BandEmom

I think it's sad that our ability of practicing sound judgement in the name of caring is stifled by "customer service" in healthcare. It makes it feel no different than selling cars or any other commodity. I think that we are depended on in the long run to help people understand when something harmful could take place. I'm sorry you've been put in such an uncomfortable position

I agree. It sounds like the decision maker in this family is aggressively pushing what they believe to be right. It's hard for us to argue with that, and convince someone that doing something they believe to be helpful can do harm. In this patient's case, there is no tangible benefit from IVF, yet obvious harm to be done. Perhaps the doctor who ordered it is not experienced with end-of-life care? It's an age-old issue to hospice care that always feel different with every patient because the families are so insistent.

With four years of experience you should be able to absorb the tricky stuff from the book, like doing dosage conversions, etc. I just passed it in June and I found that the questions really do boil down to things you know from experience and basic nursing process (what is the nurse's FIRST action? always assess first before an intervention) things like that. The book arrived about a week and a half after I ordered it. Good luck to you!

I am an on-call nurse for Odyssey. Feel free to PM me if you'd like. I can tell you that under their definition of on-call you do not qualify for overtime unless you have spent more that 40 hours physically with or talking to patients. Is that the case for you? I've probably come awfully close sometimes on the most horrific nightmares of weekends, but never did go over. I read the previous reply, and I have wondered about that too. I worry about being told that I can't work for rate 2 during the week, so I haven't made a big deal about it. I only work a few hours during the week. IDG plus some office work. Good luck to you, hope to hear back

I work 5 friday till 8 monday. There is a second nurse on during these hours as well. We have a census of 130+, and we are now going to hire a third nurse for the weekend as well. We typically have 2-4 admissions over the weekend and 1-4 deaths. We take turns receiving calls from the answering center, so that we can each rest, but still back each other up. I love my job and I don't think I could do case management. I love to solve the problem, give some hugs and get outta there. Sometimes the pager doesnt even go off much and I still get paid anyway. It's pretty good. I couldn't imagine what it would be like to carry a caseload during the week and have to participate in a call rotation where you are the primary call and not a backup. I wish you the best and hope you can find an organization that is realistic about staffing needs after hours.

I am currently studying for it. My employer pays a 2000 dollar bonus per year for it which averages out to about a dollar an hour. I have gained alot of knowledge and perspective since I started studying and I would like to be considered for leadership someday. I think its also nice to have some validation of knowledge and experience, and that's what its really about.

I struggled with this too as a new grad. I was not happy about working med-surg. But honestly, you need to listen to lots of sick lungs with someone else around to agree with you, before you can confidently assess one out there by yourself where you have to make a decision about whats a new change or decline. You will benefit from talking to many doctors with other nurses around "on your side" before you can confidently advocate or respectfully disagree with one on your own. Your passion and great heart will still be there after you get all this stuff under your belt and hospice will still need you.

gt4everpn, I think that people who are on hospice with DNR are really just not still there emotionally. Comfort care is acceptable to them but accepting the full implications of DNR is just out of their comfort zones. Some people and families worry that it may compromise their care. Many of them end up changing their code status down the line. Of course, all of my hospice patients are living at home. I can see how it would be much more frustrating to see full code hospice patients in an inpatient setting.

I agree. People have asked me the same question, and I have always found that even in the parts of town that I don't like to go to the families I visit are so appreciative to have a nurse help them. We have had a couple of male patients who have made some uncalled for remarks to the young nurses, and for one of them the other on-call nurse and I were instructed to go together if there was any need to visit at night but that never happened.

I am new to hospice and I have accepted a weekend on call position. I will be second call backing up an LPN during the daytime and then overnight its just me. What kind of calls typically come in overnight? I'm afraid that I'll think that I should always go out when there is a call. What are the overnights like?

we just adopted an electronic recordkeeping system. We call them "WOW", workstation on wheels. /shrug, it works

about a week ago I had a pt who presented pretty lucid, although a poor historian on admit assessment. Several hours later he went into DT's or something because he ripped out his IV, ran down the hall, opened the fire escape and proceeded to urinate off the balcony. This happened at exactly 7pm (end of the shift). The sound of the alarm was deafening and there were patients and family members out in the hall pretty freaked out. I was sitting down talking to the new grad that I was precepting when this happened. The oncoming night shift CNA saw the pt go out the door. I didnt witness it but I got up right away to see what was happening. He was covered in urine and feces as was his room. How many people would you suppose got up out of their chairs to help me? This includes the CNA who witnessed it.... the answer is zero. They didnt even call our charge nurse to tell her something weird was going on. They called engineering to shut the alarm, while they waited in their chairs at the nurses station for night shift to come on so they could give report and get out of there. I called for my preceptee to pull some ativan for me. (btw she didnt get up either until I called for her, she must have figured that I had it all under control too). I gave the ativan, cleaned him up, cleaned his room up, moved his bed to a room in front of the nurses station by myself. I am so completely done with inpatient work. The worst part here is that we were not even poorly staffed at the time. There were three other RN's, a secretary and a CNA, which is ironic considering my original post. The worst part is that they sat around with the alarm blaring and chose not to get up. they didnt even care that i was the only one running around at change of shift while they were all caught up and just waiting to hear the sound of the elevator opening. Even this event aside, I have witnessed such awful catty, competitive and just mean spirited behavior from so many people in the hospital. Not just here but everywhere I have worked. Attitudes about who is lazy, who is a bad nurse, who is just plain dumb, why I'm teaching someone who has already been taught something about our brand new computer charting system. I feel sad because I always wanted to care for sick people in the hospital, but this environment is really bothering me. I can handle the work just fine, but the emotional stress is too much. Readng some of these replies has given me some insight that my workplace is really not very unique, but that I am just in the wrong environment. Thank you for the replies.

wow I am so sorry you going through this. Unfortunately when someone is in that 90 day orientation phase, they can fire you if they dont like your shirt. I very much doubt that they will report you to the board. The same thing happened to me (you can probably read about it if you look at my old posts in the history) I thought my career was over. Sometimes hospitals are just unsupportive of their new grads and still unfortunately eat their young. You'll be able to move on and get the better experience you deserve and this will all be behind you. I do not think your licence is in any trouble.

I became pregnant my second term of nursing school. I already had a 2 year old and ended up having to take a term off. I still graduated with honors. I could tell there was some disapproval from the dean, but hey, what could they do? I was already admitted. You sound very determined and it can be done. Good luck.

I knew you passed nursesrock! Congrats :)