pedsrnjc

Practice using S-BAR alot; it will help you not sound stupid. Practice using it to explain everyday issues to your family, practice using it when talking with classmates, make it come so natural that it becomes your primary language. Had I used S-BAR from the beginning, I wouldn't have felt stupid so many times talking to doctors and older nurses. Life would have been easier.

Thanks everyone, I really needed to hear some kind words. I'm probably not leaving nursing, but having the summer off sounds very pleasant. So...beach days for me! I have thought about Hospice, because in LTC, that's where I really shined. I dream of ER nursing, but probably shouldn't and can't. But maybe ten years from now. Anyways, thanks again for the kind words.

Hello Everyone, I've worked in LTC and pediatric home health. I was fired from pediatric home health because the family didn't think I knew what I was doing. I was trying to give the family a sense of control by asking them about their preferences in patient care, but I guess they perceived it as being unconfident, maybe I was...I have an anxiety disorder and the family NEVER talked unless asking me to do something. This made me really anxious then it was hard to focus on what needed to be done. Anyways, the up side is they should have an increased sense of control knowing that they can choose which nurses work with their baby. The company told me that if the family was uncomfortable with me, they were too and needed to let me go. This really hurts. I hate LTC; I think it's criminal the way we treat our elders and I can't change it, so I want no part of it. Having no other experience, I have decided to leave nursing and stay home with my kids and be a housewife, never to think of nursing again. But I can't really escape it, can I? On Monday my husband's best friend called because he was having chest pain; he wanted me to take him to the ER, but refused to call 911. I called 911 because he can always refuse the ambulance and I can't help him with no resources and while driving. I headed over there and arrived before the ambulance. I had his vitals and had given him asprin before the ambulance arrived. They said I did a good job, and when the portable EKG came back with signs of MI, he did take the ambulance. He's doing just fine. :) Tonight, at a meeting, a lady was in extreme pain from fibromyalgia, I used my non-pharmacutical interventions for pain. My favorites: guided deep breathing, hand massage and guided imagery. She left feeling better; her face was no longer contorted with pain. It would be silly to think that I helped her for more than a few minutes, but if I weren't a nurse, I wouldn't have known any way to help her. I feel hopeless, like I will never land a job that I can keep, I'm a loser I guess, but I still love helping people. I will never be able to find a job after being fired, but I guess I will never lose somethings. Hopefully someday I can come to terms with not being a nurse. Thanks for listening, just want to randomly talk into the internet world.

I don't mind your being here. Not giving medical advice, but as long term care is now, from my short perspective, I wouldn't want that either. I would want my family to look into home health first. Of course we don't know everything about this, and as you will learn in nursing school, Maslow's hierarchy spelling? Of needs shows that safety is more important than staying in one's home. I wish you the best of luck with your aunt and your possible nursing career. I can't comment on the MD's behavior, too many possibilities. Good luck.

I know a nurse with bipolar and she is a nurse I would want caring for me and mine. She is compliant with her treatment. I also know nurses with depression, anxiety and panic attacks. I think you need to take an honest look at your illness and decide if it would affect patient care. If it would affect care, don't become a nurse, if it wouldn't affect care (you are compliant with your treatments, have insight into when you might expierence symptoms, take your medications religiously) become a nurse. Don't make your decision based solely on a diagnosis, perhaps ask your care provider what they think, they will probably be able to give you some insight. Good luck:)

I just put in a late note, unless it's critical, then I call and go back (once in my almost two years as a nurse have I gone back and I probably didn't need to, but CYA, CYA)

To family and friends: Regardless of the economy, if it's a calling, go for it, just know it might be hard to find a job in the area you want to work in. If you want to get rich, be a bank CEO.

Love this, sometimes we have to spend a little time fixing ourselves. Thanks.

