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decembergrad2011 BSN, RN

Oncology
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decembergrad2011 has 12 years experience as a BSN, RN and specializes in Oncology.

decembergrad2011's Latest Activity

  1. decembergrad2011

    Why do some nurses hate it in others pump at work?

    I breastfed my daughter until 2.5 but stopped pumping at 1 year. Most women who do extended breastfeeding and work tend to give up the pumping sessions.
  2. decembergrad2011

    Why do some nurses hate it in others pump at work?

    On a 12 hour shift, I would pump 4x for the first 9 months. At 9 months, I dropped to 3x, then at 10 2x, then the last month was spent only pumping once halfway through my shift. I plan to do this again. People had problems with it because it was impossible for anyone to take a break some days unless they literally said, "I'm taking a break, bye" and went away. I was protected by law and my baby was a priority, too, so I made sure to take my breaks even if my day dictated that they were brief. However, I didn't take any other breaks where I was unavailable, including my lunch breaks. I would often let my food grow cold as I attended to something, or would eat while charting. I did start allowing myself uninterrupted breaks again when I dropped pumping sessions, but I think that minimized people thinking I was getting extra breaks. Now, I try to be an advocate for pumping nurses and offer to watch their patients while they pump. I am thankful to those who did the same for me.
  3. We're scared, too. Many of us never believed our country would fall so far. I am currently trying to convince my husband to draw some lines in the sand for what we will stand for before we leave the country. We are hoping so much that Mueller can do something through this investigation to restore justice and order, as I am still not convinced that Trump was the will of the people.
  4. You cannot be scientifically minded and say, "meh, big deal" about this recent revelation. However, I also believe wholeheartedly if you read this news and say, "meh, big deal" you are part of the problem anyway.
  5. decembergrad2011

    a small gift to preceptors

    Gifts are always appreciated. I haven't received them from licensed nurses, but from almost all my nursing students. But one of my favorite students I've ever precepted is the only one so far that did not actually get me anything and I didn't think about it negatively. They usually would get me Starbucks gift cards, a nice handwritten note, and maybe a trinket like bath bomb or candy. Things that were inexpensive and practical and sweet. The meaning behind it was awesome, and my favorite part is ALWAYS the cards. :)
  6. decembergrad2011

    Many nurses do not chart?

    Sorry if I'm stating the obvious, but is there a policy to follow at your institution? For example, I work in progressive care with telemetry patients and our charting requirements are different than those of the acute care floors, but also the ICUs. I would look for this policy and follow it for your basic guideline for your daily shift charting. When there is a decline, a change, or even if I contact the doctor and it's not obvious that any action had been done (i.e. sys blood pressure is getting close to 180 but doctor just wants to recheck in an hour and continue monitoring for now, so there is no new order in place) I make sure to chart my action because I want to make it clear that I was aware and took action. Sometimes this is lengthy or requires going back and documenting every time I notified a doctor to establish that I was appropriate in following up, but that usually is for extreme circumstances.
  7. decembergrad2011

    I'm having doubts about nursing... :(

    I already said it was the first day and to let it go. I also explained why I did not think placing with a CNA preceptor was an acceptable practice for an ongoing RN clinical experience because that was a topic of debate within the thread.
  8. decembergrad2011

    Do you feel more people are entering nursing only to become APRN's?

    I am talking about the nurses that I personally work with on my floor that I have seen go through graduate school. I work with them and see the things that they miss and the gaps in their critical thinking. They are where I would expect 2-3 year experience RN's to be at, and I am not saying I was any further along at that point in my career. However, you do not even know what you do not know until around two years, and that's if you stay within the same specialty. They will be fine with experience like most people, but I do not think that 2-3 years of experience total working as a nurse in healthcare is enough to draw upon for the practitioner role. I'm in a 5 year part-time DNP program because my family needs me to continue working FT. A full-time student can complete the program in 3 years total from a BSN. I'm okay with it taking 5 years because it gives me the opportunity to continue learning and the time for a really good research project.
  9. decembergrad2011

    Do you feel more people are entering nursing only to become APRN's?

    I think that you need experience to be an advanced practice nurse in any capacity. I entered my DNP program with 4 years of inpatient med-surg oncology experience, and will finish the program with 9 years total as a nurse (planned to stay on the same floor). However, I work with many co-workers who will be graduating with an advanced degree with barely 3 years of experience total before going out there. Most of them started their degree program with less than a year of experience, sometimes just the summer between graduating with their BSN in the spring and starting grad school the following fall. They are not ready, in my opinion, to be independent practitioners at that point, but it is not their fault that programs will accept new graduate BSN students into the next semester's course. Some of them are definitely pushed by their universities to aspire to an advanced degree, if not necessarily to become a nurse practitioner.
  10. decembergrad2011

