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    What DO we do...really?

    I entered a patient room the other day, and found myself in the following situation: As I entered a patient room, I introduced myself as the nurse, told the patient that I was going to perform a quick assessment on him, and began my full assessment. When I was done, I went to wash my hands and was about to leave the room when suddenly the patient asked me, "So, is that all you do?" I asked him what he meant by that and he said, "You know, just use that thing and listen to me. Is that all you do?" Needless to say, this question really took me aback and it took me a minute to recuperate before I told him that we also give medications, which I would be giving him shortly, and quickly left the room. When I sat and thought about this question though, it really struck me and kind of got under my skin. In the patient's eyes, is that REALLY all that we do? I mean we as nurses do other things, but they are mostly either behind closed doors or things which patients either don't need to know or wouldn't understand. So from a patient's viewpoint, IS that all that we do?

    Families and Healthcare: What Do You Think?

    Picture yourself in this situation and tell me what you think or what you would do differently: I am in orientation in an ICU with one patient assigned to my care. Since I am still orienting, I have a preceptor for the duration of my day, I am still not really familiar with this environment, and I am only able to perform basic care tasks on my shift. This particular patient who I am assigned had a major MI a few days ago and is currently on ventilation, has a balloon pump in his groin, has continuous vital signs, and is hooked up to multiple IV drips including a sedative, insulin, heparin, and a vasoconstrictor. The family, who are not very educated and not as capable as most to do and to have access to research, visit frequently. I inform them that they can ask questions if they have any and they almost immediately begin asking me questions such as "What are these numbers on this machine (talking about the ventilator) and why are those numbers different from these numbers (talking about the vital signs being consistently read in comparison to the numbers on the ventilator)?" I explain to them how the ventilator works, why the numbers are different on the two machines, and why the patient needs these machines during his stay in the ICU in as elementary terms as possible. The family also begins to ask about how his vital signs have been doing, if these numbers are good, and if any significant changes have happened over the patient's stay. I explain to them exactly what each vital sign was, how they are read, what the normal ranges for each are, how some of the medications are helping these vital signs stay WNL, and why we need to reinterpret them so frequently. As I was explaining this, my preceptor interjects by saying that she needed to show me something in another area, pulled me to the side, and proceeded to reprimand me for giving the family too much information. She told me that with all of this information the family might make judgments about our care or begin to think that we were attempting to make the patient DNR (which I really didn't understand). She proceeded to tell me to keep it simple and to not disclose so much information about this patient's care. These are the people who care about this patient most. These are the people who will be caring for this patient for the rest of his life. These are the people who are taking the time out of their days to visit their family member and make sure he is being adequately cared for and comfortable. With all of this being said, not only was I completed offended by this statement by my preceptor and very taken aback by such a bold statement but I was also very curious as to what others would think about this situation. So, my questions for you all are: Did I go too far? Did I give too much information to the family? Does the family deserve to know this information? Isn't it our jobs as nurses to be patient advocates and give the family as much information and teaching as possible to help them understand that we are doing all we can to help their loved one? And if so, why was my preceptor so adamant about me giving the family too much information? Is my preceptor feeling guilty about something and therefore not comfortable with disclosing information about this patient's care? Is this teaching and education within our scope of practice? Was I wrong to inform the family of and keep the family informed of the patient's situation? What do you think?

    Nursing Application Photos: Discrimination or Not

    Thank you all for your input! Although I did send the photo as requested, I did not hear anything back from this particular agency, even though my picture was very conservative, of just myself, and only a head shot. I am not one to jump to conclusions but I AM one to be wary of practices that I believe could effect my job experience or my satisfaction and growth within a particular company. I agree that some professions should be more critical of appearances than others; I know and understand that they are running a business and need to have the best-fitted and most professional looking employees in some certain positions. But I do NOT think that as a nurse I should have defend my professionalism, which, by the way, should be very apparent via my resume, my degree, and my professional licensure and not through a single picture. Thank you all again and please continue to let me know what you think!

    Nursing Application Photos: Discrimination or Not

    During my recent job hunt in the nursing field, I decided to contact a recruiter to help me with my application and "getting my name out there," so to speak. I worked with her for a few months trying to find jobs in clinics and doctor's offices across the Atlanta area, when after a few weeks she asked if I could send her a picture of myself to attach to my resume because the hiring agencies wanted to see what I looked like before an interview or further evaluation. My questions: Is this a form of discrimination? Is this about the company's image and the company wanting to make sure only attractive nurses are hired? Is this a new way to judge nurses and keep nurses of certain appearances in certain areas of nursing (only clinics and offices were contacted by the recruiter and they were the only agencies to request a photo)? What do you think?

