whitebunny

Who does that!? Why people just don't care and being so selfish!?

Hi Ruby when I read this article several days ago I thought about you right away. Between you and OP's writing style I prefer your style much more. I still remember what you have said to me before. I definately wouldnt cry if the instructor communicates with me in a similar way to yours, but I would cry if the instructor writes a post like OP.

Hi Tinyonern: Thank you for your reply. I just went out for a quick walk to calm myself down. I read the rest of the thread and saw OP stated that breaking down/rotten students was never her intention. I saw other people's replies were good summaries: (1) not every students work well with OP's style (2) how OP writes make people feel she is full of ego, and certain words are just logically wrong. I have to admit that OP writes 90% as the way my dad talks. I got very defensive. My emotion was a mixture of personal experience. I did take it personally. I guess OP's point was simply "dont gossip about perceptors cuz perceptoring is a hard job too " when she used words "I have ears and eyes". I never think of myself good. In fact, my low self esteem probably will be my sister for the rest of my life. First several years of immigration were just rough. Low self esteem is just another thing with immigrants, generally speaking. I might present myself tough from outside but my inside was just tears and scars. I have been looking for that piece of serenity since i was 15, and have been practicing throughout work. Still far far away from it. But thank you for calming me down, pulling me away from going extreme =)

this article is (1) bitter, (2) harsh, (3) full of stereotyle, negative energy and hostility. Although it has some points, but at the end i disagree. If OP wants to say "everything im doing is to make a student a better nurse" then i would like to say "there are others ways to make students better nurses. Definately not your destructive ways." Management has different styles: (1) authrotative (2) deplomatic (3) in between. I cannot picture OP being a good manager, a supportive manager to help nurses grow. In fact I dont even picture OP has decent leadership skills. All I see is (1) abrasive (2) over the top (3) power, power, power. All these "nature selection" "I have eyes and ears" shows me OP should be a businessman----because you talk exactly like my father----bitter, hate---"no pain no gain" "the best fit survives" theories----yes, my dad is old school----and he lives a very unhappy life. Just a little introduction of myself: young, immigrant, senstive, emotional, cry----I WOULD BE DAED ON DAY 1 IF I HAVE YOU AS MY PERCEPTOR---DEAD DEAD DEAD in fact i did have a instructor like you during the 2nd year of university. She failed me just like you, she screamed at me, she told other students to pass on negative messages to me, she insults me she humiliates me---im slow, im behind----not because im not harding working, because i have a language barrier. i was always top way back at home, now im bottom in another country, i was only 18. But guess what, i went to DON. She had a different type of personality, patient, sweet, and understandable. DON followed me one day during clinical, she said i was fine. Guess what, i passed. Ever since then i worked extra extra extra hard, cuz i know, there are a lot of bitter people like OP in this world, will eat me alive at any single moment. They want me dead but I have to defend myself! Lots lots good professors helped me. After graduation, i started at nursing home, i told myself i dont have the advantages like native born people so i will start somewhere else less acute, then work my way up. I started with 28th patients, then 18 patients, then I moved into the biggest hospital of the city and started on subacute medicine, 5-6 patients. 2 months later I moved onto medicine, 4-5 patients. I love my managers, doctors, my peers. They help me I help them. We learn together. We forgive each other. I grow because people love me, forgive me and help me. Im stronger now, but I wont be stronger if you destroyed me. I always remember the manager told me "i always see you a very young girl with lots potentials." She told NP "With lots support she will be fine." I am happy now and i tell myself i do not want to be a negative depressed person like my father ever. Your post made me think of what happened when i was 18, and yes, your post made me upset. If everyone think like you in this world, all immigrants are dead. They cannot survive in North America. Thank god, not everyone is like you, tearing, and breaking people down!

our emergency does 3 swabs for VRE and MRSA, one for MRSA nare, two for MRSA and VRE peri/rectum. sometimes emergency ships pts to medicine ASAP so I do 3 swabs for the admission anyway. I explain to pts that in order to proect the pts and the staff of the whole floor, especially that you are in a 4-bed rm with one shared bathroom, it is very important that we do those screening to rule out those commonly spreaded infectious diseases. I emphasize "we do this on everyone." then I tell the pt "in order to make things easier, im taking the nare swab from you right now, and leave the two peri/rectum swab for you to do it yourself. Plz remember to collect the sample during the 1st toilet." This works all the time, and it also does not confuses the nare/peri tubes with each other. During the admission, they might start developing c-diff or UTI. Then all kinds of lab collections come up, urine (foley or 24-hr), stool (c-diff or FOB). Later on much more such as PICC, CVC, wound, fistula swabs. IMO, health care provider consider the whole hospital infectious disease status as one of the top priorities, rather than individual's self-esteem or nurse-pt relationship sort of thing. Pts do understand that and I like doing screening. I just went through VRE/MRSA screening before I got hired in July 2012.

