iamme457

I also have high arches and the less support I have the less pain I suffer. I think the arch is a big part of the shock absorbing system. Good shoes are important, I replace walking or combined training shoes every 6 months. I try to find two pair that are comfortable, this lets one pair air out for a day. I was a farrier before nursing school, I did corrective horseshoeing so I have a unique way of evaluating walking and posture. Stretching exercises are important as are rest periods. We also injure ourselves often lifting, turning and walking on the hard surface of hospital floors and we dont give our bodies time to heal. We just keep on working and do further injury. P RN has a good point, many people also have one leg that is significantly longer than the other.

And the world wonders why there is a nursing shortage. I have been pinched, bitten, scratched, kicked, slapped and punched many times. Most often by confused patients. ICU, Trauma and neuro patients are all a bit crazy sometime during their stay with us. I get offended when family members behave in the same manner. I use security and the local police to deal with them. I think the best experience I had during my training was with a crisis intervention team. These are the people that talk people down from jumping off buildings or bridges, get them to put down the gun they are holding to their head or keep them from harming another person. Empathize, that is the key..get into their mind, feel and see what they see. If we only had the time to do that with our patients every day, maybe the problems wouldnt escalate like they do.

I have never been ashamed of being a nurse. Occasionally I am disappointed of other nurses behaviors and judgements.

Working night shift isnt for everyone and if it isnt working for you definitely go to another shift. We need healthy happy nurses not near dead bodies to count on the census. I work as a clinical coordinator on evening and night shifts. Most of my weeks are a combination of both shifts. I demanded no double shifts and no double back shifts. I still do both occasionally so other co-workers can have the day off they need but not to appease the facility. The stress level in the health care field is bad enough with the added work and responsibilities and less staff, you don't need to have a really incompatible schedule on top of that. As far as how I do the sleep thing, I am a morning person so daylight and evenings dosent present a problem. Nights is another story, I sleep for 2-3 hours in the morning when I get home then I get up and do something I enjoy or feel I need to accomplish so there is some kind of self satisfaction in there. I like to golf and I might add I golf really bad when I am doing it on 3 hours of sleep LOL but I enjoy it. I might ride my bicycle or go out to lunch with a friend. Sometimes just working in the yard for 3 or 4 hours is enough or reading a book that has been sitting on the shelf neglected for weeks or months since purchase. After doing something for me I lay down again for 2 to 4 hours before going back to work that night. That nap before work seems to be my key, I feel refreshed. It wasnt that simple when I had little kids though and I can really relate to those of you trying to juggle a career and raise a family at the same time. After I read this and I realized I do babbly a bit when working nights LOL. Deanna

general guidelines are increase for respirations above 30 and signs of pain, asking for more pain meds, grimacing, restless behavior, anxious behavior, yelling, abusive behavior without being stimulated. I reassess every 5 minutes with a morphine drip as it takes a short time to be effective when IV,then increase as needed. If I see no change I go up again, if I see a small change I reasses in a few minutes then go up again if still in discomfort. I usually go up in 5mg increments each time I assess a behavior of need. Comfort measures means to me, not uncomfortable but not necessarily unconscious. The difficult issue here is personal ethics, are we actually helping or hindering the inevidible death of this patient. I believe in Death with Dignity, that allows a person to die in the manner they are comfortable with. If a patient says just let me sleep, I do that, if I am asked to talk to them I do that too. Just call the supervisor and tell them that your patient needs constant attendance during this time of near death and has requested it. Please send some help for a while until family or someone else, clergy etc can relieve me.

As a volunteer for a local ambulance service I obtained my EMT then my Paramedic prior to nursing school. I worked a 24 hour shift every saturday as a paramedic. If minimum wage is OK then maybe a gas station attendent would work, you can study while you sit in that booth..too boring for me but some have done it. Working in a clothing store works too, you get a discount on clothing and your hours arent that bad, Fashion bug has been quite kind to some nursing students I know as far as accomodating the hours they can work. Also a local mom and pop type owned business/ bar-restaurant or local gas station fast food service place/ You have to find someone willing to accomodate your schedule needs.

As an ADN degree nurse I agree on the financial reasons for becoming what you can afford at the time in money and time involved. Many facilities will assist you financially with furthering your education.

My litman II tubing cracked after 12 years of service, thinking about buying new tubing and getting a new one too. I have another one but it just dosent make the grade after a litman. And yes in all phases of nursing a good stethescope will greatly increase what you hear and can help in what you tell the doc. In nursing homes the units see a doc once a week, the nurses daily.

ty cargal for the added insight, I totally agree with you.

ty cargal for the added insight, I totally agree with you.

