reidob

I know I'm far from the only idiotic man who has done this, but when I was a nursing student, I actually said to one of the nurses, "I didn't know you were pregnant!", to which the woman replied (of course), "I'm not." Sigh. That was over 20 years ago and needless to say I have never made THAT mistake again!

I was an actor before I went to nursing school. Although I never really regretted leaving the theater all that much, recently I have been pining for the stage again. On the other hand, being paid virtually (or absolutlely) nothing to work your butt off and put up with bad reviews and tempermental artistes can be a bit...off-putting, to say the least.

Heavens, steelydanfan, where have you been? Tattoos and their meaning has changed entirely. These days, they're just a way of stating one's individual nature. My wife would laugh if she heard you refer to me as "thrill-seeking". I am closer to retirement than my youth, and I love my tattoo. You might want to rethink your reactions to tats a bit, because you are bound to see a lot more of them! Having said that, I do have a co-worker (an LPN) who got tats on her knuckles (TRUE & LOVE, so nothing offensive), but that strikes me as a form of employment suicide. If she leaves here, where will she ever find work with such visible tats? It seems to me that if you use good judgment they can be in good taste, but you must use that judgment always.

A very interesting string. I have been practicing for 20 years, including 10 in an ICU in a major trauma center, and I have never carried my own malpractice insurance. Not that I can bring any great evidence to bear to why I have chosen not to do so, but most of the best informed opinions I have been able to garner have said that it is not needed if you work at a major instituion (I work for the state), and may in fact open you up to being named when you might not have been otherwise. I know, I know, all of this has been discussed here already, but I am left no less confused than when I started. But in reading every single one of the 119 posts before this one (oh, yes, I did!), I find not a single instance where anyone has any personal experience with using the insurance, or even knows anyone who has! So, how am I to know that it is valuable or worthwhile to have? How am I to know if the insurance company will be the one to "throw me under the bus", as opposed to my employer? Yes, it's a small price to pay for peace of mind, but I hate the idea that I am paying even a dime for something that is not worthwhile. I have been perplexed on this question for my entire career.

Another perspective: if the place you are seeking to work is so stuffy that they can't stand a few tattoos, you probably don't want to work there. I work in a rather freewheeling place that is nonetheless professional in demeanor and where we get to give excellent nursing care, but tattoos are tolerated, as long as they aren't offensive. Hey, I'm turning 54 soon, and I just got my first one! Viva la tats!

By the way, skeeter, we are not the lowest-paid nurses in Seattle. Our salaries are regularly reviewed, and the state is well aware that if they undercut us too much, we will go work elsewhere.

I have worked at Harborview for 20 years and love it here. The best thing about Harborview is that everyone who works here; doctors, nurses, techs, even housekeeping, work here because they want to. There are easier places to work, and malcontents tend to go to those easier places. This is one of the most supportive, rewarding environments I think you could hope for. Does it have problems? Well, yeah, what place doesn't? I'll tell you this, though: the bureaucracy is more obnoxious than the people who hang around outside. Yes, there have been a few difficult situations from time to time, but our patient population is the neediest, so that is inevitable. This is the place of last resort for those who have been marginalized elsewhere, and nothing feels quite so wonderful as giving care to those who have been distrustful or difficult to reach prior to their experience here. I have never felt unsafe here; of course, you have to use your head, but that's true anywhere.

Though I agree with most of what you say (and disagree with those who criticize you for venting a bit), I think it is undoubtedly true that many experienced nurses are ill-prepared to be preceptors. Precepting is a specialized skill that takes a great deal of patience and a clear awareness of learning styles and the varying abilities of the nurses one is training. Just because you have been a nurse for many years, even an excellent one, doesn't mean you will be any good at precepting. I have even considered that there should perhaps be a special certification for being a nurse preceptor, except that the last thing we need is one more thing to be certified for!

I concur that foot blood draws and IVs should be a very last resort. They are done rather often in our clinic (we deal with a lot of IV drug users who have "burned" their best veins), but I think the use of leg and foot veins is sometimes simple laziness. There are often hand or even less convenient arm veins that are accessible, but because the addict is less likely to use leg veins, we go for the easy stick. I worked ICU for 10 years before coming to this clinic, and we never used leg veins. Personally, I refuse to do so. It is my perception that the risk of clotting or occlusion is simply far too great in those areas. If a patient needs a blood draw that badly, we can do a radial artery stick, and if they need an IV that badly, they probably belong inpatient, where a central or PICC line can be placed. (I obviously disagree with the person who felt that the risk of harm was greater with an arterial stick). I think we are setting our patients up for problems and ourselves up for liability if we use lower extremity veins. In any case, I would never, ever draw from a lower extremity without an explicit order, to cover myself.