurse and I think................." as if it makes a difference (Seriously, I once answered someone who said that "Well, I'm a nurse and a former landscaper and former student and former brick layer laborer and former grocery bagger and I think................). It was as if I were trying to describe some sort of individual who was bad for nursing, but I couldn't put my finger on "The Issue". So, finally, today, all the little separate details that were somehow wrong in my eyes came together to make sense. Nursing is a profession. It does combine intellect with physical labor, and neither one can be successful without the other. It does have it's theory, although I don't agree with most about what said theory is. In fact, that was what the epiphany was about: Seems nursing theory has been a bit diluted by our "leaders" who came before us AND, most of all, our current leaders. Care plans that no one reads, diagnosis that have no use no matter how far you stretch reality to say they are used and numerous other things that, in reality, are simply ideas borrowed from other fields and renamed. No wonder no one else considers us professionals if this is the best we can do. Many of the things wrong with nursing theory today have one thing in common though: They all take us away from the beside and put us in front of a chart/computer. The mechanics of the theories are followed through from an administrative angle, and are meant for people away from the bedside. NURSING OCCURS AT THE BEDSIDE. The problem with "nursing theory" is that it is often written by those who consider themselves above bedside nursing. Hence the theory that flows from them, inevitably, really doesn't have much to do with "bedside nursing". But, is not bedside nursing the point? Do we nurse our patients back to health, or do we "nurse" paperwork? Consider, for a second, nursing before paperwork and impressing administration became so important. Do you think for a second the nurses of old, the ones who nursed back when there were no computers or anything...............weren't "nursing"? Did their patients lack in some way because they didn't jot down in some chart how their care reflected "Age specific needs" or how they "Interpreted the pt. reaction to illness"? I say, profoundly, "NO". In fact, I'll follow with, they were probably better off. A little less time talking and self important chest pounding and a little more time doing the things that help (dressing changes, help with ambulation to avoid falls, taking one's time passing meds to avoid errors). THAT IS NURSING. Our profession suffers because we hang ourselves. The people who rise through our ranks and hence represent us to the decision makers often, along the road to progressing in their careers, pick up some sort of disdain for bedside nursing. It's "remedial" and "meant for the ancillary staff". If this is the face of nursing that the public and the decision makers see, is it hard to believe such a low value is placed on what we do and that we often feel the need to call our jobs "thankless"? Our very own leaders from within the field, unfortunately, are often in their position of power because they have worked hard to distance themselves from bedside nursing. Nothing wrong with that, if you don't think it is your niche, you are better off elsewhere. What I do have a problem with is when our leaders forget their roots and why they are where they are. If there was no need for the staff nurses, there certainly is no need for administrative/managerial nurses. They forget their roots, begin to believe and buy into the business side's way of thinking and take on an air that nursing is for the ones who don't get it. Why this phenomenon occurs is a mystery to me. Might be because, the nurse found out they truly hate bedside nursing and want nothing more than to never have to hear "Nuuuuuurrrrseeee, I want dilaudid/a bed pan/need tissue handed to me" again. In their efforts to distance themselves from clinical/bedside nursing, they unintentionally take on a holier than thou air. Or, it might be that, for fear of being replaced, once they get into the board room meetings they join hands with and take on the attitudes of the business minded. Regardless, the lack of respect for our profession isn't going away any time soon BECAUSE IT STARTS AT THE TOP OF OUR OWN PROFESSION. I now do believe nursing is a profession, and I'm talking about "Nursing", not board room meetings or care plan evaluating. We can not be replaced. As a "remedial" nurse who still believes my best work is done at the bedside, I will be continuing my my education soon. Why? Because I want a more well informed opinion on who our leaders should be and more say in who they are. Maybe someday I'll be in a position too where I can be the face of the profession, but I don't plan on forgetting my roots.
  3. Shortly after having a nice dinner with a couple friends I have not seen for some time, I found myself pondering the flaws in the assertion that healthcare must be "customer service" oriented. My friends, both of whom are, through no fault of their own, only marginally aware of the problems facing healthcare, both insist the push for better "customer service" in healthcare is long overdue. Well, unfortunately, I went off into a rant about all the reasons it does not and will continue to not work. I actually said a few things that surprised myself, at certain points it seemed as though I were talking and learning at the same time. Needless to say, both my friends have new and different gripes to pursue regarding healthcare now. I also believe it may be some time before we have dinner again. Have you ever seen the movie "Lethal Weapon"? If not, I highly recommend it. There is a scene in that movie which, to this day, remains one of my all time favorite movie scenes. A cop, played by Mel Gibson, finds himself on a roof top trying to talk down a possible suicide jumper. What this jumper doesn't know is, the cop trying to help him has a