This is fun. May I add some mud and put rope around it and sell tickets? Deanna

I thought all the stuff we had to do in nursing school was to help prepare us for what we would face as nurses. I am glad I did take it all seriously as it helped a lot. I went from med/surg to ICU/CVICU to ICU/critical care transport, then to Trauma/Neuro and back to critical care transport for a short time and now supervisior in a large facility with sub-acute/long term care/and alzheimers with a behavioral intensive care center. I learned how to find the answers to questions during nursing school. You won't always have staff that is experienced enough or trustable enough to depend on. I could give you the answers quickly to all your questions and write all your papers, but I cannot lead you through your nursing career. Don't get me wrong, asking questions is a good thing, but learning how to find the answers with the reference material that is available is just as good.

1) PHRN 2)9 years as RN, 6 yrs PHRN(Pre-hospital RN), 12yrs as Paramedic, NA on and off 26 yrs. 3)NE USA 4)not satisfied with pay 5)benefits are adequate right now 6)hours are alright 7)I am a supervisor now but I do not believe most of the other supervisiors have a clue what they are doing. I work in the units once a week and have been reporting supervisors that do not do their jobs. 8) new administrator, not sure yet about this one. The corporation is alright though I trust them. 9)education department had been cut in the past but is doing its job at this time. 10) I love being a nurse, my actual role has changed a few times...that is one of the things I really like about nursing. You dont have to stay in one place. 11)NO 12)sometimes I dont get a break, when I do take a break I still answer the phone and answer pages so the break is usually interrupted. 13)I am relief supervisor so I work all shifts 8's and 12's and 16's. 14)New years, worked everything else last year. 15)against 16)picket but not strike 17)I am just as overwhelmed with work as the rest of the RN's, LPN's and NA's are. I do help pass meds, do dressing changes, take off orders, call the docs, wipe butts, get patients up, put them on the toilet, put them to bed. I am usually exhausted at the end of my shift but I do feel as though I did everything I possible could as one person. Last minute call offs stress me the most, I cannot replace staff on such short notice and I really hate to have to add more work to the reliable staff members who do show up.

GI bleed poop has to be the most gag inducing smell for me. Trauma, ICU, ER, Paramedic....usually the stuff in the field that you have no warning about is what shocks me the most. Jaw dropping, stare for 30 seconds stuff. Decapitations and guns to the head and face give me the willies for a week or so...complete with nightmares for a night or two. It takes a lot of showers to get rid of the smell of something that has been dead for a few days, same smell as those sores that need debrieded only bigger odor. That about covers it for me

I got page not found and I have what is required. Please dont frustrate me anymore

Of course we want to share horror stories. The first week off orientation on a med/surg unit, a busy non-telemetry one I found myself being the only (RN)GN on staff, the rest were LPNs and nurses aids. This was a few years ago but needless to say as a GN I was put in charge. There was a small telemetry unit at the end of our unit so I had to get that charge nurse to listen in on all calls to doctors as I couldnt take telephone orders yet nor could I sign off orders so the next shift had to do that. I could take off the orders and note them but couldnt sign them off. You know what though I did learn to do only what my scope of practice allowed, when the other nurse wasnt available I told the supervisor to cover me or send someone else to do that. I stuck by that by telling more than one doctor that I couldnt take his phone order and he would have to call the supervisors office to do that. I am guessing that since I was already a paramedic they thought I would just do what I was allowed to do under that title....NAHHHH I worked hard enough to get that GN and wasnt gonna lose it before it became an RN. Yeh I could make critical decisions, and I could assess any patient quickly and make suggestions as to what should be done but I didnt have that RN after my name yet. And I didnt have the skills that come with experience in handling a large number of patients and needs. (That is why I went to a med/surg floor first after school and glad I did) I didnt refuse that assignment and I was put in charge more than once as a GN. I felt that I had the skills and ability to perform most of the duties, the ones that I couldnt do involved the legalities of doctors orders. I made sure that there was a note to the supervisor every shift that I would not do those things not within my scope of practice. I also made sure that the staffing sheet in the supervisors office stated who was responsible for overseeing me during the whole time I was there. My nurse manager was on my side the whole time with all these issues and that is probably why I agreed to this assignment more than once. Thats the kinda crap you run into during these staffing shortages. This one wouldnt be so bad except that 50% of the nurses working now will be the patients in the next 10 years and no one is there to replace them. This baby boomers thing has messed up the higher-ups hasnt it?

