LakeEmerald

I disagree with the posters who say you should leave because you are going to get fired. Continue to command respect. You stood up to this ill-mannered person and showed her (and everyone else) that you will not take any crap. Acknowledge to management that you handled this particular incident poorly, but that you have examined yourself and learned from your mistake. Then MOVE ON. If you have made it this far in your training you are likely competent and can successfully complete your training. As far as the clique - so what? Do you really care if you are one of them or not? Apologize if need be, especially to your boss, then hold your head high and keep going. Keep in mind if she was this big of a jerk to you, others see how she is. No more cursing, no more letting her get to you. Hopefully she'll stop now that she knows you won't take any crap. If she gets out of line tell her you find her behavior unprofessional and then ignore her, don't get into it with her. Count down the days and just kick butt! Hang in there. There are MUCH worse mistakes that can be made. Focus on patient care and do well. Don't give up! Best to you!

Nice article. It reinforces many of the ways of getting through the day that I have learned to practice over the last almost 5 years as a nurse. Especially the ones about slowing down and prioritizing when things get hectic, and treating others the way you would want to be treated, NOT the way they might start out treating you. It usually does turn them around. Very uplifting. Thanks for sharing!

If you already accepted the ICU job, then it might look bad to go to the ED interview. On the other hand, if you turn down the ICU position, you may not end up getting the ED position. The SAFEST thing to do is accept the ICU position (since you already did) and then transfer over to ER after a year or so. If ED offers you a job, HR will be aware of both offers, and I don't know what they would think. It might not be such a big deal in the HR world, but I don't know. Any HR people have advice? Congrats on your offer!

Sometimes we can't always prevent a death. If new orders were requested from more than 1 MD last night and you were instructed to monitor, maybe that's all that could be done. How was it your hands killed people? Instead of: They were tremendously sick and you did everything within your power to help? My only suggestion is, if you continuously updated the doctors and felt like you were ignored, then your next step is to work up the chain of command until you are sure the patient's status has been understood and needs are addressed. But also realize, sometimes the MDs have more wisdom and insight, and know they've done all they can and the patient is in God's hands under the current plan. You work with critically ill patients. The fact is, you are going to lose some of them. I work in the ED and we do lose some. You do all you can, but you can't win them all. Keep doing all you can whenever you can and be kind while doing it. Show your patients compassion and kindness so if it is their last day you can feel peace knowing they felt truly cared for. Hang in there Beats!

Your ideas are good and solid. Thanks for sharing them. I wish you all the best in your journey.

There's nothing wrong with approaching your employer with a professionally done resignation letter and stating that, "It's just not working out," without assigning fault to either side. It's called a graceful exit and will serve you well, especially if you think you are going to get booted soon. Having another job lined up would be optimal, but if you have to explain to future employers that the job "just wasn't a good fit because the opportunities were not as challenging as I had hoped," then so be it. It's obviously not a good fit, so be firm and fearless, and let your supervisor know where you stand. I hope you get your hospital job soon!

Show them as much love as you can. Most people are scared and feel out of control and want to know someone cares. I'm not talking about being fake and gooey sweet. Just simple kindness and respect. I mean truly listen to their CC, show concern (even if it's BS), and get them their warm blanket(s) at the outset. I can't tell you how many people have said, "Thank you for being nice to me" when I was just showing basic kindness. It makes me wonder what they've encountered in the past. Then, if I encounter a true jerk, I do a quick analysis - what could I have done better? If there's something, I try to fix it and learn from it. If there's nothing, I put my wall up between myself and them. Some people are truly poisonous and you can't let their poison into your spirit. You have to block them off. You can do it. It just takes time.

I don't want to be an NP. And I'm sure I could if I wanted to, I've always done very well in school. But, I love being at the bedside, where the action is! It's worth it to wipe a few butts occasionally to have the privilege to be intimately involved in helping to stabilize people who are swirling the drain. I love codes and emergent situations (just not too many at once), and I am involved in them daily at work. The NPs I know work in doctor's offices doing very important work, but the pace and level of intensity are too slow for me. Like NOAMotorcycle said, my reply would be, "Have fun with that!" The grad student was obviously ill-mannered. Don't let her/his uncouth-ness get you down. Just do what you love, and do it well, and you will shine while you're doing it!

Lol! I thought you were going to talk about how Emergency Department staff love their jobs/themselves too much! Just hang on, these types of off-balance people eventually make their nature apparent to everyone, including those who write their paychecks. Just keep your chin up and do a good job, she'll likely be gone soon.

Aren't you supposed to push 6mg, then 12mg? Wonder why the MD told you to push another 6mg instead of 12mg? Not how it's usually done. In my ED, yes, the MD would be at bedside and heck yes, the pt would be on the defibrillator/cardioverter/monitor just in case. It's a big darn deal stopping and restarting someones' heart. Yes, it's usually fine, but, if the pt stayed in asystole or went into a lethal arrythmia, it would be YOUR **s. Then you would be scrambling like a crazy person trying to get help, and everybody would wonder why you pushed it without the MD at bedside. You did right (except the 2nd dose, the MD ordered the wrong dose).

We see them weekly in our ED. Mostly male, mostly found babbling incoherently, confused, paranoid, fearful, combative. Some have tremors, a few seize. Had one go to the ICU for rhabdo recently: he was so combative and revved up that his muscles had been strained for hours, almost like malignant hyperthermia, but without the fever. His sig other said he had been smoking bath salts x 2 weeks with no ill effects, then tonight he just went crazy.

Being yelled out because you are trying to politely and professionally enforce a policy is not OK and your charge should have reinforced your back on this, as well as your director. Sorry you didn't have appropriate back up. It is never OK to be yelled at by a patient or family member and you shouldn't take this either. Tell the patient you will return and resume the discussion when the patient is prepared to proceed in an atmosphere of mutual respect. We, as a profession, cannot allow this to continue.

