lady constance

I would like to remind all of my fellow nurses, that at home we CAN do 18- 20 hour days ( because we CAN and DO go pee when we have to, we can grab a snack, drink a beverage), WE SHOULD NOT HAVE TO EVER be forced into that kind of slavery at work..... study after study PROVES the worst patient outcomes happen with staffing 12 hour staffing patterns!!!!!!!!!!!!!!!! EVERY state board of nursing KNOWS this.......... they recommend NOT working 12 hours shifts, but then sit around and continue to watch evil, less than effective policies in every institution ................and we wonder why there is such disrespect and disdain between managerial nursing and PATIENT care nursing careers......... ...." but everyone is doing it! how can we resist not following the crowd???!! ( even though research tells us this IS NOT GOOD ENOUGH FOR US ) I have 32 years of nursing experience that have made me wise and regret every BAD outcome---and I have yet to see a good outcome of any 12-18 hour shift...........unless it was at my house, with my kids or spouse............

ACCCCKKKK! I thought i was smart enough to know all management tricks--( been a nurse 32 years). Nope. The disorganization i work for quickly placed a mandatory 24 hour work week to qualify for benefits. LOSE YOUR VACATION ! ( mismanagement could not answer a question as to tax % it would be given to you when cashing out, LOSE your entire 400 hour sick bank that you have not taken/needed to use for 11 years). Sadly I countered mismanagement's comment that OTHER local hospitals did this a year ago by saying " although that sounds logical and reasonable, if your neighbor jumped off a bridge, WOULD YOU JOIN IN? "........ I quickly changed employment status from 16 hours a week to 24. in 2 shifts ...because who really wants to spend their life at work? NOPE. dedicated YES. STUPID-NO!!!! Fast forward 3 months--- out of no where, i find myself forced to a psych eval for " mania"---by a social worker in EAP-------- not for one second will i see my employers MD's- i SMELL soooo....waiting 6 weeks to see the MD of my choice has run my ETO ( vacation) down to 9 hours and because FMLA papers need to be submitted before they will use my ESB ( earned sick bank to the tune of 420 hours). My GUT feeling---oh can i see the handwriting on the wall that since i have such a stellar employment history , i cannot be fired---so they will do the GAS LIGHTING feature so commonly known and seen by management ( if you fall for it! and become their prey!!!) How do you pry gently as to what the agenda could possibly be , and to WHOM ( as human resources has become nothing but litigation and union look out behavioral services paid by CORPORATE piranhas ) do you inform that management is BULLYING, GAS LIGHTING, LYING VIA DISTORTION, AND PROJECTION ? WHO do you go and speak to about your manager being a psychopath, and a bad one at that---- ( no one cares anymore except for themselves) Sadly, i am seasoned, wise as serpent yet gentle as dove--- know how to flip tables like Jesus and yet do not condemn the prostitute or social pariah ( there is no such a person--EVER!!) My gut also says i am glass ceiling-ed out( max wages for my locale). they hate my skill and daisy wards and knowledge and personal acumen and stellar reviews for entire length of employment there ( pretty easy to do working 2 8 hour shifts a week) ............ the writing on the wall tells me they are setting me up to gracefully exit or transfer to another department.......... ANY ADVICE-- IDEAS-- PREVIOUS EXPERIENCE with said issues......... what i want-- to leave on my own terms in my own time frame and SHAME ON THEM! fact is, i may just be a catalyst after i exit on my own terms ( i am , terminally honest when NOT being employed by them)

and one more..... a young lady had just had some surgery on her insides... the doc said " demerol and dilaudid for her" when the patient had sufficient presence of mind, she said " why did that man come over her and say damn-it-all and dildough about me?"......... after i recovered from a laughing fit, i spoke to the doc about possiblyt whispering his orders

here are a few for yah.... eons ago, i had a dementia patient on a neuro floor..... as i did my rounds, checking each patient and room , i heard this constant HISSSSSIng sound...thought. " well that is odd"...and checked the flow of O2.... it was set correctly for that patient. decided the sound was just a bit odd for oxygen at 3 LPM..... flipped on the light and found my patient with cheeks stuffed like a chipmunks....??? the hissing sound was coming out of his MOUTH... and where was the oxygen tubing???? IN HIS MOUTH-- and he was chewing it... after i took about 3 -4 foot of tubing out of his mouth the patient looked at me and said " that was the toughest damned spaghetti i have ever eaten!":uhoh3: when working in the ICU, i looked up from my charting to see 2 feet on the floor..... BAD JUJU!! i ran over to check out WHY and see what else was possibly on the floor..there sitting on the 3 legged stool the doc had left next to the bed in there after interviewing the patient---there sat the patient with stool plopping down the side-- looked at me in his drug stupor and said " yo,b _ itch, they aint no ho' ( hole) in this pot":eek: when asking admission reason to new icu patient, i asked her if she could tell me why she was here ( checking orientation) and she said to me " well, i be falling out" and i asked her " did you fall out of your chair?" and she just kept repeating "no, no, i be falling out"....i told the doctor i was not sure of her mental status. the housekeeper over heard us speaking and said to us both " what she means is she faints/blacks out"...... now every once in a while when a patient wakes from surgery, the look all googly eyed and say " oh, you are so beautiful!" and i shoot right back at them.." darling you just had the equivalent of a liter of everclear--you will get clearer vision in a bit"

