toadie

my fiance's grandfather is in the hospital and i am not close with my mother-in-law-to-be. i get small bits of info from my fiance but he doesn't really understand what is going on. so i called his mom to find out what was happening. well, he went in for pneumonia and exacerbation of heart failure. after a week, the day he was to be dc, they found blood in his stool; and so the spiral begins. turns out he was having bowel issues which was causing problems with flow to his kidneys which led to exacerbation of his heart failure. they took him for emergency surgery and removed his entire large colon on wednesday. started him on intermittent dialysis on thursday. not sure of what happened between then and now, but my fiance went to visit today and came home with questions about a "feeding tube". a peg. and he also said that he was intubated, im not sure when that happened. as an icu nurse i've seen this scenario too many times. grampa will be 90 next month. my fiance and his dad want him kept alive "by any means". his mom, who's grampa's daughter doesnt want any of this done. grampa consented to everything, but i have my doubts as to his ability to consent, at his age and in his condition. i need advise on how to talk with my fiance to get him to understand what is really happening.

sorry u had such a terrible time. when i started my orientation was just horrible. worked thee six monthes and started looking into going back to school for something else. at the urging of some coworkers decided to try another facility before i quit nursing. this other hospital is great. problem with nursing is that school does not provide any real insight inot the real world. they paint a picture of what nursing SHOULD be not what it is. so when u graduate and it doesn't work that way u feel like a failure. not necessarily because u aren't doing what u r supposed to do; but because u are failing to do what u always thought u could do. good luck 2 u.

reading this post and all the replies i just had to respond. i don't think the op meant anything mean by saying her pt was "lying". i think op was just trying to voice her frustaration with trying to take care of a pt who was not supplying all the needed information to fully take care of her. it's frustating to think you are assessing pt and managing their care appropriately just to find out there's is a lot more going on. whether the pt "lied" or "fibbed" we as nurses just want to see them get better. it's just frustrating when we don't have what we nee(information). just me 2 cents

i'm 24 but appear to be 16 on a good day. i had a pt last week who refused to take medications from me because i was too young to know anything about meds and must therefore be attempting to poison him. :angryfire the other nurse who ended up having to give my pt his asa thought it was pretty funny.

while in nursing school i worked as a cna at a hospital that only allowed a nurse to start an iv after she was certified by the dept of nursing. this required 2 supervised, successful iv sticks. this was such a bad idea because there was no formal iv team. one night on 12p-8a there were no iv certified nurses on the floor and one went bad. the pt had to wait over an hour for a nurse to come from another floor to start the iv.

i have been a nurse for almost a year. i work in a large teaching hospital full of residents and med students. a lot of them come in and with the attitude that they are better because they are going to be MD's. this is not always the case though. i remember one resident who was trying to figure out how to get my elderly pt on a bed pan because i was charting and he didn't want to bother me (until he realized he didin't know how). then there is the medical student who tried to give me verbal orders and got mad when i refused to accept them.

i've had patients on this and its great. it can only hang for a certain time though, i think 24 hours.

this debate just makes me nuts. adn's work hard for their degree and bsn's work hard for their degree. i have my bsn. i am proud of my degree, i worked hard to earn it. if there were some vast difference in the education of a bsn vs an adn regarding clinical education the two would not take the same licensing exam. but they do. the difference between the two are philosophy classes and classes about the "theory of caring" and other such things. a friend at work who has her adn and is in school to complete her bsn told me that she was surprised to find out that the classes she was required had almost nothing to do with nursing. a bsn does have more formal education than an adn. for those of you who think that reading words in books matters more than clinical experience should ask your patients how they feel on the subject. i just wish that everyone was able to respect each other for their own accomplishments.

:biggringi we always brought a gift for the clinical instructor at the end of each clinical. this sort of annoyed me because some of the instructors would expect it rather than appreciate it. the gifts we gave were usually r/t their interests. a borders gift card, a gift basket with scrapbooking supplies. one time we even made a fleece blanket, which was fairly easy. a large piece of fleece (big enough to cover a bed) and then 3-4 inch slits made all over the edge. the edge pieces then tied into knots to keep from unraveling. the instructor loved it. good luck.

it's not only the general public who don't understand health costs and our salaries. i had a resident ask me about nursing shifts and whatnot. he asked me if because we work 12 hour shifts but are actually her for 12.5 does that mean that patients are actually charged for 25 hours of nursing care. i laughed and told him we were part of the room charge. he was amazed that it didn't matter how much care a patient needed (in icu) they all got charged the same "rate".

i started as a new grad in the cvicu. i did have people tell me that i might want to get experience on med-surg first....and all the icu nurses told me if i wanted icu to start icu. my third week precepting i was put with an rn who was totally old school. she spent the entire morning telling me that i should not work in icu, and i should go at the end of the day and turn in my transfer to the manager. not becuase i was incompetent or unable to learn but because i was a new grad. i spent only one day with her, talked to my manager and requested not to ever have her again. only you know what u are capable of. to those who say u can't smile, nod and prove them wrong by asking tons of questions.

