busykim

I was 45 in 2004. No regrets, I love what I do. I loved what I did before-:1luvu: and have 4 really awesome kids to prove it!

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I was working triage last Sunday and Dad brought in daughter for "psyche reasons" stated that she might be suicidal and that she was not acting normal. 16 year old calm (not looking too happy) in chair answering all questions appropriately--denies suicial ideation, plan etc. Dad standing there holding religious book--telling me that she is disobedient and everyone is concerned in their family. Pt. states she just didn't want to go to church today....Dad told her she had to go to church or he was bringing her to the ER...she said fine- take me to the ER. Dad states "she is disobedient and not acting normal--and wants to date" I ask Pt. if she is the oldest child in the family (thinking that perhaps parents aren't familiar with teen age behavior???) She tells me that she is the youngest of 5. She then tells her Dad "fine I won't have a boyfriend then..." all the while looking at me like she is embarrassed and somewhat defeated. There was no indication to hold her in the ER so I sent her to urgent care...as she rounded the corner and looked back at me with sad eyes she mouthed "thank you". It broke my heart...me thinks parents need to be evaluated by psyche...don't threaten kids with the ER to try to control them...UGGHHH!:angryfire

I think it depends on the clinic and what kind of hospital nursing you do. I work both, and I can tell you that my clinic job (even dealing with everything you listed plus 2 years as clinical manager) vs. my ER job -that the clinic job is cake it's a matter of perspective now, there is almost nothing that could stress me out at the clinic after dealing with the ER. It's made me a better nurse and less likely to stress over "regular" things --just my humble observation. So for now it's a good balance and reality check for me.- Kim

How about laser nurse? The pay is pretty good and you only laser one patient at a time Pretty low stress compared to my other job in the ER. When I go to my laser job I feel like I am playing with my friends plus- there is always the perks:yeah:

My experience so far with what I believe is eclypsis-- but called "health connect" at our facility (which we have dubbed "hell connect") is not good. I know change is hard, but to go from a computer program that was a couple of screens to input a new patient (triage or ambi, I work in the ER) to literally about 10 screens is very time consuming. We spend more time at the computer to input patient data (more for accounting and records) and it has taken away time for patient care. We no longer have a viable way to communicate via computer with our ER doc's for orders, etc. We have gone backwards with red clothespins stuck on charts to let us know we have orders vs. old system that flags everyone via computer screen to let staff know when there is orders, or pt. to be d/c, or patient has a bed assignment!!!:smackingf I literally had a meltdown on the first "go live" day when I had to input an ambi. (OK I have a few other stressors going on in my defense---marriage problems, dad dx with lung ca etc. etc.) so I think it was partially "the final straw" but I was finally feeling competent in my job as an ER nurse of nearly 2 years, and then they have to make things harder and more complicated!!! I NEED a secretary!!! HELP!!! I am actually looking at other positions as the ER itself is overwhelming at times, but now--- almost impossible. :behindpc:

I think your feelings are totally normal! Your first clinical experience is nerve wracking enough, let alone being in a nursing home. I can tell you that for me that was my least favorite clinical experience (LTC) and I like old people. I just didn't care for the environment we were at. As for hearing lung sounds, it does take practice, and a good stethescope! I had to get a different one because I had trouble hearing well (I have a little hearing loss in my right ear from scuba diving injury). So practice that, I even got a lung sounds CD to listen to help me. Hey- on my first clinical I tried to listen to lung sounds on a med-surg patient and couldn't hear anything!!! I then realized my ear pieces were in backwards :smackingf To this day I always check. It gets better. :icon_hug:

Accutane is often a miracle drug. It is the best drug we have in dermatology to fight cystic and other stubborn acne (usually after all other types of medicines have been tried). I have personally seen it change peoples lives. I think it's almost a crime when I see people suffering with scarring acne and large cysts walking around- when it could usually be changed with Accutane. Yes it is very drying- moisturizers can help, absolutely use sunscreen (more sensitive to light) Another tip that helps alot of Accutane users is to put vaseline in the nostrils gently with a Q-tip (for pt.'s that tend to get nose bleeds). Some patients with cystic acne need more than one course of treatment but usually one course is enough. You won't know until you have finished treatment and time will tell. Accutane users are monitored monthly with labs, pregnancy tests (for females of course) mood changes etc. We have not had one case of suicide or other major depressive conditions in any of our patients (that we know of) and have seen mostly the opposite---depressive, shy, self-conscious people that are changed and thrilled with their acne free skin. Also most of the time people can has laser and microdermabrasion etc. after a year from finishing treatment. Hope this anwers most of your concerns- Kim (derm and ER nurse)