tell me that you had an MRI.... sounds like a pinched spinal root to me... you need a micro surgeon who can spot in impinged spinal root.... forget PT.... pay for the MRI out of pocket.. you are too young for this kind of debilitation...............

i am showing my age, but when yah get a patient from the OR who comes to you intubated or sucking any plastic device, yah need to be able to know when it is a good time to pull plastic.... and unless you understand weaning parameters,NIF,neuro/MUSCULAR qualifications, et al... you might guess wrong no matter how extensive your understanding of Rx's given and time frame for longevity within the human body ( not all heroin and meth and methadone addicts can just eat them up quickly) tis a good idea to know many vasoactive drugs that are typically seen in the icu setting.... yes many folks can learn, but there are times it AINT time to learn, yah need to know and call on a your past expereinces to guide you and give you a solid understanding of A&P, varied disease processes to understand WHY this particular patient is going to need intensive care in the hover period..... what do you mean you have no idea how fast you can give a 6 pack of platelets? FAST AS YOU CAN RUN THEM!!! DONT MAKE ME EXPLAIN platelet function!! ( i will after we are done! the time it takes me to explain A&P, just may jeopardize the out come!! no-- this is trauma patient! sorry you have never seen that much blood all over a patient, floor, bed, face, hands... steel yourself! i dont have time to explain to you that some one with MS/MD takes less drugs-- you ought to be in the know about transmission between nerve synapses are different with these folks.... in about 3 hours, i can tell you which of my new coworkers has had icu expereince.... and which ones DON'T........... and when you are on call, yah pray for your call person to be well seasoned... no, i am not mean, and i will explain everything to you once it is all settled down, but for goodness sake, if you dont know what to do, then do what i say.... yes, folks can learn--- but at WHOSE EXPENSE???

there is a saying in alanon.... look where you stumble, NOT where you fall.... what this saying means is that, we all do fall... but if yah desire to stop falling, LOOK WHERE YOU START TO STUMBLE... all the clues and signs that you can look back upon and say " these particular events led to me doing/ feeling / thinking/contemplating _____________--and then, i fell..... i have had a coworker commit suicide...and she got real mad when i called the suicide hot line on her.. she thought i was bluffing..i called her on her words, attempted to maker her understand i loved her THAT much.... she cut me off and fufilled her plan and left me a letter that she wrote before she OD'ed........ i still pray for her this day... and yes, it is a question as to how to handle the pain that you feel and have and cannot process your way out of....see no possible relief from... and truly i think the only person who totally comprehends is God himself..... prayers for you all those you love and whom love you....

yah wont get paid. yah get a chance to see if you can stand it. they get a chance to eval you.... some places do this even to current employees seeknig a job in a different department....

personally, i would get your manager involved in these cases....they could be a litigation issue.... your manager needs to step up to the plate.... ask her for suggestions.... and on a side note, when i have a patients like this, i ask before leaving their room/bedside :" is there anything else i can do for you before i leave?".... some times i am honest with the patients " i do have other patients. and i wish i could stay here with you. but i cannot.i have tried to find some one to come and be here with you, but i have not been able to. can you talk on the phone? can i call some one to talk to you? is here a tv program that might take your mind off of things that are scaring you? WE need to find a solution to this. i am open for your suggestions and ideas"... there are other times that i SIT ON THE PATIENTS BED while talking to them. i hold their hand, i touch them, hold their hands.... PERSONAL TOUCH-- FOLKS SEEM STARVED FOR IT..and it allays fears like nothing else.... dont be afraid to touch your patients... and lastly, if my patient seems to have faith, i ask them if i might give them a blessing before i leave til i come back--then i place my hand on their head or tracea cross on their forehead and ask the good lord to come and bless them and comfort them and stay with them, give them peace until i return. in another question elsehwere here on this board, another expereinced nurse told her needy patients " here is a piece of paper.i want you to list everything you need and write me a list. and we shall do everything on that list"

