rntj

So glad this thread was started. I have been an RN for 10 years. When i worked home health, I found one of my patients unarousable, snoring, with a pulse ox of 76%. I called EMS. They treated me like dirt, acted like "why did I call them?" Even though I told them multiple times I am this patient's nurse, when they were talking to each other they'd say things right in front of me like, "I don't know why they called, this PERSON--or THIS LADY-here called us" and I insisted they take him to the hospital right away. The patient ended up in the ICU, and I got props from my home health agency and tons of gratitude from the patient's wife. I have always wondered why I was treated this way by EMS. Is it that they are jealous I have more education than they do? Or are they just unbelievably cynical and negative people? It really rubbed me the wrong way, I'll tell you that much.

This thread sure makes me glad I am NOT a conservative.

Well, if you deny people healthcare, you are essentially depriving them of their life at one point or another. It always amazes me how strict Constitutional constructionists who want to interpret everything "as the founding (racist, slaveowning, sexist) fathers)" wanted it, fail to remember that in the days of this country's founding, the town doctor provided health care to everybody, rich AND poor. I don't think they imagined at time when people's health would be turned into a commody for the enrichment of powerful insurance companies.

Uh....yes it is. We have the right to life, liberty, and the pursuit of happiness. Exactly how do you expect people to exercise their right to life without the ability to maintain their health? Life and health kinda go together

My favorite was the actively withdrawing ETOH pt who asked me if I would like to get in the bed and snuggle with him. Ah, that would be NOOOOO

I've worked days and nights. My unit is the busiest in the hospital and I just don't think I could handle the stress of day shift, although we have 4:1 ratio on days. If you are going to do night shift, I have a word of advice, especially if you have a family. I work the same three shifts every week Sun-Tues 7p-7a. This is how I've worked it for four years: on Sunday, I either sleep in till 1300, or I wake up early, go to church, then take a 3-4 hour nap. Then I leave for work @ 1800. I sleep Mon, Tues, Wed., all day, then get up on Wed @ about 1600 and spend time with my family. I am still so tired at that point from working at night that it is easy to go back to bed Wed. night and be on a family-friendly day schedule on Thurs, Fri., and Sat. I make sure I get lots of sleep. I do lose a day sleeping on Wed, but I see my daughter every day before work. When I worked days, I would leave before she got up and get home after she went to bed every night, so I wouldn't see her for three days. It's really hard working nights at first, requires a lot of caffeine, but you do eventually get used to being up all night. Good luck, I hope you are able to find what works for you.

As I have said before, I am not trying to paint ALL nurse managers with this brush. This has just been my personal experience. Can't say I haven't ever had a good one, I did have one, but not at the hospital I work at now. It has been my personal experience that the Magnet facility I work at is particularly hard on the nurses, and has a well-earned reputation for being that way among the nursing community in the city I live in.

I am sure there is a lot of pressure---as my mother who was a longtime upper management executive at hospitals tells me---but it does seem to me that it is only a certain type of person who wants to be in management, and that is a person who is on a power trip. Just my experience, not saying ALL nurse managers are like this, but I can only comment about that which I have known

Gonna go part time as soon as I can and go for my DNP as soon as possible. I don't really want to leave because I love my specialty and the majority of my coworkers are like family. But I can't do this floor nursing thing for another ten years, and I am itching to move up. So for the time being, I will just avoid her and hopefully she will just avoid me. It is frustrating to never hear anything about the good things you do, only the mistakes.

1. Always believe the worst about your subordinates, no matter how glowing a reputation or history of competence they may have. Never give anybody the benefit of the doubt. 2. Never praise or give an "attaboy", and always discipline for any minor infractions. Floor nurses are not allowed to be human. 3. Always wield your power like the hammer of Thor. 4. Be as acerbic and abrasive as possible in all dealings with your subordinates. 5. The patient, er, customer is always right, no matter how confused or crazy or vindictive or evil they may be. Patient satisfaction scores are more important than the truth. 6. Clinical nurse leaders do not make mistakes. Only non-management nurses do. 7. Always make sure that your employees shudder in fear at the sight of you; smiling is not allowed. 8. Always be sure to forget what it was like to work on the floor with actual, you know, patients. 9. Always work your hardest to make your subordinates feel as bad as possible about themselves and their chosen career, no matter how much they pour their heart, soul, and mind into it. Just a few tidbits I've learned from working at a world-famous magnet hospital that strives for "nursing excellence" and attracts "the best and the brightest." My question is, Was it always this way? Why or why not? And does it always have to be this way?