Just curious, are new nurses are being taught to give IM injections in the buttock area? I thought this practice had been rejected because of potentially hitting the sciatic nerve? We were taught to use the ventralgluteal and it's what I mostly use (although it can be difficult to find in really large patients), but I never use the buttock. I do know many nurses, however, who do still use the buttock, I just find it risky. But no, a small drop of blood isn't a big deal, and you probably wouldn't see blood if you hit the sciatic nerve anyway. Sometimes, when you pull the needle out a patient bleeds, and sometimes, you can't even see where you stuck them.

Find a friend in the ED that will allow you to shadow her without pay for a few hours just to see what it's like. In the process, make sure she/he introduces you to your director or clinical coordinator. If you express a healthy curiosity for the ED and do not diss the OR (not saying you would), perhaps the managers would consider you for PRN work. At our facility, they are not allowed to "steal" you from another department, so they won't call you to offer you a job, but they may agree to cross train you for PRN work, then it will be an easy transition in. I've seen it done this way a couple of times with success. Best wishes! Wanted to add: You aren't being paid for shadowing, so, you truly are a shadow, not a nurse, during the shadow period.

Pencil....? *shudder*

Our MD's often order IV fluids before the labs are even drawn or complete. I think it covers the patient just in case they are dehydrated, and helps speed along their ED stay since their fluids will hopefully be at least half-way or all the way in by the time the labs result. Then hopefully, they can take their nondehydrated selves home! It also seems to make a lot of people feel better to get fluids even if they aren't dehydrated. Maybe there's a medical reason or perhaps psychological that "something was done?" What gets me a little is when a nurse or tech misses a patient's vein and they tell the patient, "it's because you're dehydrated" when they show no signs of it. Or the patient says, "Oh, it's because I'm dehydrated" and the staff agrees. No, sometimes, we just miss!

My only requirement is it has to be a clicker and I have to have two in my left scrub pocket at all times. I get nervous when someone borrows one and I don't have two. Stay back, Farawyn!

Same here. Strangely high acuity this summer, especially an up-tic in sepsis cases. I've noticed an increase in patients that are healthy with no complaints the day before who come in with sudden pain and turn out to be septic.

Don't overthink. It's just the human body and it does what it does. Just be kind, compassionate, and do the procedure. If you're confident, competent, and comfortable, your patient will have confidence in you. Just keep them covered as much as possible without compromising your procedure.

I'm a coffee-head, but otherwise don't have other vices. I stay away from doctors as a general rule unless I am working. Including GYNs and mammographers. But I am a believer in Granny's Cure for the Common Cold. I believe medicines should be the last resort and not the first for minor illnesses. So this makes is awkward for me as I'm explaining prescriptions for minor illnesses to my ED patients and they ask what the price will be at the pharmacy. I often have to pause and reformulate my answer instead of saying what naturally comes to mind, "I don't know because I never use this stuff!" The Common Cold (The Beverly Hillbillies, 1965) Miss Jane: ...it's just a cold, Granny, and that's one thing you doctors haven't conquered yet. Granny: What do you mean? Miss Jane: Well, there's no known cure for the common cold. Granny: You mean to tell me that city doctors ain't got no cure for a cold? Miss Jane: Well, they can alleviate the symptoms, but no-one has a cure. Jed: Well, Granny has. She's been making it long as I can 'member. Miss Jane: A cold cure? Jed: One spoonful's all it takes. The scene shifts to the office of Mr. Drysdale's physician, Dr. Roy Clyburn. Clyburn: You have a cold. Drysdale: I knew that when I came in. Now what are you going to do for it? Clyburn: I'm going to recommend that you eat sensibly, drink lots of fluids, get plenty of rest. And, in a week or ten days, you'll be alright. The scene shifts. When the traveling pharmaceutical salesman hears about Granny's wonder cold cure and proudly announces that he is now the exclusive West Coast distributor for "the first cold cure in medical history." The final scene: Miss Jane: Granny, I apologize. This morning I didn't believe you. Your cold cure really works. Granny: Positively, if you follow directions. Salesman: By the way, what are the directions? Granny: Take one spoonful of cold cure, eat sensible, get lots of rest, and drink plenty of water. Jed: And in a week or ten days, your cold will be gone. Miss Jane: A week or ten days. Granny: That's all it takes. Jed: Ain't failed in 45 years! Salesman: Can we go back in your office? I think I'm gonna be sick.

Nursingaround, I agree, we need to acknowledge the limits and weaknesses of our coworkers, and work together to strengthen one another. If you were my workmate, I would help you do your catheters if you would help me lift my heavies! It's called teamwork. Be honest, if the OP was a big strapping guy, you wouldn't hesitate to ask him to help you lift. Doing catheters is HIS heavy lifting, regardless of his reasons.

If you are tough, willing to learn (and they are willing to teach), and if you do not mind running your buns off, then it's not out of your league. Best wishes to you!

I gotta say, it sounds strange enough to be true. Best of luck in your job search.

So glad for you, OP! The CNO saw something great in you, and so did this other employer! Sounds like the CNO didn't intervene fast enough to retain a good nurse. Their loss. Happy trails!

Take the level 2 ED if you are confident that you are competent and tough enough to soak up the training and roll with it. The training you will get will further you along in your ultimate goal. Do you have a family depending on you? Any concrete benefits to being so close to home? Moving across the street might be better if you have little children depending on you. If they pay/benefits are the same, and you don't need to be close to home, the experience you will get at the level 2 is worth it. IMO. Great problem to have!