Paravell

Thanks again everyone for the replies. So, another incident happened yesterday involving the same type of thing! But, I had learned from my previous experience, and this one ended up so much better :) The pt in this case left a happy customer, and I was not berated and insulted for not giving narcs :)

yup, I've seen that to be true. I'm glad they have a "patient complaint" committee, but no "Back up our nurses" committee:mad:

I think that if this patient had been in the main ed, around everyone, they would have either a)called security to remove her from the ed, or b)ended up giving her b52 after they told her she needed to watch her mouth or leave. :) Unfortunately, although we don't have a dedicated fast track, the 4 rooms we have are situated down the hall from the main ed, so that didn't happen!!

Thanks for your reply!!! Your advice is spot on..although in our ER there is no "losing rapport" to change patients :) My charge nurse is great, but she was extremely busy and couldn't really take over the patient for me, nor did I really want her too, I didn't want to spread the problem around :) I really wish we could have PEC'd her for delusional behavior!!! 3 days in an empty room may have given her perspective :) Looking back, I think that what actually made it worse is that I did empathize with the pt in the beginning, so I guess she thought I was an idiot and could magically get the doc to order the dilaudid and phenergan iv. Sometimes being nice makes them think that you don't "know the game" and they will really try to take advantage, then get all the more indignant when it doesn't go their way. I've asked my charge nurse if we can wear flags like referees do and use them...I would call it the troll flag Don't think administration would approve of that one...

To answer the first questions, yes, yes, and yes!!!! I notified the charge nurse after the second round of screaming, and the doc was onboard the entire time. And, the problem is that I do waste my breath! I'm working on not letting people treat me like that, you know, become one of those no nonsense type of nurse that does not put up with the bs. I think I documented clearly, and was pleased to read the md documentation that backed me up. So at least he's not throwing me under a bus!! Thanks for the reply:)

Hello all, Hope everyone made it though this Monday relatively unscathed! I've been working in the ER for the past 3 years, mostly in our fast track area. For the amount of people that I've seen over the years, why is it that one particular patient can really make me want to quit nursing and start buying lotto tickets for a living?! Pt came in with migraines/nausea. Pt hobbles to room, ice pack in tow and turning off the lights as soon as she gets in the room. Pt warms up to me, tells life story to RN, joking and laughing. Doc sees pt, doc orders his usual combo of im phenergan and IM toradol. Pt becomes livid, screaming, crying, berating rn for bringing said meds to bedside. pt agrees to receive meds. Pt screaming, crying, yelling at rn for giving her "really bad shots that made my head hurt worse" Rn notifiying md of pt's concerns. Rn reevaluates pt, receives another verbally berating tirade. Do we get where this is going? At the end of it all, house supervisor comes down, apologizes to pt for having a bad experience. Of course, I'm sure when the pt complaint board calls me on this one I'm going to be the bad guy. The house supervisor tells me that the pt says I have a personality disorder, that I threatened her, was "mean" to her, etc, etc. How I wish our rooms had cameras!! How do I defend myself against a liar??? Ugh, it just made me sick to my stomach...I charted my little heart out, and I know the doc on the case has my back, I'm just not looking forward to the call from my manager next time I work. I guess this was more of a vent than a question...although I could use an instructional manual on how not to let the trolls in life bring me down

Hey everyone, It's interesting to see your roles in Ophthalmology! I've been working in an ER the past few years, and am ready for a change. I have an interview for a RN position in Ophthalmology..I guess it's a clinic/outpatient setting but the job description was very brief. We shall see!! I look forward to getting y'alls input once I get some more information! From what's posted here, everyone that works in this field seems to enjoy what they are doing..how refreshing :)

Ugh, I almost WISH I had the problem of being a "know it all" I just started working in the ER, and I am a fairly new nurse, (less than two years of experience with 3 different jobs thanks to hurricane katrina). I've been on orientation 3 days, and so far I haven't killed anyone, so I guess that's a start. My preceptor has the mentality of "just throw her in there and she'll learn" which in some cases I appreciate, but it's beginning to terrify me!! I need some of that confidence that these know it all new grads have. I couldn't imaging pushing a nurse out the way to see a code....I'm terrified of the day that my pt codes, and only hope that experienced nurses have my back. I'm still waiting to take ACLS and PALS, and I'm hoping that at least that will give me more confidence with ekgs, and the emergency drugs. Anyway, I'm working tomorrow, and I really would appreciate it if y'all could throw some confidence vibes to me!

