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TonyaM73 ASN, RN

MED/SURG STROKE UNIT, LTC SUPER., IMU
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TonyaM73 has 10 years experience as a ASN, RN and specializes in MED/SURG STROKE UNIT, LTC SUPER., IMU.

TonyaM73's Latest Activity

  1. TonyaM73

    That nagging "Did I miss something?" feeling

    I had this recently myself. A pt I took care of off and on for over 3 weeks. Last shift I had with this pt, they didn't look good, but there was not much that could have been done since they were a DNR and the family did not want anything invasive done. Some areas looked better, but some looked much worse. Came in the next day and found out they passed about midway through night shift. I spent the next week going over what I could have done differently. I think that this is part of being a good and caring nurse. It just drives me crazy until I can let go of it. My only advice is to go over it piece by piece and see if you could have done anything differently. (You have to do this objectively and realisticly) Once you have gone over the whole senario, decide if there was something that could have been done and do it next time, or let it go and decide that you did ALL that you could have with the information that you had at the time. Good luck in your career and don't EVER stop learning!!
  2. TonyaM73

    Too many hats

    Thank you for putting it so well. I have always been stumpted by this.
  3. TonyaM73

    Too many hats

    That would be lovely. I don't think it will happen anytime soon with the job market the way it is.
  4. TonyaM73

    Medi Tech...Who slept with Who? Vent.

    We have Medi tech also and it is such a pain. It took so much time to understand that you have to press enter here, but the next page to do the same thing you have to press control and don't get me started on the function keys.
  5. TonyaM73

    Too many hats

    I have a friend of mine that I work with and we vent together. I really don't know what is to be done. I have gone to my manager about some of it and keep being told to keep a log of events and then email her with it. THERE ARE TOO MANY for me to go into specifics about everything. I have tried to relay the general feel for everything, but without stopping and writing down the details of everything, I don't think anything will be done. We have anything from the MDs ordering too many narcotics, including Dilaudid, like it was candy, to pharmacy not getting orders correct and the RNs having to back track and fix everything, to aids just plain being lazy and if you tell them to do anything....you are not a team player because that is something that the RN is qualified to do. So frustrating.
  6. TonyaM73

    Too many hats

    Just to warn you, I had a hard day yesterday. It is impossible to wear as many hats as a med/surg nurse has to wear today. We need to be RN of course, but there is also MD, case manager, aid, secretary and Lord knows what all else in one day. For example, yesterday I had a MD dc ativan for a seizure pt that was currently actively seizing. I asked said MD about this and they stated "Wellll, they are extemely lethargic, so of course I dc the ativan." Of course they said this in a really derogatory way, like I was stupid or something. HUH???? But MD, the pt is actively seizing and has been all morning. "Oh they are? Oh, is that what the ativan was for?" HUH?????? I have enough on my plate with everything else, but to have to tell the doctor that we needed ativan and to please don't dc it, just topped it for me yesterday! YIKES! Where do they get these people?
  7. TonyaM73

    Deathbed visions **UPDATED**

    It is amazing all of the things we know that we don't know. I think God gives us the comfort that we need at a time when we need it the most. If this vision is comforting to her, then that may be all there is to it. Good luck and God Bless to you and your friend. Just be there for her, talk and hug!
  8. Speaking of trachs....had a trach pt at a LTC, I used to work for, that needed O2. Came in after shift report and found O2 mask over his nose?!?!?!?!?!?! HUH? Kind of had to let every other nurse on the unit know about that and they seriously didn't know!
  9. TonyaM73

    Any tips with smells? Please!!!

    I ALWAYS have cough drops in my pocket for just such occations. If you have a menthyl one in your mouth and you are breathing through you mouth, you won't really smell anything else. Anytime one of my PCTs have to clean out a colostomy, they usually come to me for a cough drop.
  10. small nose bleed to which the pt was in the hospital for 3 days with Dilaudid ordered 2mg q3 hrs. ?????????????
  11. I had the same thing. Yes, the clinical instructor told me that "You will never be a good nurse." I was promoted to evening nursing supervisor in my first job and they are talking about charge nurse in my second job. Just try to figure out what it is that she objects to and overcome it. I still to this day do not know what that instructor objected to with me, but obviously others do not see it. This too shall pass and so will you if you keep going and learning all that you can everyday!
  12. TonyaM73

    Is LTC really a kiss of death for new grads?

    Depends on the nurse manager. I had to start off in LTC due to the shortage of new grad jobs after I graduated. I took every opportunity I could to learn and refresh the skills that I didn't use to often. I moved up the latter very quickly to the evening supervisors job after 3 months and stayed there for the remainder golden 1 year experience. When I came in to interview, I made my organization, leadership and time management shine. I told them that since I was able to handle 30 patients and hone in my time management and medication knowledge, that I could learn anything that I did not use often very quickly. Needless to say I got the job and have been in the hospital for over a year now. Working in LTC, expecially if they have a rehab, can really help you be a better nurse in the long run and can help the transition to a busy med/surg floor. For any of the other specialties, you may have to do your time on med/surg in the hospital first. Everything all depends on the hiring manager and their perspective of LTC.
  13. TonyaM73

    Not a waitress or barista

    I had one that I was discharging the other day at around 11am and the husband actualy asked me, could we get an early lunch tray to go? Really??? I told him that we really do not do that here, but if they want to stay for lunch, please let me knowl.
  14. TonyaM73

    Stubborn Docs, New Docs

    oh boy and how! Usually their response is to belittle the nurse. I give them a blank face and read the order out loud so that everyone in the area can hear it and hope to get some comments on it or hope that by reading the order out loud that the MD can hear what he is ordering and understand that there is a need for clarification. I love it when you call a rapid and the MD walks in, looks at the pt and acts like you are stupid for calling a rapid until you prove, by EKG that the pt is in rapid afib with a bp of 198/113 and completely unconcious and all on a med/surg floor. Hello MD can you come back into the room please! Sorry, end of rant here. :) Some of them are so caught up in the other things that they are worried about and not attending what you are saying. Just have to keep pushing until you have the answers that you need to take care of your pts. All about the pts is my motto!
  15. TonyaM73

    I got fired today

    All the time. :) It sounds like it was for the best. It stinks being fired, but it would stink even more to work for someone you had a bad feeling about and they treated you like crud. You have experience, so that is a good thing and you will find something else soon.
  16. TonyaM73

    So disgusted with everything

    Oy, sounds like my day on Med/Surg the other day. Not as many as 9 pts at a time though THANK GOD! 3 on the verge of respiratory distress (Full code), 1 Conversion disorder, and 1 who I asked the doc for an order for an U.S. do to edema, swelling and discoloration of arms and come to find out they had HUGE DVTs in both legs and arms. YIKES! Of course the ones that were not as touchy were on the call bell every 15 minutes and I am not joking! The secretary was keeping count for me. I just kept humming to myself "It's a beautiful day in the neighborhood, a beautiful day for a neighbor...." I stayed somewhat sane anyway. :)