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firstinfamily

firstinfamily RN

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firstinfamily has 33 years experience as a RN.

RN since 1981, total of 16 years in ICU, worked tele, PCU, Home health, LTC, rehab. Looking for ambulatory nurse type position

firstinfamily's Latest Activity

  1. firstinfamily

    Denying Death As A Society

    I think Dr. Kavorichian had it right back in the 80's when he was promoting MD assisted suicide for those patients who did not want their lives extended. Unfortunately it is true, our society has a very difficult time talking about death and preparing for death. Thankfully my sister and I approached our 89 y/o mother with what her last wishes would be and how would she want things handled. Many families avoid these discussions until it is too late. Is it because they just do not realize what will happen to their loved one or do they believe our healthcare system can heal anything?? Once a patient has 2-3 co-morbities there should be some discussion with the pt and family about how they want to handle the code process and beyond, they should be presented with the options that may be placed before them and they should be informed. The medical community avoids this as well, how many times have nurses taken the lead in discussing negative outcomes before the MDs will even discuss it with their patients?? I believe in being totally honest with my patients and often I will tell them the options that their illness may take them way before the MD will even approach the subject. Your article discusses the feelings and situations that are faced on a daily basis by ICU nurses, sometimes what we are directed to do seems inhumane. It is part of being a critical care nurse and one reason why I left critical care many years ago. Great window of what these nurses have to go through.
  2. firstinfamily

    Social Skills in Nursing (Part I): The Art of Validation

    I kind of wonder if we are connected better at work, does that affect how we are connected at home? If we are being a team at work, and learn little idiosyncrasies of each other does that make us work better together, what about in a crisis situation? During a code for instance, if we connect with each other in a more personal way do we connect better when functioning as a code team? Those nurses who communicate better function together better even in crisis mode??
  3. firstinfamily

    Ready to let go. But not right NOW.

    How beautifully put and sentimental, it is almost like a poem, the rhythm of life and death. My last living parent, my mother, is 89 and I just came back from visiting her. Every time I leave her I tell myself, this may be the last time. It is hard. What you touched is that part of me that will never be ready to let her go and the other part that knows letting her go will be the best for her. She and my younger sister have all the legal documents completed and we review them from time to time(very important to clarify things). She asked me before I left this last weekend, to "find a day when you and I can spend some time together." I do have the time now, and I will give her much more than a day. It is hard. Sometimes we really do not know our parents until we are aging parents ourselves. I still have lots of questions(my dad passed about 17 years ago) and I know she is ready to tell me the things that I most likely did not understand when I was younger. I suggest everyone take the time for their loved ones, especially now during this blessed season, but also throughout the year. Time is something we can never get back.
  4. firstinfamily

    Social Skills in Nursing (Part I): The Art of Validation

    How does the generational gap come into play here? I work with nurses who are basically 20-30 years younger than I am. I try to be interested in their "chatty" subjects, but honestly, there is only so much I can listen to. I do not want to come across as the "old geezer with advice on everything," but I kind of feel outside the loop. I try to touch on a subject all of us may relate to, but sometimes that is very difficult. We are just forming a team because over half are new hires. What advice to you have for those of us working in a more generational gap environment??
  5. firstinfamily

    Memorable Thanks

    One of my most memorable thank yous was from a 50 year old severe stroke pt. She had a rough road and she had recovered so very well. She was amazing to me and I kept encouraging and pushing her all the way. She gave me a tremendous hug the day she left and a card that I still keep that said, "all that you do is special." It really made me feel good.
  6. RLJS, you got it, unfortunately this is nursing which involves serving the public. I often wonder what these patients would do if there was not a visable person for them to ask requests from etc. Perhaps a robotic nurse will meet their needs better??? Maybe we will find out within the next 10 years, but I doubt it. Yes, we have to prioritize and also maintain good customer relations, so telling them you have a medical emergency with another patient and you will be with them as soon as you can is perfectly acceptable and if they did not like that I am sure they will reflect it on their post-stay evaluation!! We cannot be all places at the same time.
  7. firstinfamily

    Post-operative gas pains

    It is pressure on the phrenic nerve from the gas that causes the discomfort in the shoulder!!
  8. firstinfamily

    URGENT: Are CDC Ebola Guidelines 'Good Enough'?

    Hospitals in this north-eastern section of MD have not given any instructions to nursing staff or any hospital staff in dealing with Ebola. Do they not think it is coming here?? From what I have seen and understood, there are only four top hospitals in the country that can treat this virus, and they are having problems, so does that mean that if it cannot be treated there, it will not be treated elsewhere, or that the smaller hospitals will only have to deal with it when it shows up----at which point that is way too late. Are the hospitals getting some form of financial reimbursement for the extra expenditures the PPE is going to cost?? We are going to be dealing with this for a very long time. Yes, I think all of us should write our congressmen/women and elect Nina and Amber for congressional medals of honor. There is more than one type of battle to be won here.
  9. firstinfamily

    EKG: It's in alphabetical order!

    Ya know, sometimes it takes eons for things to make sense!! Those little squiggly lines just keep mystifying all of us!!
  10. firstinfamily

    Patient satisfaction or patient dissatisfaction

    "The customer is always right" was the rule in retail. "Treat the pt as a guest" seems to be the rule in healthcare. I don't think hotel acomodations are available in health care, and I don't think sick people really want someone who treats them like a pansy either!! How many positions have been justified by this hotel mentality?? When there is a problem if I cannot fix it I refer it on to "guest services." Or I make recommendtions to management so the problem will not reoccur. We are all pawns in the game of healthcare!!
  11. firstinfamily

    Post-operative gas pains

    IF it is little ones who are recovering from surgery and there are rocking chairs available, you might try to "rock" the gas away. They may not feel like walking, but rocking may help. Motion seems to be the trick.
  12. firstinfamily

    That Dreaded 3-11 Shift

    I have worked both 8 and 12 hour shifts. I started out working 11p-07:00 and loved that shift, I was usually home by 08:00 and could sleep, when we had children I would get up in the afternoon and have an early dinner and return for a nap before going back in. When the 12 hour shifts started (19:00-07:00) I could no longer get that evening nap and by 01:00 I was ready to go home with another 6 hours to go. When we moved to another area in the country only 8 hour shifts were available and I worked 3-11. I liked the shift because I was home in the morning to get the kids on the bus and could do a few errands. What I didn't like about 3-11 is all the clean up that had to be done left by day shift and before night shift came on. It was almost like we were the ones taking all the admissions and doing all the discharges all the time!! Now that I am older I really look for 8 hour shifts, I do not feel we are very productive much past 8 hours. There were problems keeping the 12 hours shifts staffed from 7p-11p and 3p-7p. It seemed there were always staff shortages during those times. I do believe safety is a huge issue and there are several articles that elude to this. Yes 12 hours are better for patient continuity, but not for patient safety. I will take 8 hours over 12 any time, even if it means I work 5 days a week. It would be nice if both 8 and 12 hour shifts were offered at the hospitals.
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