serenidad2004

I've never given IM shots or shots of any kind on the side with the AVF/AVG. Isnt that what we also teach our patients? No needle sticks BPs etc on ur access arm.

I once took care of a physician... he came to our SNF after a heart surgery at a larger hospital. He was a doc I had dealt with many times before as he often admitted patients to our unit. He was one of the best patients I have ever taken care of. Tho it was awkward telling him I had to do a complete skin assessment lol Come to find out he requested to come to our SNF, actually told his CM at the other hospital "send me to xxx skilled floor. I know and trust those nurses" :-D

Theres a doc in town here his plates say "kidney"

My employer is a smoke free facility but they haven't started testing for nicotene nor do they deny employment to those that smoke. I am a smoker but am able to work through the day only having a cigarette on my unpaid lunch. I don't think my employer should have any say in what I do during my off time. I do however need a job so if they did say "quit smoking or you're out a job" then I guess I would gave no choice but to quit. Its not right in my opinion but it is what it is.

I work in a hospital unit. I do chronics the majority of the time but am on call one weekend per month (from friday at 8pm until monday at 5am.) If there is someone in acute who needs dialysis during the week myself and the other 4 nurses take turns.

What is a level 2 background check? How is it different?

I went to dialysis a year and a half ago after almost 9yrs SNF/LTC. I haven't lost any skills if anything I've gained them and have been able to draw on the experience I had. I felt like a new grad all over again, it is A LOT to learn and I have just started to get comfortable in the last 6-8 months. I wouldn't change my decision to change specialties in a million years. Good luck with whatever you decide!

No my husband doesnt get it, he is a cook. When I get home late, say shift was over at 3 but don't get off until 4. He is always like "well you were supposed to be off an hour ago you should have just left." Yeah ok... I have tried numerous times to tell him I can't "just leave" His response is invariably "that's what I do" I tell hin you leave and someone has to wait five extra minutes for they're carnitas en salsa verde.... My responsibilities are a little bit more serious. I just shake my head and laugh

Please seek help sooner rather than later. If your facility offers EAP take advantage of it. See about FMLA to take care of yourself

While I am now Catholic I attwnded Unitarian church and summer camps growing up. They definately have a broader view of religion worship and everything else that traditional churches like Catholic Methodist Lutheran etc twnd to have fairly rigid views. Attend a few services, feel it out. I honestly had never met a more accepting empowering group of people.

I was taught in LTC/SNF I could describe a wound ie: drainage amount character odor etc wound bed color periwound tissue appearance blanching and if any slough or eschar. What I couldn't do was call it a "stage X pressure ulcer" unless it had been previously staged by wound nurse or Doctor. Documenting a thorough wound assessment is VERY important. I haven't the slightest idea why you would be told to do otherwise. I would most definately premed with the roxanol if the lortab isn't effective. Not doing that when the dressing changes cause so much pain is inhumane! Please continue to advocate for your patient!

Makes me laugh... on my last unit I was routinely refered to as "whexican." I am white but my husband is from Mexico. He has been here for over 20yrs but we do speak "spanglish" at home. Nickname came about because I would absent mindedly answer coworkers in "spanglish" when I was preoccupied. Funny that it rubbed off on some coworkers and they now routinely say "que pasa" when I call up to the floor. :-D

On my previous unit we had a "staffing" nurse as well. She was supposed to do the schedule find coverage for call ins, fill any holes in the schedule, and help with admissions. Yep those things rarely happened. A hole in the schedule? Oh she "must have missed that" oh you couldn't find coverage and ended up working a 16hr shift? Not even so much as a "hey sorry I missed that thanks for covering it" Never did see her help with an admit. Her excuse "I don't know the patient" uh yeah neither do I hence the term "admit" Management was of no help. They did nothing about her not doing her job and I was once told "It doesn't matter if you don't have a sitter for your infant, you can either stay the 16hr shift or find new employment" All of the 16hr shifts took their toll on me... I left for greener pastures. As did many of the nurses I worked with.

