nic900

I agree what I do on my own time is my biz but can u imagine having a patient for several shifts who recognized you from your Media web site?

Thanks-my brain is not working today:hug:

I am a relatively new ob nurse taking perianaesthetic courses (long story). In simple terms (i.e. obstetrical nurses for dummies) why do we give boluses prior to c-sections? I know during surgery, with anaesthesia our blood pressure drops but physiologically, why? Thanks

I live/work in Ontario, Canada. The resources I personally go to regularly are: SOGC website, NRP, AWHONN, WHO website as well as the CNO and RNAO. Your facility should have developed policies and procedures for dealing with imminent birth, fetal monitoring, preterm labour, eclampsia, etc. On our unit, you have to be a University educated RN with a current NRP certification and at least level 1 of the maternity certificate. Our OB dept is currently taking the MOREOB program. It is great for dealing with obstetrical emergencies, things that you will probably see in the ER with no OB department: shoulder dystocia, postpartum hemorrhage, forceps and vacuum deliveries, etc. We were fortunate enough to have a local business fund enough training for 36 staff: doctors, nurses, midwives and RT's. Part of the training includes lots of skills drills, as well as pre and post tests. I recommend it highly. Good luck.

Yes, I am calm now as I reflect on it so I can learn from it; however, at the time I was ****ing my pants! We only have 2 nurses on the floor (only 1 left on the floor if the other nurse goes on a transfer-as we are a level 1) and so if we are having one OR MORE deliveries, then any post partum moms, newborns, walk-ins, NST's, etc. will be dealt with as a triage scenario: by priority. Part of our preadmission is that moms have someone with them for at least the first night as we may be busy with other patients. I agree, it is totally ridiculous that many times, patients have to rely on their family/friends but it is a reality with today's difficult economy. We are currently keeping track of any overtime and the number of hours we have someone else come to the floor to help us when we are crazy busy so we can appeal to get a 3rd nurse on the floor at all times but as I said, it is a difficult economic time. If someone comes in alone, then we I will do everything I can for her as I do for all my patients but I can only do what I can do. I wish sometimes the public was more aware of what nurses really do on a daily basis so they would realize how invaluable nurses are.

We are a small hospital with no nursery. I'll admit I have had sympathy for multips who are tired and could do with a nap before heading home; however, I don't feel responsible to babysit if there is not enough staff. I will mind the baby for a short period but if I need to attend to another pt, the baby will have to return to mom. When I admit a pt, I always tell the moms they should have someone with them always in case we get busy. Once I had a mom fall on her way to the bathroom, hemorrhage and lose consciousness. Thank goodness she had her mom with her.

Then ask for more information and if you can't answer the question, then move on-it is you who was disrespectful first

I don't know all the details. I wonder if anyone has information so we can all learn from it. http://www.thebarrieexaminer.com/ArticleDisplay.aspx?e=2833581&

It is a great opportunity for students. When I was a student, during my ob rotation, I never was able to see a birth. The nurses there always said the woman refused but I think they (the nurses) just didn't want us in there. They were awful to us-just made us make up the folders for new moms. Now I'm an L&D nurse and see births all the time but I will always remember what it was like to be a student and seek out opportunities for them. I always ask the woman first and I have not had any say no. Having said that, it is your body and nobody would blame you for wanting to keep this experience private, especially considering if you know the person. When I have a woman in labour, one of my first questions is who would you like in the delivery room. I am kind of like their bouncer. Labour is hard work and you need to feel totally comfortable. Although when I was labouring the entire hospital could have been in there and I would not have cared. It is your choice-if they are your friends, they will not judge you. Good luck.

In order to make my patient's experiences "extra special", I give them the best care I can give. I ensure my care is competent and safe and always try to treat them with respect. I would not babysit on my own time because that is when I need to recharge myself and look after myself and my own family so that I can return the next shift a whole person in order to provide excellent patient care (not babysitting services).

Disappointed RN, I think there are many people that feel the way you do. There are many things in nursing school that they just don't tell you. What I don't understand is the reason why people feel the need to put people down. I guess it is because they are so low on themselves it makes them feel better. They probably hate themselves and their own lives that they want others to be just as miserable. I try to review the day as I'm driving home by remembering all the positive ways in which I helped people (listened, back rub, etc.) not by reviewing all the times I screwed up. At the time I make a mistake I always go over it and learn from it so I don't repeat it but if I don't leave the day on a positive note, I probably won't come back. Remember one thing, you are responsible for your own license. So make sure you are giving safe competent care. You are responsible to the college of nurses and your patients as well as the facility where you work. Your coworkers and the doctors are NOT YOUR BOSSES. They are also members of YOUR TEAM. Even though THEY may forget that, you must think of that everyday. Speak up for yourself. If you disagree, say so and tell them intelligently why. When they chew you out in front of patients, pull them aside and tell them that it is unprofessional and rude and if it is a learning opportunity, learn from it and move on. No nurse or doctor is perfect. Leave the stress of yesterday behind and start tomorrow with a fresh attitude, and if you can't then consider other careers. Good luck.

