blackribbon

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.

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.

I have missed the call in response to an application. I called back in less than an hour only to be told she wasn't there. Called the next day and was told that it wasn't the right day for my application...and so on with wild excuses, until I was told the job was already filled a week later. My gut says the interviewer was holding the job for a friend and was able to count me (very much qualified) as not interested.

Mag is stopped for the birth. Mag is restarted after the birth and run for 24 hours after the birth. Most my postpartum mag patients are allowed ice. Some are allowed clears. And a few are allowed food as tolerated. I have always thought it was to minimize vomiting. Mag and lack of sleep makes them feel crappy enough.

I went into nursing after my husband died (of cancer) in my arms. I have many widow/widower friends. We live the rest of our lives with the last image of our loved one. The funeral doesn't count because they don't look like themselves anymore. Clean them up as much as possible.

I am a gyn/med/surg nurse cross-trained to care for postpartum patients. Besides floating to the postpartum unit, we often get the overflow PP patients, the NICU moms, and other special cases so they are not next to the rooms full of families that are celebrating their new babies. I have taken care of women who have very delicate preemies who are very critical and moms who have lost their babies. I have even had to prepare the deceased baby after the family has spent time with them...they are allowed to have their babies for reasonable amount of time after they pass if they wish. Now, I did not lose a baby and understand that the fact that I lost my husband when he was relatively young is not the exact same thing, however it allows me to address the grief I see in my patients. I am able to tell them it is okay to refer to their baby in the present tense, to love that baby because it has been part of their life for 6-9months...not just 24 hours, to discuss options of dealing with the prepared nursery at home, and let them know that they are allowed to grieve however they need to and to allow the daddy room to grieve differently but pull together with as a couple. They both loved their baby. I think it allows me to be a better nurse because I am speaking from a place of understanding. I think your labor and delivery rotation in school will give you the best idea of how well you will be able to handle this area of nursing now. It may be more difficult than you are ready to do initially...or you might feel more pulled to the specialty. I will say that the rotation where we focused on neurological disorders was a "trigger fest" for me because my husband basically died of brain mets related to his cancer and I relived those last few days of his life while his brain was shutting down. It was very difficulty as I realized what he was actually going through and honestly, also realized the mistakes that were made in his care...he might have lived longer if they had treated what is obvious to me now much sooner instead of ignoring my pleas to believe me on what was happening when they were not in the ER curtain area. However, I have embraced and come to peace with knowing that he was going to die from the cancer...and there is no reason to point fingers because they were human, and humans make mistakes. Unfortunately, I have too. Expect to be triggered during OB rotation...set up your support system before hand and have your coping activities planned out. Only time and experience will actually tell you whether or not you want to deal with this as your initial nursing job. Each person is different on what we can cope with. Personally, I love my cancer patients (we get gyn oncology patients) but am not ready to go to an oncology floor and I am not ready to do hospice nursing yet...though that was my initial reason for going into nursing. I do see myself getting their eventually though. Ironically, my mothers who have lost their babies are my most precious patients. The baby I had to prepare was a full term baby that it was unknown why he died. He just never had any brain waves. I was able to tell the mother how gently I cared for her precious son when I had to remove his outfit and put him in the hospital t-shirt....and that I was with him until I no longer could be. I know that when my husband died, what happened to him when I no longer was with him weighed heavily on my mind. I debated for a while before offering his outfit back (she had told me to send it with him but protocol didn't allow for that)...and I decided to be honest. She did want it back and then called me back shortly and burst into tears and thanked my for taking such good care of her baby because also she needed to know that he was cared for to the end. We each have our own callings..and some of those we learn after we get our licenses. Good luck.

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.

I had a patient who was given an enema in the ED before being sent to the floor.

Morbidly obese patient...very morbidly obese. Pt admitted for cellulitis in her legs. She also had a known hernia that wasn't being address on this visit. I found her in tears because she was concerned about "the hole in her belly button" and how much she was leaking from it. After calming her down and listening to the whole story, I guess the doctor manually assess the hernia via her very large belly button area (probably less fat or the location of the hernia, not sure exactly). Anyway, she told the patient that the "hole was getting larger and would need to be surgically correct soon but not on this visit". I had to print out pictures of how the intestines protrudes through the stomach muscle...and that the "hole" was internal and her belly button was not leaking at all, in fact, nothing was leaking anywhere.

