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So Frustrated I Could Cry..
Bad management is eveyrwhere... there is even a prayers for special help section.. "God, I am in need of your guidance and your protection from the evil in my place of employment" lol http://www.prayers-for-special-help.com/protection-from-evil-nurse-manager-father-guide-me.html Sorry. There are other jobs but there is only one family. And it sounds like this is a time your family needs you. CALL IN! Stick it to them!
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When To Cut Back?
Did you get accepted for the Fall? 5 12 hour shifts is rough. Close to insanity even if it is a really easy unit. I do 6 8's. There will not be much time for anything except for work, decompressing after work and then going back to work. If you haven't been accepted yet and this is a position you really like/something you may want to quit your other position for then you could consider trying it out for the summer. I would love to be able to walk to work. Don't expect DON/upper management to be nice.organized. They are used to desperate nurses kissing their bums. I remember being made to wait or cancelled on interviews last minute back in the day. Good luck ^_^
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Taking ownership of pts
lol I like that nightclub comment! Will save it for future reference. I changed the cuff as soon as I noticed and did indeed do the aforementioned plan of care & highlight it on my off going report. You are right, patient safety is the bottom line. They are counting on us! There was a time my coworker received a pt with equipment we were not familiar with. When coworker asked about how to maintain/assess it they made the nurse feel stupid for not knowing - even though we only see it once in a blue. In the ideal world, there would have been a stop - demonstration/teaching and opportunity for question during hand off. In reality there was a bit of eye rolling and a little shaming. Luckily we have online access to resources and were able to learn more about it on our own. I told my coworker its better to "look stupid" then to start messing with something you're not sure of and compromise pt safety. Such is the world we live/work in. On a lighter note... a cartoon I saw online..(does not apply to just docs)...
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Taking ownership of pts
Well, we report to different managers/attendings. Theoretically feedback can be given by a staff nurse regarding a different discipline but the only time I've seen quick action is when a doctor/pt/family member complains - not the other way around. I've talked to my coworkers who've been here longer.. they mentioned "food chain/hierarchy" and "ego" are big driving factors. But you are right, no one likes to be caught in the wrong. My own reaction is to apologize (sometimes profusely, especially when I was a new grad lol) and make amends but that is my personality.
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I lost my love for nursing...thinking about quitting.
I've worked in different NHs. Management and coworkers really make or break you. Residents I will always love but the way the facility is run really makes a difference on whether you feel optimistic stepping on the floor or feel like crying in the bathroom. Try another place.
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Taking ownership of pts
Yea I guess the nausea and stool is not life threatening and they can pass off the pt like that. I was mostly bothered by the colleague that got upset at me pointing out the arm precaution. this all happened on the same day so I was thinking do these ppl even care about their pts? Some of them dump the pts before they are hooked up to the monitor confident in the inherent stability of their pts while other ones Ive worked with before will stand and check the first vitals while giving a good history/report. Hopefully they will get better with time.
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Taking ownership of pts
Oh I did not accuse anyone of anything. She admitted the pt had not been cleaned even once throughout the procedure. The room had MD, CRNA, RN, and techs w/new gown and sheets in the cabinet but she just wanted the single pacu nurse to take care of it "since you have time".
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Taking ownership of pts
Need to vent. I work in recovery in a teaching hospital. Every few months a new round of fellows and crnas come through. The most recent batch seems to be a little sloppy. For example one transferred a pt w/ESRD, right arm fistula. Had the bp cuff on the right arm. I pointed it out to him and he said "oh oops. owell its okay". I then pointed out the bright pink arm precaution band on her arm that states "NO IV/NO BP". He then raised his voiced and said "so what do you want me to do??" and stomped off. I wanted him to keep in mind and be more careful next time. If it was his family member I'm sure he would raise a big stink about compromising this pts life line. Another colleague dropped off a pt that was dry heaving, retching and remarked "I had no time to give zofran" . Really? Takes under 2 min. And another dropped off pt w/gown soaked thru in stool. "We had no time to clean her, Ineed to start the next case". Really? Pts are not just a paycheck/number. We are a team but take ownership of your pts. Am I over reacting?
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Least stressful nursing specialty
I feel clinic/office nursing is less stressful. The acuity use much lower, you deal with pts one at a time, doc is usually around so no need to page and wait...and wait while pt/family member is yelling. You can learn alot working one on one with your doc. Hours are nice. You may work weekends but will likely have holidays off. No bed pans. In a small practice you are more able to implement changes and discontinue protocols that are redundant/not working. You can spend more time teaching and building therapeutic relationships. The only downside for me was that after 2 yrs I started missing the insanity and went back. I am a younger nurse so I felt I needed more exposure but I am still keeping my clinic position per diem because it really is a nice niche. Another area can be specialty nursing vs floor nursing because the nurse to pt ratios are better. For example procedural nurses such as those in endo or radiology. Longterm care is also low to moderte acuity depending on the facility but the nurse to pt ratio can be more than 30 to 50 pts per nurse. Your only saving grace is that you get to know the residents very well so that most days it is managable. This area was one of the most rewarding that ive been in. Good luck on finding your sweet spot!
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things are not what they seem
agree! grrr
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I'm tired if being the new "new" nurse
Im not a new nurse. Ive had positions in a few specialties. However each time I go to a new unit I get that same "new grad feel". Dont know where things are, dont know the nuances of that unit.. heck I even wonder how will I remember everyones names. The solution is always the same. Ask questions, take notes, work well with others and reflect on how you can improve every day. Practice safe nursing. You'll be an experienced nurse before you know it.
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First day at new job New Grad- AFRAID
Review your shift everyday. Think of what you'd do differently/better and look up things you didn't know. Find a good resource person. Each day you will be more experienced then the last.
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things are not what they seem
Lol several "all the times" and one "pretty common". I have to get better at spotting them. Not expecting special treatment from patients but I do still expect some decency from humanity. There are people of all kinds though... Glad to hear from my allnurses brothers and sisters who have been there and done that.
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things are not what they seem
Ever have a patient you seem to be connecting with/good rapport who turns out to be manipulative and ends up doing something that puts you in a tough spot: sneaks off to smoke, refuses monitoring when they have sky rocketing bp, fall risks who "don't need help" etc. I end up feeling a little bit betrayed Happy New Year AN, to another good year!
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What exactly is ambulatory RN?
same day, they walk in and walk out in under 23hrs. Pay depends on your boss