If people didn't get into it for the money, then there wouldn't be very many nurses. Nursing is hard and very little respect is given to nurses nowadays. Plus, patients are more acute with multiple issues and there is a greater patient to nurse ratio. Nursing is hard - period.

Actually, in LTC, RN's would be in charge and monitor the RPN's and PSW's. Although not an acute care setting, still a huge responsibility.

Sorry "cherrybreeze"

The ng was iced but we ended up calling the doc to deal with-probably enemas till clear. Thanks guys.

I can't PM either so please post. Thanks

Does anyone know how to get bowel prep into a patient who doesn't swallow? We asked the surgeon and he said to put in an ng tube and put it in that way but we couldn't get the ng tube in-pt is very confused and combative and will not follow commands.

Don't worry-we commonly give those 2 meds together but you should always check the efficacy of any intervention. So...bp/hr.

TRUE DAT!

CathyLew, you are absolutely right- we should get paid more because we take on more responsibility. That's why docs get more-more schooling, more responsibility. Like duh!!!!

I work in a Canadian hospital I am an RN and we have a mix of RNs and RPN's (registered practical nurses-equivelant to LPN in the states I thinkj). The RPN's pretty much do the same job for less pay but they don't have university degrees and paid less for school. They have their own pt assignment, but are partnered with an RN to relieve each other for breaks and help each other, give meds, assessments,etc. but don't do central lines, hang blood, push meds, and they are not supposed to have pt's who are critical. Having said that, some of the RPN's have been nursing longer than I have and thus have more experience. Just yesterday, an RPN was saying that she thought a GI bleed was too critical for her. Yes, he did get 8 units of blood in the unit and does have a central line but he is now stable and a DNR and her RN partner could flush the central lines for her. Although I love the floor I work on and virtually everyone I work with, there is a line be drawn between the RN's and the RPN's because the RPN's complain a lot about heavy assignments. One RPN complained because she knew when she was in next that she would have a heavy assignment: isolations, and an obese, isolated pt with dressings pretty much from head to toe. She says, that assignment is too heavy, an RN should have it. Another RPN said she didn't want to learn vac dressings because then she would have to do them. She just gets her RN partner to do them. Then I overheard her say to another RPN that "the RN's make more money so they should get the heavier assignments". I may have had an extra year of school but that pretty much means I can write a better paper, I did not get more clinical training-I think RN's probably get LESS training. There are many RPN's that I hang out with outside of work but I am tired of hearing about how they are always trying to get the RN's to take the heavy assignments. We were all hired for the same job. Period.

It's so funny that you write this today. Just yesterday I had a "special" patient with a history of bipolar disorder in for a lap chol who didn't like me informing her and her husband of the visiting hours. She said, "you don't have to be so nasty". In the next breath, she said she would like to see her surgeon now. I of course said the surgeon was in surgery and would see her when he was available. Then she preceded to tell a coworker that she never wanted to see my face again and she was going to write to parliament (proud to be Canadian). Anyhoo, don't you know in the next bed beside her is one of our lab technicians in with a fractured humerus and heard everything. She of course agreed with me that this person was overreacting and would be a wonderful witness if needed. In answer to your question, no I don't like every patient that walks through the door. After I found out what she said, my blood was BOILING but I left the room smiling. She is NOT going to ruin my day. My next admission was a wonderful older lady with a wonderful sense of humor and a great attitude and sense of appreciation for what we do and she is the one I will focus on when something like this happens. After all this went down, she was discharged two hours later, I still gave her the dc paperwork and even asked if she would like some percs before she left so she wouldn't be in pain on the drive home because I am a caring nurse-even though I will NEVER like her. :):):):):)

We had one lady complain because she was moved from the eent room which was right next to a trauma bay ( we had a trauma coming). We moved her because she had her little girl with her and we didn't want the little girl to see the trauma (VSA). The mom kept trying to see what was going on and complained that she saw the doctors laughing and telling jokes at the nursing station. Well excuse me. Why don't you go where you are needed and comfort your sick daughter (who was later given tylenol and sent home). And excuse the docs who work long shifts with little or no breaks! When it is busy/stressful, we need to let off steam and besides, I love a good joke! Sorry, just needed to vent a little.

I think it's great. It gives the doc an out if they think the person is drug-seeking. The doc can always go ahead and prescribe narcs if they think it absolutely necessary.

SN2011, On our unit, we have 5 patients on day shift and 6 on nights; however, I am from a small town and we have a small hospital with a growing population. Also, we often might not have all surgical patients. We might have 4 medical patients and 2 surgical patients or 2 surgical patients, 1 medical patient and 1 OB patient. It can be very busy but surgical is a great place to learn time management and increase your skills, knowledge base and confidence. Good luck