mlbnocnurse

For MD's I write Dr. _______, When referring to coworkers, I use 1st initial & last name, If I don't know (&can't find out) the last name, I chart first name RN (or RT or whatever applies). If any of my charting is used in court, I want to be able to look @ it & know who I spoke with & what they did. I was always tought to chart specifics, not generalizations.

Based on the very limited amount of info that you have been given, I would say that I would do exactly what your answer was. I find it hard to believe that prioritization is something that you need to work on so much. You have responded to the limited info very logically, you are able to state your rationales very clearly. Great job!!

What you are feeling is fairly normal. Any ICU can get really intense. The most important thing is that you know that how much you still need to learn, you are not trying to work outside of your skill level. It will get better!! You will learn new skills & ways of coping. Nothing worthwhile comes easily. In a year you will look back @ the way you feel now & be amazed @ what you have learned. As one who was in your shoes 3 years ago, I can tell you, hang in there. To repeat myself, it will get better.

There is no right answer to this question. It all depends on what is going on w/ each patient @ that moment. If the CHF pt is SOB w/ /low O2 sat, he/she will be a priority. If the CVA pt has an acute change in mental or neuro status, he/she would then be the priority. The important thing is to look @ the over all picture that each patient presents, & to reassess @ intervals during the shift.

I am very involved w/ the CNA as a nurse rep @ my hospital. We just finished negotiating a new contract. I have been told NOTHING about any potential change in the ratio language. I have asked our union rep (he has heard nothing about it either). I think that this is something that a hospital has come up with to intimidate, confuse, & divide nurses.

If you are working in a union hospital, check your contract. Most contracts have a provision that states being placed on call must be done in rotation. Most hospitals also pay a percentage of your salary for being on call. If your hospital is not union somewhere in the policies & procedures there should be some mention of how call off are done.

Hypotensive septic pts usually have a high HR already. Dopamine increases the HR. Levophed doesn't, making it the drug of choice most of the time, there is always an exception to the rule though.

If you have children, go for the 11-7 shift, 3-11 just doesn't work if you have children in school. I slept while they were in school, was awake for dinner, homework, after school activities, then put them to bed @ 8pm so I could take a nap before work if I needed to. It worked out a lot better for me than for my freind who chose the 3-11 shift.

As a female I have got to say I do agree w/your statement that if nursing were male dominated the pay would be 1.5 x more, actually I think that it would be more than like 3x(but that is another argument). I also know that there are many MD's who respect male nurses more (but that is also another discussion). I do agree that there are to many people of BOTH sexes who fit your dumb description. In today's economy, more people are being attracted by the only money, & the imaginary glamor!! While we do see a number of new grads who really care about the job that they do, we see so more who make us wonder how they ever managed to pass their clinicals. I don't know what the answer is, maybe (unfortunately) there isn't one. One more thought, one of nursing's biggest problems is that we fight to much among ourselves. We are often our own worst enemies,collectively & as individuals. My belief is that this is our biggest problem as a profession.

I am sorry for the nights you had that lead you to write this, but I am glad that you did. This great! Every pt (& their family) needs to read this when they are admitted!!! Thank you

The life of the child who dies because the car wash did not raise enough money to pay for needed treatment is more important than any profit an insurance company makes, or the bonus the CEO makes.

I am a member of the CNA (CA Nurses Assoc), a union made up of staff RN's, not managers. I have negotiated 4 contracts @ 2 diff hospitals w/ a CNA negotiator's help. The negotiators have always been on the side of us nurses, & have done a great job. The CNA is a very strong pro-nurse unon. I know that there are many state assoc. who are not pro nurse & who are much weaker.

I started @ Gavilan College in the LVN program in 1990, when it was only a 1 year program. I went straight into the RN program in 1991. They have a great program there. I got excellent clinical experience. I know that they changed the LVN program into a 2 yr program. At the time the RN program as only 1 yr, but you had to have a LVN license.

I have worked both 8 hr & 12 hr shifts. I would NEVER go back to the 5 day/wk 8 hr shifts now that my kids are grown. When my kids were younger, I worked the 11P-7A shift. I did not always get enough sleep, but I did have time to spend w/ my kids. There are some hospitals that have 12 hr Sat & Sun shifts that count as full time. I am not sure which ones. This may be something that will help you. There are also some hospitals that have child care centers that the operate. hope some of this helps.

"Now, the hospital fired all the secretaries and aides and I have primary care of my 5 patients and legal responsibility to oversee the LVN's 5 patients as well. Do the math and you'll see things were better before AB 394. If the LVN's patients have q 1 hr IV pain meds...whew, I'm fried!" Where are you working? If you are working w/ the above ratios in a hospital, you do NOT met the mandated ratios. You are legally responsible for a total of 10 pts, not the ratio of 1-5 you should have. I know that there are some hospitals that have the RN's on the floor divide the LVN's patients which only adds 1-2 patients to the RN's patient load. This is not legal either. There are RN's that have fought the use of LVN's & won. THe CNA (CA Nurses Assoc) has helped fight this.