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blackribbon

blackribbon

Med/Surg, Gyn, Pospartum & Psych
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blackribbon specializes in Med/Surg, Gyn, Pospartum & Psych.

Nursing is my second career. I have been a med/surg nurse since 2014. I am currently working on a Women's gyn/med/surg floor. I am cross-trained for mag & postpartum. I also have about a year of psych nursing.

blackribbon's Latest Activity

  1. blackribbon

    Staffing and Unions: Beaumont Hospital in Royal Oak

    The residents at the same hospital are discussing unionizing. I suppose they are "trades people" too. I will agree that we are treated like we are trades people. Sad, considering my other degree (BS) is in engineering and the nursing degree was significantly harder to earn.
  2. blackribbon

    Staffing and Unions: Beaumont Hospital in Royal Oak

    I am theoretically anti-union, especially for professionals. However, as staff nurses we have no say in our working conditions like other professionals. I am very pro-contract so that we can have some guarantees that protect our patients and allow us to provide the care they deserve. The things this union can do is give the nurses a voice in the hospital. The way to say that we are working short staffed, working short of the supplies we need to provide quality care, and working exhausted from mandated overtime or too heavy of acuity for the assignment given to us. What is different about this union is that it is nurses from Beaumont who make up this union with support from the MNA. We are only serving this one hospital and the contract only applies to what this hospital"s nurses say are their priority issues. The purpose is to provide an environment where good nurses stop leaving all the time and to allow us to nurse to the standards we want to care for our patients. This is in contrast to constantly being told what is going to happen to us and if we don't like it, we are free to leave. A union allows us to speak as one voice representing 3500 nurses who share many of the issues instead of 3500 individual nurses saying the same thing but are being told to sit down and shut up if we want our jobs. I do work at Beaumont Hospital and simply want to be allowed to provide the level of care they claim they want us to provide.
  3. blackribbon

    3 Couplets, too much?

    We usually start with 3 couplets and get an admission so we have 4 couplets by the end of the shift. We do not attend the delivery but if the L&D is busy can get the couplet one hour after birth instead of the normal 2 hour wait. We do have a NA who does vitals on the mom (we do the baby) and helps answer call lights and escorts mom to the bath room the first few times. How busy the assignment is really depends on how many of my moms are 1st day c-sections, how many are 1st time moms, if they speak English, how many babies need blood sugars, and if they have anything else like Finnigan scores or bili lights. We do most of the breast feeding teachings, and baby things like bath, Algos, etc. The lactation consult comes for problems and never before 24 hours. I have cared for 5 couplets twice (not good nights for me because I felt my patients were neglected). Lab does all blood draws except the blood glucose checks.
  4. It depends on how comfortable you are with the topic. FYI: I have hated every psychology class I had to take and loved psych nursing class as well have some actual psych nursing experience. They are not the same class or topic.
  5. blackribbon

    Shoes, uniforms, shower after clinical?

    In nursing school, I undressed in front of the washing machine and left my shoes by the door. I don't do that as a nurse now but isolations precautions and universal precautions come as part of my regular habits. I also wash my hands before I pee since I work on a gyn unit and see infections in places I don't want infections. I don't subconsciously touch my hair or face anymore on the job. I know in general what germs I have been exposed to and how worried I should be....I mean, if my c.diff patient is waiting to get discharged and has solid stool, then I realize that he isn't really any more risk than the patient not in isolation. However, if she is pouring out liquid poop and I am cleaning her up multiple times a day, then I can guarantee that I am not making a quick stop at the grocery store and can't wait to get out of those scrubs. There is a reason why first year nurse tend to get sick more often than anyone else....good habits are still being established and immunity hasn't built up yet. I won't touch my kids in my scrubs unless I have worked on a "clean" unit like postpartum. I knew people who had immune compromised kids at home who bleach wiped their shoes during our end of clinical conference each day. The floors are some of the dirtiest places because when your patient is actively bleeding or a drain/colostomy bag has leaked, you kick a towel around on the floor while you focus on caring for the patient.
  6. Well, if you are taking two classes the first semester (pharm & fundamentals of nursing) and get C++ or less in both, you have effectively failed twice and are out of our program. We got one failure (which means a 79.9999%, no rounding) in your whole nursing career and were out after the second. It wasn't two chances per class.
  7. blackribbon

    Is nursing REALLY that difficult?

