mrf0609

If the patient had a feeding tube due to aspiration issues, then the po route would have been highly inappropriate and could cause significant issues. Most of the time people who have a feeding tube have one due to their inability to swallow for whatever reason. You do not mention why they had the tube but giving meds po when they have a feeding tube is also wrong. Asking for assistance, when you do not know, is very important and will prevent patient injury. If you do not feel comfortable asking a coworker, ask the charge nurse as that is what they are for.

It would appear that "most nurses" prefer 12 hour shifts and the topic should be left alone...

I am am over 50 nurse and come from the horse world where you work 6-7 days a week and the days are often over 15 hours. Plus you were responsible even if you were not there, making it a 24-7 type of job. Nursing is great and 12 hours is a breeze! The best part is not having any responsibility after giving report. I would definitely not do 8s in any way shape or form. Having 3-4 days off a week is fabulous! I have done both day and night and even though they are different in many ways, I would never do eight hour shifts and have to be there 5 days a week! I have fond that eight hour shifts leave no time for anything else and you are tired all of the time! I would certainly balk if 8 hour shifts became the norm! I also am an older single mom, he is 12 right now, with no family support. I was easily able to find appropriate child care for him with no issues. Childcare is not an excuse in my opinion!

We do get decent compensation, if on the A team, they do not expect you to do it out of the goodness of our hearts. If you work in the hospital there are expectations, weekends, emergencies etc,. If one doesn't like it work somewhere else,

As you live in Florida, and work in a level 2 trauma center, I highly doubt that your arm was "twisted". Your facility has a disaster plan and each employee has an obligation to be on either team A, before and during the storm, and team B, after the storm. The reason you can not leave the facility, in the first place is that during the hurricane the facility is on lock down, NO ONE gets in or out. The second place is to ensure that patients are cared for until team B is able to arrive. If you do not like it, do not work in the hospital, it is one of those things, hospitals are 24/7 and especially during the storm, there need to be nurses. You should have had an option on which shift you want, but if you ignored the request to state your preference, they will place you. If you do not show up you will be fired, they can do that. I totally understand your desire to run from the storm, but you are a nurse working in a hospital in Florida. Hurricanes happen and this is standard protocol. Quit now, and save your fellow employees the negative attitude, or suck it up. I am on the A team, my pets will be alone, I worry about my family, but I work at a hospital in Florida and this happens.

On a few occasions I have had the pleasure of taking care of other nurses from my facility. Most are appreciative but there are a few which appear a bit too keen with the dilauded. Makes you wonder...We had one person who was a horrible patient. He has since passed, he was a sick person, but he was the worst patient I have had.

two of my other favorites fake it till you make it and I can do anything for 12 hours!

There are no big deals....

You have stated repeatedly that you do not like nursing, that it is not a good fit for you. Perhaps pharmacology would be better for you, you can use some of your classes towards it. Nursing is a calling, I believe. If you dislike it before you begin you will most likely never like it. I see too many people get into nursing then hate it, at least you figured it out before you began! Best of luck!

Gifts for what? Leaving? I don't think anything is necessary, perhaps a nice dinner out with close associates would do, but I do not feel that you need to provide anything to anyone. Just my opinion.. Best of luck in your new venture! Michelle

You discussed feeling different due to being black and single. My unit has many different ages and races, we all treat each other with respect and get along, creating a nice environment. Perhaps the difference you feel about yourself is self limiting, creating a barrier due to attitude. It sounds like you are not truly vested in your unit. This may be a very good reason why you are not precepting, a negative attitude can really affect a new person. Just a thought.... Best of luck on your new journey!

Not sure you can actually take the NCLEX without some type of specific schooling, even with past experience in healthcare. Know you can test out of classes, but if I remember correctly, my school had to submit information before I could take it....

A big one for me...asked and axed.... There is no x involved in asking someone something...

No, We do not flush with a 25 ml bag post administration. We also do not prime the line with ns. Medication mixed in the pharmacy is often more than ordered dose, if primed appropriately and the pump is programmed exactly as directed, there is often medication left in the bag. If the first dose of a 100 ml bag is hung at 90 mls instead, due to priming, then all subsequent doses after are programmed as ordered. If the original line is primed with ns, then all doses can be given as ordered. We honestly have no policy at my facility, it is how I was trained.

