vintagemother

It depends on your short and long term goals. I have always had an interest in critical care. After several years in med-surg, I made the leap to critical care. I've been working in critical care for a few years now. As for me, I like a challenge. I enjoy digging deep to learn more of the pathophysiology of diagnoses and potential diagnosis. Plus, in my area, the schedule in critical care is better for me and more profitable than working the regular floor. But, yes, the stress is real. The pts are sicker and die often. However, critical care experience opens many career doors.

Great article! My facility has a social media policy that states you can’t say anything on social media that might paint the facility in a bad light. So, I post nothing negative, at all. I never mention my hospital unless I’m sharing union information- because of the protection it provides. I’ve observed that even when the nurse doesn’t mention the facility, some nurses have been reported for their social media posts even when they don’t mention their facility, but someone else goes through all their pics to figure out where that person works.

I also do not feel it’s safe to go to work with no sleep. I, too, have some insomnia issues. What shift do you work and how many hours is it? When I worked 8 hr nocs, I initially would try to go to bed as soon as I could - which wasn’t immediately because I am a morning person. Therefore, even though I was tired, I couldn’t go straight to sleep, as some of my co-workers did. But I did try to be in bed well before noon to allow myself 8 hrs in the bed. I take a combination of otc meds and also prescribed trazadone. I still also have to be in the bed before I know I will need to actually go to sleep because it takes me awhile to fall asleep - maybe an hour. Can you obtain a doctors note via a phone appt or telemedicine or even at a walk in clinic to cover you on the days you miss? That way you have some proof that you were ill and that’s why you couldn’t come to work. Do you have a union rep you could speak with regarding job protection options? With regard to anxiety being a problem contributing to insomnia, I know you said you’re under the care of a doctor, but I just wanna say some therapists are really good at helping you develop concrete techniques for managing anxiety. Mine taught me exercises such as acknowledging my feelings and paying attention to my environment and some other CBT style techniques that did help. Also deep breathing in through the nose and out with the mouth helps reduce anxiety nearly immediately - I used an app on my way to work and did these in my car daily during the heights of COVID. I also exercise daily before work. It cuts into my available sleep time now that I work 12 hr shifts, but it truly helps me feel less stressed at work and less anxious. Running also helps me to have less anxiety - I feel as good after running as I do after a good therapy session. I wasn’t always a person who regularly exercised but over the last 4-5 yrs, I have become somewhat of an exercise nut! I exercise because it helps my anxiety and stress levels. The type of exercise I do to reduce stress (among other benefits) is lift heavy weights and run.

Do you feel you need to be faster with charting or with cares? I’ve worked on charting fast, but as I said, it still takes me what I feel is a long time to clean a pt, reposition them, educate them, give oral care, etc. so I try to be fast when I can - I can give g tube meds or any meds pretty fast, I can reposition a pt without cleaning them really quick. But other things (like cleaning a vented pts BM up or educating family) take me awhile cause I want to be safe and kind to the pt.

I try to get that 1st head to toe (or at least the assessment of the main problems) assessment done first. For me, it helps to stop after I get report, to map out my day (based on the pts plan for the day- imaging trips, labs, meds, etc) I use 1 brain per Pt and 1 brain with meds / labs for each pt, in a column for each Pt)  I enter the room ready to do physical assessment, glucose checks and will likely also do a turn, oral care, temp check, etc. then I might chart and then go to the other pts room to do the same.  I’ve also tried to get faster with my daily cares- I’m still not fast, but when I go in the room, for anything, I do a turn, give meds, educate, do safety checks, do oral/ peri care. As long as it’s within the hour of it being due, I try to do it. And chart, chart, chart! We can copy our own assessments for the most part, so I try my hardest to have all the charting up to date and done within the 1st 4-5 hrs, then I can copy and paste my own assessments including any changes easily for the rest of my shift. I assume our charting is standard (I’ve heard it’s overkill) we do head to toe Q4H, daily cares (incl oral care and reposition Q2H). Gtt rates and VS Q1H, etc

I agree with the other posters who stated to get that assessment done first. For me, it helps to stop after I get report, to map out my day (based on the pts plan for the day- imaging trips, labs, meds, etc) I use 1 brain per Pt and 1 brain with meds / labs for each pt, in a column for each Pt) I enter the room ready to do physical assessment, glucose checks and will likely also do a turn, oral care, temp check, etc. then I might chart and then go to the other pts room to do the same.

When I give vaccinations, in a hospital setting, we 1. Review the order to assure that the pt meets criteria/ doesn’t fall in the exclusion category 2. Give a paper handout on the vax 3. Educate the pt on normal side effects I haven’t given the covid vax, but do give flu shots and pneumonia vaccinations.

Nurse Beth, the original poster, I just want to say that everything you wrote is true. I don’t work in So Cal, but In northern CA and you were exactly spot on.

Your post exemplifies the types of situations I believe I observed in RN school. I couldn’t prove it, but you can due to the recording. I think you should report it to the nursing school dean and if s/he does not seem to appreciate the gravity of the situation, report it to the dean over all of the health profession programs. That’s what I did. I didn’t have to take it to the dean of health professions but that was my next plan of action.

This is so true! Do things the way they do, even if they dont align with your education. Once your off orientation and off probation, do things your way.

Nurses need to be kind to other nurses. If there is a problem, there should be a way to address the issue without It being punitive. Seriously, just a way to offer feedback to help the other person.

Where I work, in an Acute hospital on a Med surg Floor, we frequently have pts who refuse to do things for themselves. Even the day prior to discharge supposedly home. It’s quite ironic, I’ve noticed that many lols (little old ladies) insist on being independent in toileting, Peri-Care, etc; while their younger able bodied counterparts insist that they can not help themselves. And as nurses, we can not refuse, without them complaining to mgmt re our “attitude”. perhaps my hospital is unique. it’s quite a challenging situation!

I’ve been in a few hospitals and have observed various policies. In 1, RNs or RTs could administer breathing tx. Where i currently work, only RTs can give them. And, the RTs are very obvious regarding their animosity when we call them. The belittle RNs, put them down when they call, etc. That being said, I know the RTs are apparently spread thin, working all floors of the hospital: from ED to the floor to ICU. And I suppose they feel like they get called unnecessarily at times. I'm not sure what the policy is where the OP works, but this info could shed light on the situation.

Yes, I see your point. But berating the nurse providing care while s/he is providing said care does not help the pt to recv better care. This behavior simply makes you have more than 1 person to attend to.

My NSO annual policy costs around 120/yr. my union dues are a separate cost I pay to CNA/NNU. Whom do you pay 600 to for liability insurance?