    Most Annoying Nursing Stereotype

    My personal favorites: "Aren't you the one who cleans bedpans and puts your hands up people's butts every day?" (Verbatim) "Why don't y'all wear those skirts and heels like in the movies or like those girls do for Halloween?" (Again, verbatim) Some rare disease comes up on "House" and I get grilled about it: what is it, how do you get it, where does it come from, how is it treated etc. Just because I went to nursing school automatically means I get the first job I want... and any other job I want for the rest of my life. Just because I work three twelve's a week means I don't really have a full-time job and/or don't really work as hard as the 9-5 crowd. When I tell people I'm a cardiac nurse and they automatically assume I'm a cardiologist and perform open heart surgery to the most complicated of patients every single day (which, by the way, completely contradicts the first stereotype and both of which were "ass"umed by the same few people)

    No jobs or nursing shortage-- Nursing isn't in demand!

    I will have to say something here. I am a recently graduated (December 2010) BSN prepared nurse, and I have literally applied to over 75 jobs since August of 2010. I decided to go ahead and try to nip the job hunt in the bud and fortunately got 6 calls back. Although 3 of these calls were to tell me that I was not qualified for the position, the other 3 turned into interviews. During all of these interviews, I was told that it was a good thing I had a BSN because if not, these agencies would not have even given a second glance to my resume. All through nursing school I have heard from friends and family how good of a choice nursing was due to the extreme "shortage." Little did I know until my last year of school that the shortage was, as you put it, nonexistent. In fact, here in Georgia, most hospitals in my area are on hiring freezes or making extreme cuts in staffing, so much so that I couldn't even get a job as an aide throughout school because hospitals literally couldn't hire me or afford me. Also, until my final semester in school, I was completely oblivious to the fast that most nursing students on average were not getting jobs until 6 months out, which is exactly why I began applying as early as I did to as many jobs as I could. After my recent interviews, I was fortunate enough to receive 2 job offers, but ONLY because I have a BSN since I have no previous nursing experience. In fact, one interviewer told me that she was in the process of completely redoing her staff and firing all LPNs on staff or requiring that they have an RN to work with, which is just more hiring and more money spent. I hate to say this, but if you really want to pursue a long-term career in nursing, you really do need to have a BSN to do so. Not only are hospitals only hiring BSN prepared nurses now, but they are also looking for many nurses to get more advanced degrees in the future, which can only be done with a BSN. All in all, I would suggest looking into working as an LPN (to get your experience and to pay for school as you go) while getting your BSN and applying anywhere feasible beginning at the start if your final semester of nursing school in order to get your name out there and to get a feel for what positions hospitals are generally hiring for at that time. Hope this helps and good luck with everything!

    First year after and I feel Stuck!!!!!

    I have recently started the book "150 Tips and Tricks for New Nurses" by Kathy Quan because I have also just begun my career is nursing and wanted to do a little research before I began my patient care. In this particular book, the author presents this issue as something very hard to overcome due to the specializations that are required to perform this type of work. I would suggest, according to the theory presented in this book, applying to any large hospitals in your area that are feasible for you to commute to and work within, specifically in a pediatric unit or pediatric hospital, since you have some pediatric experience. Also, another tip I have heard throughout many professions is that most future employers look at the job history of all applicants and many of them prefer that you have worked somewhere previously full time for at least two years. I know this may seem unfair, but employers generally like employees that can commit to them for long periods of time to get "the biggest bang for their buck," so to speak (be sure to keep that resume current!). So, I would ultimately suggest sticking it out in your current position, if possible, for another year or so and definitely applying to your state's biggest pediatric teaching hospital or in a pediatric hospital in your area every so often until they contact you and every time you notice a new opening on their job boards; be persistent in what you want, keep that resume updated, and be sure to keep your eyes constantly open for new positions to which you are qualified! Best of luck, and hope this helps!

    Nursing: What It Means To Me

    Just an update: I found out that I passed NCLEX Friday in 2 Hours and 75 questions! So excited and thank you all for your input on my post and words of encouragement! Best of luck to you all in your future endeavors, whatever they may be!

    Share Your Funniest Patient Stories...

    I was in my second semester of nursing school completing my mental health clinical rotation in a local inpatient unit. It was the beginning of the shift, around 7 a.m., and I was completing my morning vital signs. I walked into a patient's room and proceeded to tell her who I was and what I was about to do, as any nurse, and especially nursing student, should. After waking her from her slumber, I began to take her vital signs when I could not for the life of me remember her diagnosis. I figured I would complete her full assessment and then refer back to her chart to obtain this information while I was documenting. So, I continued my assessment on her when she started to really wake up and begin holding conversation with me. After about five minutes of conversation, she very politely and calmly tells me, "You have a very good bedside manner." To ANY nursing student, this is the ultimate compliment, and needless to say, I was absolutely thrilled to receive such a compliment! Although this happiness was very sincere and very much appreciated, it did not last very long. As soon as the compliment left her mouth and I proceeded to tell her "thank you," she immediately and very seriously asked me, "Do you see these worms coming out of my nose?!" I literally died inside; I couldn't decide to laugh or cry! She ended up being schizophrenic and having serious hallucinations, which not only completely negated my ultimate compliment but also forced me to look up this woman's nose to try to find these "worms" to which she was referring! Although I did not get the true compliment I had hoped for, I did get to spend some time with this outstanding patient, and she ended up being one of my favorite and most memorable patients. This particular day ended up being one of the best days I had had throughout all of my clinical rotations!

