NurseStorm

This used to happen semi regularly about 4-5 years ago on our unit, but the last 1-2 years (especially this past year) it has been rare to practically non existent. We are more often short staffed with completely full census most of the time. When we do have low census, (has happened maybe 2-3 times since september..) there is a list of when everyone has last stayed home. We look at the list for each person scheduled to work the next shift and write out the order from who stayed home most to least recently. Then we call in that order offering them the chance to stay home (usually home on call) if they want. This will come out of their stat/time in lieu/vacation. If they say no we proceed down the list. We are under no obligation to stay home, it's actually more of a privilege. If you don't want to, you don't have to- but since we are getting denied so many days off and shifts are so busy crazy and hectic, it's usually people clamoring to stay home! If everyone says no, we just all come to work, we cannot be forced to stay home once scheduled for a shift. Often the supervisor will make us float to other areas and help with tasks we can do (simple things such as vitals etc). Sometimes the clinical leader or manager will have little projects they've been wanting us to work on and get us to do that (reading manuals, checking carts, transport bags, organizing side rooms and cupboards, etc etc).

Another one, one my very first clinical rotation, which was in a long term care facility I was doing my "research" for my patient, reading through the chart and doctor notes. The patient had dementia and apparently quite frequent mood swings/changes in mood. The doctor wrote "Patient is emotionally incontinent" LOL I don't remember many specific charting things like this, but that one has stuck with me all these years hahah (occured in early 2008)

Another situation was I had a pediatric patient, with a mother who was having incredible anxiety over her child being admitted. She was about 8 or 9, and in with a mild asthma flare up. Nothing at all to indicate it was in anyway life threatening. The patient was not on oxygen, not requiring many puffers etc. However the mother was convinced her child was going to die (tonight). I tried to be very supportive and reassuring. Pointing out all the positive signs of progress and acknowledging it must've been very scary when her child was having difficulty breathing but we deal with a lot of asthmatic children and it can be fairly easily managed, etc etc. I told her I could arrange for the asthma education centre to work with her and she was starting to calm down a bit. Then the pediatrician comes in, and she states "Doctor, I'm so worried. Is she going to die tonight??" and he says -wait for it- "Well I don't know, I'm not God", then leaves. :facepalm: So I then had to deal with her becoming all upset again ("Well the doctor says he doesn't know!! So he must think it's a real possibility! Oh my god I knew it, I knew there was a high chance" etc) God love the poor woman, I finally got her to relax by emphasizing that the doctor clearly meant anyone can die at anytime and he can't predict the future, not that there was anything to indicate it. I had a little talk with him afterwards about why answering an upset parent with a line like that may not be the best approach

As a fairly new nurse my patient was a mother who had delivered approx 10 hrs prior. She was in a lot of pain and when I assessed her perineum I noted a very large firm area that I suspected was possibly a hematoma but there was no discoloration so I wasn't sure, but I knew something was very wrong. I got my senior co-worker to come assess and she agreed it was a hematoma and the dr needed to come in asap as the patient would likely need to be taken to the OR. When I called the dr I told him my assessment and stated "both 'Mary' and I agree you need to come and assess her immediately" The doctor stated "oh put a bag of peas on it" :| Confused I stated I already had tried both perineal pad ice packs and then actual ice in a bag and nothing was giving any relief or making any change. Reluctantly he came in to assess. Walking down the hall to the patient's room, he again says "I told you, all she needs is a bag of peas on it" and getting annoyed I state "Well just look at it please". 2 seconds after examining her perineum he turns around to me, with a surprised look on his face and says "Oh, we will need to go to the OR to evacuate this.. Please call the supervisor". Awhile later when he returns from the OR to chart, he sheepishly states "... and I said put a bag of peas on it.."

Ours come up from pharmacy in little plastic bags that tear easily, connected in strips usually if the patient has multiple meds, or sometimes multiple in a ziplock type baggie if it's a prn. The only ones we have to pop out are typically narcotics such as po dilaudid, percocet, tylenol 3s etc.. Recently they started including benzos into the counted narcotic drawer, so now they are in the cards with the foil backing as well. Also concerta, vyvanse, etc for adhd come in these packs. Ours are very easy to get out though, its a thin foil and then usually a plastic circle around the front, the foil tears easily to let the pill out when you push on it. I feel very lucky now! I knew from reading many posts re: pyxis and all these different ways med administration is done in the US vs where I work in Canada, that it was a lot more time consuming but never knew about this aspect, or even considered it!

