bemory

I have now been an RN for 3 years- two spent on a med tele floor and in January I will be completing my first year in coronary intensive care. I feel like Im being bullied by my co-workers. I am small, thin, quiet, young (Im 28) and shy. I look about 10 years younger then I am and Im not what you would call confrontational or agressive. I really wanted to work intensive care so I applied for a position and I got it during my interview. My orientation on days was as expected, people were nice, I felt like I learned a lot. When I came to nights, the first thing my night preceptor said was that she didnt want to orient me and that she heard I do not have critical care skills to make it in the unit. Well I dont know where that came from but It was repeated often and she micromanaged constantly and yet was such a hippocrite when it came to how she did things. I was expected to do things by the book while she had her own approach. Mind you I was not a new nurse but anyway I dealt with it- sometimes I would tear up in the bathroom or at home but could always shake it off. I got off orientation in May after I passed the PBDS, got 100s on all my cardiac tests, and was surprisingly given the go ahead by my orienter. Its now October and I still feel the eye rolling from some of the nurses when I ask questions or need assistance, I hear my name mentioned negatively, and I tend to get a lot of unneeded advice regarding my handling patients. The other night I had a patient who I needed to restrain, no one was there to help and they called a code on another floor. I was supposed to be part of the code team that day with two others. While they left for the floor I restrained my patient and was heading to the code when a nurse I worked with said " A code means now! Your too late to make a differnce" while another coworker said clearly "how did you get hired". What makes it worse is that nurse said it to a RN she was orienting in the unit. I decided to do what I always do and just withdraw into myself but this time I cant let it go. Why is it this hard? I keep going over and over in my head what is it about me. I feel like this job is starting to overwhelm me- I even started Lexapro for depression and I tend to bring some of my problems with me home which really causes my fiancee pain. He works in the cardiac cath lab and knows the nurses better then I and he said that they are just hard on me because Im too nice. What does that mean. I was considered such a good nurse on my other floor yet here they are doing everything in their power to break my spirit. I need some help-I have tried to become friends, ignored their comments, found answers on my own, and began to see a counselor to talk to. I just dont understand why its so hard.

I found this once in a physician report Amazingly well considering his erection fraction is 20%.

When I was working in the psych unit for nursing school clinicals, there was an older man who had schizophrenia and believed that he was Jesus. He had a really patient sister that would come to visit him every Thursdays and would sit with him, making herself very quiet and then saying her goodbyes. Well the Thursday before Easter, the sister requested to talk to his physician. Since I was tagging along with the doctor on call, I was able to sit in on the conference. The sister in all her shyness, started getting flustered and said, doctor is there anyway that you can increase my brothers' medication. Easter is coming and I know from prior years he's going to have a hard weekend. The doctor immediately started laughing like crazy. Turns out that the real Jesus comes back on Easter and in prior years this patient hides under his bed for three days until his miraculous appearance on Sunday. Sure enough the next day supposedly, he hid himself behind the medication cart waiting for his resurrection.

The most important things I learned about my patients were the things I assessed myself. Before you go into a room 1. look up all pertinent labs 2. check off all medications 3. check off all orders 4. review their history 5. review their vitals When you go into a patient room 1. bathe 2. assess 3. monitor all vital signs 4. I/O 5. remove all lines from floor 6. check all vent settings, and medication drips 7. check all tube placement If you do get a code or someone starts circling the drain, call for help. Assistance is more important then and there- do not think you can handle it alone The most important thing I learned was to show myself and be assertive. Develop your priorities. Even if your patient has stool up to his ears, and his medication lines are beeping- make sure you assess the ABCs first. I have seen patients whose work of breathing was incredibly labored and find the nurse finagling an IV line. Also you are not there for anything besides patient care. Developing friendships are nice but being part of a gossip ring will get you nothing but disrespect. Turn a deaf ear to it all. As far as studying EKGs- go to skillstat and practice with their little game, if you cant figure out how to stick an ABG- ask every nurse on that floor if you can do theirs until you got it down, if you cant get the Swan readings- make two copies and keep one for yourself. Then look up all the terms and write them down next to them. That way next time you have Swan readings you can pull out your copy and it will make sense. Remember CVP- right side of heart, PAP- pulmonary arteries, and Wedge- Left side of heart. Hope this helps. Tina

