strength4unityRN

Hi Everyone. I was born with a hearing loss of 25-30% & I wear hearing aids. I can hear without them but they do help me hear 'everything' alot better. On my yearly work review I received good marks and that they were happy to have me on the unit but in the comment section it included my 'hearing impairment' Make sure I keep my bed alarms on, check IV pump alarms, patients doors are open, etc. So that my 'co- workers' aren't always being addressed by my co-workers. I do hear alarms & do address them. Now there have been alarms that I haven't heard but when brought to my attention I always address it. (bed alarms, pumps, etc) If I can't hear someone I ask them to repeat themselves to clarify what was said. I also tell people in person & over the phone I have a hearing loss. I have worked in the hospital for 20 years & worked in this particular hospital for a year. My hearing was never brought up in my in any of my reviews in previous places of employment. When I was in the interview hiring process of this hospital I told them I had a hearing loss. What do you think of my hearing loss being included in my eval?

Scanning meds can catch errors & has helped prevent med errors but scanning isn't always 100% going to catch all errors. I have had computers go down, barcode won't scan, scanner stop working, EMR decided to reboot. Very annoying. Especially if it's a pressor & the patient needs it now. Get in the habit of looking at your meds before you give them. Look once & look again. Does what I have in my hand match what the order says? Remember your 5 rights. Right med, right dose, right route, right time, right patient.

You have a right to be uncomfortable if you weren’t I would be worried. I am afraid this is happening to hospitals all over. They are doing the same thing in my hospital. They are combining PCU/ICU together (basically there is no more PCU at this time) They are mixing up the staff as well so some ICU nurses go to PCU (to help the PCU nurses with the critical pts) & some PCU nurses go to ICU to learn how to care for the ICU pts. This is not for training theses nurses are taking an assignment of a critical pt they have never cared for before. This also stresses the ICU nurse who has to care for their pts & help the PCU nurse with their assignment. I felt this way the past week we had a pt who needed CRRT - I have no CRRT experience & no one in my unit did. I got a crash course 15min handoff/report & the pt was ours. To say I haven’t felt like we were in a dangerous situation is an understatement.

Yes I completely understand & empathize with you. You cannot train anyone to do this in 2-3 weeks let alone 2-3 months CC training, we just don’t have enough experienced nurses at the bedside anymore, let alone CC. Thanks for the reply & stay strong ?

Hi Nurses! With all the changes & sicker patients in ICU d/t COVID 19, I am overwhelmed as most of you are, I am also the charge RN. My unit was a mix of ICU/Stepdown pts, most of the staff I work with our not use to 1 pt this acute let alone the 7 vents who are going into ARDS, renal failure, difficult to sedate & oxygenate. We have room for more pts (the unit is 14 pts) with the 5 rooms being semi-private with doors that have no windows They are talking about putting 2 patients on the same vent in those semi - private rooms. I am want to be more proactive instead of reactive. *Making sure everyone has enough fluids & bags to hang for their drips. *laying eyes on all the patients to see who has what going on. *making sure staffing is safe for the acuity of pts we have - this has been challenging, simply because we don’t have enough critical care nurses & they are pulling nurses to my unit that have never had art lines, gtts, etc. *I feel like I am just ‘putting out fires’ fire here, fire there, new patient coming needs to be on a NRB & then another pt who needs intubation. * I am doing the best I can (believe we all our) but I was looking for advice, on how to keep myself more organized & if you have suggestions for the charge role & what are you doing as the charge nurse in your ICU to help keep the unit safe & assist your nurses. Thanks

You can’t compare yourself to your co-workers, some people may be good at hiding their anxiety, meaning they are anxious too, just not exhibiting. Till this day I still have some anxiety and ‘oh crap’ moments, but working through them is how ‘we learn and grow’ Also nursing in general is a very tough field! I was very anxious when I started and it took me at least 2 years to feel confident in handing myself with doctors, emergencies, families, etc. Remember EVERY job has its challenges, nobody starts out ‘good’ it takes time, self growth and patience.

Nursing overall is a tough field! The problems you describe our everywhere, everyplace has its problems. I was an aide too before I was a nurse, overall I have worked in the hospital for 15 years I also traveled for a few years and have worked in over 20 different hospitals. I think when you feel this way you have to find things outside of the job that fulfill you, it’s easy to become jaded and call yourself a glorified servant, but you are a health care professional, not to mention you are in the beginning stages of your career your not stuck, but stick with something and give yourself time to grow.

You had a lot of points I wanted to address but I wanted to respond to a few. I think you have a right to how you feel and even though this is the 'norm at some facilities' not all but majority operate at this ratio. Your doing the best you can and it sounds like you stand up for what's right. Patients need a good advocate. With that being said I know your frustrated with your co-workers chances are they are in the same boat. You could try and reach out to them and offer them turns, see if they need help with anything when you ask for help. I utilize this tool a lot when I work at multiple facility's. If I ask someone for help, turn, etc and when they are done helping me I ask in return if they need anything. I know its busy! But most of the time even if they don't need anything people appreciate knowing you would help. Communicate with your CNAs. Say something like when you go into so and so's room again grab me and can you help me with etc and etc. Do you have a charge nurse? a supervisor? Let them know how your doing? If you can't go to lunch at 11am go another time you feel would work for you. Six to eight patients is a big team, but you are the leader of your team. Treat this as a learning experience.

