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With the current events and everyone being SO polarized and offended about EVERY little thing.......you never know when you will stumble upon a controversial topic. I work in a small infusion area....the patients will have discussions among themselves and attempt to "draw" you into the convo. I say NOTHING or if asked, I politely say, "I don't discuss politics at work". Usually the convo stops, but if not, that's okay too, I just DO NOT engage!!!

I agree with others here who have said they NEVER identify themselves as nurses when seeking care for themselves or a family member. I have ALWAYS wanted to respond to the "I'm a nurse!" comment.....with something like....."well that's awesome! Then you should totally understand why I need to do X, W and Z for your loved one now, instead of stand here talking about YOUR nursing career". Don't worry....it's only in my bubble, have never actually done it

I wasn't aware until recently, that "private" smaller free standing infusion areas are held to different standards than larger, hospital affiliated centers. Not exactly sure what the standards are. I know the nursing staff must be trained in compounding, to be able to mix the medications. I would also think chemo therapy certification of SOME type would be necessary if administering Rituxan. Sounds scary though, compared to the infusion area I work at!!

I am at the top of the career "hill" looking down, rather than the trail leading TO the hill......Sometimes folks are unfriendly and not helpful just because that is the kind of people they are, age is not even a factor!! Yes, there is a little truth to the old vs new nurses stuff......both groups have their issues to work through and do their best on most days. MUTUAL RESPECT and kindness go a LONG way to cut through so much of it. We all need to be kind,understanding, and patient with one another......especially when it is really difficult.:cheers:

SO TRUE!!! If only we were't working against our body's natural rhythms....that is what I worry about. Long term fall out from working nights forever is questionable. It IS my family though and I love the climate of the hospital at that time. Stupidest thing I hear a lot...."oh....you work nights. That must be so nice because the patients are sleeping all night". ARE YOU KIDDING ME???!!!! CHEERS to all my fellow night shifters everywhere

I LOVED this book!!!! I just returned from camp after caring for about 80 high school marching band students in northern Michigan. I was there with them for a week. Had a BLAST!! It is the fourth time I have been their nurse but still ordered this book in April to brush up. Many good ideas and for those of us who only dabble in camp nursing, very helpful! Highly recommend this. I ordered a used copy from Amazon and it was less than $10.00. Totally the way to go! I am officially....a HAPPY CAMPER!

I recently became certified in this area. There are a lot of free CEU's on line....I used places like Gannett Education online, Medscape LLC, and Nursing Spectrum Continuing Ed. Looking at my application to take the exam, some of the course titles I have in my records are: Knocking Out Pain Safely with PCA, Recognizing Drug Seeking Behavior, Identifying Pain in the Hospice Patient, Complex Regional Pain Syndrome, Type !,Common Fallacies About Cancer Pain. You can also use conferences you have attended if they apply. Check out the references for the test and order some of the texts to study from. I studied on my own, looking at all the specific test content/objectives......I gathered this information. There are some good practice tests on the ASPMN site when you are nearly ready to take the exam. Give yourself a good 4-6 months to study the material and work on the practice tests. There is a LOT of information to cover but it is fun to learn about it! Good luck!!!!

When I worked in the Neuro ICU, I used to rip off a piece of EKG paper, label the back of it by the hour. Wrote down whatever was due each hour (12 hr shift) such as labs, vs, meds etc. and carried it in my pocket. Worked like a charm! Of course I never had more than 2 patients, so it was easy to make 2 columns, one for each patient's needs.

GOOD LUCK on exam! I just took it last week and passed. Summer begins for me NOW!!!!

I looked at the paper work posted on ANCC website: You have to have "a minimum of 2000 hours of practice in pain management within the last three years" and have practiced the equivalent of two years, full time as a registered nurse. Guess your next move is to ask them to specifically define "pain management".....the only reference to that in the packet is "pain assessment and management, pain management education, research, etc". Sounds like if they can't give you a definite NO, you can apply to take it and see what they say. The only bummer is having to pay with the application, letting them hold onto your $$ until they either tell you no, or you get to take the exam. Again, good luck, and hope you get to take exam!

