FMF Corpsman

Jlm1206, It sounds to me as if you have put together an excellent plan for your nursing education as well as for the months in between classes. I'm willing to bet you will be a superior Nurse once you have completed your studies. Good luck in all of your future endeavors.

I couldn't agree more and I can't help thinking if it were a male dominated profession, how different it would be. I just don't understand why it is that a group of educated women can't set down together and eventually form a consensus. But you're right, I've been around the block a time or two myself and heavily involved in several organizations attempting to get people to get more involved and take control of their own future and it was like asking them to stick their hand in a garbage disposal or something. They just didn't seem to grasp the importance of it all. I don't know. It was all very frustrating. Hoping maybe that the passage of time has brought with it a new awareness and a willingness to actually take the reins so to speak, and instead of just going where the horse takes you, go where you want to go.

Unfortunately, the State is usually going to side with the business interest over that of the employees, as they tend to share a mutual interest. Which was the point of my previous post. The more Nurses that can join together to make a collective voice, the stronger and more powerful they become. This can be accomplished in the form of a Lobbyist in the State Capital, Unionization, a strong Nursing Organization, anything that can form a cohesive voting block with huge numbers, can effect change. Sitting around and wishing for it, will get you nowhere.

Please, excuse me if my comments offend you, they aren't intended that way. I am certain things are much improved from the way they were many years ago and attitudes have changed significantly for the better and after a great deal of hard work. Years ago when I first joined the nursing force, men were few and far between back then and I was often treated as if I were a work horse, only around to lift patients in and out of bed or for much needed brawn if a patient were to get rowdy and out of control, handy to do the male caths, you get the picture. All of this on top of having my own patients to care for. This was a female dominated career field and if I wanted to get along with any hope of progressing, I needed to go along to get along. I was also in school and working full time. One thing I noticed was that the nurses usually got the short end of the stick as far as pay, benefits and other enticements were concerned, such as weekend differentials, uniform allowances, tuition reimbursements, paid ceu's. Yet know one was willing to speak up about it or if they did, they were threatened with termination. No one was willing to listen to a female. They didn't respect the voice at the time. There were very few Nursing Organizations with any clout and if any tried to establish themselves they were shut down by Administration and the instigators were terminated and blackballed. Sadly, today the Nursing field is still way behind where it should be because of it's late start, and male dominated professions enjoy salaries, benefits and other perks nurses won't come to enjoy for another 20 years. All because women aren't/weren't willing to speak up and demand what should rightfully be theirs. The old saying that "women should be kept barefoot and pregnant," has been utilized by male chauvinist for years to keep women down and "keep them in their place." I love one of the signatures that Esme12 uses on her posts, "No one can make you feel inferior without your consent".... Eleanor Roosevelt. I love it because it is so very true and it is a great affirmation, whether it is someone on your unit, a Physician who does rounds on the unit and always bust your chops, your Unit Manager or even just another team member, you have to let them put you down and only you have the power to stop them. As far as your career goes, only you can make it go better too. I made the changes in my own career path that I needed to make and ended up where I called the shots on the very units where I once worked lugging people out of bed, guess what, I still had to help get people in and out of bed. Nursing is nursing and some things never change. Lol. But, there are things that we can change if we work together to change them, they'll never change if we simply set around and say we need for change to come about and let it go at that. It's like the Chinese Proverb. "Give a basket to two people, Which do you think will get full faster, One who sits and merely wishes or One who gets up, goes and fishes? Lesson being, you have to act.

Actually, I beg to differ with you. The State Legislatures could play a pivotal role in the number of students that the indivual schools allow to graduate each year. The State Legislatures would then simply pass on to the Board of Education the new GUIDELINES, and fewer students would utter forth onto the job markets.

I'm not exactly certain where to start, but since you decided to unload on my particular specialty with both barrels, start I will. I'm interested in what exactly you might consider your own personality, since everyone else in the ICU were deemed to be so hostile, especially since you later go on to include yourself in "their typical actions as Charge Nurses," like assigning the heaviest load to nurses who brag so much, just to see if they can back up their mouth's. You also state/complain that everyone there is trying to get into CRNA and yet you can't tell them anything because they already know so much, yet you come back later in your post to tell us that YOU ARE GLAD TO BE IN CRNA school. I'm glad you are as well. Hopefully, that will be a good fit for you. But I have a question, What is so wrong about teaching someone how to use the "Balloon Pump?" it doesn't matter if s/he is oriented to the Heart Team, Trauma Team, or the Olympic Team. You may or may not remember this, but they use to say the same thing about the Defibrillator. It was a highly specialized piece of equipment and only Medical Doctors could ever be taught to use them. Teaching someone how to use something doesn't take anything away from you, in fact, it might actually help you one day, you never know. It doesn't mean that they are now certified in its use, or even oriented to the Heart Team. It simply means he might have basic knowledge on how the machine works. As far as personalities in the ICU, I'll grant you most of them are type A, but that's exactly the type of person that is needed to do the job. Anyone who has been there for a while is definitely a type A; otherwise, they wouldn't have been able to handle the stress. Other personality types simply cannot deal with the types of trauma they are continually bombarded with day after day and expected to treat them and move on, regardless of their own feelings. People whose brains are pouring out of the side of their crushed skulls from a MC vs. Tree, crash without a helmet, in the next bed may be a former coworker who has suffered a stroke. The Unit is filled with cases such as these day after day, week after week and the staff must grin and bear it. Is there any wonder they might not always have such rosy personalities all of the time or deal with people they aren't familiar with in more than a cursory shrug? Critical Care and Trauma Nurses tend to be guarded and aloof, they aren't always accustomed to having to deal with people who are perpendicular. Give them a coma patient or someone in need of a great deal of care and then you will see the love and compassion.

