newrnltc

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!

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 ^_^

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)...

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.

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.

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.

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".

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?

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!

agree! grrr

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.

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.

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.

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!

same day, they walk in and walk out in under 23hrs. Pay depends on your boss

Sbfairy thank you so much for your reply! Ive been trying to learn as much about this as possible. You are right. It seems with endoscopy recovery it may be a bit easier to manage (I hope) because the kinds of procedures they are coming from are more focused rather than all sorts of post op. I will take your words to heart and study how to handle obstruction, pneumothorax etc. Hope I can keep up! This will be my first acute care position since graduation and I'll be working 6 days a week!

Hello AN! I currently work in out patient clinic and am going to pick up some time as an endoscopy recovery RN. The orientation is only 1 week on the floor and then I will get 2 pts and transition to 4. Can you guys please give me some tips on: How do you organize your day? What are common challenges you face? Common meds used in recovery? I was told we do not do reversals. How fast do you turn over pts? The NM said normally q30 min. There is no phase 1 or 2, everyone goes here and then gets d/c to home or transferred in house. I know every specialty has its quicks and any tips in general would be greatly appreciated! Thanks so much!

They need to watch this: The Simplest Explanation Of Obamacare. Ever.ts like the "for dummies series" that I had to read for statistics

I've seen this in several places I've worked. In fast paced areas with high pt turn around I believe that most drawn up meds would be used within the week. As long as staff checks expiration dates before drawing up meds and do not draw up a bunch at once there should be no expired products in the syringe you pick up. I also hope they are well versed in the proper techniques to prevent contamination. However, for the final word it sounds like we need to do a literature review!

I think with your background of 5 years in the hospital it would be safe for to try out clinic without worry because you have solid acute care exp. If you don't like it you can just go back. Like previous posters clinic is a different kind of busy and there are times you miss the acuity. I personally miss working with other nurses "in the trenches".

I feel like as a new nurse it would have been nice to be able to learn the ropes worth a good orientation, support team and other RNs around. Orientation in one ltc I went to was only 3 days. 2 of themvin classroom and then u get the full load of 40 residents. In ltc on night shift I was the only rn watching 2 floors sometime. No docs. And now in clinic I am again the only rn although the doc is there and its mostly walkie talkies that come in. My friends in home health also say its difficult because when u have a question u have to call someone and hope they pick up. We did okay but as a new grad you hope for a little bit more guidance besides "heres your assignment I hope you can swim".

Sourapril, because that's what all hiring managers want. The acute care exp. Like OP, after hundreds of applications I wad unable to land even an interview as a new grad (nyc) so I ended up in SNF. In the mean time I kept looking and recruiters would always poo poo the snf experience. I wanted to shout you try medicating and doing wound care on 60 residents in 8hrs. I had chronic uti for gods sake. Alas I have yet to land that elusive hospital job. I am happy running an out patient clinic for a nice doc though so cant complain.

Yes go see your pcp! They wont be able to know if you have a past, current, acute or chronic infection vs immunity from just one value. If I remember correctly its a collection of tests hep: core, surface antigen, dna, antibody,igm etc as well as hepatic panel that needs to be done to clarify what's going on. Don't panic. It might be a false positive or a misinterpretation by the person that called you (happens). I had a needle stick at work years ago. Pt refused to be tested and swore he was "clean" (yea as if that is reassurance for me). My life would flash before my eyes and I would have breakdowns for the rest of the year each time I had to retest for hep b, HIV. In the end I was cleared and I hope you will be too!

Making a difference sounds cliche but you will. Over and over and over...You will find those extra few mins to offer comfort when the docs and everyone else are in a rush. You will find the extra patience to explain something they don't understand to give them confidence to face their challenges. Your smile and bedside manner will make them less scared of the unknown. Yes if you take away all those stupid customer service, redundant charting, understaffing cr*p its the best damn job in the world! :)

a year from now this guy and his weird behavior wont mean jack. you have bigger fish to fry!