metabolicfrolic

I love, love, love these posts from floor RN's who come down to the dark side, the ER. I wish most floor nurses could work a shift or two down here, just to see what it's really like. Over the years, my favorite "new" nurses are floor nurses who've taken a FT position in the ER. It's really gratifying in this odd way to hear them marvel at how fast we work and how the work (i.e. patient care, work-up, med admin, discharge) NEVER stops. And just when you think you might be slowing down, BAM a gunshot comes in. Or an MI. Or etc etc etc. One of my friends is a oncology RN. She was saying "Oh I hate shifts where I'm also the charge nurse because after I finish my assessments and med pass, I don't get to put my feet up and read a magazine." My eye balls nearly fell out of my head.

Time away from work is always helpful. Use that time wisely to do the things that nurture you, whatever they are: painting, exercise, yoga, church, family time, going to the movies, a cooking class. You get the idea. Taking care of other people and never yourself is bad news. Nurture those non-nurse parts of you. Interestingly, I find I have more to talk about with my patients when I can make good small talk about stuff outside work. Nothing like distraction about the latest football game during an IV start to help distract my patient. The very nature of ER work is stressful and our patients can very well suck the lifeblood out of us if we let them. It definitely took some time for me to take a step back and say to myself, "I am dealing with a manipulative patient. They need to be told 'no.'" Consider what behaviors are bothering you and then learn how to set boundaries for those behaviors. In the ER there are definitely times to "let it roll off you back" and there are times to address bad behavior. Consider that. No one deserves to be treated like crap. I'm always working on this. For me personally working a million hours a week leaves me tired and cranky and unable to deal with things as well as I would if I were fresh and rested. I limit the amount of OT I work because it will negatively affect my patient care and my ability to handle ****** situations. I find that I'm at my most burnt out after working too many shifts in a row. If you can't change your environment, change your shift. Switch to days. Switch to nights. Work fast track. Work triage. Different crew, different atmosphere. I work in a relatively large setting and can request to work in a different part of the ER. I can also request to have a different work-buddy - the RN who works in the rooms beside or adjacent to me. Talk to someone you work with about the burnout. If they've been there for awhile they've been there too and might have some practical suggestions.

New Balance 927's are the best. They will definitely exceed your budget (about $109 or so), but good shoes are worth the investment. I cannot stress that enough. I bought some $50 clogs on sale and started clinicals with them, but one year in realized I should have sprung for the better shoe to start out with. Makes a world of difference!

You all should be hearing any day now. The committee met last week. The spring semester begins Jan. 3rd.

I find the color safe bleach (Clorox 2) to be fantastic at getting the color to stay. I primarily wear Cherokee and Urbane scrubs, and the color looks stays brighter.

Here's a don't - The watches made by NurseMates get water in them! While water resistant is printed on the back, this may be referring to the "guts" of the watch and not the face. I'm the type to wash my hands and forearms THOROUGHLY after a run in with poop, vomit, bodily fluids (oh my!), and this watch is collecting water in the face. Condensation and water droplets obscure the second hand. This is just no good. I'm hesitant to get a Wal-Mart cheapie for that very reason. Fabric and leather are no-no's. I prefer the plastic variety (see my vigorous hand/arm washing routine above) because you can wash the band and swab with an alcohol wipe when necessary. Still searching for the perfect watch. I've got a few on my amazon wishlist to try.

Hey there, it's no wonder you're frustrated with the team nursing approach. I don't blame you one bit for feeling the way you do; for it to work, the group must function as a team! Do you have a good relationship with the unit manager?

I came from management in a medical practice. My frist degree is a related healthcare degree, not a nursing degree, and the powers that be decided to eliminate my job. During my years there I was constantly amazed at how much more $$$ the nursing staff made than I did. (I stayed because of the promotions and the promise that upper management would eventually out-earn the nursing staff. That didn't happen in my almost 6 years there.) Not only that, but the nursing staff worked a consistent 5 day, 37.5 - 40 hour week. In management, I worked a whole lot more than that, frequently 6 full days per week. So it made a whole lot of sense to suck it up and return to school for a nursing degree.

During lecture note-taking, I'm a pen snob. My handwriting is better when I use gel pens, anyway. Love me some Pilot G-2 0.5 or 0.7, or the uniball vision 0.6. Once you buy the pens you'll only need to purchase more refills (read= cheaper)! I do use a cheapie ballpoint pens when I add notes from reading the chapter so I can differentiate what notes the instructor gave versus what I thought was important from the book. Non-smearing highlighters, several folders are always a good idea!

I took over my husband's desk! (This is but one of the many things he has sacrificed so I can go to school full-time!) Not only is his desk bigger, his computer monitor is too, which is so much better than using my tiny netbook for practice NCLEX questions. I also pretty much took over the front room in our house. Sometimes I switch spots and study at the kitchen table. Less distractions with no computer.

I am a total believer in compression hose. 10 - 20 feels best to me. They make a big difference in how my legs feel after a long shift. Over the years I've purchased all different kinds: the white nursing hose, knee highs, socks. For the most support, obviously that award goes to the hose, but being someone who is constantly running around (read: HOT) those make me uncomfortable with a quickness. Tights make my scrub pants fit tighter, and that's not a good thing either. The most supportive non-tights are a pair of navy ribbed trouser socks. I think they are these (no navy option at Marcus): http://www.marcusuniforms.com/Prestige-Medical-Womens-Compression-Socks-P3238.aspx . In fact, I have them on right now! For the OP, I'm short too - 5'2" or so, and these aren't too long. The only drawback for me is that I usually have to wear a pair of socks over the foot as these are thin. I also have these, but they aren't quite as supportive. They are a bit too long for me (http://www.marcusuniforms.com/Nurse-Mates-White-Dragonfly-Trouser-Sock-P4398.aspx)- the tops come over my knee caps and I have to fold them over a bit. Definitely call around and see what your local uniform store has in stock. I wish more nurses knew to wear these! They will save your legs!

Second! Potter and Perry was pretty craptastic. At my school they find a way to make this course (unbelievably) hard. We had two classes, Fundamentals and Pharm, and the majority of people who failed had issues with Fundamentals and not Pharm. We took Fundamentals for 16 weeks, but it seemed like FOREVER. (Somehow my classmates kept remarking that the semester was "flying by"... right...) I kept waiting for it to get better, but it's consistently a pain in the rear. There were moments were it wasn't horrible, but they were few and far between. I passed the time by memorizing the book and marking off days in the calendar until the summer semester finally arrived.

Good question! A thick pair for sure. One with reinforced, padded toe toe is best. (Champion socks work great for me.) I have several different types of socks depending on which shoe I wear, and when I make this mistake of wearing my thin, cool, wicking bamboo socks with Danskos I can almost rub a hole in the toe of my sock! I don't know if it's me or not, but wearing thick socks prevents this and is more comfy overall. Danskos aren't known for being the most cushy shoe, but they're great for posture!

It is a very good program, but can be very hard at times. We are down to 30some folks after the spring semester. They had a 100% first time NCLEX pass rate last year!

Aromatherapy works for me. Peppermint is so stimulating. I burn peppermint essential oil or light a peppermint candle. Peppermint herbal tea is also a refreshing pick-me-up. Redbull is awesome, but I don't drink it every day. It's a great mid-afternoon pick-me-up when you're sleep deprived and HAVE to concentrate.