Wow, I really need to check back here more often! I missed out on 2 whole pages of messages!! So, I've been doing homehealth for about 2-3 months now, and I am liking it so far. I can tell the company I work for does have some problems, but as far as taking care of the patients, I'm loving that aspect of it! I love going into a pt's home, being able to help them in there day to day life, having them warm up to me (well, MOST of them. There is the guy who barely says a word for me and throws his word finder book across the room when I have to do his wound care) I love being out of the hospital and being back on a "normal" schedule. All that being said, I am finding myself working longer hours than I did at the hospital, and not being paid as much for my hours!!!! I'm slowly getting faster at the paperwork, but it seems that it just keeps piling up on my desk, with no end in sight! But, I guess everyone has to have SOMETHING to complain about :) I could almost see myself being in a management position at a home health agency, because I can see what I would do as opposed to some of the things I see now. But for now, I'm content, I still get to keep up my iv skills with lots of lab draws, and learning lots too! (so much teaching!!!) I am not sure if this is will be the niche I was looking for in nursing, but I've only been a nurse for 2 years (and only working as one for about a year) so I really don't know what I want! That was a really long paragraph! For everyone who has had interviews, good luck, and don't despair- job hunting is the worst, but it all is worth it when you find a job you are satisfied with! For all those experienced hh nurses that have replied to this thread, thank you thank you thank you! For all those considering home health, it is nursing at it's core. Have a great night everyone!!! :smiley_aa :smiley_aa :smiley_aa And yay for today, it's my little boy's first bday!!! :)

Hey! How was the ride along? The new job is going pretty well; I'm definitely liking it a lot better than my old hospital job! I'm still figuring out all the paper work mess, but it is getting easier. The only "Bad" thing is that another company that I had applied to called me to say they are hiring now..and there company pays up to 300 bucks a month for insurance...I would hate to leave a new job after only a month or so, but I'm the only one working in my family right now, and I don't have health insurance anymore, so this could be quite attractive!! Ugh, I hate decisions!!!!!!!! Anyway, what are the details of being an infusion nurse? Hope all you new (and no so new) home health nurses have a great week!!! -Colette

wow, $84k sounds nice!!! i'm actually taking a pay cut as of now....i'm getting paid hourly until i am able to take on a "full load" of pts, then i will be paid per pt. my company's health insurance is way to expensive for my whole family, so i am having to get my own insurance. i'm a bit nervous about the pay check, but less money is worth it if this job makes me happy :) i finished all the paperwork/oasis training sessions this week, and next week i will start doing office work and start shadowing some of the other nurses. but as of now, i am on vacation, and am going to new orleans tomorrow for mardi gras!!!

Good luck!!!!!!!!!!! So far I've just been doing paperwork, although Friday they sent me to this community center to do blood pressures on some folk after their morning bingo. It was actually so much fun!!!!!! This week I'll be traveling to their main office to do orientation, which means I can except about a $200 gas check :) Keep me updated on how you like it!

I really started HATING my job. I always felt that I was putting my license on the line, considering that our staffing was HORRIBLE. I was always the only RN on a mixed peds/surg/ortho floor, and while I loved the lpn that I worked with, it was just getting way to stressful! I wanted a change, and home health is def. a big change for me!! Good luck with whatever you decide!

Hey, thanks! It will be visits, largely a geriatric population but some acute post op bandage changes, etc, from what I've gathered :) I'll be paid per visit, which I'm hoping will work out because I'm used to a regular pay check!!! I really hope I get a good orientation so I can become comfortable/confident in this new setting. I'm really looking forward to getting out of the hospital setting, and being able to deal one on one with patients (and families) Two nights left! (I should be sleeping now, I work tonight!!!!) -Colette

Hey everyone! Well, I finally did it, I put in my 2 weeks notice at my current job, and I start my new home health job this Thursday!! I'm terribly excited and nervous, but I don't think it can be any worse than my job now!!!!! Anyway, just wanted to let y'all know another home health nurse has joined the ranks! Wish me luck!!!!!! -Colette

Great post, y'all!! I just wanted to throw in a little noted concerning "non-medical" inductions. At my 40 week appointment, my dr. said, ok, so when do you want to come in? I'm like, um, what? She gave me 2 dates that I could come in for an induction. At the time, i was so excited cuz I was ready to see my baby, but when I got home and actually thought about it, I started getting scared and wondering why she wanted to do the induction. After calling the office, and the hospital for like 2 days, she finally called me back. Basically she told me was that she didn't like mommas going over 40 weeks, and just kept pushing that I come in. Ok y'all, I'm a freakin nurse, and I even wanted to do the natural child birth thing, but in my crazy hormonal state, I ended up saying yes to getting induced!!!! So, i got the cervidil, then the next morning they start pumping the pit, broke my water...after about 12 hours I finally gave in to an epidural...and about 10 hours after that my little guy finally came out. Now, normally I would look back and say i really wish I would have had someone telling me to just trust my body and not be pressured by the doctor wanting a scheduled induction (haha for her though, cuz she still had to be woken up for a 2am delivery that she thought would be done in the afternoon!!!). But, I ended up back in the hospital 4 days post delivery vomiting uncontrolably and having severe pain that I had during my 3rd trimester...that's when they realized I had gall stones...got shipped to another hospital, waited for my pancreas to settle down, then went to sx. SOOOO it ended up being better that I had him when I did! Oh my goodness I am so sorry this post turned out so long and rambling! So while I still think non-medical inductions shouldn't be done, cut the momma a little slack...hormones make you do crazy things! I'm definitely looking for a midwife next time around :)