Lovern I was reading your blog and it is extremely similar to my own story. I worked as an EKG tech/CNA on the cardiac floor for 3 years while attending nursing school. Then worked as a RN there for 2 years before getting a position in CCU. The first thing my preceptor told me is that we eat our young here. I was also told that I wasn't cut out to be a unit nurse. I never worked with vents, ETT, most of the medicines, Swans, IABPs, arctic sun. I never even knew how to draw labs off of central lines. I was a wreck when it came to priorities, and time management. I dont show my stress in my behavior but sure get nervous when someone is looking over my shoulder. So I get the longest orientation probably anyone has ever had and yet here I am ready to become a CCU nurse. And the support has been tremendous since I started to show myself and make judgement calls. I have shocked, given epi, cardioverted, set up central lines, been at the bedside anticipating doctors commands, and been with families whose loved ones were extubated and passed. Its amazing but you'll make it. I promise you. I oriented with an older Rn and I understand the importance of bathing, linen changes, turning, elevating extremities, changing lines, oral care, infection sources, etc. Simple things that I knew from CNA work as being tedious but they are so much more important then charting. If there is any advice I can give- your there for patient care and not to join a social club. There is a lot of negativity and back stabbing. As long as you turn a deaf ear to that, the more respect people have for you. I really think you will be great. Good luck;)

I am a floor nurse and I guess that ICU being more one on one care would entail you sitting or standing in one place for a long time. I guess the best advice to give is to eat something before you get to work and then once a craving comes..drink some water and see if your not just thirsty. I dont smoke so I use my smoking break to just walk down the stairs with a friend to the lobby and just get off the floor and take some stress off. I always bring snacks- yogurt, a piece of wheat bread with natural peanut butter, trail mix, granola bar, or some popcorn to share with the floor. I like something with protein because it kills the cravings. I dont eat meat, but my friend likes to eat turkey and cheese roll ups. Another thing to remember is that starting the night off with a lot of sugar or coffee will make you tired, hungry and sometimes really stressed by the middle of the shift so I stick with water and if I need to a small cup of cold tea.

I had a patient call me in the room because she swore her telemetry box was attacking her. she said I felt it grip my throat and I had to fight it. One nurse answered a call light and asked the patient while in the room if he moved his bowels. the patients said "hell no, i **it my pants"

dont let an epileptic prostitute give you oral sex. klondike bars inserted in the lady parts will give you a nasty frostbite your not pregnant if you inserted 5 lbs of crack into your lady parts God wont love you more if you try and kill yourself in a church by setting yourself on fire. when a nurse asks you what your doing when you have chest pain, its very noble for you to say "I believe it was either cocaine or meth" dont complain to the nurse that your coffee got cold because you couldnt reach it to drink it then tell her (him) that next time it should have more sugar. its a good idea to know how to spell the name of your baby especially when its your name too. When you are 15 and high risk because your giving birth to twins, dont be caught having sex in the bathroom shower, your bed, your roomates bed, the stairwell and the doctor conference room. If thats not enough, its better to have sex with just one partner instead of different guys each time!!! Doesnt anybody go to school? when you are really tired after a long night at the bar, dont drive your car headfirst into a police car...especially if you have a warrent out for your arrest dont fake a heart attack in prison and then slip notes for the nurses to give him drugs to bring back for the guys. You might up finding yourself in jail a little longer. all those patients that bring bibles in to read- are not necessarily Christian. I had a patient who while reading his bible told me that if he had his stregth still he would put his hand between my legs. :uhoh21:

