nurse42long

Several years back I was hired into a smallish Labor and Delivery Department at the age of 57. Every nurse that I met was eager to work with a "very seasoned" L&D nurse except our one doctor. When he heard that the manager (also my age) had hired an "old lady" he was upset and said, "Why did you hire some old hag? She's probably thinks she knows everything. I'll never be able to train her right." Unbeknownst to him I was standing about five feet behind him. After waiting a few beats, I walked up and introduced myself. We never did get along. He was right that he was never able to train me to his way of doing things. But he also knew that I saved his butt several times. Ultimately he was let go from the hospital because he had so many lawsuits pending. But age was never a factor in either being hired or working alongside younger nurses. In fact, most of the younger nurses loved (at least they seemed to) hearing some of my "war stories" and getting career advice from an old-timer. And I loved hearing and helping with their issues with being inexperienced and hearing about their lives and young families. I enjoyed teaching and swapping tips. They helped me with things that had changed since I had last worked in-hospital. Seemed a win-win for all, except the doc.

Thrilling - seeing the crowning head emerge with each push Terrifying - not seeing the rest of the baby emerge, due to shoulder dystocia

This is how it's supposed to feel. You did good. Store this one away in your data bank for the day when it doesn't work out so well. I love that your charge nurse said "you've arrived". Soon you'll have more of these than not. Congrats.

Had an elderly physician who covered nights in rural small OB. Not sure who thought that was a good idea. But he was quite the horticulturist. He grew award winning roses and Africian violets. Anyway one night I called him about an early labor patient who was freaking out and expecting an order for Vistaril or some such. (this was decades ago). He said to give her a dose of urea and back off on the mag. Make sure she's not in direct sunlight. I tried talking to him for a few minutes because I knew he wouldn't hang up the phone properly and I wouldn't be able to call him again. Finally he woke up enough to give me a Vistaril order. I wrote the first order on an order sheet and left for him to sign the next day. He was not amused. I thought it was hysterical.

If you have been on nights for over two years and you love it. Stay there. If you can sleep during the day and feel good physically, stay on nights. I've worked everything there is in 40 years and nights with a good crew was the best. We raised our kids while I was on nights and my husband on days (teacher). I was always able to do the important day stuff and sleep later. Now that I am old I can't do the nights anymore, but I also can't do the 12 hr days either. LOL. To me, whenever you find a place in nursing that you love, stay there until you don't love it anymore or your life situation changes. Always, always trust your gut.

I usually get the paperwork done first. I think it is easier to establish a rapport with the patient and family to ask the non-personal questions first, insurance etc. Also talk about what the agency can do for the patient, pt rights and responsibilites, privacy issues, etc. That's when I get the consent signed. Then I move on to more personal questions and then the physical assessment. If you have to fill out amount and frequency of visits on your consent form, you can always add after the visit and have the patient initial the addition. We don't have that on our consent form. Only consent for treatment, HIPAA policy and release of information to insurance and physician is on consent form. On the paper OASIS we have patient sign the treatment plan which has the Plan of Care, amount of visits planned, if PT, OT or Speech will be added. That is separate from the consent. I don't think anyone is going to sue anyone over getting vital signs before getting a consent signed. The reason your office was upset about not getting the consent signed is that they cannot bill for the services rendered without it. Sounds like you did a good job assessing the patient and getting him emergency care. Pat yourself on the back for that one. :)

Take an art class through the community or at a local art museum, then take another. Maybe find a part-time job at a gallery or some other area in a creative field. Even if it's just answering phones and helping out. Then when you find something that you're passionate about you will find a way. I've been a nurse for almost 40 years for a lot of the same reasons as you, job security, etc. I like nursing and at times have loved it but if I had it to do over again I would have made more effort to change careers. As it is, I do art "on the side" and that is what has kept me going. Also keep your eyes open for ways to be creative in nursing, volunteer for projects that interest you. Right now you have a job that brings a paycheck, while you do that work at finding ways to bring more joy and creativity into your life. Most people don't love their job, that's why they pay us to do it. Create a life you love.