    Nursing: What It Means To Me

    I began my college career believing that I would one day be a prestigious doctor or world-renowned archaeologist or maybe even a famous forensic pathologist, and boy, was I way wrong. Although I did begin my collegiate career in the science field as a biomedical engineer, I quickly decided that I was definitely not meant to be an engineer nor would I ever be even remotely famous for doing so or for pursuing any other career for that matter. Anyway, after one semester of crazy engineering jargon and completely anti-social engineering students, I thought to myself, "I really need to do something with people because this lack of people, or just the lack of people who interact with one another, is ABSOLUTELY NOT for me!" (As a short side note, my first day of chemistry class I sat down beside some guy with a textbook in his hand, asked him how he was doing, and he quickly and ever so snidely answered, "Can't you see I am trying to study!" and that would be the last time I made that mistake). So, nursing school it was! I began my nursing career as a BSN student in a small school in Georgia. I thought that not only would it be much easier than engineering school but it also would be a lot more fun and I could have a lot more free time to have some fun outside of school with people who actually spoke back to me! Boy, was I wrong yet again (seems to be a recurring theme in my life)! I ended up really struggling my first year of nursing school and falling way behind my classmates due to my lack of determination and commitment to the curriculum I was expected to retain and utilize. After my second semester of school, I had made many friends in the program, but again, my mindset was not in the right place; I ended up failing my family health class by 1.5 points. Not only was it the first class I had ever failed, but it was also the reason I had to move back home with my parents, the reason I lost my scholarship to pay for school, the reason I became a part-time student, and the reason I had to wait 6 more long, agonizing months to graduate AFTER all of my friends would be graduating. It was definitely a hard time for me, and after crying myself to sleep and awake every day for two weeks I quickly decided that this was what was meant to happen and that I would do my darnedest to make the best of it. I began to lift up my spirits with the thoughts that "everything happens for a reason" and little did I know at the time, but it would end up being just that and one of the best things to ever happen to me. After this disaster of a previous semester, I ended up never seeing any of my friends from that program again because I was sent off to go to classes about an hour away from where I began nursing school. Although it was very hard at first, I quickly gained many new friends as well as many other benefits since I was now only a part-time nursing student with a HUGE chip on my shoulder. It was like they always say, "when life gives you lemons, make lemonade" (sorry for all of the cliche statements, but it's true!) and that's exactly what I did; I became the vice president of the SNA at my school, I gained two more scholarships for having such a high GPA (3.5+) for two consecutive years, I found one of my best friends, I was able to obtain a minor in sociology, and I was able to reestablish my faith, get my head back on straight, and relinquish my good academic standing. I also regained my self-esteem, confidence, motivation, and determination, which I know that I would have never gotten had I remained where I was initially and doing what I was doing an d making the choices that I was making. This slap in the face was truly a life-changing experience and in retrospect, I wouldn't have changed it a bit. I now know that I wouldn't have gotten the same life experiences and learning opportunities had my life gone as I had expected and as I had wanted. I would've been a true slacker, seriously unmotivated, completely undereducated and better yet, a very poor nurse. Today, I still give thanks to these small blessings that I am given every single day. I graduated with a 3.29 GPA as a BSN this past December and have been working to get my dream job ever since. In fact, after applying 4 times since August (literally) to the position I really wanted at the hospital I really wanted to work in and getting told every time that I needed to reapply every so often to keep it updated and that they couldn't make a decision until more near my graduation date, I was finally offered the job as a cardiac nurse in my dream hospital this past Monday. I could not have been more excited and this is exactly where I wanted to end up, but there is still that little cloud looming over my head; I am scheduled to take the NCLEX tomorrow morning. And again with the cliches, "all good things must come to an end"... Ha! I figured that writing my thoughts and experiences would not only help to alleviate some anxiety and tension before this very important and stressful exam but also help to remind me of what all I've been through to get to where I am today. I hope this story helps many of you out there who may be in the dumps or down on yourself or may just need a little laugh or way to get your mind off of things. I know that the best way for me to get through the most difficult times is to just reflect on how hard I have worked to get to where I am and have full faith that I am where I am for a reason and that again, all things truly happen for a reason. I was taught through nursing school that honest, trustworthy relationships are one of the most important things that anyone could have in life and the things that allow us to make it through the hard times, the good times, and any other times in between, especially in this profession. They are ever-present and all around us and are the means by which we all survive and thrive in this stressful and demanding field. They are the connections that brings us as nurses, nursing students, new graduates, nursing educators, and retirees together and the bonds that will forever keep us united no matter what paths we choose to take in life. We all have different experiences, but the fact that we are all related by this very strong bond and life-long relationship in this outstanding field is what keeps us sane, grounded, and above all, grateful for the truly wonderful profession we are all so fortunate to call our own. I love you all, I wish nothing but the best for each and every one of you, and remember, we are all nurses and that truly says it all. Mother Theresa: "It is not how much you do but how much love you put in the doing." Anatole France: "To accomplish great things, you must not only act, but also dream, not only plan, but also believe." Orison Swett Marden: "There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something better tomorrow."