mustangsheba

Mario, you silver-tongued devil, you. Just because we have been divorced doesn't make us retreads. The man I was married to when I was in nursing school was a college grad, had a good job, and an enviable life style, nevertheless, for some reason, he was threatened by my getting a degree. We didn't make it. I waited until my daughter graduated high school before I started nursing school, which gave me a lot more flexibility in my choices. Nursing school is hard, especially if you have children and an unsupportive husband. Something has to give. I would recommend sitting down with your spouse and children and working out a plan to deal with problems before they arise. You might want to include a counselor. Write it down. Laugh a lot.

Amy: Eight patients is way too many. Don't do that to yourself. If you want to work oncology, find some place where you have no more than four patients. Illinois doesn't seem to be a great place for nurses, does it? You could go to almost any area you like right now, but I would hold off for another year or so on doing ER or Home Health.

The policy in all the home health agencies I've worked for was to change q. month and prn. Some require more frequent changes especially if the urine chronically has a lot of sediment or other debris. Supra-pubic catheters the same. I always change when starting treatment for a UTI or any time it starts looking really grody. But always every month.

Prn suctioning is the norm everywhere I've worked. This is my least favorite thing to do not only because it stimulates my gag reflex but because it is the lesser of two evils for the patient.

I am SO allergic to whatever is in the soap at most of the hospitals around here. As soon as I smell it, my head starts to hurt and my nose starts to plug up. Someone on here said that this reaction has been reported by others.

I have read all the posts and agree with everything everyone says. Other people do not make us happy. That is something that comes from inside. I'm concerned about the DEGREE of depression and anxiety you describe. I would expect you to feel lonesome and sometimes blue and left out and like there's something missing in your life. However, I would not expect you to cry all night every night and sound so hopeless. You are describing clinical depression. Please see a good nurse practitioner (my personal choice!) and keep in touch. Right now you are in a needy mode. I don't think you want the kind of person who is drawn to that need. Being alone does not necessarily equate with loneliness. Here's another hug.

One of the things that makes nursing so compelling is it's diversity. I think it's perfectly fine to change jobs as long as one isn't being fired. I try to stay a year unless there's abuse, then I'm outta there. Most of my jobs have been good, some great, but my dearest love is home health. :)

Pain management is one of my soap boxes. When I was in school almost 20 years ago, the criteria was the same as described here: Pain is what your patient says it is. I treat pain aggressively. In 20 years, I have had to give Narcan only twice, and those times were because the patient was intolerant of the particular medication. All the facilities in which I work have pain as the 5th VS. We don't have the 26 questions. All we have to do is prove that we've addressed and managed pain. Still, I frequently follow nurses who have not taught patients how to report pain and why it's important that it be adequately treated. Not moving, not coughing, deep breathing, or using your IS is not the way to manage pain. I have a close friend who has suffered CP for many years. Before finding someone who would treat her chronic pain, she woke up in tears, crawled to the bathroom on her hands and knees every morning because she couldn't stand, was unable to find any joy in life, and attempted suicide several times. She now takes MS Contin daily and was able to enjoy Christmas with her family for the first time in many years. Is she addicted? Is a diabetic addicted to insulin? Who cares as long as there is quality of life. I strongly agree with several other posters that in this day and age, there is no reason for anyone to suffer debilitating pain. I saw an interesting special on some kind of sea snail whose sting paralyzes it's victims; survivors report that they experience no pain when stung. They are researching the use of this venom for treatment of pain - without the paralyzing part, of course. Has anyone else heard anything about this research?

Once in awhile in my journey I have been confronted with this personality. The problem is, they are so busy with their own agendas that they miss the important aspects of the report. The last time this happened to me, I felt so uncomfortable that I missed the point of what she was trying to say, which actually had some validity. When I attempted to apologize and clarify, she continued to harangue and complain and accuse. I finally asked her just what it was she expected or wanted me to do and offered her several options. She wanted none of it, so I said fine, I'm through then. She now will not speak to me or take report, so I try to make the written notes as complete as possible. It's awful starting your shift feeling intimidated and bullied and therefore incompetent. Initially, I would explain to her how her behavior affects you. If that doesn't work, resort to written information only. Be sure to check recent new orders. Best wishes!

I've never had a nursing cape, although I would love to have one. I used to wear capes all the time because I love their versatility, and personally, I think they look a bit dashing. They're great over suits. And you can ride a horse while wearing one as well!!

Of course side rails are a form of restraint. Hopefully, they "restrain" one from falling out of bed. Duh! By definition, a closed door is a restraint as are the windows, most of which do not open. I guess we could also count the walls, floor, and ceiling if we want to pursue this ludicrous path. And what about gait belts, which also restrain one? Sheesh! I guess you all know how I feel about JCAHO. Big time pork there don'tcha know.

I've always taken telephone and verbal orders. TO or VO is part of the signature. Fortunately, to date I've never had a problem with residents or staff not owning their orders. I do question orders frequently, however.

A CNA saved my whatchamacallit at a LTC a few years back. Four LOL's were sitting at a table waiting for their dinner. I had drawn up the insulin for "Mrs. Smith". As an agency nurse, I did not know the patients by sight and they didn't wear identification. One of the little dears avowed that she was indeed "Mrs. Smith". As I started to administer the insulin, the Aide yelled at me (literally). As I was climbing back into my skin, she said it was a joke that the real Mrs. Smith and the other LOL pulled frequently. Ever since, insulin does not leave my needle until the patient is identified by someone who knows them. I also identify every pill to each patient, more for myself than for them, but it keeps me aware of every medication that I'm passing. If a patient questions anything for any reason, I double check the written orders. It takes a little extra time, but it's better for my blood pressure. They can't take my license away for being slow after all.

I know the home remedies seem rough - we have to take the responsibility for taking the "medicine" and they seem to take longer to work, but in the long run they are usually safer and more effective. That is just my opinion and my choice. And I do avoid MacDonalds like the plague. If you opt for this cleansing ritual, allow yourself a couple of days for the procedure. Tell your family you'll be out of the country!. Keep us posted on your results. Make sure you have someone to call just in case.

I don't understand the part about the options being just you and one other person with three months experience. If neither of you wants the job, surely they can hire from outside your facility. Don't feel compelled to take this position just because their other option is even less experienced than you are; that's not your responsibility. Don't let yourself be manipulated into taking on responsibilities you don't feel comfortable with. Wait until you're ready and reasonably confident and then seek it out because of your own motivation. Good luck!