lot of issues of his own going on, and he suffers from depression also. His depression though results in a suicidal approach to his police work. Well, the cop keeps talking to the man in a business suit on the ledge, all the while getting closer and closer to him. Finally, he is right beside him, still putting on the "nice cop" act and he cuffs him so he can't jump, and the nice guy act immediately goes away. He tells the guy "ok, shows over, its time to go, get off the ledge." the man in the business suit isn't satisfied with this ending to his suicide jump show though. He begins to argue with the cop, even threatens to jump and take them both off the ledge. Finally, my all time favorite movie scene comes: the cop looks the jumper right in the eyes with a look of the Devil on his face and asks him: "You wanna jump...............huh................Do you really wanna?" Next thing you know, he takes the businessman by the shoulders and both are falling off the ledge towards the air bag beneath them. By the time its all over, the businessman can't wait to get away from him and is screaming for help to come undo the cuffs, "Help me, he's trying to kill me." I believe the next time someone suggests to me that healthcare should be more like "customer service", they are going to have a similar experience with me. For me, its just a simple matter of "watch what you ask for, you might get it." To start, I need to insert the disclaimer. When I say customer service has no place in healthcare, I am not advocating that nurses should be allowed to ignore pt. Needs, say whatever they want to family members or show up in jeans and a Metallica shirt for their shift. As with other healthcare professionals, nurses should be held to the highest standards of professionalism. Proper etiquette, treating patients with respect and dignity and a sense of duty to do what is right for patients has and should continue to be the basis of nursing's approach to people. With that said, I will interject though that "customer service" and healthcare do not mix. They are like trying to mix water and oil. Why? Because the industries that are considered "customer service" (the food industries, retail etc...) use liberties to make the "customer service" model work for them, and said liberties would be unethical in the healthcare field. 1. Systematic customer service vs. Individualized customer service Customer service industries, while taking (or at least advertising) a "the customer is always right" approach, don't always let their customers decide what is best or how to make the business function. Customer service industries are able to take either/or approach and decide for themselves which one is best for different situations. In plainer terms, customer service industries have the luxury of deciding when to put the business first and when to put the customer first. Take the fast food industry for example. Think about any national fast food establishment. Now, compare how differently one restaurant, from the same chain, functions compared to the others in the surrounding area. Store a is open 24hrs/day, store b closes at 10pm. Why the difference? Because the powers that be who make decisions for the company have seen trends that say closing store b at night was going to save money, meanwhile keeping store a open all night had benefits. The customer service industry makes many decisions like this, all the while keeping profits as high as possible. Customer satisfaction is weighed against the cost of keeping them satisfied, and decisions are made with the business's best interest in mind. Take the above example a step farther. You are a customer of store b, and you don't get out of work until 10pm. You can't go to their drive through and get a late night dinner on you way home. Now, complain to the store manager. Chances are, you will get a very practiced and sincere (sarcasm) apology, but nothing will be done about it. Next, contact the administration who made the decision to have the store nearest you close instead of be open all night. You will get the same response and perhaps a $5 gift certificate. It's simple, staying open all night and getting your ten dollar sale doesn't justify paying a couple hundred dollars in employee wages. So, in the end you lose. Give telling the cable man he can only fix your cable box at noon, no later and no earlier, a try. Chances are you will be listening to the radio for a very long time. Tell me what happens if you tell the local grocery store bagger that he must wear a tie or you don't want him bagging your food. Wait, I already know the answer.......you bagged your own food. That is real life "customer service" at work. This would not work for the healthcare industry though. It is a well known fact that a personalized approach to care is a major focus of the healthcare industry. If you get sick at 2am, the er at your local hospital will be open. The public and political backlash would be epic/historical if it weren't so. Can anyone imagine a hospital saying "we are going to accept patients only between the hours of 7am and 10pm, its just better for us and in turn will make things better for our patients." or, how about a home healthcare agency that does not take emergent calls during certain hours. With all the cutbacks being made in healthcare and everywhere else, it has not gotten to this point at least. This is "patient care" at work. 2. Freedom to distinguish good customers from bad customers, and act accordingly For this example, we will use a well known, national retail store, better know as a "convenience store". Cogo's is everywhere in the u.s., it survived the recession and will probably still be here when nothing but cockroaches and fungi roam the earth. Walk into the Cogo's or similar local convenience store. A few things you will notice: the ever present and popular "no shirt, no shoes, no service" sign, signs around the cash register telling you this/that are not accepted behavior or these/those