1. use the bathroom! dont hold it in 2. take good care of yourself- your feet especially 3. get some sleep 4. take a minute to take a breath 5. never leave a room saying you will be back in a minute...because that minute may never come 6. you are not going to be an expert at putting in an IV- I have seen some of the easiest veins under the toughest skin, and no veins that I have gotten in. IF they are on prednisone- watch out 7. look up the drugs that you are giving to see what the action is. Check the blood pressure before giving ace inhibitors, beta blockers, calcium channel blockers, nitropaste etc. check urine output before giving potassium 8. never never underestimate the power of golightly or lasix on an elderly patient. if they have to go, they mean it 9. rememeber that a conversation is better then medicine 10. remember that it doesn't matter if you are new or have 30 years of experience there is no reason for someone to make you feel incompetent. You graduated didn't you? 11. when someone codes and you feel paralyzed to help- remember Some- shock, oxygen, monitor, epi.... 12 you are allowed to be human and cry, sometimes it will just get to you 13. remember when you are on the phone with MD's especially at night... get to the point...and most of the time these Md's dont know these patients so briefly tell them... ms. jones, chf, on tele, no pacemaker, just bradied down to 27. Usually runs in 50s asymptomatic. 14. the biggest lesson I learned was that nursing is always going to be a challenge because you are dealing with a dynamic field that is constantly evolving. Be scared. Be afraid but always look back and see what all you accomplished and its amazing. :)

Its usually that I can only get to my charting much later. I am not staying hours late like I used to do. I guess the problem is that I just feel like I will miss something if I dont assess everything. I know that a lot of the nurses chart by exception..i.e WNL except..but I have never felt comfortable doing that. I had a classmate of mine lose her license the second month on the floor (after orientation) because her patient passed and she didnt chart anything leading up to the sudden demise. I guess I worry about something like that.

I will be completing my one year as a nurse on the cardiac floor and I feel that I have honed a lot of my skills except one...time management. I always see nurses finishing their charting hours before I even get to sit down. A lot of times my error is getting stuck in talkative patients rooms or waiting on medications that have not come to the floor. A lot of the time nurses I follow say that I give too descript assessments in the computer. A lot of times I get very stressed and unfortunately I make it known by complaining to other nurses how I am so busy doing this and that, it makes me so angry later when I think about how incompetent that makes me look. Does anyone know of a good schedule they have or maybe a checklist (we had an old one in nursing school thats not really relevant) with how to budget time. I really appreciate any posts.

1. pt who came in with a potato growing in her lady parts, had previously been in for a tennis ball insertion. Her reasons were that the lady partsl weights prescribed were to expensive. 2. pt with an earring stuck up his rectum that caused a rectal bleed (think a silver sun and moon shoved way up there). I had to place 5 iv sites in him because he kept pulling them out. Turns out he came from a drug rehab and was thinking that the earring could get him a prescription of percocet. He pulled the iv's out because he didnt want the small dose of morphine that was ordered 3. This was years ago and told to me by my nursing supervisor...he once treated a woman with a concussion and broken teeth, while her husband was rushed into surgery for reattachment of his member. Supposedly she had a seizure condition and during an intimate moment her teeth locked up. He hit her in the face with the lamp.

hi everyone..My name is Tina, I am a cardiac RN and work in a hospital in Wilmington. I am originally from Delaware but have been living here for 4 years. I enjoy the people down here and really love what I do.

I made A's in all my pre-req courses and B's in my nursing courses. The tests we had were always multiple choices and our finals were straight NCLEX questions. When it was time to study for the NCLEX, my friends and I just asked each other questions from NClEX books and if we were stumped, we would grab our lab book, med. dictionary, text etc and read what it said. This helped a lot, all five of us passed the first time.

When I was going through nursing school, I had deferred from graduate school for biology. I worked at nights as an aide and would watch people years younger then me with no experience boss me around and make me feel totally incompetent. I was suma cum laude, graduated with awards, but felt like a failure because I was making so little money and getting treated like I was no good. I had always wanted to be a nurse and decided that It was time to fufill that. Dont let anyone make you feel down because youre an aide. These people who make you feel like you are no good, do so becuase they feel that they can. Youre better then that. If you can stick it out! I worked nights full time for three years, and it got to a point where people respected me more. I have been a nurse for awhile now and there are still people who remember me as a CNA and tell me that they are so proud of me or people who were ornery to me try and be friends (believe me there are a select few that I actually become friends with). Just dont be too discouraged, and try and change to another floor if you can or in another position. I hope you feel better about yourself and your importance.