Sorry in advance for the length of this. So, I have been an RN for many years, working for the last several on a busy, demanding cardiac step down unit at a well-regarded nonprofit teaching hospital. I also have several psych diagnoses, including bipolar d/o II, severe anxiety, and some OCD features (which were much worse after I delivered my first child and have gotten quite a lot better, but still remain). Usually I like/love my job (ocassionally hate it), and I absolutely love my coworkers. Lately I have found that I am making mistakes that I would not normally make. I am afraid I am going to get fired soon, although no harm has come to any pts through my mistakes yet. My anxiety has increased exponentially at the same time, the primary symptom of which is severe chest tightness/discomfort. Last night I actually cried in the nurses station over something I really did not need to. You have to understand, I do not do this. I am usually one of the calmest (on the outside) nurses on the floor, certainly one of the most experienced. I have seen my psychiatrist, who feels that I am in need of a leave of absence from my job to adjust my meds and just get a break where I can get back to therapy and generally just take care of myself and what is going on with me, in her words, "before you make a big mistake and you really hurt someone." She fears I may be going back into a major depressive episode, which I last experienced about four years ago. She said my hypervigilance at this time can actually cause me to make mistakes that I wouldn't normally make if I wasn't quite so anxious. I totally get her point, and I agree with it. She wants me to go on FMLA and take a couple weeks off, which I could swing because I have some sick time saved up. Some of my coworkers already know that I have some anxiety, nobody knows about the bipolar d/o (there is too much stigma attached for me to ever be honest about that.) I can't use the BP dx for FMLA because I don't want my work to have any access to that info as there is such a stigma and nurses are super judgy about it, as I'm sure my manager would be. What I would like to know from other nurses, is which diagnosis should I use for my FMLA paper work: anxiety/panic attacks or major depressive episode? Which would you feel is a less "negative" or stimatized dx to use? Either one is applicable, according to my psychiatrist. Thanks for the feedback, it is so much appreciated.

"No, I am not going to push your Dilaudid "fast" because you "like the way it feels;" In fact, now I am going to push it way, way slower than I would have" "No I will not call the doctor at 3 a.m for a suppository because you haven't had a BM in 2 days. The doctor is busy keeping people alive and handling emergencies, you can handle not taking a s&^ for 5 more hours." To the CIWA patients who just want to be dead to the world so they don't have to go through withdrawals: "I understand how you want to avoid the horror of withdrawal by being completely unconscious and unarousable, but if I give you 4 mg of Ativan every hour or two you are going to stop breathing. I have already given you 8 mg in 3 hours and you had 16 mg in the ED and I'm not giving you any more until the doctor comes to see you to assess you and your treatment plan. Sorry, but I am not in the business of purposefully killing people know matter how badly they want to be dead to the world." I could go on and on but pretty much everything I want to say somebody has already posted!

Personally, I believe it depends on how you interpret the Constitution. We are guaranteed the right to life--how can we have life if we do not have health? How can we maintain health without health care? Also, I believe health care as a right falls under the constitutional directive of "providing for the general welfare." But I'm just one of those people that values human lives over corporate profits and individual wealth (ie, not a Republican).

It's crap. Nontherapeutic, disingenuous, insulting BS that does nothing to improve pt care. I refuse to follow scripts in my communication with patients. It is against my ethics as a nurse and everything I was taught. I am an educated professional, and I will treat myself like one even if my management will not. I do "round" on my pts and check on them just about hourly, but I will not lie to people and tell them that I will be in every hour on the hour. What if my pt is crashing? Oh gee, I might not get to ask someone if they need to "go potty." It makes me want to throw up. Whoever came up with hourly rounding is an idiot and needs to remember what it actually means to be a nurse and not a customer service representative.

I say very calmly and with a flat expression, "I will speak with you when you have calmed down." And I walk out of the room. Decided this was the way I would handle these people after I almost got decked by a neo-Nazi w/ swastika tattoos (I am a female). I just won't put up with that nonsense, no way, no how. Security is your friend in these types of situations.

Personally I think the sadists who came up with this nonsense should be drawn and quartered! I constantly check on my patient's pain, turn all my total care pt's q 2 hrs, but I refuse to use scripts or management-mandated communication as I believe it is nontherapeutic and demeaning to both pt and nurse. I sign those damn things off just so I don't get in trouble. I work on a very busy tele unit and I will not tell my patients that I will be in there every hour on the hour to take them to the bathroom, repostion them, and ask them their pain number because it would be a lie and I will not willfully lie to my patients. I have more respect for them than that and more respect for myself to not be made a pawn of management and their obssession w/ pt satisfaction (apparently they have not seen the new research that higher pt sat scores positively correlate w/ negative clinical outcomes and deaths). Sorry, nope, not this nurse, I will not drink the Kool aid.

