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nynursey_

nynursey_

Med/Surg/ICU/Stepdown
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nynursey_ has 3 years experience and specializes in Med/Surg/ICU/Stepdown.

32. RPN-BC. Transitioning from MedSurg to Medical-Surgical ICU. Forever learning.

nynursey_'s Latest Activity

  1. nynursey_

    New RN having the worst time

    Like the others' have said ... it's been a month. I was never an RN in a NH, but let me tell you ... I am/have been a MedSurg RN, and > 80% of those patients are often NH patients in acute exacerbations of their illnesses. Should you ever choose to go into the hospital setting (and that's not to say you should--it's more of an IF you CHOOSE to), the skills you've gained working in that NH are going to be INVALUABLE and you are going to see your co-workers asking YOU for help. Keep on truckin', dear. A month is just a blip on the radar. Give it a year. Remember Patricia Brenner!
  2. nynursey_

    ANCC Medical Surgical Certification

    Let us know how the exam goes! I have been on/off studying for a few months in preparation for mine and I'd like to hear from someone who has experienced the madness!
  3. nynursey_

    Has nursing made you negative?

    This is a tough one to answer. It's like asking me "What came first: the chicken or the egg?" I think if you ask most people who knew me pre-nursing, I was already a negative person. Of course, I didn't see this as my being negative, but rather I saw it as my living "in the now" and seeing reality. Underneath, I was a total closet optimist, but I'd rather downplay the potential for success than be embarrassed when the outcome isn't as I suspected. All in all, I think my outlook overall hasn't quite changed, but my outlook on NURSING became an entire different world and continues to change day-to-day. I went into nursing with the assumption that everyone I encountered wanted my help as much as they needed it and had a vested interest in getting better. This is absolutely not the case. And that was the blow that hit the hardest. Other smaller issues on top of that (inadequate staffing, unsafe assignments, constant paperwork, etc) kept hitting me like little jabs until I finally realized that 2016 Nursing is not Flo Nightingale nursing. It's not that you become more pessimistic or negative, it's simply that now you're seeing the forrest for the trees.
  4. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    I agree. I am not above assisting a patient onto a bedpan or cleaning an incontinent patient. What I was more referring to is utilizing that phrase appropriately for things that are nursing specific, particularly when both individuals are in sight. For example: if the tech and myself are in the hallway and I have my computer out full of medications and the tech is sitting at a computer in the hallway charting vitals, who is the more appropriate person to get? Surely not me. I can't drop what I'm doing in a med pass to put someone on a bedpan. It's not feasible. My point in this post was more "appropriate delegation" as opposed to "nurses are above bedpans."
  5. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    It matters very little what your post was in response to. My response was still relevant. It is appropriate to get the nurse in situations that require nursing judgement or assessment. Checking on the status of a patient obtaining water can be relayed to the aide. They know everyone's diet order in their assignment even when it includes thickened liquids or being NPO. We also take a team approach. However, the team approach only works if every member of the team knows the other's capabilities, duties, and limitations and utilizes them effectively. Spending 10 minutes to find a nurse for a task or information that can be delegated or obtained elsewhere is not effective utilization of time OR teamwork. It results in delay of the need being met for the patient.
  6. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    You're right. It isn't. However, rest assured, the nurse likely does not have the time to tend to that, and this is why ancillary staff and proper delegation exist.
  7. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    Request for pain medication are appropriate to request of the nurse. Needing a bedpan is not. Surely you know this. And fetching a pitcher of water, if you're concerned for a patient, can also be delegated to the PCA. I suspect you also know this as well.
  8. nynursey_