forms of payment are accepted, a security camera (sometimes multiple) making sure you are aware you are being watched and of course the also ever present and popular "shoplifting is illegal and we prosecute" sign can't be left out. The cashier working at the time may or may not say hello as you enter, depending on their mood. Not the warmest welcome, to say the least. So, why do they continue to strive with such a poor first impression being their trademark? Because, all these things are a part of being allowed to decide who deserves service and who does not. They won't cater to anyone, especially if it is not good for business. Customers who are lewd, loud or disruptive are promptly removed from the premises, because they are bad for business. If a customer who does not like the prices of soda becomes verbally abusive or physical, they will be promptly removed and may be arrested. This is real life "customer service" at work. Lets return to the restaurant scene for a moment. Do you have a favorite place to eat at? Chances are, if you go there often enough and are a good tipper, you get a little better treatment than the unknown customers. Ever been to an unfamiliar restaurant while traveling. I'm willing to bet you saw a few locals getting better service than you. Do you have a friend (or, are you the one lol) who does not tip or is demanding/abusive towards the staff? If you do (or are the one), then you certainly know what it means to get the minimal service, and, yes, your food may have been dropped on the floor a few times before you got it. Fact is, service industries do give that extra effort when a well liked big spender comes in the doors. It is a give/take relation to them, like it or not. Even the retail businesses do this with rewards for spending a lot and staff who are told "be extra nice to that one, he spends a ton of money here." anybody recall how the phone service giant, sprint, recently "fired" a large amount of customers and told them to find phone service elsewhere? This is real life "customer service" at work. The healthcare industry does not have this luxury. The mantra is "these people are sick, they are at the lowest point in their lives." I do believe that, to a degree, and believe any nurse who still has compassion does not take every patients actions personally. I think er nurses more than anyone can attest to the fact that we give people a lot of room for mistakes, and they still receive the care they need. Drug addicts attack hospital staff, family will insist you forget about everyone else and only tend to their loved one ("hey you, nurse, how long are you going to be doing CPR on that man, my mom wants water.") and verbal abuse is the norm. Despite conditions that would make the average citizen break down in tears, we strive to keep the patient first, regardless of whether they deserve it or not. We are obligated to do so. Does an er nurse telling you "sorry, can't cardiovert you until you put on shoes and a shirt" sound like something you want? This is "patient care" at work. 3. The ability to keep business as the primary focus and turn away customers who can't/don't pay No need to specify any specific industry for this, they all exemplify it. Go to the local burger joint and when it is your turn to order, say to them "I don't have any money or credit cards, but you are "customer service" oriented and i am hungry. Soooooo..............hop too with making my burger and don't forget to hold the onions. After the laughter stops, you will be excused from the premises by the manager. Don't pay your phone/cable/gas bill for a few months then call them and tell them "I'm going to give you very low ratings if you shut off my service" and see how effective your threats are. After the laughter stops, you will be isolated/bored/cold. Fill your gas tank at the local gas station, but leave without paying. Trick is, you have to leave a card with your personal information behind so they can find you (ok, this is a stretch, but you get the point). After the laughter stops (for your stupidity and for your inability to pay), you will be fined. This is real life "customer service" at work. As healthcare providers, we are obligated to provide the best care we can, regardless of ability to pay. Yes, healthcare is a business just like all the other service industries. We do have to keep the doors open and staff paid somehow. The healthcare industry also gives vast amounts of charity care. Even without taking how uninsured patients use the er as their primary care service, this is still true. People are well within their right to sign up for "self pay" and receive the same care as anyone else. We know they will not be able to afford the bills, as do they. Its just a formal dance to get the patient admitted so treatment can be rendered. We take these people in, give them the same care as everyone else and don't look back. Often, people think its that way because it has to be. In truth, we wouldn't have it any other way. Everyone deserves life, regardless of ability to pay for insurance. This is "patient care" at work. What is the point of all this? My point is, you can not make "customer service" a part of healthcare without taking the good with the bad. To invite w/e aspects of "customer service" it is you are seeking into healthcare, you also invite "real life customer service" into the mix. This would be disastrous on many levels. Do you want a healthcare system that: Closes at night, because its more profitable. Tells the nurses to ignore the uninsured patient and focus on the paying patients (like the waitress). Tells patients who are not as pleasant as they would like to "get lost" and not come back. Only offers the services that are profitable for them at the time ("sorry, we don't have cardioversion equipment, it was too expensive to upkeep.") So, I will say to the proponents of "customer service": "Do you wanna jump?.........................huh................Do you really wanna?"
  4. eriksoln