I was taught that even giving any NS or other fluid, as a primary, without orders is administering without orders. I have a few issues with hanging a separate primary line of NS if the patient does not have fluids ordered. First, fluids need to be changed every 24 hours, most of the times when I see people hang a ns primary with an abx piggybank no one ever changes that fluid every 24 hours. The other issue is that many times the patient does not need additional fluids due to other conditions, kidney failure or chf, they do not need the extra fluids given. Often times I find the night nurses tend to hang the small saline bags so that they can run the fluids, albeit slowly, overnight and not have to deal with mapping the patient. Just my thoughts on it, and what I was taught.

My biggest concern is that you state that you inserted the foley until urine return and then inflated the balloon. I was always taught that you insert the foley until the "Y", inflate the balloon and then allow the foley to drop until resistance. If the balloon is inflated in the urethra it can cause discomfort and ultimately ischemia of the tissues. Sometimes men do have bladder spasms, but they are not that common. I once inserted a foley and it actually looped around in the urethra. The urologist said it was not a common occurrence, but it does happen. Prior to that I always thought that foleys in men were the easiest because you can see the urethra, and there is only one hole. Now I take my time to make sure it is inserted properly every time.. Best of luck!!!

As others have stated, L&D is a specialty. It would not be a good way to go into critical care. One year in med/surg will give you the experience that will help you move on to other specialties. I do not recommend going the mother/baby route unless that is where you want to be. Good luck on your path!

I first became an LPN prior to my RN and worked in a hospital as a team. The RN did all assessments and called the MD for orders, since the LPN could not take orders, which I am not sure why... As the LPN I did all med passes, dressing changes and did most hands on care. We had CNAs, but they did the bare minimum and it was allowed. We typically had 8-12 patients. The RN would hang blood and give IV narcotics, some would do more, but most sat at the computer and charted all day. To this day I still get frustrated thinking about the RNs who would not assess wounds, how do you chart on them??? The LPN did have charting, but I primarily wrote a lot of notes. When they phased out LPNs we were told that patient outcomes were better with RN as primary care givers. I think cost is a factor when establishments use team nursing.

But I can be highly aggressive and have had a tendency to speak without thinking causing undo pain and bad feelings. Although I am aware of my communication style, I still believe I am a bully but am working on change. I am not empowered at all by my behavior but nevertheless belittling and demeaning a person is not nice and a behavior I am working on changing...I am finding it ebbs and flows, at times it is worse than others but it should never occur...thanks for your thoughts!

I have not only read your post but all of the comments which follow it. I am not sure that some people get it.. While the situation you discuss is a patient safety issue, it is how you dealt with it, including the feelings you had and projected is what hit me. I can completely relate. You discuss the test you took. I am afraid that I too would have far more than one yes to the questions. Am I a bad person, no.. I am a great nurse and my patients love me but my co workers are not so fond of me. At 50 it is difficult for a tiger to change it's stripes, but it is possible. Often it is how something is said, not what is said and I can honestly feel it sometimes as it occurs... that it is wrong but can not control myself. I have little tolerance for mistakes and patient safety is important, it is not how it often appears. I can be short and abrasive. I can really help a younger nurse, it is the way I say it. What could have been a teaching moment is lost due to the nurse shutting me out because of my attitude. I always say I wish I could just be a nice person, very easy going, and fair to everyone. I am a work in progress, awareness is the first step. Will I ever be that nice person? I do not know, but I can at least try to practice new skills which will help me communicate more effectively. I am passionate about nursing, loud and outspoken, always have been, I just wish I wasn't considered a bully. Thanks for your article, I related in so many ways and can only hope to grow and change to have better relationships on the floor. Good luck to you too!!!

Now that the storm has hit, hope you and your family are doing well. In South Florida we have to choose to be on two teams -A and B, A must arrive when the hospital says, no matter your shift and you must stay until relieved by the B team. If the B team can't make it you are there until.... I decided to pick B last time, it was a huge mistake. It is just my 10 yr old son and I and I was stressed getting everything ready for the storm prior to, stayed up all night, no by choice, but worried about tornados, during the storm then had to go work 12 hours the next day... This year I signed up for A shift because I would rather just stay at the hospital with my son, they offer that, and go home afterwards. Although I have pets, they will be ok, I have friends who will help. If they were calling for a Cat. 5 and it was going to be a direct hit, I do not know what I would do, Andrew was horrible and the damage was incredible. Many things have changed here in Florida = gas stations and grocery stores have generators so food and gas are available right after the storm now, this is as long as they have supply. It is tough, but we have a responsibility....