LolaRN

I was in the bathroom with my 8 year old at a restaurant and I was thinking about the time she accidently walked into the mens restroom instead of the womens. She noticed that I was just standing there and I looked at her and said "whats the matter member?" when I meant to say what is the matter peanut! :imbar

Has anyone done anything like this? How did you start and where have you been? What kind of background do you have? I am very interested in helping in the future. Thanks!

A new stethoscope

I need some feedback. I recently had a patient who had stents put in. She has an art line and her platelet level has fallen to 10. The cardiologists wouldn't order platelets for her when I asked and finally they called in a hematologist, who did have us give platelets. They went up and then down, more platelets were given, up and then down again. The patient had an episode of severe confusion. I called the cardiologist (primary) and he wasn't there. They gave me his partner who ordered a CAT scan and said he would come see her. The confusion went away. The doctor came in and said that she was just fine and he was ticked but controlled. I told him that she IS fine right now but was severly confused and that with a platelet level of 10, I felt that he needed to be notified in case she had a bleed. He said that was correct and that he still wanted a cat scan. Later he came back and it hadn't been done yet and I asked if he still wanted it and he said yes. I go to lunch, come back and my manager rips me apart for getting the original cardiologist mad, exagerating the problem and making the patient have uneeded tests. She does this in front of everyone. Apparently the doc had complained about me. Then he comes back in and told me that I am creating problems for this patient who came in for something simple and now is having all kinds of problems. I just bit my tongue and walked away. Then to top the whole mess off, he came back again and yelled at me for taking heparin out of the art line flush, for not pulling the lines yet, and for holding plavix and aspirin. The patient had a platelet level of 26 and the hematologist had written those orders. I explained that to him and he yelled that HE wasn't the one who had to come back and take care of the patient when she clots. He then goes in and tells the family that he disagress with the hematologist and that he would definitely do things differently. He leaves and the family comes out and is upset because of this discussion and they had seen him yell at me, which mades them feel bad too. I then spent 30min trying to convince them that this dr conflict will be sorted out and that we would watch out for the patient. I wonder what you all think about this whole mess and if there is anything I should do now or have differently. Would you have called about the confusion? Would you pull lines at 26? Thanks for taking time to read this and give comments.

There is a big ruckus a my hospital about nurses unionizing. Anyone have any experience with this or can tell me some pros and cons? Thanks!

Currently I work on medical oncology floor night shift 8-9 patients each staff. Very, very busy floor with dying patients, neutropenic patients, needing blood products, chemo etc. Then there are the brain injured pt, quads, bilat amps, with all kinds of sig medical problems. I have been offered a position in the ICU and at a nearby small town hospital ER. I cannot decide what to do. The pros of where I am: I know how to do the job, the manager is great, I like the people I work with, the hospital values its nurses. The cons- heavy patient load, lack of support from cna, a lot of repeat customers- no one ever really gets better, it is a ways from home. The pros of ICU- very sick but less number of patients, interesting and challenging work, same organization, good hours. Cons- a ways from home, the need to have a tough skin (told to me by the nurses themselves), the fact that I could do something to kill someone. Pros of ER- challenging, variety of work, a few blocks from my house, small family atmophere. Cons- seems disorganized- they have had trouble communicating info to me, may be boring-small town. Also important to know- I have turned down ICU once because I didn't feel ready. And, I have been offered the position at the ER once before but turned it down because I had already accepted my current position and felt obligated to remain where I was. What would all of you do? Please, please give some feedback. THANKS :)

I think that they can. I know bi polar nurses and they are very effective. I also know that almost every nurse that I work with, including myself, has some psych issue-OCD, depression, phobia, anxiety, etc. I think that this makes most of them more compassionate to the multiple patients we get that have psych issues.

I am interested in doing weekend package. What should I consider before I make a decision? Thanks

Our charge nurse takes up to three patients. The rest of us take up to 7 or 8. It does vary between shifts though. At night, the charge nurse takes 7-9.

Staff who think that DNR is an excuse for sloppy nursing care. Charge nurses who sit at the desk in full view of the patient who is trying to beat you up but never comes in to help. :angryfire

One time I miscalculated a dose of Roxinol and gave the patient 4x the dose that she was supposed to get. I had to give her Narcan. I was ready to turn in my lisence. I felt terrible. Now I have someone double check any calculation dose for a med that I haven't given before. Probably drives my coworkers crazy but I will never forget the sick feeling in the pit of my stomach.

