echoRNC711

In our hospital nurses do not insert caths in males unless they have in house certification. Female inserts of cath is standard nursing care though.

Becoming a nurse for "the money " is a little like the woman who "is searching for a rich guy to marry ". In both scenarios you will work for every penny of it!!!

I have worked both as an LPN and RN and quite honestly there was no difference in how I was treated. How we represent ourselves is often how we are treated whether your in housekeeping,ward clerk,nurse or management.In short we teach people how to treat us.Examine why you feel less than because no one can make us feel small unless we believe what they are saying is true.

Madness!! Anyone got an emesis bag?...I'm feeling a hurl coming on.!! What's next?... Pt check off the care they don't want to receive like the "awful " , painful dressings, suctioning, coughing/deep breathing post op...... Congrats administration!!! Smokin hot idea! This plan smacks of success. Keep up the good work!

Next time you could ask about getting a lasix order? (and request pottassium to prevent PVC's post diuresis. That might have solved the problem to lessen the heart failure symptoms. The problem seems cardiac in origin,respiratory issues are a consequence of heart failure progressing. The supervisor made the final call,so you are covered, The treatments were just a temporary solution but didn't really address the fluid issue. Are you sure it wasn't rales rather than rhonchi? Was there edema?

We got nothing. And....This was the 1st yr in my 20 yrs working there that no one got a cost of living increase (3-4% ) drum roll....ho! ho! ho!

Examine your heart not your defenses because that's where the truth is for you. Keep your focus on the correctness of your actions not your bosses response. Forgive yourself if you feel it wasn't the best choice and just learn from it. _____ a mistake just means your still teachable If you feel your actions were correct there Is nothing to feel bad about. ______guilt is always a complete waste of energy,let it go The root of both scenarios: amount to "forgive yourself. " (no worries,really ... move on )

well said jchilds!

I am gentle in my nature and found the 1st yr nursing challenging because dominant characters were allowed to run a muck . You will learn to toughen . I am here to attest it does happen. Your manager is not a good one. I reflect back now on how much I put up with myself. Make the decision to leave and begin looking. Once I made the decision to leave (I told no one ) the remaining months I stayed I made the decisions to focus just on learning . Something sort of snapped in me where out of nowhere I decided this is a temporary situation that I am going to use to make me the best nurse I can be. I completely stopped caring who liked or didnt like me. Some how that made it much easier. I decided I would find a way to ask for as little help as possible. Unit nursing will probably work better for you,you function more independently in your own cubicles. That kindness you have pt will appreciate and tell you that. This will boast your confidence. Over time other nurses will begin to see your skill and kindness as something honorable. It does take time. Meantime hang in. The aide is just unhappy,thats why she is such a misery. She will be a misery long after you have left. Remember next time she is just proclaiming her own misery next time she shouts. It has nothing to do with you. The manager who stood back and let an aide peck at me was herself fired yrs later. Everything comes to those who wait. Do your time, focus on getting skilled then find a unit or another branch of nursing where your skill will be valued. Kindness is one of the best virtues. There is nothing weak about being kind.Hang tight,it will get better. Just remember you will be shinning soon. Start looking now for a better oppurtunity. It will come.

