robinbird

This nurse eloquently said everything that I could not put into words for the past few years. I recently quit my job after 10 years because of the working conditions and the absolute insanity that had been occurring. I became a travel nurse where I can do my job and not be involved directly in the politics. I posted this on Facebook a few weeks after started working as a travel nurse: "As I sit here in my RV at my travel assignment, I reflect on the last few months of my life. I love my assignment here. Yes, there are problems (or I wouldn't be needed here). It hammers home my realization of the dysfunction of the organization that I worked for for so many years. The corporate machine that has been lubricated with sand. Someone remarked to me the other day, that there are two mechanisms at work, one wonderful (the staff and the providers) and then there's the corporation. The corporation is destroying itself and its MOST VALUABLE ASSET, its people. My fear is that the staff and providers will leave and patient care will suffer. But just as its necessary for the addict to hit rock bottom before he get help and recovers, this organization is on a downward spiral, imploding and self destructing. I only hope that the ones I've gotten to know, like and love will not suffer." Robin

This happened about 8 years ago and was told to me by the nurse who experienced it. A elderly patient was receiving palliative care on our cardiology floor and was expected to die anytime. To make her more comfortable her family brought her her favorite white night gown to wear and her pillow and blankets from home. Her daughter was staying with her one night and brushed her long gray hair and the patient went to sleep for the night. The nurse did her final rounding on the patient, gave some pain medicine and put the call bell in reach. At about 3 am the a call bell rang from the room next door. The patient said that someone was standing at the foot of his bead and he didn't know who she was and she wouldn't answer his questions. The nurse walked down the hall to the room and the patient was sitting up in bed. He said, "There was a lady with long hair and wearing a white gown standing right there (pointing to the foot of bed). I was about to get up to help her out into the hall when she just disappeared." The nurse reassured him that there was no one there now and told the patient to call her if he had any other problem. The nurse left the room and walked next door to check on her other patient. The daughter of the patient was softly crying and holding her mom's hand. She said that her mom died a few minutes ago. The nurse was convinced that the patient in the next room had seen the ghost of the women who died next door.

I would say outgoing, flexible, caring, realistic, forgiving, thick-skinned, a good sense of humor and confident. I have been working in the ER for a year now and I have discovered that the people I work with are quick to welcome new people, loyal and I love them like they are my family. There's a different relationship that exists between ER staff members. At times it's like we're in a combat zone. We have to be ready for the worst to roll through our door at anytime, yet we have be ready to comfort a little kid as we put a bandaid on his cut. Our friendships are deep and strong. I feel like any one of them will have my back when the poop hits the fan and I will do the same for them. Welcome to Emergency nursing. I hope you love it as much as I do. robinbird

I did an externship during my last year of nursing school (as a CNA-II). I got to work all over the hospital. This gave me the opportunity to see the areas I wanted to work in, but more importantly the areas I DIDN'T want to work in. I was hired at the hospital where I externed, but I don't think I was hired because because I was an extern; I think the experience was one more thing in resume. I'm glad I was an extern mainly because I had no previous patient care experience and this was a good way to get basic nursing experience (turning, transferring, cleaning up patients, etc.).

I just took TNCC (Trauma Nurse Core Course) after working in the ED for 9 months. I bought the book for the course 6 weeks before the course and read most of it. The course was 2 days long, which focused trauma assessment and system by system review of what we need to know for the trauma patient. The course was focused, and relevant to my practice as an ER nurse (with very little actual trauma experience). We had a 50 question multiple choice test and had to perform a trauma nursing process assessment on a mock patient. I found that this class really tied together everything I've learned so far in the ER.

Love/hate. There's plenty of things I love about it so it makes the things I hate bearable.

I had a patient in behavioral restraints in the ER who was a spitter. After the first loogie-launch he was placed in a mask whenever we were in the room.

I graduated nursing school when I was 37. I started when I was 34, which was the mean age of my associate degree nursing class. Many of us were second career nurses. Some of us stayed home with kids then went to nursing school. I've found that my life experience made me a better student and a better nurse. You are only as old as you feel. Go for it! Robinbird

When I worked in the cardiac stepdown unit I had a male patient who was diagnosed with Takotsubo, no medical history, clean coronary arteries and and EF of 30%. He traced his Takotsubo to a very stressful work situation. Our daughters went to school together so I saw him 6 months later at a school event and he said he was "back to normal". Full recovery doesn't happen in all cases but it does happen.

Sometimes things work out for the best. When I graduated from nursing school in 2006 my dream job was working in the ER. I applied and didn't even make it to the second interview. I took a job as a telemetry nurse on a cardiac floor (my second pick). I was disappointed that I didn't get the ER job but after working on the cardiac floor I realized how much I learned, how good the orientation was and was thankful it worked out that way. Now, 3 1/2 years later I applied for and got that ER job, but now I bring floor experience, cardiac expertise and I know how to read EKG's better than most. People come to me when they have a cardiac questions. Make the best of the job you were offered. HD is a very specialized field and you will learn A LOT! You can always apply for that OR job later. Good luck to you! Robinbird

My mother-in-law came over from Latvia when she was 14. Not only did she learn English fluently, you can't even tell she's wasn't born here. She graduated from college and is adamant that immigrants learn to speak the language like she did. When her children were born she taught them to speak English first and Latvian second. She said that when she went to school there was no option for English as a second language for Latvians, and her only option was to learn the language. Could it be that we are making it too easy NOT to learn English? Just a thought. Robin

First time I assisted with rapid sequence intubation. My adrenaline was flowing. I drew up all the meds, finished giving etomidate and was about to give the succinylcholine. I said, "I've always wanted to give succs!" Everyone paused, the room got quiet, then everyone started laughing at the same time (except the patient). I was horrified, but laughed about it later. You never forget your first RSI!