I can understand your frustration and agree with the other poster quote by Eleanor Roosevelt. As difficult as it may be being in a new work environment and your 'go to person' difficult to approach for questions, you cant beat yourself up for her attitude towards you. #1 its ok to ask questions your not gonna be perfect while your learning, you aren't even 90 days into the into the job, give yourself sometime. #2 she sounds like she has an issue with you asking questions, its her issue, you cannot take it personal, also refer back to #1. Like I said give yourself time, every job comes with learning curves including new personalities, you never know in 6 months, a year (especially when your not asking as many questions) she wont seem as difficult to you when you first met and/or by then you will have a basic foundation of job role and feel more competent. You sound like your on a good track, just give it time.

It depends on the patient/situation. Use your nursing judgement. I agree it's a great way to assess the skin etc. Plus a CHG bath and doing a quick turn doesn't take long at all in most cases. However it depends on patient and situation, if drips (pressors,etc) are already infusing. I like to know what the vital signs are (have the monitor applied, blood pressure taken, art line zeroed, etc) prior to turning the patient, changing sheets and bathing them. Plus there are quite a few other situations there that I did not mention. What I think has happened is a CHG has become a requirement in general and if not done disciplinary action is taken to those who don't complete it in a timely manner (this is what I have observed in some facilities). You have your priorities right, but one thing I have learned is every nurse does he/she nursing routine differently.

Exactly. I understand. Just let them know, so no one is surprised. Also some travel companies like to know once you complete a contract if you can provide a reference from someone at that facility. So keep that in mind while out on assignments.

I don't see why not, you will eventually have to give a notice to your employer you are going to be leaving. That 1 month will fly by before you know it. I would first let your manager know, then inquire for references as you feel comfortable. However be timely as it will pend your file from being complete for the travel agency. P.S. I enjoyed my staff job overall, and I worked there in variable roles for almost ten years. Not easy to let them know as most were like second family to me. However the sooner you let your employer know, the sooner you can get all your paper work completed.

There is a state board test you do or 'did' have to take. When I was a CNA, I received a certificate from my school that I completed the course. Then became eligible to take the state test, which consisted of a lab/skills assessment. Then if you pass that, you take a written test. Once you pass those you receive a certificate through the state. Last I knew my hospital was not requiring their nursing assistants to maintain or keep renewing their certificates through the state. I did not investigate this further as I was transitioning to a nursing role. I can't recall how long it took to get my certificate in the mail, but there was a site that I cannot recall at this time that I was allowed to view it online

I personally wouldn't hold it. Do you know why your supervisor requested you hold it? Does the patient have a diet ordered? Are they NPO for a procedure? Have they been having problems with hypoglycemia?

i love this article, teamwork AND a good work ethic go hand in hand. I do however believe in the fine balance of work and family life, however I have no problem helping out my co-workers if my assignment has been lightened due to discharges or etc (dont laugh due to lighten assignment lol). I just dont mind helping out if time prevails, I dont like to see others struggle, especially if they are pulling more than their own weight. Just my nature.

I picked my username because I believe that strength unifies us as people. In a whole to me a nurse is a strong person, you are the backbone, the one people look to for help and most of all support. I am a big believer in the energy you project to others comes right back to you. A nurses inner strength not only gives strength to those around them, but to their co-workers and most of all the patients and families.

I would hang it with a NS as a primary and infuse the Flagyl as a secondary. Just due to the logic of wanting to get all that antibiotic infused to my patient. I am not sure what kind of IV access you had, such as PICC, PIV, central line, etc. Usually there is order to flush the lines, that is why I wouldn't be worried about infusing the NS you could run at it 10ml an hour (think of this as your flush) and shut it off after the Antibiotic is done. Also if you really want you could call the doctor to get an order for fluids at KVO, but consider the history of your patient too, renal dialysis, CHF, etc

I agree with you, it's sad we don't always have enough time to walk away for a few minutes to sip a beverage. The whole eating at the nurses station is not allowed at my hospital, but it still happens. I personally don't feel comfortable eating at the nurses station, especially if your by a patients room who is NPO. But I have had to... some nights you just don't get a break. However we do need to take the time to feed ourselves and give ourselves something to drink. I did witness one incident where one of my co-workers, was talking to me and in the midst of sentence, her eyes started to roll to the back of her head, and she started falling down. I had to catch her, call for help, and grab a chair to set her down. She didn't go unresponsive, and wouldn't really let us assess her (you know how some nurses are lol). At that moment we just made sure she got something to eat and drink, she was fine afterwards. I think we spend so much time taking care of other people, we sometimes forget how important it is to take care of ourselves, just the simple things (drinking, eating, and using the bathroom..yesssss we deserve a potty break too!!! lol) Even though I don't really like eating or drinking at nurse's station, I wouldn't make it an issue. My thoughts are if we don't take care of ourselves, how can we take care of someone else.