the ADN programs will not go away easily...why? because the cost factor... in the locale where i live the salaries of starting nurses is 40,000/ year... the cost for the education of an ADN is about 10,000 here..... if your education costs 50k-70k and you get out and only earn 40k ????? and you can look forward to a 1-3% raise... of course, with the industry in FLUX, ummmm they might suspend all raises.... sooo..... as far as i am concerned,unless momma and daddy are paying for your education and have no expectation of you paying them back, ( which i consider those who dont repay to have an entitlement thinking issue and need to buck up and stop lying to themselves that anyone owes them anything!!!) who owes you anything anyway????? SERIOUSLY--- WHO OWES YOU ANYTHING???? we have been lead to beleive LIES... that wonderful lie that a college education shall lead you to greatness and success and good money.... AHAHAHAHAHAAAA! experience says other wise... YOU WILL NEVER get any respect simply for the education you have..... you have to EARN THAT...by your actions, words, deeds...... your education is not an assurance of good character..... you said it yourself... folks dressed well in crisp clean uniforms and look professional have nothing to support their " looks" and " acts".... character is defined by your actions, deeds, accomplishments, behavior......not your credentials...... and ericsoln..... your rejection of the white lab coat.... is this covert rejection ? i would love to hear WHY..... do you reject what is stands for? or are you still having an emotional reaction to those students/ fresh grads years ago who looked good on the outside yet could not carry out basic nursing tasks?

ericsoln--- i love reading your posts.... :) cant say i have ever been in danger of physical assault.. unless we are talking about patients who are out of their mind or simply cant reason ( either because they have never been able to, or we have removed their powers of reason because of what we have given them med wise).... but many times i have been able to turn around a situation of verbal abuse from all walks of the profession...RT's MD's, fellow RN's.....and when others witness this happening, they decide not to mess with you... had an anesthesia md refuse to give more pain medication to a patient who really should have been on the floor by this time ( yah-- nursing short staffed and refused to take the patient til more staffing arrived--i applaud the nurse manager for doing so).the anesthesiologist screaming at me that he was no longer responsible for the patient as he had been signed out!! raving like a lunatic at me in front of the entire staff.... i clamly stated that i understood his position, but i was not sure how administration was going to think about this abandonment of the patient-- could i call administration for him? ( as i dialed the phone in hand).....he huffed away and said " dont call me about this again! find someone else!! ...... so this placed the patient in no mans land. i opted to call the surgeon and say " i am using your orders for pain medication, and clearly the parameters needs enlarging, may i have a verbal order to give more?"... now usually this nice mannered surgeon slammed the phone down and showed up 15 minutes later, screaming at me once again in front of all the staff... i took the verbal abuse, let it sail right over the top of me and said to the surgeon " look at your patient. have pity and compassion on him. do with me what you will, say what you will. BUT OUR FOCUS IS THE PATIENT. may i increase the dosage of __________?"......he screamed at me " write for whatever you want! "....... i remained and kept my composure. sought out another doc who would write more pain orders so my liscense was covered.... been doing this long enough to know since all the other nurses felt and saw all of this, i would need to do nothing......... needless to say, i never had an issue with either of these 2 doc's ever again. anesthesia doc came to me and said " they are sending me to anger management--what do you think about that?" i never said a word to him but redirected the conversation about how grateful his family would be to have a peace filled daddy and husband.... the surgeon never apologized.....but i beleive in leaving a " space for grace"....we all have bad days...and he regularly seeks me out to just chat.. knowing i will just listen and be there....and i know he requests me to care for his post op patients....( the OR and chanrge nurses come and tell me) at the end of the day it is easier to sleep with a clean conscience... you have done no harm.....caused no pain....

do yah want to stay annoyed? what can YOU do to remedy the current problem... and i mean changing yourself --because you cannot change another..... what needs to happen so that you are not so annoyed????

do yah plan to stay a victim? or become a victor?

truth..... but people will be able to say " i know ONE professional nurse" and hopefully they know you by name...... take the challenge for one week and put your heart and soul in it... then get back with me....LOL

ummm quite a few.. one stands out..... sick icu patient--17 year old ... pressure so low, we emergently placed a venous line femorally----- and once the levophed was going, BLOOD was pulsing up the tubing.... probably the only reason the patient survived.. doc did not beleive me and was tired as all get out... to save his orifice and mine, i quickly converted it to a arterial line and told the doc " yah come take a look at the waveform THEN you can tell me whether it is a artery or a vein, OK???"........ yah dont want me to repeat what the doc said to me as he had to get out of bed AGAIN..... and doc placed another central line... i thnk he bought me a bunch of flowers or chocolate he was so mad at not believing a nurse..... not sure who learned more,,, he or i intubating patients when they residents could not get them into place-how they made so much fuss about my bending the stylet in a sideways L shape--think alligator forceps/clamp)--( and the year i did it so often they gave me a turkey with ETT for a christmas present) when they pick me to stick my hands inside a patient to hold a bleeding artery while rolling down the hall to OR since i weigh the least ..sitting like a whooping crane to apply enough pressure... picking gravel and sticks and leaves out of a patients extemity's i got so many stories....