The only problem with having an internship on nights is that there are far less procedures and therefore less learning opportunities in your average hospitals, then than there are on 3 to 11 and especially on 7 to 3. Or for those on 12's, 7a -7p. For those fortunate enough to be interning in Level One trauma Facilities, it might be a different story, but even then, chances of newbie's landing fresh traumas are few and far between there as well, and whoever does, isn't going to have the spare time to mentor a student or intern. However, the schedules may very just enough that they can get in more treatments and procedures on the other patients than those in lower status hospitals and LTC facilities. Schools' cranking out far too many students has been a problem throughout the ages or at least since I was in school and graduated. My graduating class numbered 92 and we started with 130. A few years later someone started the never ending rumor that there was a nursing shortage, and it was true for a while, but it soon abated, but the schools keep turning out student nurses like a mother rabbit turns out babies, please do not take offense at that anyone, as I mean it in the best possible way. But there is now a glut of nurses and the ability for nurses to negotiate with HR or Administration effectively is non-existent, which leaves us with fewer benefits and at lower salaries in many areas of the Country. I know most of the Country is going through dire straits right now, but we started out at a lower place on the grid to begin with, so when the economy rebounds we will still be lower than most. We need to lobby Congress to initiate bills which will limit the number of students churned out each commensurate with the number of expectant retirees and nurses expected to leave the field to pursue other interests, thereby lessening the glut instead of increasing it.

It has been lingering in the conversation, but never really said out loud, those Nurses who try to fast track themselves and skip over as many steps as they possibly can, are doing THEMSELVES a grave disservice. They should be taking every opportunity they are offered or can find, to expound on their education and experience. Many nurses only take the CEU's that are required for re-licensure, and frequently at the last minute, while they should be finding educational offerings that are available in their particular fields of interest or practice, not because they need too, but because it makes them a better Nurse. This is a relatively inexpensive way to advance their knowledge and to network with other professionals who work in the same areas they do, but in different facilities. It is also a great idea to join professional organizations, depending on the situation; many of these things are tax deductable. This sort of goes back to the Nurse versus nurse conversation. If someone really wants to excel in their career, they need to be willing to work at it. You can only get out of it, what you are willing to invest of yourself. If you aren’t willing to put anything into it, you can’t expect to go far and trust me, if that is the case, you will live up to your expectations.

LadyFree28, You almost made that sound as if it was something hard to believe. At any rate, I applaud your efforts to achieve your own goals in your own manner and not allowing roadblocks to be put in your way. As I said in another post, those in HR and Administration who design and set up these programs really don't have a clue as to what might be best for you, in fact they aren't working to make things better for you at all, they could even be working against you. Not even Career Counselors know everything that will benefit you in the end, and unless you are paying them yourself, they don't actually work for you so their fiduciary is with someone else first. Only you know what your goals are and it is up to you to figure out how best to achieve them. It sounds to me like you have done that, so good luck and you will do well in your career.

As I said, I was hopeful I was mistaken as that is a very drastic mistake and one I wish Hospital HR's and even Nursing Agencies and LTC facilities, would learn not to make.

I'm afraid this is turning into a discourse where some of us will simply have to agree to disagree. I will never agree that a new grad should be allowed to cut their teeth in an intensive care unit as counted staff. If they are working under a Preceptor, okay, but not as a staff member, they simply do not have the required skills or the mental acuity needed to work in that capacity. If you think they do, then I question your judgment as well. Do you think that Certified Orthopedic Surgeons grow on trees? Yes, there are Orthopods that function in the field, but to be Certified or even before you specialize as an Orthopedic Surgeon, you have to start out somewhere in General Medicine. You don't graduate from med school as an Orthopedic Surgeon. To be Certified as an Orthopedic Surgeon you have to take the specialty Boards as I'm sure you know.