Hello everyone! So Monday I officially start my career as an RN, again! I graduated from nursing school in Dec. 2004, worked until Hurricane Katrina (Aug. 05), relocated, recovered, then got pregnant! The small town I now live in evidently didn't want to hire a pregnant nurse, so I haven't worked in a year now. My baby boy just turned 3 months, and now I'll be rejoining the work force. I was hired to a mixed floor that gets all the pediactrics, plus post-ops and orthopaedic. Weird mix, huh? My orientation is 6 weeks, mostly during the day, then I"ll be working nights. I am SO nervous about going back. Half of me is so excited to finally continue with my chosen career, the other half is absolutelly terrified that I will have forgotten all that I've learned (since I was a new grad anyway!!!) And, I've never worked with peds before, so that part will be brand new to me. I'm really hoping that my preceptor is great, and that my floor will be organized and helpful to new nurses. We shall see. Thanks for listening, I hope that everything goes smoothly -Colette

Congrats on getting this far, and good luck in your future endeavors!!

Ok everyone, I got my lab data (double checked), and my amylase was 33,000 and lipase was 11,000, on admit, using the "normal" standards of measurement (U/L) Now, I have read that pregnancy can raise levels slightly, and as i was only 2 days post partum that might have affected it a bit, but I still can hardly believe they were that high. I'm glad I didn't know it at the time, it probably would have stressed me out even more and hindered my speedy recovery.

Thanks for the info...I wasn't sure if amylase itself could cause damage.....the whole thing was pretty crazy; I was pregnant, and evidently it's pretty common for pregnant woman to get gall stones (due to all the estrogen) well, I got gall stones, and would have attacks of acute pancreatitis a few times a month, but then it would subside. All this went undiagnosed (we just thought the pain was a lovely part of being pregnant) until two days after I delivered...i started having that damn "chest" pain again, which radiated to my back, and i started vomiting non stop. So, off to the ER, and after a ct, mri, some xrays, and a bunch of blood work, they finally figured out what the problem. Evidently the gall stones were lodging in the bile duct, inflaming my pancreas. I waited a few days for my pancreas to settle down, then i got my gall bladder out. I had a bit of atelectasis in my right lung, but after a few days all was well. It was after I had already recovered that I heard talks of "lethal levels" So now i'm all curious since this is the FIRST thing that has ever been "seriously" wrong with me, and it looks like it was pretty serious there for a while! I figure if I can labor for 24 hours, then have abdominal surgery and come out all right, I'm doing pretty good :) Although I'll tell you it wasn't fun being on the other side of that bed rail!

Thanks for responding... I do know that pancreatitis will send the enzyme levels up, I was just curious on the actual numbers that people have seen.... I'm really asking because I, the nurse, was a patient recently, and my amylase levels were 47,000 due to pancreatitis. I didn't know they could get that high :) That was not a fun time:uhoh21: But hey, I'm still alive!!

Hey everyone. Sorta a random question, and I don't have my lab test book, and internet searches haven't really turned up anything, soooooooo I thought I would ask all you lovely smart people! Have you ever seen a patient with RREEALLLLY high amylase levels? And if so, when do these levels threaten their life, or start to do organ damage? Thanks y'all- p

Hey Everyone! First let me extend a good job out to all those pregnant nurses who are still bustin' their butts and not using pregnancy as "an excuse" not to work! And, just to add another side to the story, try being a pregnant RN looking for a job! I lost my job in New Orleans due to the hurricane completely destroying my hospital. After that nightmare, we relocated and shortly afterwards I found out that I was pregnant! I needed time to recover from the whole hurricane ordeal, and then I started putting applications out. Well, the interviews go great but they always manage to ask the questions that make me say, yes, I'm pregnant. And now my my belly is getting bigger by the day so there is no hiding it! I have an interview at a dr's office monday and i hope they are more understanding. I have had no complications (knock on wood), i'm feeling good these days, and I don't plan on taking any kind of huge long maternity leave. I am desparately broke and WANT TO WORK! So, we'll see what happens. Anyway, just thought I would throw that in :)

Hey all! I graduated from nursing school last december and had worked on an oncology/med surg floor until August when Hurricane Katrina came and destroyed my hospital (and my home, town, etc...) I've finally found permanent residence and am applying for jobs (ugh!) Tomorrow I have an interview at a Dialysis clinic which I am very excited about considering that I am ready to try something outside of the hospital setting. The only little problem is that I'm pregnant!!!! I found out as soon as we relocated from New Orleans, and now I'm dreading to tell them at the interview! I know legally they can not ask me if I'm pregnant, but I don't want to be sneaky and I would rather be up front. (i'm starting to show considering I"m about 5 months now)Any advice? I plan to work until the last possible minute, and I plan to go back as soon as I can considering I need income, but I really hope this won't be a deciding factor. Any dialysis nurses out there that have been pregnant and working? Any advice at all would be appreciated! Thanks!

Just a follow-up: Dr.'s office and diaylsis job options were just off the top of my head....I'd be open to anything at this point! (I loved my psych clinicals in school, and in the future I would like to get involved with informatics) I guess I just need to go to the local hospital and see what's out there. Still, any advice/suggestions are greatly appreciated. Thanks again