    Can I add, that "adrenaline rush" that you seem to seek won't turn off anymore on its own so I am anti-anxiety and depression meds to be able to go to work. I love what I do but I realize it isn't healthy. I always have too many patients and am on hyperviligent status that something isn't going bad in a room that I haven't had time to check on. A fellow nurse was just diagnosed with 30 ulcers. Yes, we do help people...we also face people who seem determined to kill themselves inspite of our interventions and care, and we lose people too, often people that we have started to care about....and even harder yet, when you go home, you usually do not find out what happened to your patients because HIPAA means we can't look at their files if the are not currently in our care (need to know only). I found out my patient's precious little baby ( a micropreemie) died several days after I stopped caring for her from a NICU doctor who came to check on one of my babies. When my patients die, I often don't know because they are transferred to more critical units before they pass away. It is hard wondering if that brain bleed you caught made it or died...especially after you spent several days learning all about her children and their life as you cared for her. Nursing is a hard job. Harder than most people realize. I can't imagine doing anything different now but honestly, I wish I had picked a different field that allowed for better balance.
  8. blackribbon

    Is nursing REALLY that difficult?

    I would love 4 days off...however, the day after working is all about recovering, it isn't really "a day off"...and if your shift is split like ours usually are (not 3 days in a row) then often 2 of those off days are spent recovering. Is it really that difficult? Well unless you assume that all those nurses that you read about really are just whiny children who are lazy...maybe there is a reason why there are so many articles/posts about nursing. My nursing instructors basically told me to expect to cry a lot until you had at least one year experience on the floor. What other profession gives you a warning like that? (it was true though I was usually able to make it to my car before the tears fell)...
  9. blackribbon

    Nursing school questions about having a "disability"

    The incubators and warmers that may need to be moved in NICU are definitely heavier than 10 lbs. A standard E cylinder of oxygen probably weighs more than 10lbs full (it is 8lbs empty). And LGA (large for gestational age) babies often end up in the NICU for observation too...these can be over 10 lbs. ( I suspect my work supplies bag that I carry with me weighs more than 10 lbs). To get through nursing school, you have to pass clinicals on med/surg units and that would definitely involve lifting more than 10 lbs multiple times in a single day. The other issues are probably not as big of a deal. My other concern is how much time off would you anticipate having to take related to medical issues. Schools is not very accommodating for absences. I had a classmate who went to clinicals while her mom was having open heart surgery and another who only missed a day after her sister died. Everything moves so fast that there isn't a way to make up missed classes or clinicals very easily. It is hard reality of life that nursing is a very physical job. I come home from every shift with every muscle in my body aching. Sometimes we have to recognize that life does hand us limitations but we just learn to find new dreams.
  10. blackribbon

    Need advice--possibly failing orientation

    I think that you belong at a small hospital or in a different type of specialty. People are often given an extra week on orientation but it does not sound like you were ready to safely work independently yet if you were making these small but significant errors and even worse, someone else had to catch them. Giving a patient twice the order dose of medication is a significant issue...it isn't just about splitting a pill. Do you not have access to Micromedex on your Emar because that is a fast way to look if a med can be cut, crushed, or a capsule can be opened. (I disagree with idea that they score meds that can't be cut though...but you should always know your medication before giving it...what is is, what it is used for IN THAT PATIENT, and if you are dealing with an appropriate dose - which means you will be looking up a lot of meds very quickly when you are still learning what it standard on your unit). I verbally tell my patient what I am putting in their pill cup before I even open the wrapper so they can tell me if they don't want it or don't believe it is an appropriate med or dose. I also immediately split the pill at that time and throw away the extra so I don't loose track of what it is). The labeling of the IV bag immediately may not be as big of an issue but it is a huge concern of JACHO and accreditation issues, so that may have been an issue for them. Or it may just have been a concern that you were not noticing the multitude of small details that are involved in quality patient care. The problem with not being fully ready when you go off orientation is that you are expected to be able to carry a full patient load independently...and give quality care plus recognize when you need to get advice. I am relatively new to the postpartum nursing side (I am shared by the gyn/med/surg unit) but I have noticed that as the newbie who doesn't have friends on the unit that I often have the most couplets before anyone else. Multiple times I have had to care for 5 couplets which is critical staffing levels on that unit ... and I have to give quality safe care anyway...my new moms and newborns are depending on it. On one of these nights I was caring for a new c-section mother with q2 hr checks for mom, a Finnigan baby with q4 hr checks (respiratory rate funny enough I had to call in the NICU resident to come assess the baby), a 1st time mother who did not speak English as her first and primary language, a baby who could not get his blood sugars stable and the mom was having building a nursing relationship with the baby, and all the mothers needed assistance and teaching with breast feeding. And the whole time doing the normal baby vital signs for babies, full assessments for both, teaching baby care, doing scheduled activities such as Algo, CCHD, weights, TcB, etc. Unfortunately, in a big hospital they don't have time to let you use training wheels when you leave orientation. I am kind of disappointed in the whole orientation process at my huge teach hospital because between the two units I am now qualified to work on, I never had the same preceptor more than twice. It was a huge teach yourself project and I spent a lot of time at home looking up what I didn't know or revisiting my personal organizational plan. I was vocal about my disappointment concerning my orientation and since I had already established myself as a good nurse on the gyn side, I think I was heard because they have since instituted multiple new policies concerning having a more planned and better precepted process. I do not have any reason to question your ability as a nurse but it sounds like you are not a good fit for a large hospital. I think they were simply letting you know you were not a good fit for this unit the way it is run. Know that in a busy hospital you have to learn fast and perform fast. It isn't personal. And trust me, I went home in tears as many shifts as I didn't because it was hard and exhausting. I spent a lot of time at home looking up policies and things I didn't understand. Post-partum nursing is primarily about schedules and doing things on time even when multiple tasks on different babies are due at the same time, recognizing when a baby or mother is out of the range of "normal", and recognizing when a patient needs teaching and being able to give it with the attention of someone only caring for one couplet. On the gyn/med/surg floor my shift is guided by the patients who are the most sick and need the most care...on the postpartum side, it is driven by a tight schedule of tasks that are dependent of the type of delivery and the age of the babies under my care. Good luck at your next position. Don't let this one experience steal your confidence. Learn what you can from it and find the unit or specialty that is a better fit. Sometimes life's lessons are about finding out where we don't belong.
  11. blackribbon

