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Long term care; med-surg; critical care
Platinum Platinum Nurse
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JBMmom has 9 years experience as a MSN and specializes in Long term care; med-surg; critical care.


JBMmom's Latest Activity

  1. JBMmom

    Florence Nightingale's Revolution from Home

    Thank you for sharing this interesting piece, I was unaware of how long she was homebound and how it affected her career.
  2. JBMmom

    Interview Panel, riddle me this?

    Often team members are included in the interview because they have valuable feedback on how a potential employee may fit, they are more familiar with the team dynamics than management in many situations.
  3. JBMmom

    What is harder: Hospital or facility?

    Not sure what you mean by facility. Are you comparing hospitals with long term care facilities? I think that everyone chooses their work environment for a number of reasons and deciding what's worth it is an individual opinion. Some people love long term care, with the opportunity to make more lasting connections with people that rely upon you for care. There are high patient to nurse ratios and often poor staffing plagues these facilities, some have management with potentially suspect motives. Other people love the hospital environment, despite also potentially dealing with short staffing, a potentially more intense patient population from an acuity standpoint, and sometimes also from a family standpoint as family deal with new diagnoses or sudden changes in condition. All work environments have advantages and disadvantages, making a blanket statement of which is harder difficult to say. I have worked in both long-term care and hospital environment, I gained valuable skills in both places, and have had some very good shifts and very challenging shifts, in both. I think the biggest challenge in long term care is that there is a significant lack of resources by comparison with the hospital. Assessment skills, when you may see a patient for 15 minutes in an eight hour shift, and knowing a doctor will only see them for a few minutes a month, are really a key component of care. You have to rely on your techs to also keep an eye out for changes in patient condition. Lack of supplies is always an issue as well, even moreso than in the hospital.
  4. Is there a particular reason you changed your mind? Was your initial acceptance a knee jerk "yes, sure" reaction and you hadn't the time to consider it thoroughly? Has something changed in your unit that makes precepting more of a burden? Perhaps short staffing puts more pressure on nurses to provide care without the additional challenge of teaching simultaneously? Are you concerned about how orientations have been carried out in the past? If you can present your educator with some concrete thoughts/concerns perhaps the conversation will be more likely to go smoothly. Good luck.
  5. In my area it seems that the worst of the COVID pandemic has passed, we are now seeing maybe 1-2 COVID patients at a time in the unit, and we've even had a couple stretches of a few days with no COVID positive patients. That's been a nice change from the past year. What hasn't been a nice change is that a part of the population of patients we are seeing are so sick that they are coming in and dying relatively quickly. Especially young alcoholics (30-50 years old), with such profound liver failure that they come in and only last a few days. We've also had more cardiac arrests related to drug overdoses and even alcohol intoxication. For the past year there has definitely been an uptick in the number of cardiac arrests due to cocaine being laced with fentanyl (or maybe they're looking for the fentanyl specifically in addition to cocaine). We've heard stories in our area about more fentanyl contamination in other drugs- and those patients are often even younger. I wonder how much these situations have been impacted by COVID. Did these patients lose their jobs and turn to drinking or drugs? Was the lack of social interaction a precipitating factor for patients that were trying to navigate sobriety, or were at least able to keep their drinking more in check when the world wasn't closed down? I know a few people that relied on AA zoom meetings throughout the past year, but surely there were many people that were cut off from their support system entirely. I don't think that we will really have a good grasp for many years about the true cost of the pandemic, if we ever do. Deaths like these will never be attributed to COVID directly, but for so many people and so many families, COVID forever altered the future. Have any of you seen a difference in your patient population that you think might be related to the pandemic? Is anyone's place of work pretty much back to where they were in February 2020?
  6. JBMmom

    Seasoned and Newbie Nurses

    A very mature and seasoned attitude, and one that many early 20-something new nurses may not fully embrace yet. I sense many of them are hesitant for the exact reasons you mention. However, many are very open to feedback and I hope they find what they are looking for here.
  7. JBMmom

    Seasoned and Newbie Nurses

    I could be a nurse with 25+ years of experience, but I've had a couple careers, so I've only been a nurse for 9 years. I think that my age and general life experience probably lands me more on the side of the seasoned nurses, although in true nursing experience I'm really more an inbetweener. I like to try and help other nurses because I've worked in a few different nursing environments, LTC, med-surg and ICU so I have, what I hope are, some insights from different areas. I think newbies may be hesitant to post here for a couple reasons. First, they may not know what the expectation of a post on this thread would be. Second, they're probably on this site looking for help, advice, camaraderie, so they're focused on specific types of posts they can glean something from.
  8. JBMmom

    Whats next after the pandemic?