    blood pressure drops after dialysis

    I hold most medications prior to dialysis, including blood pressure medications. There are medications know to dialyze out during treatment, and often times antihypertensives are one of those medications. If I'm not sure, I call the dialysis RN and ask her. And often in many cases I simply send the medications down with the patient and the dialysis RN administers them post-treatment. I understand your concern over the Hydralazine, but once a patient has finished tx, blood pressures normalize. In any event, you weren't wrong to use your nursing judgement, but it may have been pertinent to ask the doctor to put in parameters.
  9. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    And doing that is just inappropriate. Unless you work in an ICU. I can see the need for possibly less PCAs relative to nurses because there are lower ratios and the nurses are usually accountable for more aspects of patient care as they pertain to assessments. I'm a big fan of assigning an appropriate amount of staff for an appropriate bed number and acuity on a unit. Management not so much. It's a never-ending battle.
  10. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    I sincerely believe this. I'm not sure why adequate staffing is such a foreign concept to hospital administration. More people to attend to the needs of the patients would equate to better survey scores, thus increasing reimbursement, and allowing more profit for the hospital to fix the cost of a surge in employees. But, sadly, the attitude remains "do more with less," and nurses happen to be on the receiving end of the assignment of new/more responsibilities. Perfect example: it used to be a physician's job to complete the medication reconciliation on admission as there are often times they are more familiar with certain medications and doses that may appear questionable to the bedside nurse. From there, they can simply sign the list and order all home medications at the time of admission. Starting two months ago, bedside nurses became responsible for obtaining all the patient's medication information and verifying a home pharmacy. Yes, please. Let's just add another responsibility to the nurse who already faces many dilemmas when admitting a new patient and balancing her patient load.
  11. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    Don't get me wrong, I don't mean to imply that everyone does this all of the time, but it happens often enough that I leave work late a few times a week because I have done everyone else's job AND mine.
  12. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    Thank you for your input. I completely agree. Not only do we send the message that it is acceptable to expect the nurse to perform all aspects of care, but we also pre-set our patients to expect and even demand it. Each person has an essential function to the well-being of the patient. It just happens to be that many, many tasks are easily delegated and nursing care is exclusive to nursing.
  13. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    To the contrary, I love my job so much that I want to be able to dedicate my skills exclusively to their nursing needs. At the same time, I recognize the importance of their comfort needs, so I need my fellow co-workers to assist me in making sure all needs are met, and that includes respecting my nursing time as only I can provide those nursing needs. Please don't presume to know you wouldn't want me as your nurse. You've no idea what an ignorant statement that is. I am a fantastic nurse and frankly, it'd be your loss.
  14. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    I didn't mean to imply that the Case Manager's job to assess the blood pressure, but when you walk by the person whose job you know it is to take a blood pressure, and instead find ME with a bunch of emergent O2 supplies in my hand, that seems ridiculous to me. The reading comes from a machine. The PCA puts the cuff on the patient's arm and hits the green button, then a blood pressure is generated. Those readings are utilized all the time in clinical decision making, so yes, I would have trusted her reading.
  15. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    At my facility, unit clerks do not page physicians. That task falls to the person who needs to get in touch with said physician. As for answering the phones in general, I'm more irked about the fact that the unit clerk will take a break at their convenience, not at the convenience of the staff, leaving the nurses and PCAs to answer the phones and call lights. Someone else can get the phone. It's not exclusive to the ASA. Someone else is not going to start a blood transfusion. That's exclusive to me. If you aren't sure which person is going to respond, a simple "I'll send someone down for you," is more appropriate. When unit clerks begin allowing patients to summon the nurse to the room, and the nurse then fetches things, and the patient associates the nurse as the ONLY person who can do that. Yes, you're correct, a patient is entitled to request to speak to their nurse, and I don't mind attending to those calls. But those instances are rare. I truly do appreciate each member of the healthcare team, but it really does get old to constantly be the 'go to' or 'fall guy' for absolutely EVERYTHING.
  16. nynursey_

    Let's Ban the Phrase "I'll Go Get Your Nurse"

    And I'm sorry I didn't clarify before hand. But what I was referring to above was the snarky, passive aggressive post clearly aimed at me.