Da Monk

I saw a recent blurb advertizing the show "House". I do not like the show, but I will never watch it again (that would be the second time). In the ad House has a patient who has a seizure (phony looking) and falls to the floor from the bed. House exclaims, "Clean-up on aisle three-that's why I invented nurses." He then grins. He must have attended the same med school that Dr. Nick attended on the Simpson's. "Good-bye everybody!!"

I do not know how it is in NY or where ever, but it seems a bit presumptuous to me ( having been in this game for 30 years), for one to expect to be exclusively hired onto the day shift directly out of school. You may expect to have to put in you dues first. Although it is possible for a new grad to get day shift, say, in the OR because that's when most of the work is done. Having been a director, I would think twice about hiring a new grad demanding first shift. And the excuse about not performing well on other shifts will cut no ice. We are all expected to do other shifts in our careers at one time or another. And flexibility is a characteristic looked for in staff nurses by management. Nevertheless, good luck.

We are in the top 100 wired hospitals in the US. We use McKesson Care Manager. I did not like it when I came on board about 6 months ago. But the system is infinitely adaptable and I think it's a pretty good system now. All units use it. It is a windows driven setup and so you use it just by clicking with a mouse. There are free text boxes. Orders are put into the system via the program also. A few older programs are used too, but I think they are being phased out. The only problem is that most of the MD's on our service can't (or won't) use the system and there are still thick paper charts. Some of the cardiac unit MD's put in their own orders. Of course, the goal is to get everything computerized. I must say that the only thing I see as problematic is that too much time can be spent nursing the computer and not the patients which can foster functionality over professionalism. But program familiarity with the system lessens this problem.

I heard that in 2006, they will be checking to see if the staff's shoe laces are tied according to the standards and if pants are the right length. All buttons also must all be buttoned. OH! And stethescopes must NOT be worn around the neck.

Hi kcsun3. Maybe this idea is erroneously based, but if you feel so down about all of this, perhaps it would be a good thing for you to seek psychotherapy regarding your issues. I know this sounds like something a psych nurse would say, but I myself have utilized this approach in the past on several occasions and except for one disasterous run in with a guy who must have been the worst marriage therapist in North America, I remember my sessions as helpful and I never failed to learn something about myself about which I was unaware. Be happy.

My wife, also an RN, but who is unfortunately now disabled by chronic illness, was a psych CNS. She worked over 25 years in nothing but psych, both clinically and in management. I worked in OR, ED, MED-Surg, ICU, and privately for a neurosurgeon before settling into psych and completing an MSN in psych. She is not as "well-rounded" as I am, but she was the best damned group leader I ever saw. She never suffered any practice problems until she became ill and had to give it up. I know a lot of the differences in our respective knowledge bases are in the fact that she did not have the opportunity to see and do as many different things that I got to see and do so she wouldn't be a adept as I was at IV's, respirators and the like. I guess there are good reasons to support both sides, but I'm sure the answer lies within the individual. I do not know for sure, but I bet Dr. Gail Stuart did psych and nothing else and look what she's done for nursing.

I noticed that you exposed yourself to nursing situations where you are working around foks that are severely ill where you are sticking things in them, hanging IV's, and whatnot. Plus in hospice folks are dying and on chemo floors folks are fighting the crab. Plus little babies who are bad off enough for NICU can drop like flies sometimes. In the first part of your post, you seemed to be quite creative in the description of your activities. Have you considered psych nursing? I can be, but is not so technically oriented and being creative is a plus. Most of the work is done between your ears and with your mouth, not your hands and back. While you work with the suicidal patient and there is always the chance of a patient acting out, the pace is usually slower than with the critically, physically ill. It's a right brained world there. It might be just the place for you. Good luck.

I've taken care of several patients over the years. I know there a different degrees of the illness. I hope your problem is of a lesser degree. The patients I cared for were not being treated for NF, but other problems and they had had NF for years. Peace!