Maybe you should contact ANCC with your specific question about this. They have pretty specific guidelines for eligibility to sit for exam. Not sure how strict they are on them. Good luck!!! Hope you get to take the exam!

I agree with keeping up with the PT. Work as hard as you can. Possibly, getting another primary care doc's opinion if you think you still are not getting any better. Does anything help your discomfort? Like whirlpool, heating pad, ice pack, stretching exercises?? Can you alternate acetaminophen and ibuprofen?? Back pain is so frustrating.......hope you find something that works for you!!!

Computerized order entry is great for the most part. I LOVE that you can determine WHO wrote WHAT and the exact time it was written. My personal opinion is, at times the computerized system keeps Docs/Practitioners FARTHER from the patient bedside. Example: You are concerned about a symptom/change in condition you are seeing in your patient........you notify DR X via telephone about the situation.......she/he puts orders in, based on what you have shared. Yes, you have used your critical thinking skills to share an observation.....but the Doc has not LOOKED at the patient (I know this is not always possible). Another issue is the "soft stops" or warnings that pop up with some order sets.......sometimes clinicians just acknowledge these and keep on going, without really thinking about what they mean or how they apply to the specific patient at hand. This can cause BIG problems!! Learning to use computerized order entry is frustrating at first, but eventually navigating the system becomes an advantage and time saver for nursing. Change is hard!!:)

My answer is based on practicing on the USA but some of the principles may apply......I think you need to get into a PACU situation, working with patients/ pain issues Also lots of CEU's are available online regarding acute pain and post op pain management. Typically only larger medical facilities have actual teams dedicated to acute pain management and they are anesthesiology based. You can consider pain management nursing certification, but you need a minimum amount of hours working with pain patients to even qualify to take the exam. So basically, congrats on getting the education, now you need to acquire the experience to compliment it.

I realize the upset, stress, and anxiety evoked by reporting disruptive behavior in the work place......BUT if no one reports it, and folks WAIT for someone else to do it.......said behavior WILL continue. Believe me....I DID report someone who is higher in the food chain than I am........was very nervous about doing it. END RESULT: others must have chimed in and reported this person as well, because this person's behavior has done a 180!!! We have a very open and good working relationship now. I realize things don't always work out this way, I consider myself fortunate.

Need to file a disruptive behavior in the workplace report, regarding the manager......you HAVE the witnesses

I would be HAPPY to encourage my employer to hire new grads......but currently there is the issue of "down staffing" occurring at the teaching facility where I am employed. Nurses who are gainfully employed, are not getting their hours due to lower than anticipated patient census over the past 6 months or more. Work is beginning, to align nurses from low census units TO units experiencing overtime situations and over appointment work hours =AKA floating. Unfortunately, there are no job postings here. I feel bad for new grads out there.......when I graduated I could have been employed anywhere. Things are very different now. I don't know what the answer is.

epidermal=epidural

Posts are referring to a brain sheet.........I ALWAYS used this when I worked even with one or two patients in the ICU. Truly the BRAINS of the operation some nights!! Get an index card ......large if you can..........or I even used EKG paper too. You can tear off the size you need and fold it for safe keeping in your pocket. Write the hours of the shift (hour by hour) and leave a space for meds or tasks you will be doing. Take a quick minute at the beginning of the shift to fill it in. IT WILL SAVE TIME LATER!! Cross items off as they are completed. Use whatever system that works for you, but very important, come up with a system. Be patient with yourself. Try not to waste time waiting. There is always something you can be doing, while waiting for a doc to return a page, waiting for a medication from the pharmacy etc...... you see what I mean. You will be fine but it takes time. It is good that you know you want to be managing your time well!!! CHEERS!

