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pers

pers

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  1. pers

    Who Gets To Be Called Doctor?

    I agree with your last two points but the first portion I quoted I take issue with. You have to have a PhD to be a doctor, you aren't required to have a degree to be an RN. I worked as a PCA before I became licensed as an RN even though I had completed my BSN. I never introduced myself as an RN because I wasn't one until I became licensed. I did however tell people who asked about my education that I held a BSN. If a BSN was enough to grant me the title of RN I would have been comfortable using it even before I was licensed. Your comparison is apples and oranges. Doctor is granted by the degree but is associated with MD. I'm becoming much more careful to refer to physicians as physicians when discussing them generically. I no longer say that I need to call the "doctor" but rather that I'll call their "physician." Unless of course, I'm actually calling their DNP To be honest, I think the public cares a lot less than ALL of the doctors think they do. When they or are a loved one are sick, they want treatment and they'll take it from the best source available to them regardless of what they call themselves.
  2. pers

    This is making me nervous

    It's not a situation I would find myself in at my current facility, but the OP was asking what people thought about the situation as it is one she faces so I offered my opinion.
  3. pers

    This is making me nervous

    Fired? No. Prepared to protect my license? Damn skippy. We all take risks and that's one I'm not willing to accept. I refuse to accept any assignment I consider unsafe and being the sole nurse on my unit is not safe. There may be some who are happy to take that on and they can have it. If my employer tried to fire me for refusing such an assignment I'd happily take the unemployment and get another job. Patients on my unit can go bad quickly and having help is essential. Sure, folks will be there within 3 or 4 minutes to help if my patient codes but I'm more concerned about all the other things that can go wrong. Like when they are circling the drain and as the only person on the floor I'd have to make a choice between being with the patient and being at the phone to deal with the doctor/supervisor/lab/pharmacy/whoever. Or dealing with a confused and combative patient by myself without a reliable way to get help quickly. Or getting slammed with multiple admissions. We don't have a secretary at night so as the only person on the unit I would really be the only person on the unit. That's not happening. Ever. Fortunately, my employers also think that sort of staffing is beyond stupid and not safe so it's not a situation I'd find myself in. Our core staffing level requires two nurses at all times regardless of the number of patients. It doesn't have to be two RNs but it does have to be two nurses.
  4. pers

    waterproof mattress

    I got a waterproof mattress pad after getting an expensive white mattress because stains void the warranty. I don't remember the name of the brand but the mattress store where I bought it had cut a piece of the pad and placed it over a jar filled with blue liquid so you could feel the pad and also see that it didn't leak. I started with a typical plastic pad that may be waterproof but caused me to sweat like you wouldn't believe, even with a thick fabric pad over it! The new one I bought is really nice and very comfy, it feels like fabric and I don't sweat at all. It was pricey, just shy of $100 for a queen size, but worth it to me to provide the comfort I need to sleep but still protect the mattress.
  5. pers

    Can I refuse an assigment if .....?

    You are in orientation and expected to precept two new grads? I'd refuse that!
  6. pers

    This is making me nervous

    I would refuse to staff a unit as the only licensed person. Even if there was only 1 patient on the floor, I wouldn't accept the assignment unless there was a second nurse with me. You never know what will happen with that patient, or on my unit, how many admissions you are going to end up with.
  7. pers

    Best way to space out 12-hr night shifts?

    I wear earplugs most days and still hear my alarm just fine. I currently have a dark and heavy curtain in the window because I found it blocked more light than the room darkening curtain I'd been using! I tried a sleeping mask but I'd take it off when I slept and then when I'd do the groggy roll over where I'm just awake enough to register it's daylight, I'd suddenly be wide awake. I think with my next move I'm going to make some styrofoam window blocks that I can pop in and out of the windows based on my schedule. The current set-up is great for when I'm working but in the evenings when I'm home and in the bedroom, I find myself wishing for more light without having to leave the curtains open.
  8. pers

    how did they pass theyre boards??

    I have never heard of a jurisdiction where good samaritan laws cover on the job conduct. Even if they did, good luck finding a medical professional willing to testify in court that a 92% O2 sat justified your action.
  9. pers

    how did they pass theyre boards??