I am not a psych nurse but my daughter is being tentatively diagnosed as Manic depressive. She has been being treated for psych problems since she was four. Her doctor thinks that it is very hard to give an actual label at that age, even now at 7, because kids are so neurologically immature. She has worked on treating the symptoms and we have been pretty successful with that. She still has problems definitely but we are not getting bitten, kicked, hit every day. She takes zoloft and risperdal. My heart goes out to you because I understand how hard it is. And if you are anything like us, we have had loads of armchair parents telling us that "if only you....she'd be fine" or "i'd never let my kid get away with that". Until you have dealt with it, it's impossible to understand. One book recommended by our doctor was " The Bipolar Child" by Demitri Papolos and Janice Papolos. Excellent resource. Let me know if I can help.

people who think that DNR means do not treat ("why do they need tele if they are a DNR"- uh maybe because we can help heart dysrhytmias and they DO get to have that treatment even if they are a DNR) :angryfire

I just had the worst night. Reading these makes me realize that it's not just me. I keep wondering what I am doing wrong (yep I am a new nurse-just 2 months). Thanks for the posts.

I agree with Shotzie. They should have had a plan in place for this already since many other places DO donate leftovers for other types of diseases.

I couldn't agree more. Also spelling errors which are consistent drive me crazy. We all make mistakes but it's hard to have faith in your nurse when they can't even spell. Also, nurses who say "o2 stat" instead of "o2 sat."

I guess that my issue with the whole situation is more that the supervisor provided the cigarettes-even the right type. Usually we have them sign a release and then you are on your own, except for the few smokers that you can harass into taking you outside with them. But to provide cigarettes and waste nurses time by trying to find the right kind just seems incredibly stupid.

How about family members of patients becoming aggressive (especially in ER), ex-patients who become stalkers, needlesticks, MRSA, SARS, any number of communicable diseases actually, carpal tunnel syndrome (from computerized charting), definitely losing your license and mental stress/depression, and making a mistake that causes a patient harm (obsession about making these mistakes is also a risk)? Yeah, I know that I sound like a worrier.

Why do you want to return? Just curious. :)

I guess that the part about her giving in to the patient and letting her leave the floor and making one of us go with her was not as shocking to me as the fact that she didn't even have cigarettes and the HOUSE SUPERIVISOR not only found them for her- she PAID for them and had to find the RIGHT kind-menthol. UNBELIEVABLE!

Thanks to all of you for your replies. I was starting to wonder if I was the only one who thought that this was a bit much. Usually I am pretty vocal but this time I was caught off guard and could only walk away.

I understand the push for "customer satisfaction" but I think that the following situation is taking it too far. A few days ago we had a patient on the floor who was in constant pain. She had MS PCA, Ativan, Phenegran for her pain/anxiety/nausea. The doctor had ordered a bed alert put on her because she was so unsteady from this pain and the pain meds. Well, she was with it enough to insist on going outside to have a cigarette. We explained that #1 she would have to go out in a wheel chair and that no one could take her out at this time, we were all busy (imagine that). #2 she was a huge fall risk and couldn't hardly stand up without tipping to one side, so we didn't think that she was up to the trip #3 she had a MS PCA, which we don't really allow to just freely float outside of the building #4 her doctor DID NOT want her to leave. We babied her, gave her all the meds she could have, bent over backward to try to please her. But, she was adamant and we called the house supervisior to take care of the situation. Well, house went in to talk with patient. SHe comes out and says that one of us needs to stop taking care of the patients and take this woman out to smoke. NO surprise to anyone I'll bet. But, the story gets more interesting when we find out that the patient doesn't even have any cigarettes. So, the house supervisior buys some from a staff member. BUT, the patient wouldn't accept them because they weren't menthol. So, house calls everyone in the hospital that she knows smokes to find menthol cigarettes to buy. I was so mad that I couldn't even speak, except to say "we appreciate the support ) Her response was that this woman might write a letter to the editor or something. Isn't there a line between patient rights and doctor/nurses orders/knowledge? I guess now we have to give the patient whatever they want and we have to reinforce their bad habits/behavior. UUGH!

I didn't mind it as a LPN. We had a team of an aide, LPN, and Rn for about 10-12 patients. I took a group and the RN took a group. I did all oral meds for my group and did assessments, dr calls, etc. The RN did the same plus all IV meds. We covered each other for breaks and fielded questions from family for all patients. Sometimes I would take 6 pts and she would take 4 or something like that. I really learned a lot and it has given me tons of confidence as a new RN because I am used to doing a lot myself. However, I left that hospital when I became an RN because I didn't want to be responsible for that many people. I now have 7 patients of my own but I don't have to worry about the LPN being competent and worry about whatevr goes wrong that the LPN can't handle. As an LPN, it was great, I could take on a lot but when the going got tough, I could turn it over to the RN. Not so great for the RN.

Patient Care Standards (don't know who it is by). We used this and the Ackley book. We also have these on our hospital floor.

I work on a medical/oncology floor and had one of my patients die on Monday. She was only 50 and had cancer everywhere. You could feel the tumors in her abd. It was heart breaking and I cried the morning that she died. I know exactly how you feel. We have had 4 patients under 40 die in the last week. I just keep trying to tell myself that it matters to the family and just the empathy and trying to keep the patient comfortable matters to them. I am not sure if its true but I need to say that to myself. My thoughts and prayers are with you and the patient.