I started nursing before many nurses here on line were born...! I started out in (Ireland ) in the early 80's in Peds and the Nursery. (Fun field to start out in ). I nursed here in the USA from late 80's on beginning ,like many in med surg (provides a nice solid base. Here you learn organization and how to handle stress .This is challenging at 1st. It took me 6mths to get out of my own way expecting perfection of myself and annoyance that real life was not what nursing school had prepared me for ) ) While on med surg I also per diemed everywhere in the hospital . I liked the variety,getting to know everyone in the hospital and getting a glance at fields I might like to try. It also provided a way for me to be seen by other managers so that when I wanted to transfer they knew me and how I worked. I did per diems because nursing excited me, I wanted to know everything but I didn't know at the time how much it would spring board my career. I did a spattering of research,pain management and helped get holistic care started in an era where some people thought I was a witch doing reiki. (now it's main stream ) I rotated through the ICU's and settled in CVRU for several yrs. This was higher stress, a huge learning curve, an incredible experience (like nowhere else in the hospital ) ,it provided great autonomy and after that nothing scares you. Also after working there everything was easy with the exception of the OR. I loved the inside of the body,that was pretty spectacular however standing all day, heavy aprons , little pt contact and having little say in care was not for me. ASU was one of the most fun places I worked,lighter acuity,on the whole well "walkie talkie " pts. Its a good place to go if your feeling burn out as the atmosphere is quite upbeat and stress is considerably less. I only per diemed in psych and detox which I also thoroughly enjoyed. I worked in a homeless shelter for a yr prior to nursing so already knew that results can be very slow in the psychiatric world. For me then ,I felt I could do more in pychosocial outside of psych where I felt I might burn out there too quickly. Now I am in cardiac rehab,I do teaching in the hospital with pts,run stress management classes ,for both pts and hospital staff, teach meditation and provide reiki .In addition I do admissions to rehab and and run tele classes. This has been the job with the most flexibilty and I get to mentor students which I absolutely love.I'd like to see us nurture more new nurses as I believe that is the only way we will change the culture of nursing. I have learned "picking " the right boss is as valuable as the specialty you choose. (I learned this the hard way ) Today (after a 20yr wait ) I have what is for me the ideal boss ,She welcomes growth, new projects and imput. I need to feel I can grow and express myself . Rehab is hands down for me the least stressful nursing (but you do have to be able to function alone,with no back up,if a pt crashes ) We do quite alot of research here on depression. For me now, I just finished publishing (I am only a contributor ) in a book on soul midwifery a branch of care that deals with helping the spiritual needs of dying pt . In my career where I have served the best is being there for the dying and it is where I plan to both go next and finish my career in nursing. I would like to introduce more gentle dying that address spirit /soul. Through reiki I have learned that souls too can be nursed during the stages of dying . There is so much to do in nursing you could live a 100 yrs and not get bored.. It is work to keep learning but it also keeps the fire burning inside. I am still proud to be a nurse even amidst change. When I started I had 17 pt in my district.Now those days are gone but scrutiny is higher. Every generation has its struggle and as nurses we find a way to make it work. No question nursing is stressful I started meditating 25yrs ago and for me thats been key. It has taught me to take life 1 second at a time, nothing is personal and if I stand back for a moment there is no crisis that can't be faced 1 moment at a time .It has not all been easy nursing has a way of exposing all your own flaws which can be challenging. The key for me has been being open to change,keep learning and develop a little dark humor. Remember, Nursing school is purely a template,be mindful of that. Scores in nursing school are not an accurate indicator on the type of nurse you will be. Every nurse gets to decide that them self. Without ill intent I do encourage people to examine their motives for choosing nursing. Nursing requires a lot emotionally,if you do not have an interest in service the job is doeable but may be more challenging or obtusely difficult. I have said before if anyone chooses nursing for the money they learn quickly you will work for every penny of it. Choose it if you feel it will bring you happiness. Nurses are not unlike their pts if everything is great you seldom hear it but if its a complaint.....then...there is a lot to say.Goodluck . Hope this is helpful.Goodluck

Seems like we have 2 threads going on within the same topic. OP I am really happy for you that you have found purpose and happiness in your new career. Good for you following your heart. OP this commentary is not reflected at you ,just my own perspective and observation. I am old school and feel that without a calling to nurse I simply would not have remained happy or been able to stay in it. I precept nursing school students and it seems that for many , (in their words ) it is the starting salary and speed of entry into a professional career that seem to take precedence. I get it and I don't judge for it but be cautious ,to anyone choosing nursing for the money I assure you ,you will discover quickly you will work for every penny of it. You don't have to have a passion for service but without it is may be difficult to navigate the emotional and physical demands without turning into either nurse Ratched or apathetic. Gloryfield, I think by your posting here a part of you recognizes you need some help. Whether it's anger that nursing is not what you thought or depression I think it may be worth considering getting some professional help.Either way it will help you gain clarity, unburden you and help you access to your own truth. I do feel that the 'reality" of nursing can be a tough pill to swallow at first. There are many many avenues in nursing.Your current path clearly isn't working .Best bet ,to expedite the process ,may be professional guidance.

