Morainey

Does anyone know exactly how to do the VACO appeal? I'm trying to get Level II. I basically touched up on my letter from my original appeal for the dimensions that I missed. My manager hasn't really offered any advice and I'm not positive on how to proceed. Any suggestions or advice would be appreciated!

Sounds like the regular old learning curve to me. Even a seasoned nurse starting in a new place can be confused by the order systems and procedures. I had to learn to draw blood at my current job. I used to dread it but now I actually enjoy drawing blood more than starting IVs. Practice is key.

Good for them!! I think this is great. The questions are awkward to ask at first but then they just become part of the assessment.

Okay... I'm talking about someone literally watching TV episodes on their phone while they're assigned to be watching a patient and protecting that patient from harm such as dislodging lines or getting up unassisted. I don't think that's acceptable. Would you want a lifeguard at the beach your family is at to be browsing their phone while they're supposed to monitor people in the water? I don't expect anyone to literally sit and stare at a patient for with hours straight with no distraction or break. However I have a reasonable expectation that people pay attention to the job that they're doing.

I agree with above reasoning - I think it's unprofessional to sit on one's phone. A phone for some reason seems more engaging than a book or a Kindle or homework. I've been a sitter and I know it can be agonizingly boring, but we have a CNA who will literally watch Dr. Phil episodes on her phone and ignore the patient. When you walk by in the hallway she's totally engrossed in her phone, not even looking at or paying attention to the patient. And this is during a busy shift! She's been spoken to multiple times but it keeps happening. It just leaves a bad impression IMO. However, in the middle of the night in the dark is a different story and your supervisor seems like they're being unnecessarily harsh, unless your facility has a zero tolerance for phones? FWIW my work environment is fairly phone friendly but most nurses leave their phones at the nursing station while doing patient care.

I probably wouldn't have told them that you hadn't gotten around to it yet. I think there are other really good suggestions on this thread for responses - such as explaining that a thermometer or BP cuff can be invasive or painful, or that frequent VS monitoring isn't indicated. Family members sometimes need to make their voices heard as part of their coping process. It's difficult to watch a loved one when you know the inevitable is coming, and some people handle it differently than others. Whenever my stepfather was in the hospital, his daughter would make the biggest stink - harassing the nurses and second guessing their every move. And she's a nurse herself!! I'll never understand some people.

Does anyone have any suggestions or examples of what they wrote for their Level II proficiency under Performance? I'm really struggling here! It reads: "Evaluates practice of self and others using professional standards, relevant statutes, and regulations. Takes action to improve performance". I'm thinking that maybe providing feedback to nurse residents that I precept might be an example of this? I'm also thinking maybe when I contacted my manager about how we all hated the new IV catheters and she arranged an inservice. Any advice, please let me know!! Thanks!!

I'm so sick of these threads, complaining about not getting paid enough. I think my job is frustrating and exasperating sometimes, my assignment is too heavy, my patient or that doctor didn't ask how MY day was going, charting takes forever. But you know what? I'm still getting paid. I'm getting paid a lot for an associate's degree nurse. I am not volunteering my time and I'm not some benevolent saint. So you don't make as much money as some rando. I bet you make a lot more money than a lot of other people do.

I would work on med-surg. It's a good foundation, and I find it somewhat unlikely that they would hire a new grad directly to step down or the OR, even if you already work in that healthcare system. It's an exciting time. Good luck :)

Lots of narcotic diversion and stealing from patients in my neck of the woods. It's been awhile since I looked but no one lost their license for forgetting to cut a metoprolol in half.

I knew it was too good to be true!

I like the Z-grip pens. I basically like click pens because I can shove them in my pocket or clip them on my clipboard. I always bring a highlighter and dry erase marker as well, and a pair of Kelly clamps. I carry scissors also.

Wash your hands. Like all the time. I try to stay beyond arm's length - you never know. I picked up an awful GI bug from work recently and it was just the worst.

Don't be whiny. Be nice and polite to everyone, even if they are not nice and polite to you. I don't have Facebook, and I find that cuts down on a lot of drama and gossip.

On the social side... I went from nights to days and for awhile I got treated like I was the new guy again... I think I wrote a post about it a long time ago, nurses that I had given report to in the past and seemed friendly enough with were standoffish and would do stuff like stop talking as soon as I came in the med room, etc. Basically I chalk it up to being too sensitive on my part. Just be aware that you might get that kind of treatment, especially if there are already "big personalities" on the floor. As far as work goes - yes it is more intense - orders come flying in, gotta get that assessment and med pass and charting done before everyone starts getting discharged and all the new orders come in. You'll get used to it I think! Just busy, is all. The best part is it goes by quickly :)

I like tone deaf posts such as: everyone I work with is awful. I refuse to ask for help but get upset when no one helps me. I didn't bother to get to know anyone or act friendly, they should be nice just because I am so great. I feel entitled to a successful career without investing in my education, I don't know why everything isn't handed to me. I'm too good to work in an LTC, I hate working with the elderly. I hate being a nurse because it isn't as perfect as I imagined and no one gives me pats on the back just for showing up every day (except when it snows or I already have vacation planned, LOL!) I didn't go to school for 2-4 years to clean up poop, even though I appear to have scraped through clinicals somehow! I don't get why everything just doesn't always work out for me!!!

Oh, good grief.

I would like to know what my former manager is doing about the consistently negative "Doctors took time to listen to me" section that CONSISTENTLY gets dinged on Press-Gainey, and continues to decline, yet nurses get scolded for not answering call bells quickly enough when they cancel half the staff in order to be "lean"!

If someone sent me a picture of their hemorrhoid I would unfriend them forever. Ew.

Keep going. You're doing God's work. ...seriously this post had me rolling. My friends call me the Poop Whisperer because when I come to work, and have a constipated patient, I'll be darn tootin' (no pun intended) if we don't have oceans of poo by shift change. A moment of solidarity for Poop Whisperers everywhere!

3 years sounds like plenty of experience to me. Where I used to work you had to take a BS class (which was really just an excuse for our PhD educated nurse educator to talk about herself, unfortunately) and you got an extra $1/hour, made the assignment, assigned admissions, and were out of assignment on days and evenings.

They may be in restraints for injurious behavior (ex: with potential to harm themselves or others) or to prevent interfering with care (such as a confused person pulling at medically necessary interventions, like IV lines, Foley catheter tubing, or NG tubes, just to name a few). Your facility should have a policy on this which clearly defines when restraints are indicated.

I think a lot of the drug-seeking, coffee-demanding belligerent patients and family members a lot of us complain about (*looks in mirror* GUILTY) can be chalked up to venting. I think a lot of the nurses on here would say that they can't really describe their workday or their patients to someone who isn't a nurse and doesn't get it, myself included. So thus you see a lot of venting posts because it's easy to vent to a group of anonymous colleagues who are in pretty much the same boat and can empathize. So when I was in nursing school I didn't really envision what kind of patients I'd be taking care of, but more the kind of qualities that I wanted to have a nurse - knowledgeable, compassionate, level-headed, not-easily-fazed. I don't know if that really answers your question, but I hope I didn't come across as snarky in my last post. I guess it's all a matter of perspective?

I didn't really "go to school" to be a hero nurse every shift. A lot of my job is the same weary drudge, day in and day out, we have lots of frequent flyers and rude and entitled and people whose chronic condition is just worse than usual. It's all fine. I don't get bent out of shape anymore when people sign out AMA and then come back the next day. They're all patients, and they all deserve care. Source: med-surg tele floor.