Thanks JanFRN, Nothing will get me more agitated than that phrase and before I retired, I used to go thru long dragged out fights with HR and the Nursing Supr. who were trying to staff my unit with "warm bodies" just to meet quotas. I can't count the number of evenings and nights regular staff had to pull doubles, of course then came the over time wars, just to staff the unit. I just don't believe in leaving patients with extremely high acuities with unqualified staff. There is nothing anyone can say that will justify making those decisions. HR is staffed with non-medical personnel and the House Supr's are usually not critically trained nurses, so aren't capable of making those types of decisions either. They are administrators in their current position, not nurses, which is why I resigned my position as an administrator, I didn’t like the position it put me in and I missed the patients and my Unit. NY_Teach, if I read you wrong, I'm glad, I was certainly hoping I was mistaken. Thankfully I didn't call you any of those nasty names, LOL.

Scott I don't know how old you are, but there used to be a saying,"You get out of it, exactly what you put into it." or a similar concept,"You reap what you sow." If you wind up practicing in the same area where you went to school, you will likely find that those same lousy students will be lousy nurses, after they fail their boards a few times and eventually pass or either give up and go to work for Hooters or some other equally fine dining establishment. Keep striving to do the best job possible and your results will be there own reward, and you will have a great career. "When you have a job you love, you never have to work a day in your life."

I couldn't disagree with you more. Perhaps that is true in some facilities, but it is the absolute worst mistake they could make. Hiring only warm bodies instead of the best candidates, they can find, sets them up for failure and only poisons the staffing pool they already have with discord and discontent. "A nurse is a nurse is nurse is a nurse," is pure BS. Are you a Nurse or a teacher? Those without a calling to be a nurse don't stay in the field very long, and you can usually tell pretty soon, who they are, it isn't difficult. They turn their nose up at certain task, or make themselves scarce when it comes time to do certain things that are beneath them, they are the last to answer a call light, and they think that is always the LPN or aides job, even when they are standing right next to the room. They are quick to say, "Not my Patient," but get highly indignant if someone else, who is juggling 3-4 different things at the time, says the same thing about one of his or her patients. NO, you're wrong, a Nurse is definitely not nurse is a nurse. There is a whole world of difference.

I agree completely. What baffles me is while all of this is going on; some of those same nurses are trying to be assigned to the specialty units. If they aren't yet fully qualified to work on Med-Surg or Step-Down units, what on earth makes them believe they are even remotely qualified to work in a unit that requires specialized training in addition to a few years of experience? Can a fresh grad go into an ICU and successfully do open heart massage if it is asked of them without passing out at the bedside? I rather doubt it. That doesn't happen everyday, but it does happen.

Tewdles, you make a very good point, so far one that hasn't been spelled out quite as well. Each nurse or at least, each specialty needs to develop their own method or nomenclature to utilize when assessing their patients pain levels. Obviously, Pediatrics might have some degree of difficulty understanding what it is exactly you are asking them, just as someone whose first language was something other than English. This is a little bit off the pain score, but I once had a woman the staff was trying to collect a urine specimen from and try as they might, they simply couldn't communicate with her. It wasn't until someone finally came up with instructing her to "pi$$ in the cup," that she finally understood. Sometimes communicating with patients can be difficult and occasionally, we have to look from where they came to get a better understanding of how to reach them. Being able to do that doesn't diminish us, it makes us all the better.

Nice post LadyFree28, it's great to be back.

This will be the last time that I am going to repeat myself, any further inability to comprehend that I didn't make a sweeping generalization about any nurse’s rest fully on the shoulders of the reader, not mine. Even from my previous post "Weeping Angel and any other VA Nurse I may have unintentionally offended. I attempted to stress in my OP, that I certainly wasn't being all-inclusive." I am in for this particular post especially, writing from the perspective of the PATIENT, rather than another nurse, but having spent as many years in the trenches, both literally and figuratively, I feel I am more than qualified to voice my opinion. In order to not offend, which is something I find offensive to my own standards, as I usually call a spade a spade and damn the fallout. Truth be told at the VA I go to for services some of the nurses sit around on the butts while their patients call lights go on for over an hour, they have been left on bed pans and fracture pans for exorbitant amounts of time, left in soiled beds for even longer, after their call lights were ignored and they didn’t get the assistance they required. These are soldiers who don’t like to ask for help to begin with and were just fighting the Taliban in Afghanistan, and some have been returned here to recover and recuperate. For them to be ignored long enough for them to soil their bed is a terrible affront to them, they already feel diminished, but most people don’t understand that. It takes special nurses to work at the VA, those with a special kind of empathy and sensitivity, but then some suit hires any yahoo that walks in off the street, it ruins everything.