Of course we want to share horror stories. The first week off orientation on a med/surg unit, a busy non-telemetry one I found myself being the only (RN)GN on staff, the rest were LPNs and nurses aids. This was a few years ago but needless to say as a GN I was put in charge. There was a small telemetry unit at the end of our unit so I had to get that charge nurse to listen in on all calls to doctors as I couldnt take telephone orders yet nor could I sign off orders so the next shift had to do that. I could take off the orders and note them but couldnt sign them off. You know what though I did learn to do only what my scope of practice allowed, when the other nurse wasnt available I told the supervisor to cover me or send someone else to do that. I stuck by that by telling more than one doctor that I couldnt take his phone order and he would have to call the supervisors office to do that. I am guessing that since I was already a paramedic they thought I would just do what I was allowed to do under that title....NAHHHH I worked hard enough to get that GN and wasnt gonna lose it before it became an RN. Yeh I could make critical decisions, and I could assess any patient quickly and make suggestions as to what should be done but I didnt have that RN after my name yet. And I didnt have the skills that come with experience in handling a large number of patients and needs. (That is why I went to a med/surg floor first after school and glad I did) I didnt refuse that assignment and I was put in charge more than once as a GN. I felt that I had the skills and ability to perform most of the duties, the ones that I couldnt do involved the legalities of doctors orders. I made sure that there was a note to the supervisor every shift that I would not do those things not within my scope of practice. I also made sure that the staffing sheet in the supervisors office stated who was responsible for overseeing me during the whole time I was there. My nurse manager was on my side the whole time with all these issues and that is probably why I agreed to this assignment more than once. Thats the kinda crap you run into during these staffing shortages. This one wouldnt be so bad except that 50% of the nurses working now will be the patients in the next 10 years and no one is there to replace them. This baby boomers thing has messed up the higher-ups hasnt it?

I agree with you, it is just plain bullying. Angry people taking out their frustrations on others. As a supervisor I am really getting tired of smoothing things over for all you bullies. It is hard enough to find staff on a good day so why are you so nasty to your co-workers? Havent you noticed that many times about halfway through your shift someone gets sick and goes home? And every time you are scheduled to work more than two days in a row half of the nurses aids call off sick on the third day? It is also difficult to schedule everyone else as they wont work with you more than 2 days in a row. If we do schedule them more than 2 days with you they call off. The last 3 people that quit, one nurse and two aids did so directly related to the way you treat them, they found another job quite easily. So you know what???? I really dont want to hear that you are short staffed and you want me to pull someone from another unit to help you because you did it to yourself. Oh yeh, you have been spoken to about this and you just will not or cannot change. No we arent going to fire you, but we are looking forward to your resignation. Just Venting

I agree with you, it is just plain bullying. Angry people taking out their frustrations on others. As a supervisor I am really getting tired of smoothing things over for all you bullies. It is hard enough to find staff on a good day so why are you so nasty to your co-workers? Havent you noticed that many times about halfway through your shift someone gets sick and goes home? And every time you are scheduled to work more than two days in a row half of the nurses aids call off sick on the third day? It is also difficult to schedule everyone else as they wont work with you more than 2 days in a row. If we do schedule them more than 2 days with you they call off. The last 3 people that quit, one nurse and two aids did so directly related to the way you treat them, they found another job quite easily. So you know what???? I really dont want to hear that you are short staffed and you want me to pull someone from another unit to help you because you did it to yourself. Oh yeh, you have been spoken to about this and you just will not or cannot change. No we arent going to fire you, but we are looking forward to your resignation. Just Venting

Hummmmm, need info today. Did you get this assignment today? I will answer one of your questions though, you would be a part of our typical day. Waited till last possible near death moment to go to the doctor. Now you are near death in the ICU, you and your family want everything done...NOW...it is your right as you are paying for it. You had a high fat diet with lots of eat out fast foods, you are overweight and dont exercise. Your family is irate that we are not answering your questions quickly enough, and they (all 4 generations) are on the phone telling us that. We havent been able to get into your room for more than 5 mins at a time because of family phone calls. Last time you went to the doctor was about 12 years ago for a bee sting. You were advised to have a follow up visit for a high blood pressure and a slightly high blood sugar but because you felt OK you didnt make the appointment. You know....doctors are only after a few more bucks from the insurance company. Charging for visits that make no sense to you, you feel fine. Today though was the last straw, a totally healthy person with indigestion when they are stressed is now not able to even stand up due to chest pain that makes you vomit. The nurse has to tell family that you need open heart surgery but because of a blood sugar that is around 600, you need a few days in ICU first to control that. Later in the night we call your family to ask if they would like to come in to be with you. You have suffered a very large heart attack and probably wont make it till the morning. Sobbing and still angry at us for not fixing you in the first place, 14 family members arrive at 3:45am, one has a small child in tow and you want blankets and pillows to use in the waiting room. At this point we take turns talking to your family members as you have really stressed us out. We are understanding of your grief but we do have a lot of other patients to take care of too. You respond to our taking turns, so a fresh non-drained person talks to you and counsels you as to dealing with this impending death by going to the adminstrator that we are so indifferent as to not give you the same person everytime you need to talk. Mind you this is after 3am. Your perception is we are passing you off, a dump job...mind you, each and every request has been met including the blankets and pillows and even a carton of milk for the kid and some cookies (ICU patients are usually intubated so we dont get extra food from the kitchen) we went to another unit to get that for you. And this is probably a good night as there was enough staff to take care of your family along with the patients.