I have to agree with the other posters that it is soooo irritating when people come in at 9:00 pm and "haven't eaten all day" and now is an emergency! --- or the patient with abdominal pain that is eating an In and Out burger that her husband snuck in---ended up with chole dx. I also love the "I've been waiting for" (insert exaggerated time here)- I sometimes want to ask them if they had an appointment??? Then there is the patients wife that was miffed that she had to transport her husband back to his board and care (you mean I have to take him back???he came in by ambulance!) after explaining that we can arrange transport but she would have to pay for it- she was then miffed that she needed to fill a RX for him! You don't have someone that can go get this for me?? :angryfire Then there are the family members/lurkers that give you dirty looks and complain loudly about the wait. Especially love the ones that complain when you are on the other side of the curtain with another patient or cleaning up a room to bring in another patient. They talk loudly just to make sure you can hear..... We had a wife the other night that was tired of the wait (pt was referred to ER from PMD for abnormal lab) We were slammed with serious patients...their nurse kept in touch and explained Doc would be there asap etc. After a while wife comes up to nurse's station and yells "so are you trying to kill him?" Everyone stops what they are doing and there's instant shock/silence--(we couldn't help but laugh after the fact) :roll

I worked with an anethesiologist that was first a nurse, then a CRNA and now an M.D. I don't know how long she was in each profession. She is an excellent Doctor though. I think it sure must have been a long road to go though. :)

As said in other posts there are all types of jobs out there. I work in the ER (very stressful) and also for 2 private practice Dermatologists. I love the variety of both jobs. My derm job is sooooo not stressful, just busy. I mostly laser there and assist in lipo. I love both my jobs and am thankful for both the experiences. I also have a friend that works for a county agency and manages cases for disabled infants. She works part-time and loves it's pace also. :) Kim

Are you talking about a cyst like a boil? These are easy to remove in a Dr.'s office, I work part time for 2 dermatologist's and they do them all the time. They are usually gone permanently with a small incision (the doc has to remove the sac or they can come back) Sometimes they are packed for drainage, and sometimes people are put on antibiotics to prevent further infection. They can sure smell though when removed!!! :uhoh21: They are usually caused by an infected hair follicle. Hope this info helps. Kim

I have only worked at one hospital in the ER, but I have heard nurses say that we "dump" patients on them at shift change. In our facility that is not the case, once we have orders from the admitting Dr. we fax for a bed, admitting has up to one hour to get us one, then once a room is assigned we must call report and have the patient out of the ER within 15 minutes. All the while everything is timed on the computer. This is all done to keep the busy ER moving. There is no way we could orchestrate and hold patients just to "dump" them at shift change to inconvenience other RN's/ I sometimes think that a "exchange program" for day- would be a good thing between different areas of the hospital to try to understand each others perspectives. I think most all of us are hard working and judge each other too harshly. Just my observation :) Kim

As said in other posts--- it is a very common feeling to be overwhelmed, unsure and scared as a new grad. I have been a nurse for only a year now and boy can I relate!!! I used to have nightmares all the time and replay the shift in my dreams for the first 6 mos. in the ER. I also had diarrhea so bad that I used to joke that I was worried that I had C-diff! The funny thing is I only had it on the mornings before I worked!!! You will soon learn which nurses you can go to for help, there are always certain one's that like to teach and remember what it is like to be new. I can tell you that after 6 mos. it got alot better, and now after a year I love my job I am still learning and striving to be an excellent nurse, but am gaining confidence daily! Thanks to all seasoned nurses that encourage and teach us newbies!!! Kim

Respiratory Rehab! There is a speciality Hospital here that deals with just that...my father in law was a patient there. Just way too much mucus for me!!! :barf01: I also would hate Ped's- just couldn't handle the parents. I get just enough of them in the ER (love kids) but don't like dealing with overwrought parents...justified or not. I also would be afraid of burns :angryfire --but I so respect the nurse's that do! The funny thing is that I had said that I would never work ER because I didn't think I could handle the stress... spent several rotations there my last semester of nursing school and fell in love with it. Love the ER!!!