    What scares you most as a rn?

    I'm the guy everyone gets for stuff that makes their stomach turn and churn. Vomit, sputum, trachs, BM, loose BM, blood..........eh, w/e. It don't bother me. I work on a M/S unit, so, the one thing that does bother me won't be on our unit: Bone flaps. The neuro people with part of their skull missing. I'm so afraid I'm going to poke their brain or something. I won't take these patients, and I don't care if that makes me a bad nurse.
  5. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    Any Star Wars fans out there? Remember Han's quote: "Must've hit pretty close to the truth to get her all rielded up like that" BSN nurses take it so hard when they find out they aren't all that, don't they?
  6. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    HEY:mad: I googled those names BTW:madface: I'm nice to animals. I have two Orange Tabby kittens............Calvin and Hobbes, and they are spoiled to death. So naaaaahhhhhhh:p >_> :eek:Oh. Wait. "Beat a dead horse".................ok, I get it. N/M.
  7. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    IDK. Maybe it's me. I just get annoyed when people so boldly pronounce things such as "My BSN makes me a better bedside nurse than ADN trained nurses" and then can't back it up. I mean, I wouldn't throw such statements out then then have nothing to fall back on when someone asks "Why?". Well, at the very least, I'd have more than "Well I don't know cause I've never been a ADN" and "I learned cultural sensitivity in school" to back up my statements anyway. It's kinda like...........if I say my baseball team is better than yours. Well........I can quote stats, point out how many people are in the all-star game, refer to the win/loss record and make all sorts of arguments as to why it is so. But.........as you can see.....those who claim BSN training makes you better at the bedside have............"Blah blah blah".
  8. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    i'm all for bettering the profession too. but part of that is, as you put it......."learning to check our biases and stereotypes at the door." one of the biggest biases with nursing at this point in time is that bsns offer something at the bedside that adns don't. that is a joke, to say the least. and to top it off, this bias is fed by schools who want people to spend more for their degree and by healthcare admin. who want to make cosmetic, cost free changes to their staff in hopes of impressing the general public. if bsns really offered anything "extra" that adns didn't, they'd have been offering more money for the bsn trained nurse and all sorts of incentives for people to take that route instead of adn. but........they didn't. why? cause it doesn't change much of anything other than cosmetics. instead, they waited for the opportunity to require bsns without having to pay for them. the recession came, jobs are scarce and everything is more competitive. so, they offer the same old wages and benefits but require a higher degree for it. doesn't sound to me like they truly believe bsns have much to offer beyond what they already get with adns. i'm moving on to get my bsn because i see and appreciate my away from the bedside opportunities to invoke change and have my voice be heard. i feel i will be better heard with the bsn education. that, in a nutshell (plus job security) is why i decided getting my bsn is worth it. i do not believe however that i will suddenly have magic wands in my scrubs that were not there before that i wave around and all of a sudden........my co-workers respect me and my patients understand their eduction better and i see things hours before they happen. that is the fluff schools push off on people while trying to convince you to sign the dotted line.
  9. Dexter? who? oh, I need to meet this guy.
  10. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    Explain it then. Tell me what outcomes you can generate with your patient an ADN trained nurse can not. Answer the (trick) question. Or do you agree with my friend who says its "zen-ish" and can't be put into words.
  11. eriksoln