I worked at a psych hospital who proudly touted their no-restraint geropsych unit. Unfortunately, there were numerous falls, and one that was fatal. There were numerous 1:1's ordered, but other patients suffered from lack of staff and the cost of the 1:1's eventually led the unit into the financial red. But, even after the death and a fractured budget, the administration clung to the belief that a restraint free environment was the only way to go, no matter what. The state regulatory agency, in reality works against the acute hospital setting, saying that any device is a restaint. This included the medications that helped the patients and enabled them to return to a nursing home setting. As soon as the patient returned to the nursing home, the agency started pushing the staff to decrease the medication down to a level that was nontherapeutic. The meds were considered a chemical restraint. You can guess what happened. The patient soon returned to the acute setting with the same symptoms or worse. I found these policies detrimental to patient well-being. I would rather see a relative of mine bouncing around in a Merry-Walker rather than lying in a bed with a hip fracture or in an ICU with a subdural. Even a simple lap belt is considered a a restraint. Common sense seems to have no place in these situations. It seems that regulatory agencies must find something to monitor simply to justify their existance. And I would rather see that demented relative in a calm state of mind rather that in an agitated state perpetuated by regulations that promote the belief that the elderly are better off without psychtropic medication, no matter what. Let's get real. I know that studies show decreased death and fall numbers when there are no restraints, but I wonder about the staffing ratios where these studies were done. In a few years when I'm in a nursing home and unsteady on my feet, I hope that someone cares enough to put a little more thought into my safe care.

Pricklypears's story about the entitled MD is priceless and I think the story is indicative of how more than a few MD's view themselves in relation to the rest of the people they "serve". My father always said a license to practice medicine was a license to steal. Too bad they do not program a little more humility into physician education. Some of them need it.

Are not people who are infected with deadly diseases such as HIV liable and prosecutable for having unprotected sex and not informing their partner? I would contact your local police or health department or an attorney to find out about possible law violations.

I hate to break it to you, but I am a man. Anyway, I think our point is made. There is age discrimination out there, no matter which sex is involved. And I may have been the victim of silent sex discrimination in a female dominated profession. Plus, I must admit that some of the men I have worked for are true SOB's. They seem to see other men as rivals rather than colleagues with something to offer and the younger females with possibly something else to offer. One other thing. Managers have the opportunity to keep their department under budget when their personnel budget allows for a slot and it's not filled. That is so shortsighted. I think what is so disheartening to me is that I have a proven track record as a manager, but no chance to continue with it. So be it. I do not look forward to getting older, but I do look forward to retirement, spending more time with my wife, and watching my children continue down life's path.

I think susannyc has an interesting perspective here. I'm 57 and had a number of contacts and interviews for management positions over the past 15 months. I have continued to hear about the nursing shortage and have seen evidence of it in the number of open positions on various institutional websites. I've been an RN for about 30 years and have an MSN degree. I ran into a number of excuses for not being hired such as: 1. I'm sorry. I just got off the phone with our HR VP and we've decided not to fill the position. 2. I'm sorry. It's going to take us about another 6 months to fill the position. It's been put on hold for now. 3. I'm sorry, but your lack of experience in Rehab was a problem (the Psych Manager position included having to manage the Rehab service-What a combination!). 4. I'm sorry. But, you couldn't make up your mind soon enough (4 days later!). 5. I'm sorry but you OR experience is too old. You'd never be able to catch up with the new technology. And the most insulting institution was the one who refused to call me back after the interview. So I eventually decided to forget management positions and have taken a position as a staff RN. I got the definite feeling that some of these places really did not want to fill the positions they were advertising. I think some of the people who interviewed me who had less credentials than I have, were afraid to hire me, fearing being replaced by me later. I know that might sound conceited or defensive, but many of the interviewers were less educationally prepared. It used to be that an RN walked into a hospital with a valid license, asked about a job, and were asked when exactly could they start work? Not anymore! This experience has been very upsetting for me. But, I have decided to make the best of my situation, take the staff job (my last before retirement), and get on with it. In all of my interviews over the years, I have never been asked such vague questions such as the one's posted in this thread. I think I got off the subject. Sorry.

Some people have no business in management. Quit!

I'm sure part of the robot's programming will be it's ability to articulate, "DANGER! DANGER, DR. ROBINSON! YOU HAVE JUST SEVERED A MAJOR ARTYERY. DANGER!", or, "DAVE. I HAVE EVERY CONFIDENCE IN THIS PROCEDURE, BUT I PREDICT A FAILURE IN THE PATIENT"S CARDIAC MODULE IN THREE HOUR'S. SHALL WE REPLACE IT NOW?".