    Handling an issue at work

    The best way to handle this is to be a good nurse. Stop focusing on him and focus on your patient care and patients. He has the right to observe and if he was observing me, I'd simply introduce him to my patient. "This is Don. He is one of the team leaders for our unit and part of quality control on our floor is that from time to time they observe the staff. I guess it is my turn today." Are you that self-conscious about your skills after 12 years in nursing that you can't perform without being nervous in front of your leadership team? I'd probably ask for feedback from him on anything I was doing off of policy or any suggestion that he had concerning my care the minute we walked out of the room so that it could be address right then and there. You have already admitted that there are policies that you are not aware of like reporting the leader when you go on break. Stop being so defense and just using it as a chance to learn. The quickest way I have gotten people off my butt is to show them I know what I am doing and instead of being defensive, treated them with respect.
  12. blackribbon

    Long Term Care Nursing is Lame

    Okay...I don't work in one of the highly specialize areas but I do work med/surg with a huge variety of patients. I see the result of good and poor LTC nursing by the condition of the patients when they get admitted into our service. We often spend a long time repairing poor nursing care from outside the hospital (pressure ulcers and other wounds of neglect are high on the list). I also see it in patient's faces when they know they are being sent back to LTC facilities that isn't a quality place. Most people will never need the specialize services of the nurses that you idolize but most people will need the services of a LTC facility, either for themselves or for their loved one. To make a comparison, yes, someone repairs some exclusive expensive cars may have special skills that makes him seem special but the reality is that the mechanics that work on the average nothing special car have more value to society as a whole. You are taking care of someone's mother or father when they no longer can do that. How on earth can you minimize your role and value as a nurse? Our value as a nurse isn't determined by the skills we have but the difference we make to the patient in front of us.
  13. blackribbon

    Best MD note

    My favorite discharge order was not a funny one but a compassionate one. The hospital was in a very poor neighborhood with a lot of homeless people. The patient was homeless and determined that it was safe to allow him to be discharged to his chosen "home". The patient was stable for discharge in the early afternoon but the discharge orders said "d/c after patient eats dinner in the pm".
  14. blackribbon

    Orders from hell...

    Not a order, but after a friend of mine called the surgeon who placed a stent in her patient went home without talking to the patient and the patient was freaking out because she had blood in her leg bag but not in her urine. She said that she was "fine" and tell her he would talk to her in the morning. My friend put her note in. "Contacted doctor with patient's concerns. Doctor said that it could wait until morning. Patient informed." Strangely enough, that doctor was in the patient's room 30 minutes later around midnight.
  15. blackribbon

    Orders from hell...

    Co-Ed Behavioral Health Unit. All patients were involuntary admits. Two patients were found having sex in a room on rounding (early 20 year olds)....glad I wasn't working that shift. MD orders were that the two patients were not allowed to be in the same hall at the same time or must be sat on opposite sides of the dining room/group room. It was funny to watch them try to meet in the hall not visible by the nurses station. I guess they didn't "get" that we could monitor every public area on the floor via video cameras. When I finally went out and confronted them and threatened to become the male patient's "best friend & shadow", he announced that I couldn't keep them apart. I told him I had explicit doctor's order's from the chief psych doc that said they couldn't be in the same hall at the same time ... and he looked at me and said "okay"...and they suddenly complied. Maybe he was thinking of hoping to meet criteria for discharge (he was actually sent to the state long term facility) but I have never been so happy for strange doctor's orders.
  16. blackribbon

    What does your nursing career repair bill say about you?

    Honestly, I would have told myself to explore other options and find a job that had paid vacations (not PTOs that you had earn), guaranteed schedule (didn't call off at the last minute for low census), no unpaid on-call status, and didn't act like the world was going to collapse if you had to take a day off (you could make up the work the next day). I'd also look for a profession that treated me as a professional. I love nursing but it is not a healthy career. I don't want to be an administrator but hands on nursing is treated pretty poorly in comparison to other professions.