I feel for ya, I really do. So many nurses also have anxiety, you are not alone. I've been a nurse for 10 years and my chest still feels tight and I get really anxious before going in to work on my first day of the week. The most important thing for a nurse is to actually give a rip about your patients. Surprisingly, there are those out there that just don't care, or maybe they never did. Please take me at my word that, with time, IT WILL GET BETTER. Seriously, I was a total anxiety ridden mess who wanted to cry every 5 min when I first started as a nurse. You will get through this, don't give up, and best of luck to you.

I will not get into specifics here, as I do respect doctors and don't think they are "stupid" by any means, even if they at times do things that may be unadvisable. What I will say I have observed from working w/ residents and interns at a teaching hospital is at times there is a failure to see the "big picture" e.g. giving IV fluids for acute kidney injury when the patient has a hx of CHF,etc etc and so forth. But becoming a doctor as well as a nurse consists of a learning curve, and everybody--I don't care who they are--makes mistakes. Hopefully they are not mistakes that will kill someone

When I was in my last week of peds preceptorship in my last semester of nursing school, I had two babies w/ bronchiolitis. Well, turns out I gave PO flagyl to the wrong baby. I realized my mistake right away, notified my preceptor and the doctor (who told the family). I had to have a meeting with the director of the nursing program where we discussed the five rights and three checks and I expressed my complete dismay at what I had done. The director said, "Well, I bet you'll never make that mistake again, will you?" Thankfully they did not kick me out of the nursing program. As a result of this situation, I am completely anal about med administration and the five rights/three checks. The preceptorship taught me a lot about that type of thing but also taught me I NEVER want to work with babies or children or their families again. Give me a heart failure pt w/ an MI and ESRD on HD any day.

I was a CNA for 7 years before I became an LPN, then an RN (have been a nurse for 10 years). I feel it very much prepared me for nursing school and dealing with patients and coworkers. I feel I am a much better nurse because of my CNA experience. IMO if you hate being a CNA (not just the obvious parts, like lifting and stressing your body out), you probably will hate any type of patient care. As far as I have seen it's the former CNAs who are the best, most hardworking nurses.

Your instructor sounds like a control freak psych case to me. Hopefully you will have a better one next time, this one's totally batty

UAMC is a good hospital w/ probably the best rep in town (in my opinion). the only unit I know you definitely want to stay away from is the GYN surg unit 7W. they hire tons of new grads so hopefully with your experience you will be able to get hired. Good luck!

If you have a strong "protector" instinct and you like dealing with people (as well as have the brains for A & P, microbiology, etc,) and good critical thinking skills, and ESPECIALLY if you know you want to be a nurse, I'd say go for it! I've been a nurse for 10 years, and was a tech for 7 years prior, and I can tell you I still love my job and get a big kick out of taking care of others. Nursing is very stressful annd challenging, but it is extremely rewarding, and I couldn't see myself doing anything else. Keep in mind, the place you work and your shiftmates make a huge amount of difference in whether you will like your job. I have absolutely hated some jobs but I found one that I really love--it may take some searching, but it's worth the journey. Even the nursing jobs I have hated I have learned from and become a better nurse due to the experience. Don't be discouraged by our "venting." Often AN is the only "safe" place we have to gripe about the things we don't like about our jobs, management, difficult patients/doctors/coworkers--so don't take it too much to heart. Best of luck to you and don't give up on your dreams!

I respectfully disagree. I am very respectful to the doctors I work with, but it was their choice to become an MD, which they all knew when they got into the field would require being woken up when need for their expertise arose. They get a lot of money and perks and adulation for what they do--there are up sides and downsides to everything, and having to answer phone calls in the middle of the night is one of the well-known downsides. I feel it denigrates our profession to apologize, which indirectly is making the statement that we shouldn't be waking them up and that we are in the wrong. I am not in the habit of apologizing for something I did that is not wrong.

Little bit of a rant about a particular pet peeve of mine here. I was taught years ago in nursing school--don't apologize to the doctor for calling him/her. So many times I hear other nurses, especially new grads, do this, and it makes me just cringe! Who told them they need to apologize for doing their jobs and taking care of their patients? It just brings down the entire profession, in my view. We are not making social calls when we call the doctors, we are notifying them of things that we, in our professional, trained opinion, feel they need to know in order so that they can do their jobs correctly as well and, most importantly, to protect the well being of the patient. It just irks the heck out of me!