Gently.me

I work at a surgery center and a lot of times when a pt is stable recovering from the anesthesia, we become the waiters/baristas. Some patients are so frustratingly picky......which is fine. It is good to know what you want. Just be gratefuland say thank you!!

Review the protocol in your head. If you really are unsure, practice on a family member (not full compressions mind you but just scenarios). Talk it over with your DON. You have different circumstances that I do, in the fact that people WILL go into cardiac arrest and die in your facility. It is your job as the nurse to provide CPR if not contraindicated via DNR. If you do not think you are up to this, maybe re-think your position? Once a patient goes into cardiac arrest, they have minutes so calling your DON is not really going to do much but waste precious time. I have seen it on here a few times, and I think it is a great theory. Cardiac arrest=death. You cannot get worse than dead, so a few broken ribs are nothing in comparison to potentially saving a life.

Enough with the superiority complex because it is garbage. There is no nursing conspiracy where we have a secret nightly meeting to see what information to hold back from from the aides for "funzies". It is a moral and ethical decision for the rights of the patient. The nurse determines what information gets relayed, and the nurse should do it with the pts best interest in mind. Sometimes this means filling them in 100% sometimes it means withholding information. If at any time, the nurse does not have the best interest of the patient at heart, the nurse is not doing their job as a patient advocate. I think one of the biggest problems we are having in this debate, is that we all work in different settings, that have different styles of nursing. I work in an ambulatory surgery center where we have a pain clinic and do back surgeries. My other job is at an Urgent Care. In both jobs, a patient is there for a specific purpose/goal, and they are only treated for that specific diagnosis. Treat em and street em so to speak. We see roughly 40-60 patients a week for pain management. That is roughly 200 patients a week, and 2400 patients a year in pain alone. They are there for their steroid shot and that is that. We dont even ask them if they have a bloodborne pathogen because we do not need to know to do our jobs correctly. We do have them sign a consent that states that if someone does get exposed, we can then draw the appropriate labs. For surgeries, we do ask them beforehand if there is anything we should know about their blood history. Sometimes patients tell us, sometimes they dont. We do have them sign the same consent. At Urgent Care, unless they are physically coming in for that specific disease related process, we wont know ever. I have found that most of my patients who have these diseases, hate these diseases and do not wish them upon others. It is why they tell us about them so we can be aware. A lot of these patients have been ostracized because of their disease, even by healthcare team members who do not know better. Now, to a lot of the CNA's here. You guys truly seem intelligent and caring for your patients. I hope you continue your education to nursing so you guys can do more than what you are doing. When it comes to nursing however, a CNA is usually working under the license of an RN. This means an RN is liable for everything regarding the patient. It is up to that RN to delegate appropriately. Although there are many CNA's that I know who are smarter than a lot of nurses I know (in my humble opinion), but "street" knowledge does not hold up in court. You guys need your nursing degrees, because our field can use your intelligence and your passion. As much as I love this debate, I do think we need to agree to disagree. I do respect your guys' opinions, and it does give me food for thought when I get myself into a nursing field different than the one I am in :)

"More experienced nursing"... Yikes! That sounds like an assumption and you know what they say about those....... I think those of us that are standing by not telling anyone who need to know are looking out for the patients best interest. I can only speak of my own nursing style, but I always see the need to be a patient advocate first. Although I understand certain circumstances would deem necessary for everyone involved to be aware of a pts bloodborne pathogen status, not all circumstances require this. In my personal and humble opinion, drawing blood/starting IV's are not a need to know situation, because if we do our jobs correctly there should be no problem. Sure we could be EXTRA careful when there is a positive bloodborne case, but we should be EXTRA careful anyways. My experience comes from having two needlesticks. Both were silly errors on my part, and either one of them could have been extremely life changing. Anyone who deals with patient care should take it very seriously because it only takes ONE little drip of blood to change your life forever. I see nurses start IV's all the time without a glove or the tip of a finger (and I am guilty of that as well). This is just so stinking silly of us to do. I feel like this entire conversation could be avoided if we all took universal precautions more seriously. It is just safer and more intelligent that way. By reading these posts, I have learned a lot, but I still think I stand by my initial response. CNAs are a vital part to the team, but their education does not include pathophysiology of diseases. I am not trying to sound mean or demeaning because I hold the highest respect for every person on the care team, but CNAs are nursing assistant not licensed nurses. Every facility is different on the role of the CNAs. I respect the opinions of everyone here, but I have a right to my own opinion. Please please please take precautions seriously guys, because we know Murphy and his law. The one time we forget, is going to be the only time that matters. Assume everyone has HIV/Hep B+C and take extra care with everyone. Slow down and protect yourself first. You do not need to know everything about a patient to protect yourself.

I feel like at anytime, being undercautious when dealing with blood and bodily fluids is irresponsible and just plain unintelligent. I know out of habit that we do this a lot (and I was guilty of it before my needlestick) but it is so silly to not assume every patient has a bloodborne pathogen. I feel it is the patients right to disclose this information if he/she feels like telling you as a courtesy to you, but otherwise you are using bad practice to not treat all blood as if it had a pathogen. Is it nice to know? Sure. Is it a need to know? Not really if you do your job correctly. When I was working at the hospital, I did see the people who did not need to know about illness like HIV informed. They did not have the medical knowledge or training to understand the transmission of that disease, and I found those patients were treated differently. It is even true for those of us to know better. Very sad situation for those patients. I am still sticking to my point of you don't need to know. Sometimes you will not know. Treat everyone as if they have it. And you will never have a problem. Otherwise you are playing with fire and you will get burned (or poked). Hopefully if it happens, you get lucky like I was and the person was clean. We will find out in my recheck 6 months from now......... if only I didn't make the assumption and took better care to protect myself.....

