annmariern

"I've got that Immaculate Degeneration". Guess Catholic school never leaves you.

It is sad that in the most developed nation on earth, the old are subject to this at the end of life. This place pays the CNA's well $14/hr. The nurses $28. 10:1 ratio which is comparable to the hospital. Just seems to me, to prolong a life that has no quality, is cruel. We pump meds into people. Why? I had one lady with contractures and decubs who just repeats "please god just let me die" endlessly. Hard to see.

Get out. 120:1 unheard of to me. But that is no way normal. Get out now.

So; after 32 years as a nurse, 13 on a very busy med/surg unit I was burned out. Took time off. Thought LTC might be a little bit less intense. Was I ever wrong. 5 day hit and miss orientation, third day I get 30 demented patients with so many meds my head is still spinning. Half have no ID, so its guess the patient when meds are concerned. Most meds seem to be OTC stuff. Massive amounts. Quality of life zero. I could not hack it. The staff I have to say were amazing, came in unasked and helped me, but even so I was overwhelmed. Most of them are LPN's, the ones hospitals don't hire anymore. Let me tell you, these people are amazing. Same goes for the CNAs. I have a whole new appreciation for them. I always did, but this experience has opened my eyes. It disturbs me that in 2017, 30:1 for vulnerable people who need care, meds and treatment, that's an ok ratio. It isn't. Even California, land of ratios don't bother with LTC. They are still paying for a service, there is still need for care. Being told "just go in your diaper" instead of taking them to the bathroom. Its been an eye opener and a humility wake up for me; But is it just me, or is it time it changed? Just because they are old, DNR, etc, does it mean they get crappy basic care? Does the nurse need to be standing for 14 hours because there really is nowhere to sit and chart? Long term care gets a bad rap. It deserves more, as do the staff and nurses dealing with some of the most difficult patients in healthcare.

This reminded me of to this day mystery theft of an entire Christmas Dinner when I lived in a nurses residence. A group of nurses got together and created a feast for themselves, large turkey in the oven and all. The kitchen was a bit of a walk from their rooms, when the timer went off for the turkey and they went to get it out of the oven...yes, the turkey and all the trimmings and desserts vanished. Everything closed of course, so no takeout options. A lousy trick. Personally I would have sniffed my was along every hallway, outside every room until I found the culprit. They never did find out who did it. Dried foods became pretty popular after that.

Hearing this story more and more; I worked with a new grad ADN who owes $45,000 for her LPN/ADN. She came from Cuba, had to earn and learn, hence the LPN. Now she is finding the hospitals are requiring BSN or that she be enrolled or they wont give her more than PRN. She is now a single mom. She's been quoted as much as $50,000 and 3 years to $9000 for her BSN. Now she's having issues getting schools to take her previous credits. Some of these Schools are providing lousy education and massive debt. Depressing actually. I read an article that it is impossible to qualify enough BSN's in time to make up the shortfall for retiring RN's and people leaving the profession. So making it expensive and difficult seems to make no sense at all.

(Sorry about the long post and bad grammer. Hopefully I will have time to edit once I get out of class I am assuming this is a nursing school class? So the very first thing that struck me was why you are on the internet instead of paying attention to your teacher? I'm saying this after talking with a very experienced LPN that has been forced back to RN school (or be fired) and is amazed that in class he sees a lot of people playing on Facebook etc. The only time they pay attention is when the information might be part of a test. Not interested in the theory, rationale, just in passing the tests. This explains a lot of new grads lack of basic information we are seeing lately at my facility. They treat the job as an extension of nursing school. It isn't. Its a job. I'll leave psychoanalysis to others. But if you don't want to be a bad nurse, start by paying attention to the people your paying large amounts of money to teach you. Just a thought.

They seem to be betting on a sense of fairness and honesty. Good luck with that today. The woman in the article was mad because she had to pay $100 up front, a pretty normal thing. So she had apparently successful surgery, but got not just her copay back but $50 more. Yes; smart. Forget all the care, the successful surgery, her tray was late? Insanity. Further instilling the hospital is now a hotel mentalliy that is killing us.