Weeping Angel and any other VA Nurse I may have unintentionally offended. I attempted to stress in my OP, that I certainly wasn't being all-inclusive. I've known some excellent Nurses who worked at VA Hospitals; unfortunately, I've also known many bad nurses who have worked there. I can only relay my experience and it has been my experience, that it takes and act of Congress to dislodge a Nurse from his or her position at a VAMC, while they apparently will hire anyone with a Nursing license who happens to wander in from the streets. My own administrative experience tells me to hire only the best nurses and I will have the best staff, with the least turnover, with fewer c/o, higher than average patient satisfaction surveys, and overall the least number of fires to put out. You don't build that kind of team when you hire slipshod, lazy nurses who are only there to collect a paycheck every two weeks, and try their very best to get by with the least amount of effort expended. We've all worked with nurses like that; some of you might even be nurses like that. I've been absent for a couple of months and certainly didn't mean to start a controversy with my first series of post on my return, but many of you know I don't shy away from issues and I don't sugar coat my replies.

Maybe it depends on where you look or live.

WeepingAngel, I'm not quite sure about your response. My critique of VA nurses was not meant to be all-inclusive by any means. I have met some Silent Angels there as well. Those who go through their shift and commit to their task with barely a sound as some are surrounded by incompetence on nearly every level from administration to housekeeping to Safety and Security, and I know it makes it very difficult for one to continue to do their job, day in and day out when you are surrounded by mediocrity. I’ve worked on and seen, some “bad floors” myself in the past 30 years, I would have had to have had my head stuck up somewhere “anatomically uncomfortable,” if I hadn’t.

delilas, I'm sorry your husband went through what he did at the hands of an incompetent nurse. It seems to make it all the worse when we know what is going on and are powerless to stop or change it ourselves, we just feel so helpless. Some of the Veterans Hospitals are known for hiring any breathing thing that can walk in under their own power, irregardless of their capabilities, leaving their nursing pool filled with some woeful and wretched creatures that couldn't empty a bedpan with the instruction printed on the bottom, left to care for its patients. If you open the Obituaries in the Newspapers (or Online) of many of the areas that have VA Hospitals you will likely find that most of the deceased will be from the VA. That isn't by coincidence or age, it's because they get sub-par care. I'm sorry, I didn't mean to get so far off topic, and unfortunately, this is a whole different story altogether. Best wishes for your Husbands complete recovery.

It has really become a problem in our culture today, which many in the field of medicine feel that everyone that comes through the door is drug seeking and unfortunately, they treat everyone that way and it's dead wrong. I do understand that there are many that are, but it reflects badly on the professional that cannot discern the difference in between those who are from those who aren't. It is tantamount to having a horrendous bedside manner if you mistreat those who come to you for care, by overtly suspecting them of seeking drugs, when they are in fact sick, in pain and in need of treatment and relief not remonstration and reprimand. If you wanted to be in Law Enforcement, you should have made that decision long ago, not when you are standing in front of a patient seeking treatment for an illness or acute pain.

One thing I think we all need to remember is that we are not DEA or any other sworn LEO’s. We are professional nurses here to take the best possible care of our patients. It is our job to determine if our patients are suffering from pain and if so, to relieve that pain by administering prescribed medications. We are not gatekeepers, we do not get to decide that our patients are not really suffering enough by our standards and therefore not worthy of his or her prescribed medications. Many nurses claim to worry they’ll “turn their patients into addicts if they ‘overmedicate’ them,” which is in fact, a load of bunk, because most patients aren’t hospitalized long enough for that to happen. At best, you’re going to end up with a satisfied, pain free, patient who doesn’t spend his days or nights on the call light the entire shift. I’m not suggesting that everyone gork their patients, simply medicate them appropriately, according to the Doctors orders and the patients request. If a patient asks for his or her meds, I give it to them, they know better what is going on with their body than I do. Until someone invents a machine that can adequately display pain levels within the human body, it’s the best we have to go with. Some might suggest vital signs, but that isn’t always a true indicator of elevated pain levels.

Pain, whether real or perceived, is PAIN for the patient experiencing it. It doesn't actually matter one way or the other, and should be medicated all the same. Pain, being subjective, I've always had a problem with the pain scale, especially after having gone through L&D in Nursing School and witnessing the miracle of childbirth. One of the mothers I had suffered thru 18 hours of excruciating pain prior to delivery. I can't imagine that fitting on the 10 scale anywhere. Also, I spent a lot of time in the jungles of Southeast Asia trying to put body parts back together, where did the smiley-face fit into that scenario? I'm not trying to be inappropriate, but to ask reasonable questions. I get a little glimmer of PTSD whenever this pops up when I go to the VA now, and thankfully, I am retired so I don't have to deal with it as far as my patients are concerned. One more point I'd like you to consider though, before you write me off completely, please consider Phantom Pain in amputated limbs. That pain is as real as the pain of a fractured femur, prior to treatment.