    I'm having doubts about nursing... :(

    I would have been annoyed about being paired with a CNA as well. When I was going through CNA clinicals, I expected to be paired with a CNA and see that role in its entirety. However, the RN role is much broader and requires a different skill set that includes the skill set of a CNA. I can understand their desire to allow the students to shadow CNA's in early clinical settings for the purpose of learning basic hygiene, bed changing, and mobility (and a whole lot more) if they do not require them to go through a CNA licensure prior to starting their clinicals. However, that should not be the norm for a med-surg clinical in any respectable nursing program. If there are not enough nurses to go around, the clinical instructor should facilitate learning by taking a small group of students themselves, splitting them into teams, assigning multiple students to one patient for parts of the day...there are just so many more creative ways to allow students to get an idea of the RN experience rather than being another body performing hygiene tasks. Yes, these tasks are important. Yes, the CNA role is important. But that does not change the fact that placing a student nurse with a CNA is not allowing them to see the delegation, prioritization, and coordination that a registered nurse performs in the hospital setting on a daily basis. While yes, you may have to be your own CNA for patients due to short staffing, you still are responsible for the duties performed by the RN. One clinical - I would let it go. But I would not allow myself to be placed with a CNA the next clinical without speaking up, especially if they are not rotating the nurses around. We had anonymous evaluations every semester - if you do, I would also make sure to note that this occurred in your evaluation and how you felt honestly. Schools do make changes, including clinical site changes, based on evaluations if multiple people speak up.
  11. Watching the abbreviated video made me sad. Watching the full version made me angry. There is no justification. Although, we knew we had a cancer growing with the police force if we were listening to people of color who were seeing it and providing us evidence of it happening in their communities. The only positive out of this situation is awareness of the corruption and brutality that is silently accepted by police and steps to prove it is not okay. Legally, she was expected to stand there without protest while he moved her body. In fact, she was supposed to comply with his "arrest" and then let the law figure it out later. That infuriates me even if I don't have a solution. HE SHOULD NEVER HAVE TOUCHED HER! The fact that he was not placed on administrative leave until after the public leak is ridiculous. He needs to be held accountable by being let go. Let him have his early retirement, whatever, if this is the first and only incident and chalk it up to PTSD. But if he has a pattern of being involved in "situations" like this, then the appropriate departments need to take measures to ensure justice where he was involved and negatively influenced others with unlawful actions. I also believe he is a sociopath, but that is a gut feeling based on only 20 minutes of footage and a few hours of internet perusal.
  12. decembergrad2011

    Antecubital vein for chemo

    If they need it for chemo when I go to start a peripheral IV, I attempt to stick it in the forearm, avoiding wrist and AC. I'm not real keen on giving chemo through a peripheral IV because *many, many* times I've not been able to get blood return after the initial placement, and other times I've been able to get it at the start of chemo but not at the end.
  13. decembergrad2011

    Giving report/day shift probs

    Make sure you have a report sheet that reflects your patient care area. As a general rule, chief complaint and primary diagnosis, along with current treatment plan, is what I start with when I give report. Example: Mr. S is a 56 year old man with newly diagnosed AML on day 3 of 7+3 induction. That tells so much about everything and is important for EVERY oncology nurse to know. I'm not perfect but I have not had a good day if I do not know that information about my patient! IV access, mobility, toileting, cognitive, and VS that are not normal should be discussed as well. On my unit, we report the labs to each other because we give blood and electrolyte replacements based on those values. History is important but nitpicking is not helpful. I assume things were normal if they were not discussed. I do my own assessment so it doesn't seem important to tell me everything was normal. :) I will ask a question at the end of report sometimes but I move on if the person does not know. However, if I ask a question and you hem and haw about how you don't know and how you had the busiest night ever and blah blah blah, then you are the one making more out of it. I can only speak for myself, but I move on and look it up if I need to know. I also don't make a big deal about it if a nurse asks me a question at the end of report or if I am being disorganized in my report - I either answer or admit I do not know the answer and we move forward. I remember this feeling a lot more hostile when I was a brand new nurse. Likely because there were times that I did not know things that I was expected to know by people who had been there longer. I find myself having a subconscious list of things I expect my peers to know now that are much more natural to me. Good luck! Try to look at it as a learning experience. You could also try this line - "I'm not sure - is that something we usually pass along in report?" It is also important, very important, to remember that day shift and night shift can be two different beasts depending on the unit. You typically do have much more time to organize your thoughts on night shift. I have worked both on the same unit within the same week on a regular basis so I know that on my unit, night shift usually gives more time to read through notes and catch small details. Day shift may not have that same opportunity. It might not apply to your situation, but look at ways to collaborate with your coworkers rather than fight with them. I like the idea of a standardized report - in general we give reports similar to each other on our unit.
  14. decembergrad2011

    Graceful way to NOT answer all the personal questions my patients ask me.

    My answer is going to be a little different. I'm also down south, so people are open and friendly and most of the time think that you have the same perspective and/or lifestyle as they do if they are asking. They also get easily offended if you don't answer them, lol. I say answer the question, but do it in a brief way before springboarding directly back into patient care. That's usually how I handle it if it's a question I feel uncomfortable answering. For me, usually it deals with a religion or political question when I know my honest answer will not be received well. Example 1: Patient says, "I can't believe people think Trump is doing a bad job! Who did you vote for?" "This election was so crazy and polarizing, huh? I feel like everyone has a strong opinion on the outcome! Oh, look at your dressing here, looks like it's coming loose. I'm going to go get the supplies to change it." Example 2: Patient asks, "What's your religion?" I reply, "I am a member of ____ Church. What made you think about religion today?" Second one is not a lie even if I haven't gone to service in a decade, and recenters back on the patient. That's usually my way of handling it because I'm a floor nurse and my patients have a longer length of stay (so I may be assigned them again in the future) so it keeps the rapport. I agree about the blunt "I'm a professional so I can't divulge" response being a bit much for some patients, even though I also believe it is perfectly appropriate, especially if you are backed into a corner where you feel the questioning is affecting your care delivery.
  15. decembergrad2011

    My worst fear come true.

    4 years later and I have precepted several students and new nurses of my own. I still come back and read this thread to remind myself of two things: 1. I am not and never will be perfect, and 2. I can persevere and overcome. Love to you students.
  16. decembergrad2011

    You know the shift is gonna be a hot mess when ...

    If no one is at the nurses station when I walk on, and report doesn't start until 7:15, I'm scared for what the shift has in store.