Kudos to LTC nurses, it stinks. Nascar nurse explained things very well. As far as the falls go, you have to learn how to assess whether there is a fracture or not. Your assessment skills will probably strengthen in LTC, as often these poor people are warehoused waiting to die, which is often the only way to discharge, and many MD's don't really care about LTC residents. When I worked LTC, even when calling a doc about a fall, their first question was always code status, which often even affected their treatment. For instance, if the resident fell and neuro assessment wasn't right, MD would ask for code status and if a full code, send to ER, if DNR, keep on monitoring. I learned to always contact the family first and find out what they wanted even before calling the MD. Of course, you have to use your head, feel free to call an ambulance and then get an order to send to ER, just make sure it is really called for. A not uncommon call for me, "Good evening Doctor, thanks for calling back. So and so fell off his bed and hit a garbage can with his ribs and was in respiratory distress with tracheal deviation, he is now in ER, facility policy states we must have an MD order to send to ER? May we please have an order?"(yes this happened) As far as pneumonia goes, some of these people can develop pneumonia in a matter of hours, seriously. I couldn't do LTC anymore, I don't believe in the care model. In this bad economy, I quit my job with no safety net and ended up getting hired in pediatric home care, which I believe in. It has gone very well. Also, be wary of any place that says "In Christ's love everyone is someone", very bad employment practices there. Unionized LTC facilities seem to have better nurse to patient ratios and overall better care. Good luck to you.

Anyone else remember high school? Quit flaming the poor kid. Yes, OP should talk to a nurse in person, but I know very few people who actually applied themselves in high school. I didn't and I could totally see myself doing something like this and then wondering why everyone flamed me. I don't think the brain completely develops until age 65 or something, right before it falls apart. Anyway, OP, you might like nursing, but we generally like to have people who really apply themselves in our field, so when you get to nursing school, you will want to step it up a bit. Also, we eat our young and I'm kinda hungry. PS. I still don't have the English language mastered. We keep plugging along...

I've been there with my husband too, he only smoked pot in the garage, and never had a stash around (except, I persume, in the garage.) but I asked him if he was happy with the amount of money I make, "yes". I told him that any legal trouble he might get into could affect my job and our kids (though once I called child services on a heavy meth user and they indeed did ask, "is the house clean? do the kids have bruises? then we won't bother.") He didn't call my bluff, but started attending NA and quit using. He's been sober for over a year now, life's better. On the other hand, many long years ago, I had a baby by a man who used meth (I know, big mistake.) I told him he could live with me as long as he never used meth again. I ignored all the warning signs of using, even found a light bulb and straw hidden in the house. When I confronted him on the light bulb, he freaked out in such a scary manner that I told him as long as he never did it again, I would forgive him. I continued to ignore the danger signs and he left our 3 month child at home alone. When I found her, I secretly began packing and when he came home I gently explained that we don't ever leave infants home alone and said nothing else. Next day when he went to work, we left forever. I also reported him to child services to ensure that if he ever tried to get custody, he wouldn't stand a chance. Years later, I wonder at how crazy I was. To make a short story long, I would confront a pot head directly. I would not ever confront a meth head, just run, fast...

There is this drug I give to patients, it's called Visteral/Atarax/hydroxizine, pretty sure I spelled them wrong, it was a long night shift. The drug is named Visteral if my patient is having trouble with anxiety or needs something to be symbiotic with their Vicodin. The drug is named Atarax if the patient is itchy. The drug is named hydroxizine if the patient is needing an antihistamine. (sometimes allergy problems make them itchy;)). If you call it the wrong name, like Atarax for anxiety, or Vistaril for itching or hydroxizine pretty much anytime...the whole world stops! I totally understand why drugs might have two names, trade name and real name, but what happened with this one? Did two manufacturers patent it at the same time for different things? Or did somebody decide one day that they could trick folks into thinking it was two/three seperate meds and then they would sell more? It must be time for bed, if I take it for sleep I guess I would call it vistaril, but melatonin works alot better with no hangover, right? Drugs will always annoy me.

I would highly reccomend TNCC for every nurse, we all see accidents, whether it's the nursing home resident who falls and develops a pneumothroax or seeing a kid and dad get hit by a car, it's the peace of mind in knowing what to do. I will go a little farther...stopping if no one is there is more than a nursing obligation, it's a human obligation. If you saw someone choking in a restraunt, would you walk away? Obviously, check the scene for danger, but if it were me, even if you know NOTHING, stop and sit with me and tell me I'm not alone and help is coming. I probably wouldn't have left in this situation, but you stopped, who knows how many other nurses drove past while you assessed the situation. Thanks for stopping. Now...flame away.