i don't think there is any risk imposed by working on the unit that you wouldn't find on the floor. there are pt's with nasty bugs all over. on my unit we have a couple nurses who are pregnant and we try to work their assignments to minimize their exposure and the amount of lifting they have to do. as long as co-workers are thoughtful it should be safe.:)

i work in the unit so i don't have first hand experience but i work with many nurses who just transferred from step down into the unit. they say that they had 6-7 pt on telemetry. a pt who is on vasoactive gtt can only go to step down if they are semi stable, meaning the previous nurse has not had to titrate much. the thing that concerns me would be the vitals. at our facility a pt with vasoactive gtts, regardless of where they are or how often they are being titrated must have vitals charted every twenty minutes for the duration of the drip. that makes for quite a bit more work if normal vitals are Q1H or Q4H.

my facility gives NO bonus pay for any holidays. they employ many international employees and have international patients as well. to give a bonus for christmas also requires a bonus for hanukkah and all muslim, hindi etc. holidays. they say to give a bonus for one holiday and not another shows favoritism for one religion over another. how many jewish people get all the days of hanukkah to spend with their families?

i work in a vascular icu. three weeks ago we admitted a 23 year old female, she had a blood clot in her leg only three inches away from where she wore her birth control patch:uhoh21: :uhoh21:

i don't know that there is a minimal time interval for documenting. at my hospital there are policies for each unit stating when a re-assessment must be done, and that is when we chart. i don't think this is a legal issue. i think its just a hospital policy.

the state i live in allows lpn's only to hang ivf and some antibiotics. no ivp meds. they are not allowed to take verbal orders from md or allowed to do assessments. they are not allowed to titrate drips either. they may not initiate an iv infusion but may hang a new bag of ivf if it is empty. i don't think they are allowed to access any type of central lines either. my hospital doesn't have lpn's in our icu. the truth is i think they would be very bored to be there. while in nursing school i worked on med-surg and found the lpn's to be more knowledgeable about many things than some of the rn's. i think it doesn't have so much to do with your degrees or certifications, rather your own states practice act and what things are within your scope of practice that determines where you can and should work. just my 2 cents.

i think its a nice sentiment but inappropriate. the reason is that it may be looked upon as crossing the line of professionalism. its not appropriate to accept gifts from patients either.

we had a t-shirt that listed the top ten reasons i became a nursing student. all gender neutral, some of them quite funny like... i wanted to see what it would feel like to be up at 3am without a drink in my hand. i am way to smart to go to medical school. there's no better physical exercise than carrying around hundred pound a&p books there's nothing better to do on a friday night than read anyway.....:chuckle :chuckle :chuckle

hey mich 01085 i read your post and understand your frustrations. the truth is nurses who have been nurses for a while are often convinced that there is no way a new nurse can be right. i even had a preceptor when i first started who tried to convince me that a fentanyl pca bag didn't need to be wasted by us because we didn't hang it:eek: anyway, the way that i would handle these RN's would be to ask specific questions in shift report. " oh, so mrs. smith was admitted today. Is her admit assessment done in the chart?" this way if they say yes and its not then they are lying and you must tell on them. and i don't think i would fix any of their mistakes. for instance, if they don't do the admission paperwork that means that their mars aren't done. i would make it known that i finished the mar on night shift. which means that if meds were given on days they were not checked with the mar or signed off. these nurses arepointing out your errors to cover their own.

jahbingrn i read your post and it sounds like my own orientation. i recently graduated. i had an 11 week orientation. i was hired into cvicu. my orientation consisted of three weeks of classroom, 2 1/2 weeks in a heart failure icu,3 weeks coronary icu and 2 weeks cardiothoracic icu, and two DAYS on my own unit. iwas then told that i was on my own. my first week i felt like i was still on orientation because ihad so many questions and needed help with many things. but, who wouldn't, i had almost no exposure to the pts i was to care for. i was completely honest w/ my nurse manager, assistant nurse manager and other nurses about my feelings. i doubted myself everyday. i knew i was smart and knew many things about this area but what it comes down to is i have a lack of confidence in my clinical decision making skills. sounds like that might be your issue too. i think the best thing to do is try to educate yourself about your pts, ask questions of your fellow nurses. be honest w/ ur nurse manager, tell her if u think u need more time.:)

at our hospital dialysis nurse comes and sets up the crrt/cvvhd. the floor nurse is responsible for maintaining the machine, doing i&o and adjusting the machine volumes. there are tech's that can be paged but don't always come. there are no one to one patients in my facility, ever.

sometimes i think its amazing that more of us don't make errors. our mars have the sliding scale with the time the sugar should be checked and the diabetic flowsheets get the sliding scale written on them too. sometimes i still ask other nurses to look at my meds if they don't look right to me or if the order does not seem right.:)

hey, i just graduated in may and to tell you the truth i've never even seen a cover letter. my instructors at school told me all i needed was a resume. ask your instructors what they say and if they think you need one see if they will help you write one.:)

:kiss i think this website was very helpful fo a new grad. i just started in ccu three monthes ago and this was very helpful. my hospital has a critical care class we all had to take but this web site breaks it into english and helps understand what things mean. thank u very much, i will pass this along to my new grad friends.