BSNGUY

I can tell you that in my experience, it took me five years to "adapt" to nursing. They didn't teach me in nursing school how stressful and awful nursing can be, esp. in med/surg. We had no education on how to work with angry family members, angry and disrespectful doctors, etc. I had to keep working because I didn't have the luxury of looking for another job because when I graduated, there were too many nurses, believe it or not. I was thankful to be in acute care. So I stuck it out and adapted. I can remember shifts so horrible they can still give me nightmares. I now work in day surgery, after 13 years of med/surg. I hate to say this, but "welcome to nursing" is somewhat appropriate. Many people get into nursing not having a clue just how hard it is. I worked as a CNA for 9 years before becoming an RN so I did have some clue. Hang in there and try to get into some other part of nursing. The usual situation is that you need experience before you can land something "cushy", but now with a "shortage" it might be easier to get something that used to take years to get. After over 20 years I finally have weekends off.....Imagine that.

I can't believe this came up! When I was a CNA in a nursing home, I had a favorite patient of mine with end-stage Parkinson's disease. She could not move anything and I had to feed her with a syringe. (back when that was allowed). One evening, as I was getting her ready for bed, I slipped one out and said "Mildred, how rude"... This sweet lady couldn't move but she started laughing so hard her body shook. When I checked on her later that night, she still had a smile on her face.

Most doctors I've dealt with are great. But,now that I'm in my 40's and have been doing some form of nursing for over 20 years, if they are rude or mean, I don't put up with it. I don't care who they are. I treat them with respect, they must also treat me with respect, or they hear about it. Doctors are not better than us. Nurses practice nursing, doctors practice medicine. We collaborate. Our bosses are not doctors, but other nurses. I've actually walked away from verbally abusive doctors and once, security was called on a doctor who threw a chart at a unit clerk. We have "hostile work environment" rules at my hospital, so doctors are to act like everyone else and remain professional. There have been instances of what is called a "code white", when a doctor is going off on a nurse, all the other nurses, if they can, come to that nurse, stand next to him/her, pull out paper and start documenting the doctors behavior. (Saw it happen once, that doctor never did it again....)

I've never noticed that. I did read somewhere once that the "millineials", or the younger generation, has a much different work ethic. That is generalizing though. Since I'm the only male nurse on my unit, I don't see this. Of course, where I work, in day surgery, we have no night shift and most of my coworkers are older females in their 50's and 60's and even early 70's. When I was a younger male nurse, in my 30's, I worked nights because that was the only shift available.

Sounds like we worked at a similar place. Another fond memory is seeing two young female pica residents "sharing" their "kotex" pads. By sharing I mean eating. Then there is the guy with a colostomy who when he got mad at someone, would rip his colostomy bag off and shower the entire room with the contents. Then there's the client who I was feeding (I was a CNA during these fun times) and he was sleepy and I tried to rouse him to eat. He fell asleep with his mouth open. I kept hearing buzz buzz buzz sound. I keep prodding him when suddenly about 4 horse flies came flying lazily out of his mouth. I am so thankful I work in day surgery now. I've seen enough of this kind of stuff. I have said before that if I wrote a book about what I've seen working in psych, no one would believe me except nurses and those who work in psych.

When I was working med/surg I had a coworker who had a patient with an NG tube. The cannister got full and she went to change it. If you don't push down and secure the top, it can be loose. Um, anyway, as she was carrying it down the hall to dispose of it, the lid came off and the ummm, contents, splashed up and into her face and a big plop fell on her shoes. Needless to say, she went home ill. When I worked in a psych unit we had a pt who was mentally retarded who had a pica infliction (eating non-food objects). It was my turn to shower him and as he was in the shower, I noticed him chewing something. I asked him to spit it out.. umm, out came a very large turd. He spit it out just so, and it landed on the wall of the shower and slowly came down, resting on the drain. His teeth were brown. This I noticed because he had a large smile going on. Now I feel sick. Off to another thread....

In my experience, there is no difference in the pay between the ADN, BSN, or even the MSN. I believe any nurse who gets more education should get paid more. It's one of the strange things about our profession. It only makes sense to get compensated if you've done more schooling. Every hospital I've worked at, (3) over the last 13 years, has NO difference, even with an MSN. When I was an ADN, I still believed BSN's and up should get more money... Now I have my BSN, which does open a lot more doors, but no change in pay. I wonder what other professions do?