Hummmmm, need info today. Did you get this assignment today? I will answer one of your questions though, you would be a part of our typical day. Waited till last possible near death moment to go to the doctor. Now you are near death in the ICU, you and your family want everything done...NOW...it is your right as you are paying for it. You had a high fat diet with lots of eat out fast foods, you are overweight and dont exercise. Your family is irate that we are not answering your questions quickly enough, and they (all 4 generations) are on the phone telling us that. We havent been able to get into your room for more than 5 mins at a time because of family phone calls. Last time you went to the doctor was about 12 years ago for a bee sting. You were advised to have a follow up visit for a high blood pressure and a slightly high blood sugar but because you felt OK you didnt make the appointment. You know....doctors are only after a few more bucks from the insurance company. Charging for visits that make no sense to you, you feel fine. Today though was the last straw, a totally healthy person with indigestion when they are stressed is now not able to even stand up due to chest pain that makes you vomit. The nurse has to tell family that you need open heart surgery but because of a blood sugar that is around 600, you need a few days in ICU first to control that. Later in the night we call your family to ask if they would like to come in to be with you. You have suffered a very large heart attack and probably wont make it till the morning. Sobbing and still angry at us for not fixing you in the first place, 14 family members arrive at 3:45am, one has a small child in tow and you want blankets and pillows to use in the waiting room. At this point we take turns talking to your family members as you have really stressed us out. We are understanding of your grief but we do have a lot of other patients to take care of too. You respond to our taking turns, so a fresh non-drained person talks to you and counsels you as to dealing with this impending death by going to the adminstrator that we are so indifferent as to not give you the same person everytime you need to talk. Mind you this is after 3am. Your perception is we are passing you off, a dump job...mind you, each and every request has been met including the blankets and pillows and even a carton of milk for the kid and some cookies (ICU patients are usually intubated so we dont get extra food from the kitchen) we went to another unit to get that for you. And this is probably a good night as there was enough staff to take care of your family along with the patients.

I think my biggest pet peeve about new hires....Hummm, I like to orient new people. Only a few things have ever bothered me about any nurse though one is a fear of body fluids. In ICU and really any area of direct care nursing you are going to have to locate where it came from, describe it in detail (odor and texture included)and measure it hourly. Occasionally you need to wash it off the bed, side rails, walls and floor. Another is lack of compassion and the inability to empathize in any way shape or form. And last but probably the most annoying; Not believing a patient that says they are in pain..pain is and always will be a personal perception thing.

I think my biggest pet peeve about new hires....Hummm, I like to orient new people. Only a few things have ever bothered me about any nurse though one is a fear of body fluids. In ICU and really any area of direct care nursing you are going to have to locate where it came from, describe it in detail (odor and texture included)and measure it hourly. Occasionally you need to wash it off the bed, side rails, walls and floor. Another is lack of compassion and the inability to empathize in any way shape or form. And last but probably the most annoying; Not believing a patient that says they are in pain..pain is and always will be a personal perception thing.

All valid complaints need to be put in writing, dated and signed. The supervisor and DON/ADON can then have a chat with the offender and the complaintant.

Did you accept this position or were you told you were to fill it? I have a millions questions for you but dont really know where to start. A DON job is a lot of work, it is something someone has to really want to do. Do you get along with the Administrator? and do you know the Board of Directors and their stand on issues? What are your current staffing issues and when did state last visit your facility and how did it do? How big is the facility, how many beds, are there any certified medicare beds? What type of support staff do you have, RNAC, Infection control, restorative, OT/PT, wound control, instructor, ADON, how competent are your supervisors, is your Medical director a reasonable doc to talk to. We could go on and on I guess. I cannot make any suggestions except to look into these areas and then maybe I could help out more.