I am SO SORRY this happened to you!!! A few things I am thinking, based on the information you have provided.......Sounds like the nursing staff did not understand that you had MORE than a lady partsl hyst and were basing their administration of pain medication on that alone. You certainly would require more pain meds with the surgery you had!!! The other thing I wonder about.....do you have a chronic condition (I mean pre-op) that causes pain or changes your normal pain response? Such as fibromyalgia, some type of neuropathic pain or the like?? Were you on any medications pre-op?? If so, what medications?? I am a Pain Management Nurse and when I have trouble managing a patients pain after surgery on the current meds ordered, I ALWAYS go to the patient's history. I look for other diagnoses or currently prescribed medications. Were you taking the ibuprofen and oral dilaudid, as often as they were ordered and the maximum dose ??? If you were and you were still having uncontrolled pain, the nurse had an obligation to notify the surgeon of your unrelieved pain and obtain further orders to assist in managing it. Again, I am so sorry for you and hope you will recover from this awful ordeal.

While rounding recently on a surgical floor, I saw a medical student remove a patient's abdominal dressing WITHOUT gloves on! I was horrified! I looked for her when I was finished seeing the patient, but she was gone. I remain stunned and will talk to her about it if I see her.

An additional TRIED and TRUE night shift assist= GET A FAN! I am SO about the "background noise" ....it really does help block out neighbors mowing lawns, family in the house showering or just doing stuff, even loud horns honking next door, and little ones playing outside! For awhile I did wear ear plugs too, but don't do that anymore. It wasn't too bad though. DO IT, get the fan. You won't be sorry. Get a box fan.....you can find them at Sears or Target. The newer "quiet" models defeat the whole purpose

I can see it from differing angles..........some folks like answering/offering advice, sharing information and welcome the opportunity offered by these "HELP" posts. Others are more logistically intense....... preferring that posts are named clearly and concisely......so they can read them or NOT! It depends on my sleep dep issues, unbalanced estrogen, and recent M & M consumption whether I am annoyed or not ;? Most of the time it is all good fun.:jester:

Yes, I agree ..........GREAT question! I think the focus of care delivery has changed.......since 1978 when I started nursing. I mean, think about the fact that a patient having surgery for cataracts might be hospitalized > a week, on strict bed rest, and with sandbags on both sides of his/her head!!!......that was back then. NOW the patient comes in for procedure and returns home the same day!!! In this regard, WAY more patient education is necessary. Most surgeries, in the "old days" would come in the night before, have a prep done and hopefully get some pre-op teaching. So I would call this change, an opportunity for greater patient education (now I mean). Another positive change which is advantageous to nursing (but not ALL would agree!) is computerized records and documentation. It was overwhelming to learn and adjust to at the time, but now I LOVE it!! You can find out everything......like who gave exactly what medication at what time, current lab values, patient health history, which MDs ordered what test or med and what time!!! These facts are very helpful to me, working on an interdisciplinary team and communicating with nurses all over the hospital. I do agree there seems to be a bit more "scripting" of practice by management types. I think this translates to less freedom of practice. This is unfortunate, but falls under the old "patients and families first, RIGHT after the computerized documentation!!!". Family focus is more prevalent these days. We are also working with internet savvy patients and families.........many read all about their diagnosis and treatment of same on the internet. This makes them question us more, which is fine. Over all......there are days that I say to myself, "I am glad to be at the top of the hill, looking down, than at the bottom climbing up"..........regarding nursing. Usually the days of feeling happy and satisfied with my job and how I am able to do it, out number the other days :)

I really try to keep patients "in the moment". i KNOW it is really hard to do! (and let me tell you.......I am asking patients about their pain......so you KNOW that is like opening THE can of worms. I can't tell you how often I have to gently refocus them in the current moment, where I can help them. I have actually said, "I am here to help you now.....let's talk about that"). Things like, "sounds like that happened to you last month or last year (whenever).....let's talk about and focus on right now". This, coupled with a polite, " I am sorry to have to do this, but I am needed in another patient's room at this time. I will return at XX time". At times the "assembly line" type of care gets to be overwhelming. But we work the best with the situation and systems we have.