Working ,in the past, in CVRU I took a direct approach. I met the family in the waiting room prior to pt's arrival and told family " "Your mother/father is my priority . I understand you want to be in the room but if you get in the way of care I will ask you to leave because I want your mom/dad to get all of my attention and get the care they deserve." Depending on the family I may add "I am sure you would agree your mom/dad comes first, right? " As regards the over nighters , my approach is "Your mom/dad need you to help them to progress during the day. If you are over tired you are not going to be the best help to them. I know it might be hard to leave but if you want to be the best help to them go home and get rest so that you can best help them in the morning" To the more resistant family members. "I need to put the light on to give your mom the proper care she needs If you don't want her to get that care then I need to document that because I am very concerned that if staff can't put the light on your mom will not get the care she needs. "

This is a non issue. Maybe a better topic might be "Why is it still an issue in your country " (or how it even merits being a topic in your school )

Perhaps you could put it in writing and let her employer know too?

Before we get too carried away with tradition ...a reminder that the caps were worn originally to keep the nurses lice from dropping on the patients!!

I suspect if you just show up wihout the cap they will just say "go ahead." I am from over sees so didn't realize the pinning ceremony was going to be a big deal. I figured if I have a gown on who would notice what I was wearing so I wore my jeans a t-shirt and white sneekers. Wow! was I shocked when I got there and seen how dressed up everyone was. They took one look at me,laughed and said "man those white sneekers look a riot under the gown ". At the pinning I got a special mention because of it and I think its my fondest memory of nursing school because I was just being true to myself.

OK blood starting to curdle....I feel a vent coming. Let's try something novel, the truth. I have worked on 2 continents nursing for the last couple of decades and I assure you every nurse has cut corners somewhere. Promoting this myth of perfection serves no one. It is not only dishonest to paint the picture of the nurse who is perfect every time it is quite frankly a disservice to the profession. It is attitudes like this that make nurses not fess up when they err when the climate portrays and expects perfection. Just look at the poor new nurses. What are we thinking. Not perfect...there's the door. God I would be petrified to be a new nurse in this climate. Zero tolerance. Its just brutal. No one and I mean no one can tell me they do it right everyday. So let me start the ball rolling. Forget to wash my hands, yes. Made medication errors yes. Told the pt, yes. Felt the wrath for making that mistake,yes. Next error I got the Dr. to write an order that covered me and I am not ashamed of it. Do I reflect,yes. If it is a stupid rule like the script hospitals have us say, no. I work under my own honor. I do the best that I can. I treat people how I wish to be treated. It sets me on fire that a climate has been created not to tell the truth. If I don't do my work I am honest. If I didn't do a dressinsg I admit it. If I don't want to do the next admission I say it. I say what's the truth "I am tired , or I'm feeling lazy, or I'm just too grumpy today "I don't care whose looking because what you see is what you get, a real person. Instead of all this perfection let's try trust. Work on establishing trust that the pt knows you are giving everything you have got.That we begin trusting each other. That management create an environment where trust is valued over making things look good. Lets give the care rather than writing stacks of paper on what we are meant to do. I do not believe that people are doing head to toe assessment because I have seen enough on pts to tell you they weren't looked at . Furthermore nurses on med surg have looked at me ga ga at even the thought of doing it. Your really lucky if the nurse is listening to pt lungs when they are admitted for CHF. Don't take my word ask your pt. Again,lets try some honesty. It is done in units but not on the floors. If anyone tells me "oh no,not me" .Then you are the exception We would have less law suits and paperwork if we actually valued forming a trusting relationships with pts. Why, because we miss the most basic thing we don't take the time to listen. People who feel heard ,validated forgive us the mistake of not washing our hands or forgetting an alcohol prep. Why, because they feel cared for.I simply can't take this holier than thou attitude. I absolutely think that when we harm pt,correct it, even sue but trying to make people perfect is just denying our basic humanness We are flawed. So lets just start focusing more on making an environment where people feel safe to tell the truth, room to learn, safe to be yourself without a camera hanging over you. Lets start with the basics give the best care you can. Forgive yourself when you don't and try for bettter tomorrow.