    So sad, Nurse Assaulted

    Makes sense.
  12. eriksoln

    Job Satisfaction Declining for Nurses, Survey Says

    they want bsns because they look better in publications, not because they are better. since the only thing having your bsn does for the facility is allow them to boast "we have "x" percentage bsns", exactly what you said is true: you are paid as an adn and you get treated like an adn. why..............you are an adn. i'm going for my bsn. i though long and hard about whether i wanted to or not. i joined in on a lot of adn vs. bsn threads, dove in head first, looking for something concrete that separates the two. i wanted something to hang my hat on, something to keep in the back of my head while i went back to school. never found it. i know why too. see, as i did earlier this thread, my question has always been "what does having your bsn do to help you with bedside nursing?" i would often, as i did here, expand it to "what do you do or understand, given the same patient and resources, that an adn does not? what happens differently for your patient, since you have a bsn?" as with this thread, i got no answers. most changed the subject very quickly, others tried very hard to talk with big words and complicate the issue........but it always came back to there being no real answer for the question. one nurse did tell me something i believe (to a degree), which is that it is somewhat "zen-ish" and can't really be put into words or explained, that it is like being told to describe what vanilla tastes like. i found my own answer, and am confident in it's truth. that answer being: at the bedside there is no difference. same outcomes, same pg scores, same understanding, same everything. the difference between a bsn and adn nurse presents itself away from the bedside. hence, my question is a trick question, since it only concerns bedside nursing (i knew that this time around, not before). adn nurses are taught more of the language about research, they are judged rigorously on their writing styles (apa must be learned), they are forced to take more of a community look during clinicals (i had to write a very large paper describing my nursing experiences otherwise i would have had to do clinicals.......ones that didn't involve hospital bedside nursing) and the mechanics of political nursing are introduced on a larger scale (contacting politicians about certain bills etc). in short, the adn is more prepared to do things off the clock and away from the bedside to help advance nursing as a profession. and, this is what brings us to why so many people believe there is no real difference. bsns are more prepared to "enter the conversation" regarding nursing being a profession. they are better prepared to take nursing leadership positions in which they can make a difference and be the voice of nursing. but................this is a huge but.............most don't. they perform the roles of an adn nurse, go to work, clock out and go back to their everyday life, all the while telling themselves they are better at it for some (very imagined) reason or another (often things the school told them, the same schools who tell people there are thousands of jobs in nursing). since their higher degree only grants them powers away from the bedside, and they don't use them..........the line between the two degrees is very thin and blurred. i have news for the bsn grads who think they offer anything at the bedside that adns don't. your kidding yourself. it's probably a form of denial, denial brought on by the fact that you know your education has gone to waste because you aren't doing anything extra away from the bedside..........just clock in and clock out and be done. as i said, i am going back to school for my bsn. why? because i think i am ready to take that extra step in my career, the part that has nothing to do with bedside care. i feel, while being a part of committees with my hospital, i need to make myself better heard. no one wants to hear what an adn thinks, but some people (admin. and higher ups) will take a bsn trained nurse into account. heck, right here on this very site i was called "a layman" in an article i wrote about how "customer service" kills healthcare. i imagine the point the person was making was that i am adn trained and hence "don't see the whole picture". i'm also planning on being more politically involved. too many things changing and being done these days to sit idle and hope for the best. but this stuff is all off the clock and away from the bedside. thats where my bsn can help me.
  13. eriksoln