    Our census is pretty seasonal, smaller community hospital, and I will probably be canceled for part of my shift tonight, actually. Our ICU is only half full and part of my shift is an overtime pick up. Summer tends to slow down a bit for us. I understand the frustration of using PTO time for situations beyond your control. I'm fortunate that after working 50+ hours a week for many weeks over the past year, I've planned to cut back for the next two months. Good luck with your situation.
  9. JBMmom

    Does it get better?

    That's the best thing for you to take away from most new situations you encounter. Fortunately, you are unlikely to experience an emergency in a situation where there isn't someone else around. Who knows, one day soon another nurse may post that they weren't sure what to do in a new situation- but fortunately Toaster2k18 was there and could handle it! Give yourself time, that's what it takes.
  10. JBMmom

    Setting my orientee up for failure?

    I think that if all preceptors put as much thought, effort and heart into teaching new grads as you have it would be a whole new world! She's very lucky to have you, no matter how things turn out, because you have her best interests at heart, not only as a future coworker, but as a person navigating a new and challenging career. It sounds like you are very consistent with positive and constructive feedback, and she's unlikely to be taken completely by surprise no matter how things turn out. Have you asked her how she feels that her orientation is going? Does she feel like she's where she should be, and what areas does she identify as weaknesses of hers? As many other people have mentioned, sometimes things don't work out. It's not a judgment of a person, or their intelligence or capability as a whole, but not everyone is right for every work environment. Orientation is the time to figure out, for all parties involved, whether it's the right fit for all. No one really "fails" orientation, if it's just a matter of finding a better fit. I hope that the next few weeks feel productive for you, and for her, and you can all come to the best outcome.
  11. JBMmom

    How does your unit determine who floats?

    That sounds like an odd system to use. We have a binder and your name goes in whenever you float, that puts you at the bottom of the list. The system you mention would penalize people just for being new employees. Weird.
  12. JBMmom

    Nurse Personality Change

    Since my working years have spanned two very different careers I would say that my personality is as it is today more because of life and experience in general than anything from nursing specifically. (Aside from the fact that my family members would now need to practically amputate limb in order to get a band-aid or much concern from me.) I think life has brought challenges, successes and disappointments in so many areas I've learned to let a lot more things go. Not that I've mastered it, and the state of my unit at work has still caused me to go on some recent rants, but I find that I can better find the line between what I need to get worked up about and what I don't. I've never been a very emotional person outwardly, I have only a few friends with whom I share a real connection, and I think that maybe this past year with COVID has highlighted for me that I could benefit from being a little less closed off, so I'm working on it.
  13. JBMmom

    What Was a Highlight of Your Career as a Nurse?

    I'm not sure that one's anywhere in my skill set, thank goodness you were there and stepped in!
  14. JBMmom

    Regretting new job. What to do?

    Kind of hard to say which way you should go. If you see absolutely no value in moving forward and gaining some of those skills you might want to cut your losses and move on. But do you have a job to fall back on? Do you need the benefits from this job? Can you afford to be searching for a little while in case nothing comes up immediately? And are you really sure after only three days that you cannot see yourself staying in that position. The employer may appreciate you not using their time for training when they won't get any benefit from you as a trained employee, but you also might burn a bridge. Good luck with your decision.
  15. JBMmom

    "Waiting" to apply for NP job after graduating?

    Thank you, I did know I could test before all of my paperwork is submitted, but since I'm in no rush to find a job I figured I would give myself more time to study and wait until everything is submitted and in order first. I appreciate your time and response!
  16. JBMmom

    What Was a Highlight of Your Career as a Nurse?

    I've had quite a few over the course of my nine years in nursing. One that makes me particularly happy is related to a patient I cared for a few times before he passed away in December of 2019. His wife would always stay with him at the hospital and they would sort of set up camp for a few weeks as we dealt with his latest infection or illness. I was their nurse in critical care and a few times when I picked up per diem med surg shifts. I was his nurse for most of the last two weeks of his life on nights. I went to his funeral service that December and thought that would be the end of it. Then in April, just a couple days after losing a particularly heart breaking patient (I wrote about it in the COVID thread), one of my coworkers said I had a call. I picked up the phone and I heard "Darling, it's so good to hear your voice. This is ____, and I've been thinking about you ever since ____'s death. You were our angel in those last weeks and I was hoping that I could have your address and phone number so we can keep in touch." We text back and forth every few weeks and we're planning to meet up this Summer for lunch. The timing of her call couldn't have been better. Just when I was feeling so down that we couldn't save the young man with COVID and really doubting that I was doing the right thing, here was someone saying they remembered me for my care. That made it all a bit better.