I hate it when parents use nurses, doctors, etc. to threaten their children to behave. For instance, "if you're bad, that nurse will give you a shot". Not good. Well, now I've heard it all. I got to my little old patient's home and the sister/caregiver was yelling, "Oh boy, just you wait now. The nurse is here, she'll put your butt in a nursing home." This does not set the stage for a therapeutic interaction. Also the patient pinched me. Can't say as I blame her.

I've been a nurse since temperatures were taken with glass/mercury thermometers. We had fifty that we kept in a metal pan in Cidex solution and went from one end of the floor putting them under tongues. Then we went back and collected, checking the temp, shaking down the thermometer and putting all together back in the metal pan. Uggh, right? Also suture needles were not disposable, we had to "save" them from the delivery or surgical tables and clean, resharpen and sterilize. The ONLY time you wore gloves was to do a sterile procedure, if you didn't get a little blood on your hands you weren't working hard enough. LOL IV bags were glass and nothing was scarier than dropping one and glass shattering everywhere. I am old, but still at it. I've retired three times but can't stay away.

When my daughter-in-law was in labor, my son made sure everyone knew I was a labor and delivery nurse and that the other grandma was a lawyer. I don't know which one of us was the most intimidating, but she got excellent care.

I hear you. After 39 years of nursing, it has finally beat me as well. I've done L&D, NICU, OR, ER, LTC, etc. I did some great work but I can't take the "customer service" approach anymore. Doing more with less until there is nothing left to work with. Since I can't retire yet I'm looking for an office job, reception, filing, whatever. I don't want anything medical or nursing related. Good luck to you, Viva and to all the nurses out there who have to stay at it. Bless your hearts.

You could also look at it as more patient access to care may be great for hospital nursing. For example, patients who waited until condition was so bad that it required emergency care and hospitalization may now see a PCP or NP and have the problem dealt with at an earlier time, requiring no hospitalization. I would think clinics and other preventative measures could decrease need for over usage of emergency care. People are not going to naturally get sicker just because they have access to care. Prevention and better maintenance of chronic problems may solve a lot of hospital overcrowding, especially in emergency rooms.

Medicare and some insurances will pay for Home Health wound care supplies, but in most states Medicaid will not. If patients can't afford wound care supplies, we have to sometimes "MacGyver" it. Usually wound care in the home is aseptic not sterile. We have used one teaspoon of non-iodionized salt to one cup water for homemade saline. If the water can be boiled for several minutes prior that is great but not all patients have access or ability to cooking. Sometimes Home Health can be primitive but we do the best we can with what we have.

I think this could be the future considering all the fuss about Press-Gainey scores. The patient "prefers" applesauce with her meds even though is NPO. Nurses who know better let the patient have her way. Easier to go along to get along. I was taught back in the dark ages that NPO meant NPO. Checking if any of the meds were actually necessary prior to surgery, if so, you get a sip of water. I'll be happy to explain and teach why but patients can't always have what they prefer. Or you may not get your procedure today.

Again to all who have commented, thank you. As the comments have been split as to what to do and are so heartfelt it has made it harder to decide what to do. I did talk with the Nurse Manager earlier today and told her of the situation. She did not seem shocked, which, I admit, did shock me. She did say that the doctor would more than likely back whatever this nurse said as they "always back each other." They are not romantically involved but they go back about 14 years and have covered for each other all along. He is somewhat reckless and gets into trouble frequently. This community is very small and he is the only doctor in his specialty here and the hospital and community want to keep him here. He threatens to quit and move off every 6 months or so which would close our unit down. He's not likely to leave at this point in his career but he has them convinced. The NM told me that this nurse has been "the bane of my career but there's nothing I can do" She said if I wanted to report this she would try to support me but she felt that it could come down more on me. She then told me of a laundry list of issues she has in dealing with this nurse including daily tardies (up to an hour), repeated call-ins, issues with other departments, etc. So it sounds as it's a no brainer that if I stir this crap pot the stink will stick more to me. I told the NM that I may have to leave if that is what the culture is here and she said "I hope not, you are an excellent nurse and we're happy to have you, and we've lost too many because of things like this. I can't promise you it will get any better but it certainly won't if you leave." How's that for a guilt trip? Anyway I've decided to decrease my hours to part-time and the NM said she would schedule me on a separate rotation from the nurse in question. For now I will bide my time.