When I was in high school I wasn't a social butterfly. I had my close friends and that was it. I was nice helpful and would go out of my way to help the person who seemed was the "odd man out" Flash forward to nursing school... I too did things backwards had my daughter at 16, graduated high school and she was 10 months old. LPN done with minimal outside contact with classmates. Went back to school for my RN and found myself surrounded by snobby rude cliques of women most being 5-10 years older than me. Most were rude and mean because I had already been a "nurse" as they would call it while doing quotes with their fingers for 3 years. The fact that I already had the basics down intimidated them. I wasn't rude or condescending when I participated in class discussions or when I offered my view on a topic. They got their 8th grade attitudes going when I would finish an exam before them or when I wouldn't share my grades. In clinicals I was refered to as a brown noser or teachers pet because I could run circles around them and was constantly seeking out new things to do. I'm sorry I had already inserted more foleys than I could count and didn't need practice with injections. So yes my instructor, who I knew on a professional level when working and she was a house supervisor, would send me to the cath lab the OR ICU or anywhere else I could get new experiences. I went to class and clinical everyday wanting to learn more and increase my knowledge base. I had a positive attitude and it showed. While they were whining about how unfair something was or how horrible an instructor was or how they were so hung over from their "study" session the night before. I managed to get A's and increase my networking with other units and managers. All while working more than full-time with 4 kids at home and one on the way. Having a friend in school is a great thing but not a necessity. Sometimes the politics and navigating the cliques is more trouble than its worth. Just my 2 cents :-D

Simple answer... ask them to refrain from drinking alcohol while in the hospital and remind them if they can't do that they will be asked to leave. If they're being loud and disruptive have security escort them out. While everyone deals with the illness or dying of a family member differently it is not appropriate. It isn't respectful of their family member other patients or the staff. I would imagine it could also be a liability for the hospital. What if one of them fell and hurt themselves?

Wonderfully said as usual Viva

"Cry me a river then build a bridge and GET OVER IT" Maybe not the best way to address passive aggressive, whiney or otherwise inappropriate behavior... But I have said it once or twice after trying more appropriate ways of addressing the behavior. I simply tell them I have been here for X hours and want to go home, as I am sure you want to get your shift started. So lets just get this over with! 4 out of the 5 times I have had to do this it has worked. Thankfully I am now in a unit where I love the people I work with and haven't had to deal with much of this kind of behavior.

My DON is one of those that doesn't hesitate to help when we are short. One time comes to mind.... A nurse had to go to ICU to dialyze a critical patient and a tech had called in. They called for me to come early and I got there as soon as I could get myself showered and ready. When I rounded the corner to the desk to go into the locker room there was our DON in capris with a jacket on pulling needles and our medical director helping to assess patients! If I didn't know before that morning I definately knew after it that I am truly blessed to work where I do.

Always always ALWAYS call the doc if you have concerns. You did what was best for the patient. The doc can get as mad as an old wet hen but your responsibility is the safety and well being of the patient. You did everything correct... called on your more experienced colleagues and followed up with the doc. Dont let an angry physician on a roll make you think anything different!

I just can't imagine having to be a charge nurse as a new grad... When I started in LTC/SNF I was the only nurse on my floor but was not the charge, their was 3 other floors and a more experienced RN as charge. With time you will develop a routine. Get to know your patients and staff to start with. Review your facilities policies and procedures. Good luck to you!

I had no choice but to work fulltime while in school. It was hard... especially seeing my classmates that didn't have to work and didn't have kids. If you can afford not to work I would say don't work!!! Nursing school is hard and adding work on top of it just makes it even more difficult.

Definately agree that you should have checked the orders.

I am truly blessed to work with the group that I do. :-D

I have seen 2 cases of spontaneous hip fractures and one spontaneous ankle fracture with out a fall or other trauma. All 3 were dialysis patients with weak bones related to dialysis and dietary noncomplaince that resulted weakened bones.

To the wonderful RNs and techs I work with - Thank you so much for being available on your day off to help when you know that our day is crazy We had a code in our unit recently and it still amazes me how we work so well together as a cohesive team... like a well oiled machine we all know what the other wants before someone asks Thank you for understanding that while I am low man on the totem pole and usually have to close on Mon Wed and Fri... you each gave up some day hours so I can see my kids now that school is starting Yes I will come in on my day off to dialyze a patient in ICU so you don't have a 16hr day because I know you would do the same for me While we all have had and will surely in the future have our differences and disagreements, I enjoy working with each and everyone of you. The commitment that we all have not only to our patients and our unit but also to eachother as coworkers is great. I could have had a laundry list of negative things to say... but I am all about the postive and it usually out weighs the bad ;-)