    Putting myself in your shoes, I would have helped him by telling him I notified his nurse and she'd be in shortly. In a few minutes, I'd check on the patient and remind the nurse again. If I was really concerned, I'd let the nurse know if she doesn't have time to assess the patient I'd be happy to get someone else to look at him. You can bet your bottom dollar though, I'd call 911 before I gave him a breathing treatment! You not only do not have a duty to administer breathing treatments to patients no matter how much you believe they need them, you don't have the authority to do so either. How do you even know the patient was allowed a breathing treatment? What if they had been discontinued? Or if he'd just had one earlier and it wasn't time for one? You not only don't have the skills to determine if the patient needed a breathing treatment, you don't have the information necessary before providing one. I'm a nurse but I can't give a breathing treatment because I think a patient needs it, I have to have an order for it. If the order is for a treatment every 8 hours, I can't give one every 4 just because I think he needs it, I have to call and get an order for that extra treatment. If you worked at my facility, you'd not only be fired for that stunt, they'd most likely turn you in and try to get your certification pulled.
  10. pers

    Best way to space out 12-hr night shifts?

    Another vote for all 3 in a row. If you hadn't said you were a night person I'd have suggested 2 on, 2 off and back for the final shift as dayshift people often struggle a lot on that 3rd night. One night off is not a night off when you work nights--you come home and are either a zombie till bedtime that night (maybe or maybe not after having a quick nap) or you sleep the day away and stay up in preparation for going back to work the next night. If you really want to feel like you had a day off while working nights, you need at least two scheduled nights off to really accomplish it.
  11. "If you didn't chart it, you didn't do it." That was drilled into us repeatedly before we even started clinicals. I follow that today and hold other nurses to it as well. It's not just CYA either, documentation is also communication between staff. If I need info about something that happened on a previous shift (even a previous day) that wasn't passed on in report, I look to the documention to find an answer (particularly when I'm being asked about an order that was written).
  12. pers

    Departments that cut the most shifts?

    I've been at my hospital over ten years and in that time the only department that has never closed is the ED. Telemetry closed once for 3 days when they did some cleaning/renovation work (usually they close part of the floor down while they do the work and leave the rest of it open, working in stages till it's complete). At my facility the unit that closes most often is pediatrics or OB followed by ortho, neuro, progressive care and then med-surg. Of course patients are shifted from one unit to another to accomodate the closed department, if they have 4 patient's on neuro and 10 on med-surg then they'll close neuro and move those patients to med-surg. The MICU, ICU and CVICU close in rotation as well, when census is down they often combine to one or two units being open rather than all three.
  13. pers

    How do you assess your patients post-cath?

    We no longer use pressure dressings either but if I had one I'd definitely feel underneath! We check the site and compare groins, check VS and pedal pulses q 15 min x 4, q 30 min x 4, q 1 hr x 4 and then q 4 hr x 4.
  14. pers

    Tele interview Tomorrow. Need your help!

    The market is more competitive now than it has been for a while so I'd be prepared to sell yourself not just as a nurse but as a tele nurse. Why do you want to work tele? And remember, they aren't just interviewing you, this is your chance to interview them too! Ask about their turn over and ratios. How many new grads do they have? There are plenty of horror stories of the most "experienced" nurses being those with barely a year experience, that's not a floor you want to work on! My unit is tough for new grads, if you were interviewing here I'd strongly suggest you ask how many new grads hired in the last year are still here (or how many hired in the last two years remained after a year). What about your work schedule? Will you be expected to work weekends? Will you have 12 or 8 hour shifts? Work nights or days? Will they alter those things without asking you first? Nightshift has a crew of "weekenders" so I only work the occassional weekend but I can be scheduled as often as every other weekend because that's the policy. Our policy also says nightshift workers only have to work nights but dayshift workers can be scheduled days or nights (and that tends to fall to new hires). Telemetry nurses should be ACLS certified, is that something they will provide? How soon should you expect that training? What about the length of your orientation? Will the NM meet with you regularly to check your progress? If you don't feel ready at the end of orientation, is an extension possible? Will you have one preceptor or multiple preceptors? In the event you and your preceptor aren't a good fit, are there other options? Really think about what you want to know about the unit you are interviewing for, this is your opportunity to find out! Ask if you can speak with a new grad or two. There's no guarantees of course, but the more questions you ask the better decisions you can make about what kind of work environment you are entering.
  15. pers

    How long did it take to get use to working nights?

    Like a couple of others, it was an easy adjustment for me. I spent a year on dayshift and never did get used to it. I couldn't fall asleep early enough and was far from my "best" (both in personality and function) for the first several hours of my shift. For those I've seen struggle with sleeping during the day, melatonin and herbal teas can help. Making the room very dark and developing a strict bedtime routine generally helps the most though. To stay awake at night, some swear by coffee, others by energy drinks but most of us are so busy you don't have much time to think about being tired though!
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