    One in four RNs wants a new job

    DOH. Or they just need to change fields. Being able to move around, even within your own facility, has become limited since the recession. My hospital at least, likes you to stay where you are at.
  14. Are you allowed to admit what you'd probably be is a serial killer? Will I get modded for it? I know all the details too. I used to be a landscaper before I was a nurse, so I think the breaking point would have arrived while I was still doing that. My weapons would be from the landscaping field. A weed whacker to torture people with and for leaving my mark (a circle, representing the moon, in the forehead). I would need the clippers used for trimming thick branches too cause besides my mark, they would also be missing the fingers of their good hand (would require some research). My target: Anyone, especially rich folk, who is nasty to service industry people. I would sit in Taco Bell during the day, wait to spot a nasty customer and then make them my next target. I could also go to the hospital, pretend I am visiting people and seek out a few nasty patients to pray on. My name: Man On The Moon. I would tell my victims "the man on the moon told me to do this". If you've read Stephen King's "IT", you'll get the humor from this. All the while, I'll preach to them how they were unwanted little "nasties" for being so rude to that Taco Bell cashier.
  15. eriksoln

    What's the issue with med surg?

    A year an a half ago, when census was low (seemed to be for every hospital), for some reason the admin. made it mandatory that when ICU didn't have enough patients, they could float ANYWHERE. Before, it was to the ER and step down units only.........no M/S, rehab, ortho or any other high ratio units for them. In the past year and a half, they've lost over half their staff, there are only a few veterans hanging on. Most that quit cited the above policy change as a contributing factor.
  16. eriksoln

    So sad, Nurse Assaulted

    I know, its a fine line but, I'm lead to believe her being a nurse is why she was attacked by the title. Not so. TBH, if the title read............"Girl attacked at nightclub"...........I'd have said "That's the nightlife for ya" and moved on.
  17. eriksoln

    What's the issue with med surg?

    I've said it before and I'll say it again (or, rather, ask it again): How in the world did good "customer service" and safe healthcare get interpreted as............pretend you are a quadriplegic and have as much done for you as possible?
  18. eriksoln

    My Student is draining me.....

    I don't know your student but I'm willing to bet they work as a CNA somewhere. Sometimes this is a good thing, other times it is not. They've probably heard all the bad habits nurses around him are in and hasn't figured out that it's not good nursing to be so jaded. I once had a former CNA new hire nurse tell me "Oh, those chart checks they do on night shift are all BS, they just make the nurses do that cause everyone is asleep." Mind you, this was said to me while I was desperately trying to get off nights because..........eh, well, thats another thread. So, I waited till the new nurse was at the point in her orientation where she took a reduced load of patients and had them all day. I followed her after one such day. Did the chart checks. Yes, there were errors, more than a couple. Wrong labs entered, wrong CT ordered, a med order was scanned to pharm. but never posted but was still signed off by her. I didn't raise a stink, but I knew she was coming in the next day and would have the same patients, so you can imagine what the report was like. "While doing chart checks, I was lucky enough to find the ordered CMP entered as a CBC so I chagned that. I'm glad I found that cause the pt. is on TPN and they need those labs early so they can order today's TPN." "While doing chart checks, I saw the CT was ordered to be done with contrast, but the order is for without. Oh my, that would have been bad to give barium to someone admitted with suspected bowel perforation." "The patient is supposed to begin PO protonix this AM, they D/C'd the IV. I asked pharm. why the changed the order (:oOK, this part, I was rubbing it in but it got my point across) back to IV and they acted like they didn't have a clue of what I was talking about. But, the orig. order is signed off, so sometime during the day it must have been changed to PO, but when I did chart checks........it was back to IV again. But, anyway, they corrected it and changed it back to PO again so all is well, we caught it before they had a dose via the wrong route." I still work with this girl. Her attitude about night shift is still about the same, but at least she knows enough not to voice it so arrogantly.
  19. eriksoln

    What's the issue with med surg?