That's the dumbest thing I have read in a while. It is unsustainable. I wanted to know how the ladies herniated disc surgery turned out? If she ever got over the trauma of having her tray delayed? This is why experienced nurses are giving up bedside nursing; it just isn't actual nursing anymore, the priorities are all wrong.

my first thought too. No they don't usually bleed at all. But low platelet count, common with chemo patients and that would make sense.

I have been approached several times by former patients at the store, etc to tell me thanks for my care. I have had a patient send me a friend request on Facebook, I declined, just too awkward. Only one time I met a patient outside of work; it was a 90 year old, sharp as a tack who insisted on buying me lunch after she went home. It meant a lot to her so we did, at the end hugged, wished each other well and that was that. In general I would say it is a bad idea for many reasons. That one time, I don't regret it, but I did worry about it beforehand. Social media has made this more than a little harder to navigate, I have colleagues who happily have former patients on FB. One married and went on to have 6 kids with a former patient. But I have to say its wise to have boundaries. Some patients we just don't forget and maybe they don't forget us either. Better to wish them well and let it go, than deal with a friendship that starts on unequal footing go bad and deal with that hot mess.

Lot of new grads on my floor lately fall into two categories. The know it all, nothing is their fault, everyone is supposed to take care of me kind. And the ones that are polite, ask for help and advice, thank you for it and come and see if they can help you out if you've helped them. The latter are the ones who get the help. We all started in your shoes. I clearly remember that helpless feeling. Nursing has become so much more complicated. My advice, accept your not going to know everything. Spot the people on your floor, even the cranky ones who have experience and use it. Using the criteria listed above. You can not do it alone. And give yourself a break, never forget we are all always learning something new.

I once got report from another unit for a transfer. 35 year old woman, came from the Er went unresponsive a couple of hours ago........what? Stop right there? She came in A/O x 3 and now shes unresponsive and your sending her to another med/surg floor because we have tele? I have had several ED pts come and immediately had to call to go to ICU. Several PACU pts come and found mysteriously their BP bottomed out on the ride up, their temps at 95, or hypoxic and needing to be vented. Not just your hospital. And yes, it is scary.

Not bitter or angry. I hate having to be embarrassed to be a nurse. A career I have given 30 years to.

Every time I log on here see such a thread. Well let me see. My hospital has recently decided to hire only new grads or people who were new grads and worked in nursing homes etc. I have been amazed at the attitudes. Some signed contracts and got sent to an area that's apparently low rent. Med/Surg is not sexy enough apparently. Just this months some of the fun the "nasty nurses" have to fix. The heparin drip that gets shut off because the patient wanted a shower. The nurse who called the doc several times overnight for a patient with a low bp, bolused fluids and gave 40 mg of lisinopril at 6am "because its was ordered". The patient with an NG tube clamped, who spent 12 hours pucking and it didn't occur to them the hook him up to suction. The trach pt gurgling, in distress, because the nurse didn't know she was supposed to suction him and then criticized the day nurse for her technique in suctioning. Holding IV antibiotics because the pt was NPO, but continuing the PEG tube feed, so surgery was delayed and I had to explain to the surgeon. OK we all had to learn but really? We have the new grads coming up stating they don't have time and you have to start their IV, pass their meds, you have to do it. Meanwhile holding their lunch they had time to go get on the other side of the hospital at 11am and leaving at 7.30pm while your there till 9.30. It's a if they are still students and the other nurses are their assistants. You go to help and never get so much as a thank you. Just complaints if you so much as try and point out what they need to do to take care of the patients. The word Entitled comes to kind. Not all of them we have some new grads that are willing to learn, grateful for the information. And then this this whole new breed. Is it me? I remember my new nurse days, the crusty nurses who were hard on me but to whom I owe so much. I became a much better nurse because of it. Yes it was hard at the time, but I would never have behaved the way I am seeing now. Generational thing no doubt. But as the as one who is cleaning up the mess, enough. This job is hard enough.