i had a pt who has a routine of getting confused at 0300 in the am. 2 days ago he got an odd confusion moment after lunch. He kicked the 1st nurse out of room "dont u even get into my business. i dont give a damn about you!" when I went in the room, hes half body was in the bed, stiff, and said "I dont want to have a damn thing to do with you. you are not an angel of heart you are an angel of devil!" I smiled and asked "are you comfortable lying like this? Can I reposition you?" and of course did not help. An hour later I went in he already adjusted himself into the middle the bed and i woke him up he said "You are a terrific nurse. thank you so much. i am not even exaggerating a bit!" By the way, I do not give prn cuz i do not consider mood change presented by veral is same as agigtation/anxiety. The 1st nurse suggested me to give seroquel but i did not. Not only my assessment and my clinical judgement tells me not to but also i knew if i tried he was going to spit it out. Pt who lost independence are lost and frustrated, if they wanted to be left alone they should be.

very rationale answer. thanks for your reply, i will keep that in mind

I am a bit confused with insulin administer time because the nature of pts we have on medicine floor. I understand different kinds of insulins, including their onset, peaks, and duration. I was taught in school to give regular insulin 20-30 minutes before eating, and according to our hospital policy insulin premix 30/70 (30 regular 70 NPH) is also given 30 minutes before eating. Now the problem is, a lot of pts are confused and dont eat much at all! I can take the BS at 0730, gave the scheudled regular @ 0740 and BRFT comes at 0800 but they tell me "I dont want to eat." or they ate couple spoons and stopped. I do encourage the diabtic pts to eat and drink more, sometimes i say "Okay you can leave the toast and egg, but you gonna finish the chocolate milk/boost so you are not dehydrated and you just had the insulin" (half of the time they dont understand what im saying), also another disadvantage is that 0700-1000 is the busiest time for me, not only that i had to finish my vitals, med pass, assessments and am care but also set up/feed the pts and have my 30 minutes break. In fact, I cant really force them to eat because not eating much is fairly common among such population, as their activity level is not high during the day either. I see some practice is... 1) give the sliding scale: regular, rapid, or premix (regular and NPH, rapid and regular) in front of the tray and watch pt start eating. Give the NPH a bit earlier before eating. 2) give the sliding scale and premix after eating. Give the NPH in front of tray. Now my problem is: they ate, only couple spoons. Now what? Gave the needles? So far I have not seen any hypoglycemia related to sliding scale or scheduled insulin during day shift yet, but i have seen rebound hypoglycemia at 0100 on one pt who totally lost consciousness and was bubbling. She had glucacon and d50w and then transferred to ICU. Plz help, thanks!

I am not a new grad cuz i graduated in 2010, but i am a "new grad" to medicine. I started in extended care, not that i chose LTC but LTC chose me. I worked 2 facilities including one special care unit and one peritoneal dialysis unit. I started in a private facility with a patient-nurse ratio 1 to 28 including orthopedic patients, and after 9.5 months I was fortunate enough to be hired by the facility of the largest hospital of the city. By then the patient-nurse raito was 1-17. I stayed there for a total of 8 months and I felt very comfortable. At the same time, I also used all my savings to pay off my student loans and credit card. I realized my nursing skills were disappearing, including assessments, hands on, and in depth analysis (criticle thinking). I decided to move on. I told myself, nursing should never be so comfortable. This is a high-stress profession in nature. Again, fortunately I was hired by the medicine unit of this hospital as an internal transfer. The manager told me that I reminded her 32 years ago she was the same as me, knowledgeable, nervous, and looking for self-identity. Likes challenge but lack of confidence, looking for the "perfect" specialty but doesnt know where to go. She said she was glad that I was seeking for acute care, if I stayed in residential care a bit longer I probably would not have the same opportunity as today. So she offered me a full time job. They offered me the maximum orientation, which was 3 days and 2 nights. What I brought to medicine was my team work skills and customer service. I practiced in residential care setting for 1.5 years I worked with LPN and PCA all the time, and I dealt with family complains all the time, including the ones that involved case managers. So I had a plan, I learn on site as days go by, I review my med/surg knowledge at home to refresh criticle thinking. I was nervous, but not overwhelmed. After three days, I am trying to figure out my own way of assessments. 1) making my own set of head-to-assessment. If the pt is lying in bed, I wake them up, listen to lungs, heart, bowel sounds, check the brief, both radial pusles, capillary refills/edema, lower extremity edema/pedal pulses, check tubes/IVs. Then having the pt sat up and listen to the back lungs and check possible bruises on the back. I am aiming to get this set done within 5 minutes. or 2) focus assessment related to the pt's current diagonises which would be 5 minutes as well, however, more thorough. In terms of teamwork, I saw incompetent nurses, lousy nurses, fishy nurses, critical thinker, task oriented nurses and team-players within one week already. It is a big team! I am not surprised, I had complaint from the nurse who oriented me already. I didnt panic although I am suprised of what she said. I am just so used to those type of personality so I stay away from her. She was on this unit before I started, the problems were already existing in this world before I was born. I have been on my own 3 days so far. I learnt a lot and I sweat a lot due to the physical work. Patient ratio is 1-5 during day and 1-6 at night. I lost 5 pounds. One 12-hour shift I changed 15 times briefs myself (all 6 patients are 1PA and all incontinent multiple times!). Any suggestions how to do that faster? In 3 days I had PICC, CVC, CBI, IVs, rebound hypoglycemia, death, dialysis f/u, blood transfusion *2, catheters d/t retension, elopement, aggression, family complaints, chest tubes, falls, post-op. I havent had a cry yet, maybe sooner or later I will. I passed out on the bus after night shift. When I wake up on the bus, all passengers were gone. The driver was quietly sweeping the floor. He didnt want to disturb me, I think he knew i was a nurse who just got off night. Another day I felt into sleep on the bus but was waken up by police officers who were checking bus fares =)