    Nurse pt. ratio is the biggest concern. But there are MANY other points that make M/S unique and difficult: 1. Everyone will tell you "acuity" is going up and up. M/S most certainly has seen an increase in pt. acuity. In the not so distant past, patients with certain treatments simply weren't accepted onto the M/S unit (Q2 hr blood glucose with insulin gtt. for example) but they are now. But the pt. ratios are not adjusted to reflect this. 2. You deal with patients from admit to D/C........the whole spectrum. Not everyone does this as much. So, you have the new patient while they are extremely sick all the way up to D/C. You're not just dealing with one facet of the patients hospital visit. You can (and often do) have: A new ER that needs admitted or was just recently admitted, someone going to OR, someone coming back from OR and someone being D/C'd all on the same team at the same time. 3. Many other units use the M/S unit as a "soon to be D/C'd" dump off. The pt. on the Cardiac Step down unit go to the M/S unit one day before D/C. Then, the next day go home, with the M/S unit being the last stop. This is VERY BAD for your PG scores. Every patient from every other unit who is unhappy with their care comes to you last, and if you can't use your 1/2 day with them to magically make everything right, the PG scores reflect it. Unfortunately, since they were on your unit last.............all those comments about rude nurses and doctors or w/e.......are accredited to your unit, even though it's plainly obvious they are talking about the other units. This leads to many emails/meetings about answering call lights and "smiling while you enter the room" that really should be directed at others. 4. People in general don't get it that when you go to M/S from another unit, it is usually because you are better and getting close to going home. So, you have this patient from the ICU who is used to having a nurse with 2 total patients come to you. They don't want to hear about doing things for themselves or about figuring out how they are going to do things at home. They want their dilaudid and pillows fluffed like on the last unit. Getting them from "enjoying the service" to taking part in their own health often is daunting.
  20. Accounting. I just think I'd be good at it. If I had taken my studies more seriously when I was younger and went into accounting, it'd be my career path today. Everything happens for a reason though.
  21. eriksoln

    So sad, Nurse Assaulted

    Feel bad for the girl, the guy obviously had issues. But a quick thing I want to point out: Thread title is a bit misleading. The girl was not attacked BECAUSE she was a nurse nor while working. So, in essence, you had a girl at a bar being assaulted (who happens to be a nurse), not a nurse being assaulted. There is a difference. The difference isn't so much that the crime is better/worse but........motivation is different. I was scanning the articles and replies to find the connection to her being a nurse and the beating. There is none. She was at a club/bar and ran into the wrong guy. It would have gone the same way if she were a McD's worker, an engineer or a teacher.
  22. Well, I've admitted it before, I'm not the most politically inclined, but this seems like scary news to me. http://www.msnbc.msn.com/id/43635698/ns/politics-the_new_york_times/?GT1=43001 So, in short, not only will the Soc. Security I've been paying into not be there for me at retirement, but health benefits too? I'd better start paying more attention to saving for retirement:o.
  23. This. Tired of paying into a system that will not give me back my due. Its like going to a restaurant and paying, but the cook says "Eh, don't feel like making that, sorry, maybe next time." Or, it could be like waiting in line for a roller coaster ride and it closes right when you are next to go.
  24. eriksoln

    Alcoholism: disease or choice?

    Kinda like telling an overweight person they need to lose weight and calling them fat I guess. I still feel like the whole "gene" theory is cruel. It's like telling someone they are a mutant or biologically less than. That's what it sounds like to me anyway. Would you say that to a diabetic? "You body is all ****** **, you're going to spend the rest of your life having to do stuff to make up for it." Hmmm. Food for thought I guess. Maybe taking the disease process into account doesn't necessarily mean "condemning" the person like some Morlock. People with cancer aren't simply hooked up to morphine and told "Sorry, your genes were different so you got the CA when others didn't." But then again, with CA, there are concrete medical/surgical practices that improve the quality of life. With alcoholism...........isn't recovery primarily focused on changing one's thinking/values?
  25. eriksoln

    Medical student admits to killing 13 dogs out of anger.

    I know. My two boys get along so well, I was tempted to check and see if the other cat had been adopted yet and bring him home if not. I can only have two cats in the apt. complex I live in though. I'm sure he is doing well. He was a cutie. I can't imagine once the cast was off that he took too long to win the heart of someone looking to adopt.
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