This comment really disturbs me. This is not about nurses "getting their jollies", it is about nurses being a patient advocate. Period. If someone is trained to do a task where there is potential for blood exposure, then use the precautions. Being "extra careful" with certain patients implies you are not being careful enough with others. There are people walking around with bloodborne diseases and they dont even know it. What if you were not "extra careful" with them!? Seriously, learn to do your job correctly and this should not be an issue. Ever. And as for the isolation case. You have no right to know what they are there for if it is deemed you do not need to know. End of story. Those precautions are there for a reason, and it would be intellgient of you to follow those precautions, even if you dont know why. I start more or less 10 IVs per day. I do not ask or need to know if they have anything icky in their blood. Many times, patients, as a courtesy, will inform me that they have a bloodborne pathogen, and that is appreciated. Do I treat them differently? Not at all. Safe is safe. Unless you are physically involved in the patients care for that diagnosis, you simply dont need to know.

If you are spending more then you are making, you are living beyond your means. Period. My mother raised 3 kids by herself on a $20/hour job.

Spoken like someone who didnt pay attention to anything anyone said.....

thank you guys for all your support. you have no idea how much it means to me!

I am curious as to how much an hour you think you should get paid to make it "fair". Most of us knew what nurses made, but also, most of us didnt join nursing for the "money". at $27.00/hour you are making >$4,000.00/month and >$50,000/year. And that is for an associates degree. Sure we work our rear ends off, but we knew what we were getting in to, and we signed the contract for an hourly, not salary pay. Imagine how frustrated teachers are when they are making $40,000/year (average) for a masters degree. And they do this willingly. I just get frustrated when I hear complaints about salary and wages when it comes to nursing, because we truly have it pretty great.

Hey guys. Life has been throwing some hard balls my way and smacking right in the face. That is just the personal and at home life. Recently I just got hired full time at a position I have been working at for almost a year per diem. With the position came more responsibilities and expectation, which I was and am more than ready to take on. I work as an LPN in a neurosurgery center where we do surgeries, and injections. I was originally hired to help out with the injections, but now I am training to help out with surgeries as well. When a surgery patient comes out of surgery, they are assigned to a nurse. Ever since I started full time, one of the nurses it seems has gone out of his way to make sure I know I can't do anything correct. For example, one of the nurses went on break, and when she left she gave me specific instructions on how she would like her patients pain handled. As I was following her isntructions the other nurse comes in and tells me he is doing it his way, and completely makes me look and feel dumb in front of that patient. The past few days have been miserable, and I have just gone home feeling like a horrible nurse, and for the first time ever, I have doubted my calling. This facility is such a great opportunity to work at, and my problems are with this one nurse, but I dont really want to be the tattletale. The other nurse who works PACU with us has already warned me about him and told me that "since I am new, he is going to nitpick everything you do, and it is going to be frustrating. Just hang in there". The nurse who is giving me the problem is a great nurse, in fact one of the best that I have seen or been around. I know I am a good nurse, I just hate the feeling of being so freaking new, and not having confidence in what I do!!! Thanks for listening, and if you guys have any advice, please share.

They will survive without you. get yourself into that school!! DO not revolve your life and future around a new employer. I am sure they will understand Regarding the child, congrats! One of the students in my nursing school found out she was pregnant, and we just babied her. She had the child midway through school, and she got so much support from everyone! good luck with everything

I think accomodations are acceptable within reason. I remember in nursing school, we constantly had a disruptive student who would fall asleep in class only to wake herself up, and ask questions about something she missed when she was sleeping. Add that to always being late, not having a great hygiene (she had hand fungus on all nails) and constantly disrupting class, and there is a problem. She was given accomodations and those accomodations disrupted the rest of us. I think this lady is a great person who has had some tough times. I do not think she was cut out to be a nurse. When we had a vital sign assessment test, I told her i would be her volunteer to practice on. She pumped my BP cuff all the way, and let it out VERY slowly. Then her cell phone rang mid test, and she answered it! My hand was purple and numb. Obviously, she didnt make it through nursing school. Moral of the story: If you are not cut out for nursing and the "real world", it will catch up to you.

I started nursing school fresh out of high school so I had no nursing experience, and not a lot of life experience as well. The prerequisites were very ahrd for me, because I couldnt seem to understand how any of the stuff I was learning applied to life. Nursing school was very overwhelming, and I just studied to pass the test. i dont feel like a lot of stuff stuck with me. I got lucky and nailed a few jobs where they taught me quite a bit, and I was able to practice. It's been almost 3 years now, and I still feel pretty lost. My aunt has been a nurse for over 20 years and seeing her talk with experienced nurses about medical related subject, I get soooo very lost. I am an LPN right now though, and getting ready to go to RN school. I am excited about this because I feel like I have a second try, and I have a great foundation of WANTING to learn more rather than having to do it. Good luck with everything guys. You all rock!