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cbreuklander

cbreuklander

icu staff nurse
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  1. Amen to that. What the patient wants is not always what is best. If they had the ability and knowledge to take care of themselves, they wouldn't be in the hospital. Not to say that we should ignore their requests entirely, but sometimes they need to be encouraged to make healthier choices.
  2. cbreuklander

    Snow- at what point do you call out?

    I have worked for a hospital that took into consideration the safety of their nurses during winter weather. They would call me at home to let me know that if I felt the roads were not safe for my car, they would put me home "on call." If they didn't have enough volunteers who lived in town coming in (with incentive pay for working an unscheduled shift), they would come out in 4WD vehicles to pick us up. I thoroughly appreciated this as I have never before nor have I since worked for an administrative team that gave so much consideration for the safety of their nurses. I would go back to work there in a heartbeat if circumstances allowed it.
  3. cbreuklander

    Sometimes you just can't bite your tongue.....

    Happens on Med-Surg, too. I had a patient with an unstable heart rhythm. I will admit it took me some time to settle it down, get the Dr. on the phone, IVP meds and calming the patient and family. However, amazingly, I had no other patient call lights come on during this time. Well, I walked into my next patient's room to do a routine assessment. She had orders for discharge and was just waiting for a ride home. She looked at me and said "I don't want you. I want a nurse who has time to see me. I have been waiting more than an hour since you came on duty." I told her that wasn't a problem, I would get her a different nurse and walked out of the room. I called the charge nurse and she re-assigned the patient. The charge nurse came to talk to me later about it. She said that she went in to talk to the patient (cause we're all about Press Gainey scores now) and the patient assured her that she hadn't needed anything. She just expected that her nurse would be in to see her in the first few minutes of the change of shift and if this hospital couldn't provide that she wouldn't be back. Her loss. We are an awesome hospital with awesome nurses who take care of unstable heart rhythms:)
  4. cbreuklander

    Question about BP control in your ICU

    Much the same in our ICU. The treatment protocols haven't changed a lot in the last few years. I think the perfusion issue is what keeps the docs conservative with BP control. Also, once it starts to drop as the pt stabilizes, it is difficult to control if there are aggressive meds on board.
  5. cbreuklander

    Nursing Diagnosis...the sacred cow that needs to go.

    When we enter a care plan into our computer program (which we are required to do on admission) it automatically generates nursing diagnosis that fit the physician's diagnosis (reason for admission). Once each shift, we are required to bring up this care plan and document on the outcomes. As a general rule, most of us do this at the end of the shift and it generally amounts to "Making progress" on nearly every one of them. Useful? I don't think so. Just something to put us into over-time.
  6. When I was a student, once the clinical instructor was confident in our ability, we were allowed to take meds in to patients unsupervised. However, we were not allowed to go into the patient's room without the instructor or primary care nurse first looking at the meds we were taking in.
  7. cbreuklander

    Just for fun; Quotes you use for encourgement

    When you get to the end of your rope, tie a knot and hang on.
  8. cbreuklander

    So do you actually take your breaks?

    It's basically an administrative attitude. I work a busy med-surg floor. I am an RN. The hospital I worked at previously, we took our breaks and the charge nurse would remind us to go on break. He/she would offer to cover for us to make sure that we had time. If our 30 minute meal break was interrupted for any reason, we got the whole 30 minutes paid at time and a half, even if it did not put us into overtime. The hospital I currently work at....well if you suggest that you are going to go off the floor for a 30 minute break you are looked at as uncaring and unprofessional. Co-workers let you know that it is a huge inconvenience to them to cover for you when they don't actually leave the floor for their breaks. Meals are consumed in bits and pieces...a few moments here and there. Our 30 minutes is unpaid. We don't actually clock out, but it is automatically deducted from our time each shift. It just feels wrong:(
  9. cbreuklander

    How to explain how hard you have to work in nursing school

    My school sent a letter to my husband shortly before the first semester started. It talked about the commitment nursing school required and the long late hours that would be needed. It also thanked him in advance for being supportive and lowering the expectations at home.
  10. cbreuklander

    For those new grads who are employed, what's your method?

    Don't know any nurse recruiters. Here's what I did...I applied for a position at every hospital around. I interviewed at 4 of them, passed pre-employment physical fitness tests at 3, and took the job I felt the best about in the end. Make sure to have your resume proof-read by an instructor or someone else that is current on what employers are looking for in a resume. I did all of my application on-line and wore business casual to the interviews. I live in an area where there is still a shortage of med-surg nurses, so I was at an advantage.
  11. cbreuklander

    To flush or not to flush...advice please.

    Our policy is to push 1mg or 1ml over 1 minute, but I've also seen nurses push Morphine faster.
  12. cbreuklander

    To flush or not to flush...advice please.

    If it were me, I would flush unless my supervisor specifically told me not to. And in that case, I would ask for a policy so that there is no question. The potential for drugs that are not compatible being in the tubing at the same time is scary to me.
  13. cbreuklander

    Snow- at what point do you call out?

    Hard to get to the county seat to get that piece of paper when the roads are closed! Management should take a hard look at how much they value the lives of their staff. It's harder to get to work post accident, no matter how serious.
  14. cbreuklander

    Snow- at what point do you call out?

    By the way, I have been the nurse stuck at work due to someone else not making it in. I still do not go in if the drifts on the road are taller than my car!! Get real. It is different out in the country than it is in the metro areas!
  15. cbreuklander

    Snow- at what point do you call out?

    I have to say that I have called off work because of snow more than once. I live in a rural area on a gravel road that is just not a high priority. I do not like to call off because it makes me feel guilty, but sometimes it simply can't be helped. My employer knew my address when I was hired and I do not feel that it is fair to expect me to move into town after they hired me. That all being said, I work three different part-time jobs in two different towns. They all handle weather situations differently. One of them calls it an unexcused absence. After three in a year I get a warning. After six it is probation. So be it. One of them expects me to find my own replacement. The other nurses there are really good about it and I haven't had any issues there. The last one actually calls me to see if there is any chance of getting through my road. They have a policy that the maintenance crew goes out in 4 wheel drive vehicles to pick up nurses in rural areas. The last time we had more than a foot of snow, I got a call that they weren't going to make an attempt to get to my house so I should plan to have the night off. The only way to know for sure what happens where you work is to wait and wee if it happens. I have known some very good nurses who died in car accidents on icy roads trying to get to work. Probably not worth that. Be safe.
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