Bikechicky

[color=silver]i have been debating on whether or not i should go on for a bsn. there's a mostly on-line program that i had planned on doing this year, but changed my mind. i just can't make up my mind. like a previous poster, i don't have any specific plans for what i want to do once i get it. i just like the idea of having as many doors opened as possible. i don't want to go on for np, i don't want to teach... it seems like maybe it's not worth the time, energy and expense. i would not make any more money if i get it and i have no tuition reimbursement available. anyway, it's been quite interresting to read this thread.[/i ]i agree with orsmurf above. i have 30 years experience bedside nursing as a diploma rn. in august i will complete my accelerated bsn (yeah!!) why did i do it? not for any of the reasons listed by others. i simply wanted to prove to myself and others i could. i've found the non-nursing courses interesting, and most of the nursing courses boring! as someone else said, lots of jumping through hoops! but i'm so glad i've done it.

Med reconciliation done on admits only, by the admit nurse (not ED) You need time to obtain as accurate a list as possible, this can not be done adequately in the ED.

Potential patient: "I want that medicine so I can have sex with my wife" Nurse: Viagra??? That is not an emergency sir, we can not see you for that. Nurse, smiling under her cool calm demeanor

where can I get a copy to post in my ED, and why the heck didn't our ED docs post it for us!!!!!!

I've always wondered the same thing. What is it that some of these nurses do to get all the praise?? Sometimes I wonder if they don't flat out ask for it. I'm a good nurse, but business like and not all sweet and smiley so that is why I figure I don't get the thank you stuff......... but I always wonder how some of those nurses do it???? and fried pickles are the bomb!

#1 most important thing is CARE, care about the nurses that are working under you. Care about what they care about, #2 LISTEN when they have a concern #3 Say THANK YOU (I almost fainted the first time a charge nurse thanked me at the end of my shift, a simple and honest "thank you for working today, you made a difference") Wow, you know how often nurses get thanked? It is amazing how much a simple thank you boosts my morale.

OP, I've seen good and bad nurses and medical staff in equal amounts. The stories you relate are not unique to the nursing profession. As to your statement that you don't understand nursing, I agree with you. In reading your posts you sound to me like you think you are superior to nurses, am I right about this? Honestly? It is a sad commentary that nurses and medical staff can work side by side for years and never really understand each other. If you truly want to understand nurses then ask us some questions!

Now we usually have no more than 4 patients, if the assignment is too much it is your responsiblity to let your superivsors know. Once years ago, when we didn't have room assignments and they just kept piling the patients on I made a big scene, I loudly refused to take any more patients. I said it was unsafe and we had to close the ER. Well I got more doctors and supervisors that came out of the woodwork to "help". I refused their "help" I said I need a nurse that will take RESPONSIBLITY for these patients. Funny thing is none of the doctors or nursing administration were willing to do so so We went on bypass for awhile till it got better. You must speak up for your patients safety!

I have many, but the best I think is this: a guy was driving his car with the drivers window down, and his arm resting on the car window sill. His car was sideswiped by another car. He came into the trauma room with a badly fractured arm, open fracture......... well the X-rays came back with a large portion of the humerus was missing, gone, not there! So sent EMS back to the scene to look for it. Found the missing bone under the hood of the other car. It was dieivered back into my hands, it was so cool, a perfect section of humerus, no blood and guts attached, just a 3 or 4" section of bone, I was impressed by how heavy it was. We sent it up to the OR, the plans were to sterilize it and re-implant it, I never heard how it turned out.

Do the best you can during your shift, then when leaving to go home, leave your work behind!! You did the best you could, it is never ever perfect, we can never be all things to all people. You did the best you could when you were there and patients benifited from your care. Once when it was really a bad day in my ED, and I was inviting my coworker to go to lunch with me, she didn't want to leave because there was still so much work to be done, so I asked her 1. Is anyone dying here? 2. Will anyone suffer damage if we take a lunch break? 3. Won't we be better nurses, better able to give care after we have taken care of our own needs? The patients and their problems will still be here when we return, it helps set priorities in our minds.

Julie, I made a serious med error once, by the grace of God it did not result in death. I was assisting a resident placing a central line and handed him a syringe filled with lidocaine instead of saline for a flush, then heard the words we all dred from the patient "I don't feel good"... she went into a temporary cardiac block and recovered, the doctors were very supportive. I was a wreck, I seriously considered quitting nursing for a long time, my hands trembled when I did meds for awhile. I talked it over with close friends (not nurses). I finally found forgiveness from one of my close friends, who basically told me "how could I as a nurse expect to never make a mistake!" He is right, as nurses we expect that we will never make a mistake, it is not in our culture, we have no avenues to help us deal with the fact that we are human and we will make mistakes. I think doctors are taught that some of their patients will die as a result of their mistakes, they seem to be able to handle it better than we do as nurses. I think this is an important line of discussion. I decided to continue in nursing and I learned that ALL of us can make a mistake, and it has made me a better nurse, I always give myself the extra time to double and triple check my meds, I have never forgotten that mistake and the lesson that I learned. I hope you are able to find support, and forgiveness and stay in nursing, we need you.

I'd like some feedback on this one please. I'm an ER nurse so my med surg experience is ancient history. A family member is in the hospital for trauma, crush injury to his lower leg. Has a external fix on his tib fib and has 2 skin grafts covering his open wounds due to fasciaotomy. I witnessed the nurse change his dressing, she put adaptic dressings over the skin grafts and since they were on both sides of his leg they kept dropping off, she simply picked them up off the bed linen and slapped them back on several times before finally getting the whole thing wrapped back up. Then she removed the dry dressing from the donor site, it was stuck so she just ripped it off causing the whole thing to bleed. When she put a new dry gauze dressing over the bleeding donor site I asked if she might use adaptic and she told me there was no order for that! He was discharged from the hospital that day and is getting much better care at home. Now several days later he has a infection in the whole thing. Also they never did any care of the pin sites either. I have great empathy for over worked and under staffed nurses but this is beyond that this is just lousy care. I want to call the nurse manager of the floor and let her know that the nursing care on her unit is less than optimal, what do you think?

Oh I love reading this, it brings back so many memories! How about counting IV drips! We had mini and maxi tubings and when giving Medications such as lidocaine or dopamine we used the mini tubing and counting the drops! We had a few IV "controlers" we had a little thing we clamped over the drop chamber and it counted the drops! When working in CCU 30 years ago (YIKES!) we would get patients up from the ER they had muscle twitching and hallucinations from Lidocaine OD, it was so common because the ER had them on a high dose to control the PVC's, we would simly turn down the drip and they got better. To call a code was called "pull the phone" because we had a red phone on the wall, when we pulled the reciever off the hook then the operator knew to call the code. And when I first got approved to defribrilate patients I had to go before a board of 5 cardiologists for an oral exam!!

Well Congrats! How do you focus on transistion? Are you changing jobs? I've worked with several techs that have gone on to become RNs in the same unit. They mentored with someone they respected. It was really interesting to watch the transition. They were all good techs, but when they became RNs I could see the stress of responsiblity on them. I think that seems to be the difference, a higher responsiibity. Think about how you want to improve your practice and find a good mentor.

with lots of experience I can accurately estimate resp rate between 16 - 20/min, just by watching them while I talk. If out of range, or any resp complaint I count, 15, 30 secs, whatever it takes to get it accuate. The really tough ones are the babies, Yikes they go up and down, I sometimes have to count for more than a min, esp when they are screaming!!