A PICC is a CVAD, so yes, you need to wear a mask when changing the dressing, changing the cap, or doing anything involving an "open system". A PICC sits in the superior vena cava extremely close to the heart (you see the outside location in the upper arm, but the catheter is much longer than you would think if you are not familiar with them. It goes extremely close to the heart, almost into the right ventricle in fact.), providing high risk of dangerous infection if bacteria were to enter. A peripheral IV is nowhere near as close to the heart, they range in length from 5/8" to 1.25" generally and are normally inserted in hands, lower arms, antecube, etc. So the risk if bacteria were to enter it would be nowhere near as dangerous as with a PICC/any cvad. Also, the system isn't typically open as there is usually tubing/saline lock etc attached. And even if it were to be completely open, (depending on your brand/type I suppose, but this would apply to ours:) blood would be pouring out further eliminating risk of bacteria entering...

Nope, we were taught in grade 3 and 4 which for me would've been around 1996/1997/1998 ish. Not only were we taught it, but we were required to use it on all assignments, reports, etc etc up until the end of grade 6, after which we could choose to write in cursive or print.

I was about to say, this has to be a typo- otherwise makes no sense! lol. I feel bad you wasted so much time and effort due to someone's careless mistake! :X

Maybe do something like ACLS/pals, etc, depending on what type of unit you work on. And/or some courses/certifications/workshops etc on relevant topics. I wouldn't think it would be too much of an issue, lots of people have babies. It's not like you had time off work due to med errors or something. Good luck! *edit* Sorry guess I missed the 8 months of experience in 5 years as I was skimming a little lol. So yes, I can see your concern. Still the only advice I could have would remain what I said above! :)

WOW yours is cheap. Ours are like $450-500 annually :/ Although I have never known anyone to let their license lapse in the 4 years I've been an RN. Our union sends reminder emails.

I hated it. Hated APA, hated having to find the certain set number of references, and there always had to be certain ones within certain time frames which usually ended up being very difficult. They mostly were largely about theory. I always have done very well on papers but I hate doing them. One paper I did in nursing school, I didn't mind doing. It was in maternity class and you chose a topic (I chose multiple births including high order multiples), and wrote about what it was, the risks, the interventions etc etc etc. That was very interesting to me and useful. Mostly all the other papers felt like make work projects re: theories, trying to match the rubric that they wanted you to meet, etc. Frustrating and I didn't feel I got much out of it.

I have to say, I laughed out loud when you said you actually said to them "yeah, white" *rofl* While 'perhaps' not the most 'professional' response, I personally think nothing wrong with saying that when that's what they are getting at :X Although I am a little bit sassy by times so perhaps my opinion isn't the best lol. It also makes me very upset hearing of racism. Luckily it's not something I've encountered directly in my work that I can recall. We are a very white population where I live, with a number of doctors with "foreign" last names or appearances, and I have never had any patients express anything other than respect for our doctors, except for one child with behavioural problems who, through his tears, said "I wish I had a doctor who I could even understand better! I can barely tell what he's saying to me!" which is not a racist remark in my opinion, as he did have a tricky accent if you weren't used to it... However, things like watching the US election and coverage is quite alarming, heart breaking and .. I don't even know the words to say how it makes me feel I think most good managers would've stood up for you in that situation, however maybe I'm naive. It's not like you called them nazis, or other names, etc, you simply stated exactly what they were clearly thinking :| :|

As non medical advice, just wanting to point out that the main targeted injection site of the thigh is the vastus lateralis... So keep that in mind when choosing injection site. Other than to state that, I agree you could discuss your experience with your HCP as I have nothing to say re: your experience otherwise.

I'm confused about why so many of you seem to have rules against drinks anywhere but break room, etc ? Is this all across the US? I understand obviously not in direct patient care areas, but what's the issue with having drinks at the desk? We have no rules re: this, and even have food at the desk frequently, such as if a patients family brings us a fruit/veggie tray, or a box of chocolates, etc. So I have no real issue staying hydrated for the most part. I make an effort to have a reusable water bottle with me, and my coffee, and everytime I am charting, or walk back to my computer to get more meds, I have some sips. If I don't take a reusable bottle I find I can end up not drinking enough especially when it's really busy. When it's really busy sometimes I don't make the effort/take the time to refill it as much as I should so that's the main time when I am less hydrated than I should be. As far as not having time to use the bathroom, there have been (many) times I've had to wait much longer than I would've liked to. There has been at least one shift I realized in the morning I hadn't used the bathroom all night as it was such a crazy night. But to literally not have time to THE WHOLE SHIFT? My god, what is going on in your hospitals down there Americans Makes me sad for you all if that is common..

Yes it was an insane injury/accident! I was back working about 8 months later, starting with easeback and then up to full time after 6 or 8 weeks I forget. Worked full time from January til the 3rd week of July, where pain flared up very badly (had been kind of gradually declining and then 2 insanely busy short staffed shifts sent it horrendous) So sadly I have been off work ever since trying to get it back to normal I am now in a 5 day a week program with specialized workout routine and chiro or physio each day. Wow to get punched in the face while working is horrible. And your poor co-worker, sounds like something that would happen to me :X lol.