If we get an abnormal BP that isn't expected, the NA calls us and takes another one 30 minutes later (assuming we aren't talking about critical levels). If they are critically high, then I grab my personal manual cuff and go check myself. If I see that the wrong size cuff was used or suspect that the NA did it over clothing or in an odd place, I may use the electronic. Most times, I will just do a manual...the reason isn't that it is more accurate but rather that I want to do the recheck personally AND I want verification that electronic measurement was accurate (a similar reading verifies this). I started this habit because the first thing the doctors used to ask me was to take a manual reading to verify the electronic reading. Remember, the automatic cuffs can get very tight and painful and drive the BP higher r/t to pain - especially if it keeps refilling and trying over and over. I have been challenged because my manual cuff hasn't been calibrated by the hospital but I am not making a medical decision based on it alone but rather a combination of the electronic reading and my manual...my manual is the backup reading. We do have a rolling manual on the floor but it is always hard to find. If I need an "official" manual reading, I can hunt that one down but honestly, a manual cuff isn't that complicated and all external readings (electronic or manual) are more general estimates and not exact measurement. (Manual readings change as the hearing range of the nurses change...electronic ones change based on the location of the cuff to the artery being read)

Just a comment... I am "only" a ADN at this time because this is a second career and my husband died so I needed the fastest way to get to work earning money to raise my kids alone. I did already have a BS in Bioengineering and years experience in hospital sales where I actually spent time on the floor working with nurses & doctors. My experience is that all nursing students are smart people. You have to get very high grades to get accepted and have critical thinking skills to survive the programs and graduate. Probably some schools are better than others and I was in a very difficulty program....one where the nurses in the hospitals saw our scrubs and smiled because they knew the standards we were held under. Just because you did well on the tests or prereq, does not mean that school will be easy. Studying for a nursing class is totally different than studying for any other class I ever took. Those who adjusted fast, were the ones who finished. Almost every one of my classmates started the program with a 4.0. Many were quickly struggling to keep the B minimum they needed to complete the program. Anyway, all I wanted to add is that intelligence only gets you so far. The part that is hard to teach is the part that comes on the floor. It is walking into a room where the vitals all are within normal limits but you realize that "something has changed". It is knowing the difference between someone who has a low pain tolerance and someone whose surgery went wrong...both with the same complaint of uncontrolled pain. It is being able to tell the difference from a physical condition and anxiety ... and being able to have a relationship with the patient so that they feel safe to admit the deep dark secrets of their life. It is the real life habits of remember to always check the foley bag and watch the output...know what to do when the output is low (which involves calling for an order)...and the experience of knowing how to break a vapor lock in that foley bag to get the urine flowing if it is just a mechanical problem. If they accept people with no experience, they must have a way they feel comfortable overcoming this issue. I'd ask the school what is their record of having NPs with no RN experience getting hired. I might also go to a couple areas hospitals and ask if they have a problem hiring NPs with no RN experience. I did this with my ADN program and found out the hospitals want to hire nurses from my program but we did have to wait through the first tier hiring process where they looked at BSN applicants first (necessary for their magnet status). I had a hard time finding my first RN job because I had no Nursing Assistant experience. I was actually hired at a small hospital where the DON (director of nursing) was an instructor in our program and liked to hire us older "non-traditional" grads for our real life experience. I promised to stay a minimum of a year to justify the cost of my training. Six months in, the hospital declared bankruptcy and let her go and I wasn't getting regular hours. I was hired in a week at a huge magnet hospital since I now had a track record and a shining recommendation to go with my degree from this program which was known for preparing nurses to work independently. I will admit in spite of my "magna cum laude" and passing the NCLEX with the minimum questions allowed, it was hard learning how to manage on the floor. Good luck with following your dream...regardless if you go straight through or do it in stages. FYI: in the hospital setting, my BS means nothing...even though it is in a medical field. I am struggling to find the finances to complete my BSN (9 months online) while I am also paying to put two kids in college. I do think it helped me get my current job but mostly I can only do laterally job changes...that BSN is coveted and mandatory for so many jobs...and I have heard that it can count against me even if I went into a MSN program that allowed me to bypass it based on my current degree. Maybe that is just in my area of the country though.

I hate when I go through the whole list of meds....verify that they aren't refusing anything and they are okay with the meds before I open them..and after I give them the cup of meds, they start asking me which pill this one is and oh, I don't want to take that one at this time "so I'll just save it".... ????? Next time, I am prepared. Stack of paper cups. I give two or three at a time per cup so I can remember what is in that cup when she changes her mind or questions....other nurses think I am crazy but I promise I get out of there faster this way. I once had a VIP early dementia patient who told me that she didn't want to take more than 2 or 3 meds at a time....so I was in her room every 30 minutes trying to get the pass done. Luckily a family member was in there because one time she got upset that I didn't give her a particular med...and the family remembered me going over each med as I passed it and could back me up..."Mom, she did give you that med first because you said it was the most important one".... (in my mind EVERY patient is a VIP and I don't have time to kiss the butt of one whom the hospital is expecting a huge endowment from...if she is that important, give her a private nurse)

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.

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.

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.