Seriously???...... The nurse who last tried this kind of perfection.... has now snapped, is in a four point restraint and is tended by a nurse unburdened by the need for perfection " Let's take a reality check. Robots may perform this way but I am very happily human!!

I absolutely loathe hairy backs! They just makes my skin crawl . I am also not a fan of the surprise sputum catapult (The one where you ambu a pt and it shoots out with such a force you get splat if you don't duck! )

Thank you so much funkmarv , I really appreciate it. I was feeling kind of drained today and your comment felt like an instant tonic,Thanks!

Am I sensing you are a teeny weeny bit passionate about this topic!!!! Well hats off to you .Nice job. And yes, I have both a living will and a proxy. I picked as my proxy my husband and the most skilled Dr. I have worked with because I implicitly trust his judgement. My husband initially felt a bit bruised that it wasn't just him as my proxy until he realized I want it this way to make it easier on him.. I was in my 30's when I did mine (I was driving all the way across America and I know how I drive! ) anyway, I was really surprised that even though I am perfectly healthy it definitely made me feel more peaceful that I have cared for my family ahead of time. It makes me feel good that I can save them from some pain and a lot of unnecessary guilt. My previous reservations was if I acknowledged death it was like a part of me felt like I was saying I am ok with dying now.Weird maybe, but it was how I felt. Strangely, by doing it it had the opposite effect and lessened my fears of death. My conscience feels clear that by doing so I am showing my family how much I love them.(and that makes me feel it is so worth that momentary feeling of yeah I will die too someday ) I encourage everyone to do it, it brings a lot of peace.

It sounds like your preceptor wasn't around much or in retrospect were you a bit of a bronco bill charging ahead without knowing what you were doing? Either way,learn from it. You may have been trying to hard to "show " you are a good nurse but the truth is perhaps you didn't know and were winging it? You are on orientation you are not meant to know everything. New nurses frequently lack judgement because experience is our greatest teacher. I feel very badly for new nurses. In the yrs of nursing shortage we gave people a chance,allowed for a learning curve and even extended orientations so a nurse could gain confidence. Now, it sounds like new nurses are turfed with the attitude of there is someone right behind you ready for your spot. I have precepted for 20 +yrs and in my experience what you did, didn't merit firing. My sense is your willingness to jump ahead (because perhaps you wanted to be seen as team player) made you a risky nurse to take on. The nurse who is unsure but continues to act can kill people. The nurse who doesn't know may get some flax for not knowing but stays employed because they won't put pt safety in jeporardy. I applaud your enthusiasm, now work on judgement. Ask questions. If you are a natural leader you may find being led very difficult. You may even send cues like "Please, I know that already " or "I can do it myself " so the preceptor gets annoyed or just backs off as you are already an "expert". If this resonates, back up, make a decision next time to be more open to learning. Be kind to yourself and give yourself a chance to learn. This is said not as a judgement but to help you examine rather than getting stuck in either poor me or I am such a terrible person. EVERY nurse makes errors and usually far worse than you did,even the ones pointing their fingers self righteously at you. Nursing is a team effort,not an orificenal of one, (remember that when you think you are expected to go it alone). Try not to focus on I made a mistake but rather what can I learn from this and how can I do better. It's a painful lesson. Rise above it, aim to be the preceptor you wish you had and this experience will just be part of the education you needed to be the best type of teacher. Be kind, gentle with yourself, you will get there. PM me if you need assistance on your next orientation

Black is slimming so I guess we can all gain another 5lbs without anyone noticing,......."chocolate anyone? " I am sure the pts will be disappointed as nothing inspires confidence or screams professionalism than nice neon thongs or flowered undies beneath the paper thin white scubs. Ahhhh...the end of an era of the nurse with theflower power!!!

Have a little fun with your name,try introducing yourself as Uglesha and watch the pt try to keep a straight face. Works like a charm!

Thanks commuter , Nice link . Well , for me, I believe in reincarnation ,so I see death more as a continuum than the end of a circle of life. Works for me. But hey, all roads lead home in my book.