kateRN

We do a verbal report. I work in the ICU- there are 4 nurses assigned to each pod, and eight patients to a pod. We hear verbal report on all eight patients, and then decide amoung ourselves how to divide them up. When I first heard this method, I never thought it would work, but it actually does! A drawback is that sometimes it's long to hear all 8 patients, but then you know a little about everyone.

Care plans are meaningless wastes of time. They don't mean anything, and their only purpose is to generate more points when JCAHO comes. :) I fill mine out everyday because we're supposed to, but they don't influence my nursing care at all. Especially because most of them have information about prescribing meds in them. I'm not going to say to the docs, "excuse me? as you can see here on the care plan, it is day #3 on the 'acute coronary syndrome pathway' and this patient is not on an ace inhibitor. don't you think they need to be on one?" They would look at me like I had three heads. Patients would get much better care if nurses didn't have to spend hours doing worthless paperwork.

Most of the time i don't believe things that billy rants and raves about either, such as the "gay, jewish bashing", but i do believe in the resurrection of Jesus. I can believe in the Son of God rising from the dead, because I believe that with God anything is possible. It is ignorant to believe that people heal people. God heals people THROUGH other people. God gives people in the medical field the understanding and the knowledge about the human body to treat it, but in the end it is God who is really doing the healing. I understand that it goes against everything we are taught in the medical profession to believe that someone could "rise from the dead", but isn't that what faith is all about? Faith is believing in something even though you don't have physical prove right in front of you. I do believe that some things in the Bible are metaphorical, of course. The Bible was written in a different period of time, and we have to account for that. It is my faith, however, that leads me to believe that God can do whatever He/She wants to. And if He wants to bring someone back to life, He will. It may be a defibrillator that jump starts the electrical activity back into a heart, but it is God who really brings that person back to life. In my Christian/Catholic opinion, that is. :)

Sounds like this COUld be exzema?? I had a really bad problem with this myself about a year ago. It popped up out of no where- I now think it was due to an allergic reaction to some scented lotions I was using. But anyway, I would scratch myself raw while I slept, unconsciously. Oral stuff didn't help any, but then my doc tried me on Eladil. That stuff is a lifesaver. It took away the itch and allowed the rash to heal. I think that it also could be used for psoriasis. Make sure his fingernails are clipped really short too, to do some damage control.

It seems that on our floor they wait until a person has about one year of experience before the orient them to charge. I was oriented to charge nurse after about 14 months of working. It's kind of nice for a change of pace, and we do have support staff available at all times if we have any questions. I feel pretty comfortable so far, however, I haven't had any big catastrophes happen during my charge shift yet either! That could definately change my opinion...

We actually just changed out policy. We used to have to send everyone on tele all the time for every test. Now, there is a list of criteria that states when a patient must travel with a monitor, and as long as they do not meet any of the criteria, then it is up to "RN discretion" to decide whether of not they can go "off tele". A pt. must go on tele if they: -have been admitted to our floor (intermediate cardiac stepdown) less than 24 hours -have any kind of frequent ectopy -are having chest pain, or any kind of distress (obviously) -are currently on any drips (excluding saline or bloodthinners) If they do have to travel on tele, our techs who are certified travel with them. The nurses on our floor would never have time to leave the rest of their patients to go down to xray for 45 minutes. Since there are still a lot of gray areas with "RN discretion", I just call the doc to get an order if I am uneasy.

I also graduated in 2002, and began my career on a cardiac stepdown tele unit. I have had a lot of good experiences since I've started, but I'm also beginning to feel frustrated. I can definately understand why nurses get burnt out so easily. Some days I drive home and feel so good about myself, and others I feel so incompetent. On the good days, I am so excited to be a nurse, and on the bad ones, I ask myself why I ever chose to do this! I just want to let you know that you are definately not alone in feeling this way. What I've found is, once you start to talk to the nurses around you, you realize that almost everyone has days where they just want to turn around and never ever come back. But we really do know what we are doing, and we really are good nurses, because if we weren't then we wouldn't even care if we were doing a good job or not. Keep doing your best, and try not to be too hard on yourself. That's what I'm doing.... I'm just hoping for a good day to come VERY SOON!!