Know-it-all (and crazy) family members have all different professions, unfortunately some are nurses. You can add to what the person says by saying, "I've found..., I've learned..., In my experience..." without actually saying they are wrong.

In that situation I AM NOT A NURSE. I want things explained to me as if I know nothing. I don't want special treatment or anyone to feel uncomfortable because they may feel I'm judging them. (Because, I admit that I feel uncomfortable when I'm taking care of a nurse or doctor--or a family member of a nurse or doctor).

Thanks to all who replied. I can't wait to try your suggestions. I'll let you know how it goes. Robin

Ok, so I've been a nurse for 4 years and just started working in the ER. I'm off orientation and I am doing fine except for one thing. Starting Iv's. Where I worked before, we had an IV team, so I never started IV's. Now, for the first time, i'm learning how to start IV's . Last night I was 0 for 4. I would find the vein, get as far as getting the flash, but then when I tried to thread the catheter I would meet resistance and would blow the vein. I tried twice on each of the 4 patients and I ended up having to have someone else come in and start the line. I was so frustrated by the end of the night, I was questioning my abilities as an ER nurse. I love working in the ER and I really want to learn this skill. Any tips or suggestions out there to help this struggling ER nurse would be helpful.

Not a lab value, but wild nonetheless: A 16 second pause (asystole) on telemetry. Pt. fell and hit her head at her nursing home. Came to us in the ED, had a CT of the head (WNL). The doc was about to discharge her when all of a sudden, asystole came across the monitor. She was unresponsive, then came to as her SA node kicked in, a nice sinus rhythm, and she opened her eyes and said, "What happened"? Went for an emergency pacemaker for sick sinus syndrome.

I started working in my ED about a month ago after working for 3 1/2 years on a cardiology stepdown floor. I love it. At times it's overwhelming and I am learning to deal with that by prioritizing and remembering that I can only do one thing at time. My advice to you is: Learn the processes the way they do it and never say, "but we do it like this." (I'm sure you wouldn't anyway, but the experienced ED nurses say that they hate that!) When you make a mistake, remember that it is a learning experience and you've just learned something new. If you have down time, walk around and see if anyone else needs help. It's a team environment and everyone helps everyone else. You will see things you never thought possible, people in situations that are unbelievable, and people do things that make you think that its amazing that they have survived this long. Don't judge, just do what needs to be done and move on to the next thing. You will have days where you feel like you can't do anything right, where you'll be behind all day and where everything goes wrong. That's normal and expected. Just go home and come back and try it again on your next shift. I feel like making the move to the ED was one of the best decisions I ever made. It's a different kind of nursing, raw and untamed. Good luck to you. Robin

I also do core strength exercises, push ups and I run. The things that I do to save my back: -- Use good body mechanics when pulling a patient up in bed. I step to the side as I'm pulling the patient up. --Using slides to transfer a patient from stretcher to bed whenever possible. --Have lots of help, preferably 2 people on each side and one at the head and feet if possible.

I sent a patient for a second CABG who had 6 the first time and was going for a "redo".

A nurse I work with told a story of elderly patient she took care of that was dying. She was receiving palliative care and had said goodbye to her family. She was on our floor because she was in end stage heart failure and didn't expect to live much longer. We were trying to make her last hours more comfortable since her lungs were filling with fluid. Her family brought her a beautiful white night gown to wear so she would feel more more at ease. This patient had long gray hair and a beautiful smile. She was always smiling when anyone would go into the room, even when she was having trouble breathing. Anyway, she died peacefully, late one night. The nurse went to call her family to let them know that she had passed. As the nurse was on the phone with family, the patient in the room next door pressed his call bell. When the nurse went to his room to answer the call he said that there was a lady standing at the foot of the bed looking down at him. He wanted to know who she was. When the nurse asked what she looked like, thinking that it may have been another nurse, he said she was wearing a white gown and had long gray hair. He said he asked her what she wanted and then she just dissappeared.

Can you tell me how you become a scribe? My son will be attending the local community college next year and that would be a great job for him while he's in school. What kind of training do you need?

Gloves do indeed protect the injector. Another reason is that they act as a "squeegie" if you do receive a needle stick injury. As the needle penetrates the glove, the glove material slides across the needle and the theory is that some of cells from the patient are pulled off by the glove, before it enters your skin. It doesn't protect you 100% but it gives you more of a chance. I had a needle stick injury a while back and was wearing gloves. When I received my testing and counseling they told me about wearing gloves and the squeegie effect.

I was 35 when I started nursing school and graduated when I was 38. I would say 1/2 of my nursing class was over 30. We even had 2 people over 50! Go for it! Robinbird

I had a job interview for another unit in my hospital this past week. I prepared by rehearsing answers to some common questions. Here are some of the questions I was asked in my interview: Why do you want this job? What five words would you use to describe youself? How do you handle stress while at work? Describe how you are a team player? Why should I hire you for this job? What in you life are you the most proud of? I also reheorificed: Greatest weaknesses Greatest strengths Also: Know exactly how to get to your interview location. Drive to the location the day before (if you need to) and makes sure you know where to park. Arrive 15 minutes early on the day of the interview. Good luck to you! Robinbird