Oh no no no, stop right there. Don't be so hard on yourself. I know you are a driven person I mean you were evidently a mom during school, and we all know nursing school is no easy walk in the park, let alone being a parent while in school. They say the the first year of nursing is the toughest, and it's harder on us than most of us realize. I know you want to do more with your career, but don't think this first job has ruined any future chances of you getting into a hospital or working where you really want to. The market may be stuck right now, but I don't believe your career is going to be stuck forever at a doctors office. Don't think that. My advice is to not give up, keep working towards that position in a hospital. In fact, any positions you see available be a little open minded about. You might have to try med-surg/ortho/neuro, etc, for a while before you get a position in peds. What I am saying is the buck doesn't have to stop here. Keep applying, visit managers, don't let somebody from HR make you think you just ruined all your chances, you didn't. Don't give up on yourself, things in life happen for a reason, we don't always know why, but eventually when all is said in done it will make sense to us. Take the experiences you have now, and grow from them (both good and bad). What doesn't break us, will only make us stronger. I wish you luck, and I hope to hear that you found yourself a job where you really want, and don't stop applying.

The reason I strongly suggest a NCLEX book is to help prepare you for the test you take in nursing school. A good nursing school will give NCLEX type questions on the test. For those of us who are in or have completed a nursing program we know how difficult those test can be, they can make or break you from passing the course. I think getting a NCLEX book now and start preparing for those test would only put you a step further ahead. Just my

There is a definitely a difference between the emergency side of healthcare vs. bedside care in the hospital setting. However I think any experience in medical will be a big plus. However I admired the paramedics in my class, and the LPN's too, when we merged together for a our last semester in nursing school. Nursing school is tough for different reasons, everyone struggles in their own way (god those care plans lol). For some they do great in clinical and others are better in the classroom. One thing that comes to mind is I recommend you get a NCLEX book. This will help prepare you for the test's you take in nursing school and get your mind thinking in that direction. You can find them relatively cheap online at half.com or even ebay. I strongly recommend you get a book now. Second find a good study buddy or buddies. Some people study better by themselves others study good in groups, if you like groups this might work. But if you find someone pick someone who is focused and wanting to go all the way through the program. Some of my best study buddies became my biggest support persons. Good luck in nursing school! Even though it was tough, in a silly way I had alot of fun and made great friends along the way. I look back and appreciate all the hard work :rckn:

I agree with you! The CNA's work just as hard as the nurse if not harder. The way I look at my job as a nurse is I have a bunch of different duties to do, and I need to pull my team together and delegate each task according based on who can do what. Not based on what I don't want to do. For example I can't answer every call light, help patients to the bathroom, etc, cause I may have to call the doctor or I might be dealing with a crashing patient. I also can't ask the CNA's to go into the chart and figure out why my labs are trending this direction. I am the only person who can do this. Answering call lights, turns, baths assisting with patient care are something I can do too, when my time is freed up ('freed up time' we know how that works lol). But I still believe that should not be all the CNA's responsibility. They help us, we should help them too. Bottom lines is its not about being a CNA, or a RN, its about taking care of the patient. When everyone works together it makes a world of difference.

I agree you should know all the rhythms. I would take a systematic approach to each rhythm as they present it to you. 1. Is it reg or irregular? 2. Count the ventricular and atrial rate. 3. Are there P waves? and do they look normal? 4. What is the QRS interval? Is it in normal range? 5. Is there a P wave for every QRS complex 6. Is the ST segment elevated or depressed? 7. Is the T wave normal? Is it elevated or depressed? 8. What is the QT interval? Also know a three to five interventions that you could use for the fatal rhythms. Such as what would you assess for, medications you can use, etc. Hope this is some help, good luck on your test!

In my facility we are expected to fill out a hourly rounding sheet, checking with the time we enter the room, assess for pain, noise, make sure the call light is in place, etc. I personally feel this sheets are a waste of time, just because I sign a sheet, and put a couple checks on it, doesn't mean I provided good patient care. Good patient care in my eyes is safe nurse to patient ratio. I believe any nurse who works in a busy hospital setting or any setting for that matter wants to provide good care, and does their best. Together we try to find that happy balance between patient care and charting. Patient care is top priority, but charting is just as important, cause if you don't chart it you didn't do it. Why give us another thing to chart on? Because it looks good to the public's eye? I believe happy nurses make happy patients, not a hourly rounding sheet.

I think this is a great question and alot of the other posters added great points. I also wanted to point out that depending on how lethargic your patient is, giving them something to swallow isn't a great idea (not sure if this person has a peg tube, but assuming if they dont). I would consider them at risk for aspiration, since the order is for tablets. Since the fentanyl patch seems to be working, you could call the doctor to get the order changed or even change the route it is given, just in case you happen to need it.