I needed to find work out of high school in the mid 1980's. I had no education and no real idea about what I wanted to do. I was medically inclined, but poor and didn't have resources or the high school grades to do something like medical school. I kept looking in the paper and seeing jobs for CNA's. It seemed like there were tons of them. I didn't even know what a CNA was. So, I called one of the numbers and the person on the other end told me what it was and did it sound like something I'd want to do. Being naive and needing a job, I interviewed and got the job. Wow, did I work my rear off! Very hard work, almost no pay, and no appreciation. From my perspective, it looked like the nurses sat on their butts and the aides did all the work. One day, I went to pick up paychecks for everyone. Out of curiosity, I peeked at an RN's check. I almost fell over! It was probably 5 times more than what I was making. I got mad about it and started to ask and research about what it took to become a nurse. I felt I could sit on my butt and chart all day :) Well, I got through nursing school learning more than I thought possible. I didn't know what the nurses were doing behind that desk, and just how much responsibility they had. Now, over 20 years later, I'm still in nursing and can't imagine doing anything else. Obviously I didn't get into nursing just for the pay, but for the satisfaction and the security. Not many people can say they've saved someones life. Remember if you save someone life, you're a hero, save hundreds of lives, and your a nurse. (I admit looking at someone check without their permission is wrong, but I was young. Forgive me....)

Thank you very much. Yes, that does help. Congrats on almost being done! I graduate this May too.

I'm an RN to BSN nursing student. For my senior project, I'm working with a nurse educator and we are trying to find information on part time ADN nursing programs. We are interested in knowing if there are any nursing programs that schedule students for a term of just lecture, then follow with a term of just clinical. Do you know of any school that does something like that? If not, do you have any information about where else I can investigate? Thank you very much for any information you may have.

Oh, and I should add, I wrote that "MD notified, no new orders" after calling. He then did his storming into the unit and ordered the 10 mg of Lasix and left, WITHOUT charting anything. I wonder how that would look in court if the patient went into full CHF and coded or something? HMM?

I was working in med/surg and had a patient with a long history of CHF. She measured her ankles daily, well her daughter did, anyway. She called me in the room one day and said she was getting more swelled up. I did a quick assessment, lungs, heart, edema, JVD, BP changes, pulses changes, etc. Called the doctor who says "I don't care if her ankles are more swollen, leave me alone and call me when something important comes up". Well, this patient also wasn't getting her lasix, it was somehow overlooked. I mentioned this and he kept saying he didn't think it was important. Very rude voice. I said, "OK, I'll go tell the patient that I called you and you don't want to do anything about it." Ten minutes later he comes stomping in, didn't even talk to me or even LOOK at the patient, wrote a ONE TIME ONLY order of lasix 10 mg PO, and stormed out. He always listened to me since then. If there's anything I can tell a doctor is: Listen to the nurses. If there's anything I can tell nurse is: Listen to the CNA, and IF you need to call a doctor, have all your information available, and I mean everything, I/O, vital signs, recent labs, LOC, lung sounds, everything possible. They may still ask a question you don't know, though. PS, I told my nurse manager about it, who promply did nothing. I also charted "MD notified, no new orders".

UGH, I think I'm going to be sick.. :stone

I see you're a nursing student malusport? Come back in about 5 years after you've worked your *** off with no breaks. Then ask that question....

Thanks very much. That's the type of reply I was hoping for... :)

Thank you.. I may be interviewing soon for a transfer to my hospitals home nursing. Any information is helpful...

What? Don't know what you mean.....

I was wondering if there are any men working in home health. What kinds of issues do you have to deal with and how do you cope with it? I'm wondering if there are very many men in home health. I'm looking into it and have some concerns like personal cares to females, when you are alone in their house. Are there issues with that? Do they (agencies) mostly assign male nurses male patients because of that, or if female patients, something like COPD follow up or dressing changes on the leg, etc... Very curious. Thank you for any replies..... :)

I was wondering if any of you guys work in home health. What kinds of issues do you have to deal with and how do you cope with it? I'm wondering if there are very many men in home health. I'm looking into it and have some concerns like personal cares to females, when you are alone in their house. Are there issues with that? Do they (agencies) mostly assign male nurses male patients because of that, or if female patients, something like COPD follow up or dressing changes on the leg, etc... Very curious. Thank you for any replies.....