Asystole, I agree with you totally that some people just need a conspiracy with everything, but it scares me that some people don't get vaccinated, because sometimes vaccines fail. With vaccines we also depend on herd immunity and if enough conspiracy people don't get vaccinated, then my kid might get polio because maybe my kid is in the 10%+/- that had a failed vaccination. It worries me, but by not getting vaccinated, people put others at risk. Of course, there are vaccines I wonder about like the cervical cancer one. Stuff like this could keep me up all night worrying. IDK

I had tried to get morphine for this guy, because I really believe that having every single organ shut down has to be painful, regardless of the disease. When they're unresponsive, I think that they can still have pain, and the hospice nurse angered me because, she said, other than elevated vitals how do you know this guys in pain? Then she said I really didn't know he was in pain, I know he was. She told me to continue using the oxycodone. I hung up the phone absolutely angry. The oxy helped, but I think we could have done better for him. My grief has mellowed, but I think I still feel bad because we could have done better by him. When I go, I expect very liberal morphine, ativan and atropine gtts. I expect my nurse to give it to me liberally. I know it's not all about me, as someone previously eluded to, but every time someone dies, I ponder my own mortality. Thanks everyone for all the kind comments.:heartbeat

It was a rough night last night. The resident was one I had worked with for years and I loved that resident. I had never seen that much mottling. Family was at bedside. Resipirations 60. Unresponsive. Eyes looked pained, not normal dying. No Morphine order, just oxycodone and tylenol rectally. Gave tylenol and 10mg oxycodone per prn orders. 50 minutes later resident dead. I know I didn't kill him, the disease did, but my heart hurts. I feel responsible. An elevation in vital signs can indicate pain in an unresponsive person, right? Right? He was also twitching his eye brows and occasionally clenching his fists. After working with him for years, I loved this one. He suffered as many years as I worked with him, he needed to go, so why am I grieving? Just needed to debrief. Thanks.

Wow...my brain hurts a little, but this was great education. I think of my PD residents right now and their PRNs and I think they're ok, but I will be double checking tomorrow when I go to work. I wish there was an easy way to save this thread to my computer for future reference. This type of thread is why I love allnurses.com! Thanks for all the great information!

Have you ever read "The grapes of Wrath" by John Steinbeck? I would be careful relocating out of state, in state you can be assured of public assistance if things go bad. Nursing is a saturated market right now, if you love it and dream of it, then go for it, but right now (not forever), the jobs are few and far between. Good luck, I was a single mom in nursing school, I made it, you can too. Good luck.

The survey doesn't work

I'm pretty sure I've cared for this lady. Did she just fly in from the US over the weekend? As far as I know she's still at my facility, but she did seem like she was on the way out either heaven or hospital. BTW...I love this lady.

This was so ugly and mean from all posters. Reading this thread was like driving past a car accident with blood and guts all over the road; you want to look away, but can't.

I hear you, but maybe it's a personality thing, or maybe I'm at too low of a level of thinking to work on my BSN, but I want information I can use, tonight when I go into work. I'm pretty sure I use several pieces of several different theories, but I like Henderson's the best because it's practical and fairly simple on the surface. I really want to learn stuff I can use immediatiely. There's probably a DSM Dx for what I'm going through and it will be a miracle if I pass. Perhaps, multiple theories are vital to nursing and I'm just lazy so I'd prefer one. IDK

But what are they meant for? And if they're irrelevant to day to day nursing, why do I have to learn about them, I'd rather have a large dose of TNCC;). But really, what are they for?

Thanks guys, please tell me more, I think I'm not understanding these concepts. I also agree about the full assessment statements, I was just trying to think of an example of theories in action, but I have unfortunately seen nurses do crazy things like put alarms on a resident who crawled onto the floor to ease her back pain. I really do see many nurses with opposing viewpoints that affect their clinical decisions.

Sorry about my spelling of independence. Just realized I do have a discussion post reply for my classmates. Cool.