i dont lie about med errors. i made few med errors(small) when i was casual, and when i became full time i became one of the RN with the best practice(least incident report) on the floor. Because i learn from my error and i figure out a way to establish the best practice for myself. i admit med error during interview and stating i learn from it, and i believe all interviewers expecting you being honest. they know me young,novice and they want to see that i can grow and i can learn from mistakes during interview.

i am shocked by this article. i am glad i have never made such awful appearence to any interview or job fair. I am glad i always tell myself simple things like arriving on time, not using cell phone, not using facebook, well grooming i have always obeyed the rules so i dont get into trouble. i have seen lots ppl losing jobs for those common sense, which is really not worthy the pay.

this is an awesome post! classic example including a review of textbook from nursing school but also in depth critical thinking from experienced nurses.

What a wonderful article I am 25. I became an rn at age of 23 went to university at age of 18 and came to this country at age of 15 (sorry going backwards) I went through tears/burn out just like newbies, but I have always been responsible and mature throughout my life. My english might not be as great as any of you but I consider myself "Being proud of abrasive/blunt/on the point" and "Became serious offended/sensitive when others have done the same to me"---yes, I am insecure, vulnerable, and extremely sensitive. I tend to go extreme: over pleasant when my clinical performance is well done at work or over depressed when new nurses/team members are bright, have no language barrier and young. I go home and remain in "No peace" by beating up myself--(1) reflect on my day, do research, figure out how to be more efficient tomorrow and how do I not to make the same mistake tomorrow (2) crying on why people are tongue slashing at me yet make themselves sound so "Reasonable"? --she is dumping her new admission on me, dumping her discharge on me, even demanding me to deliver vital sign machine for her which is a simple task that she could do it herself---she is an lpn with at least 10 years experience, I am an rn with 1.5 years experience. Because I am scared, because I was wrong at the very beginning when I got this job. When I 1st started, I want to make friends, I want to fit into the culture, I want to survive. And some girl came to me, very friendly, invited me to her social life, made me feel "I am all supported and I am being accepted". Time tells the truth--she doesn't want to be my friend, she never looks upon people who speak english as a 2nd language, she wants me and others to (1) get ot for her, (2) helping her stabbing people she doesn't like, and most importantly (3) do her job so she can be lazy. I regret I didn't keep distance from her. Now its harder for me to pull myself away from her as she constantly reminding me "You are already part of the club, too late" and harder to set limits cuz I never set my limits in the beginning. However, I would call her a "True manipulative" and a "Controller" but not a "Bully" as she blows up at the whole team including our leader. She constantly using phrases such as (1) let me make myself crystal clear.... (2) I don't have time nor I have the patience to... (3) this is not fair.... (4) this is getting ridiculous....When she wants to let her anger and frustration out, she doesn't care, she blow it on your face, not only me but also the rest of the team. Some team members tell her off "This is your job and go do it" and some team members suck it up like me. When people do tell her off, she would (1) complain to leader "I don't like the way this person talk to me" (2) do incident report on coworkers (pinpointing), (3) telling the person "I have always be on your side and protect you, now I ask you to do one thing, one thing you forget? You always have excuses. I will never, ever talk to you again, I will never, ever protect you again". I felt so funny because I always hear she says "I told this person off because I told her we are adults so be it" meanwhile she behaves the exact way as a high school girl. I appreciate this site with op's generous thoughts and selective replies. Now I clearly know I should not get too close to any coworkers in a work place nor I should share my private life with any of them, that's the 1st step to set up my limits and boundries, because if I ever did, my life today wont be so hard and stressful. I guess part of my age is naive. I open my heart and trust people easily. I am not saying that you cannot make friends in a workplace, I made one very good friend from my previous job. But I have learnt a very important lesson when it comes to boundry =d

i have seen 10.2. Peeing blood, nose bleeding, decrease consciousness---sending to hosp----upset families. Regular dose warfarin 1mg, INR has been steady before.

son is the POA