Better Staffing Ratio's for RN's can save lives Working as a Registered Nurse in a busy hospital, I have noticed the importance of staffing levels. Too many patients and not enough nurses can lead to increased complications and even death. Higher RN to patient ratios should equal better care. What if your RN has 7 other patients? Sometimes RN's are discharging a patient, getting a fresh postoperative patient, and supervising nurse's aides all at the same time. Patients admitted to the hospital are much sicker than they have ever been. It is common knowledge among nurses that patients on a typical medical/surgical unit would have been in the ICU (intensive care unit) 10 years ago. Patients in the ICU today would have died 10 years ago. Patients on a medical/surgical unit back then would be sent home today. RN's are responsible for all of the nursing care a patient receives. Teaching about medications, how to prevent complications, discharge instructions, intervening during a crisis, these are just a few of the most important things. The general public probably does not fully understand all in which the RN is responsible. We are guided by the nursing process which has 5 major steps: 1. Assess the patient's condition. 2. Analysis of what was assessed. 3. Make a plan. 4. Implement that plan. 5. Evaluate that plan and if it isn't working, start over. We also need to hold the hand of someone who is scared or answer the same questions many times to help alleviate anxiety. While the nurse is doing all of these things, the phone is ringing, call lights are going off, patients are coming and going, pumps are beeping, crises are happening. Ill people and their families can become very egocentric and not realize how busy their nurse is working. They don't realize that we can't get their mother a fresh pitcher of ice water right away because we are dealing with someone who is going into respiratory failure or some other major emergency. Asking for something simple like more ice water should not be a problem, but nurses always have to prioritize. There have been a lot of studies done recently about nurse to patient ratios. The state of California is currently undergoing issues with this and the governor of that state is fighting it, citing a nursing shortage. 1. A recent study by Linda Aiken, RN, PhD, and others, found that for each additional patient over four in a nurse's workload, the risk of death increases by 7% for surgical patients. Patients in hospitals with the lowest nurse-to-patient ratio (eight patients per nurse) have a 31% greater risk of dying than those in hospitals with four patients per nurse. On a national scale, staffing differences of this magnitude may result in as many as 20,000 unnecessary deaths each year. To me that is very much a sobering statistical analysis. When the impossible is expected out of a person, that person can "burn out". Nurse burn out is a large contributor to the shortage of nurses. Not many professions go to work and get little or even no lunch breaks. Doctors and visitors can be very demanding and even rude. There's even a new term called "ward rage". Nurses can be threatened on a daily basis, sometimes even by doctors. This abuse can be verbal but it is sometimes physical. The only other profession that seems similar is being a police officer. A shortage of nurses is a factor in about one-fourth of patient injuries or deaths in hospitals, according to the Joint Commission on Accreditation of Healthcare Organizations' 2002 report. The Institute of Medicine says long work hours and fatigue contribute to errors. They suggest that nurses not work more than 12 hours a day. A 2002 study by Harvard and Vanderbilt university researchers, examining millions of 1997 hospital cases, found preventable deaths and patient complication rates were up to nine times higher in hospitals where the most care was given by licensed practical nurses and aides, not better-trained RN's. Again, these are sobering statistics. One RN for four patients is better than having one RN for seven patients or more. Why? If you have fewer patients, you are able to spend much more time with them. Your assessments can be much more thorough allowing you to catch changes that could result in serious complications. Nurses have more time to check lab work and catch potential life-threatening conditions. It's possible to not catch a change in condition fast enough than can even result in death. This is "failure to rescue," or a patient who has a major change in condition. Usually it's because the nurse who has this patient has other unstable patients. There have been deaths and lawsuits from this. The hospital is usually the one found guilty for not providing enough staff. An example of a "failure to rescue" would be someone who develops a pulmonary emboli, or blood clots to the lungs. The mortality rate is high if not caught soon enough. It is interesting to note that when staffing ratios are increased, nurses who have "dropped out" of the profession come back to work. It is possible that the nursing shortage is not as severe as believed. There are plenty of nurses; they just do not want to work under such horrible conditions. Nurses work under a professional "license" that is governed by the state and are accountable for every action they perform within the scope of their duties. Is it no wonder nurse's fear losing this license because of a mistake? At hospitals with better RN-to-patient ratios job satisfaction is much better. There is less of a turnover rate, which is much better for continuity of care. It costs institutions a lot of money and time to "orient" or "train" new nurses. This adds to the overall cost of health care. It is vitally important to do what we can as a society to keep down these costs. It will be interesting to see the developments that occur in nursing over the coming years. Everyday I get an email from Google email alerts telling me of all the steps various states are taking to help improve the coming severe nursing shortage. When addressing this shortage, my hope is that it will also apply to the actual ratio of RN's-to-patients. When this ratio is "proper" for the acuity of the patients, there is a belief that the nursing shortage will be more easily fixed. I don't know why this didn't copy over very good. No paragraphs or anything. Sorry, but thanks for reading. NOTES: 1. Aiken, Linda, Journal of the American Medical Association, October 22, 2002.

Just remember, people like him will be put in their place soon enough! Just keep up your great work.

I look it as a door opener. I don't regret ever getting my ADN. But, with an ADN it seems to open only about 4 doors (just as an example). The BSN seems to open about 10 doors. I've been doing direct patient care for 20 years. I want to do something more along the lines of a desk job of some kind for when I'm older. Maybe teach, maybe work for an insurance company. Just can't do that on an ADN, even with the nursing shortage. Sure, you may get hired to do something, with the priviso that you get your BSN or MSN or even PhD eventually. So, I'm going for it full bore at this time. Hope to have BSN by 2008 at the latest and MSN by 2011. That's the goal anyway.

All of you have voiced why I'm going back to school to advance my degree and get the heck out of the hospital...

I'm only a nurse, not GOD...

No offense to CNA's out there reading this, but replace all CNA's with RN's and LPN's. Never going to happen, never going to have better conditions in a nursing home. Just my opinion. Worked as and aide up to the care manager RN in a nursing home. My biggest problem was always the CNA's... Not doing what they're supposed to, late for work, neglectful, etc, etc. This is just general. I know there are a lot of good CNA's out there too...