hikernurse

Of course you passed, you were so ready :-). Congratulations!!

Kids with multiple congenital anomalies always grab my heart. They have a lot of issues, but are interesting and something about them just pulls me in, they are so beautiful in their own way. Lots of these kiddos have families who don't show much and I love that I can be there for them :).

They can in some states...

And who among us hasn't done that, right??

Um, the light bulb in his ceiling burned out and he was using the flashlight to see to change the bulb. He unfortunately was naked and accidentally fell on the flashlight at which point it inserted itself into his bum. Totally accidental.

This is more the case where I live. Police officers will target areas right outside the hospital right around shift change. Especially in the morning, there can be several cars with nurse drivers pulled over, waiting for their tickets to be issued. To be honest, after working a night shift (and scheduled for one later that day) I know all I want to do is get home and in bed ASAP.

You're exactly where I would expect you to be at this point! Give yourself some time. When you do something well--even something you might not think is a big deal--give yourself credit. That will help build confidence. Also, finding a few unofficial mentors to run thoughts past would help. Most nurses are happy to help a less-experienced nurse. As far as the recommendation part of SBAR, it doesn't have to be an entire care plan, it can be as easy as recommending a physician assess the patient in person or giving fluid. You'll find that there tend to be typical issues on your ward. I am a NICU nurse and a common order would be a CBC, CRP and CXR. Other units might find that giving fluid is a common response. I guess my point is that with experience you'll get to have a pretty good idea of what needs to be done. I promise it gets easier! It won't be all that long before you look back and can't imagine ever not knowing what you don't yet know now .

We love our female docs where I work. They're pretty awesome :).

Wow, thanks GrnTea! This info was helpful to at least one of us :). Off to research this...

I wouldn't argue with you . You do need a working knowledge of APA because the headings/content, etc., can't really be formatted by even the best software. The real benefit is the "edges" of the paper. Being able to click on an icon and get automatic headers and a citation builder is well worth the little bit of money the software cost.

Something else, if you are focusing on doing everything perfectly, sometimes you miss the forest for the trees. Some things need to be done exactly--for instance you want to keep sterile procedures sterile--but there is a lot that falls under the art of nursing. Working with humans can be pretty messy sometimes; both metaphorically and literally. Keeping things fluid and going with the flow will sometimes get you better results than trying to do everything "right".

I don't even write in full sentences in my charting narrative, lol. But I do currently use APA format in my MSN program and did through nursing school as well. With the proper software (PERRLA) it's a breeze. You can focus on your writing instead of the format. The downside to APA, I've found, is that the capitalization of every word in a title now looks all kinds of wrong .

I don't know that bleach would have been necessary with MRSA/VRE exposure. We use bleach for C. Dif, but not the others.

Wow, y'all must have incredible time management skills to be able to plan to the minute the next time you will be in to check on each patient. I'm sure that's a testament to your wonderful managers...

umcRN, have you had any problems with cooling on ECMO?

Agree with the others. But, technically, many are incubated as well as intubated And swearing somehow really does help, lol.

And this is another issue that comes along with this problem. Patients and/or visitors complain to a Charge Nurse, management or patient relations and blame gets placed squarely on the nurse. No matter what the situation. Even if the complaint is followed with, "I just had a bad day and now that I've vented, I feel great about everything", the response is "Sir, Ma'am, we take every complaint seriously and will follow this up with your nurse." And following up involves discipline, even if the nurse did nothing wrong. Even if the nurse is following protocol (which if not followed leads to termination). Nobody at all is on the side of nursing. I would love it if validation of the complaint was followed with, "We have the best darn nurses here. You are lucky to have had Nurse X during your shift." And it would be nice if a patient/visitor was the cause of the problem, that an apology be offered to nurse--by them. And just for the record, I tend to view difficult patients as a challenge (instead of horrible people) and do understand this is a bad time for them. However, poor behavior needs to not be tolerated. Ever.

I wouldn't do anything now. If you see something in the future that bothers you, please speak to the nurse. I think, for the vast majority of times, if there is a problem, it should be addressed by the people involved. I'm not a big fan of writing people up as a way of avoiding a face-to-face discussion. Not saying this is you! I know when I was PCT there were a lot of things that I saw that I now realize weren't quite the deal I made of them. I'm not saying this falls under that category, although I agree that not wearing gloves only puts the nurse, not patient, at risk. And I generally trust my just-cleaned hands over an open box of gloves that has been exposed to who knows what.

At a minimum, anything that is posted about my hospital that can potentially be perceived as not positive will lead to a meeting with your department manager, HR and admin. And from what I've heard, it's not a fun meeting! If one is lucky, one will walk out with disciplinary action, but a job. Some aren't so lucky. It's a really dumb move to do stuff like that.

GrnTea (which is what I am drinking right now on this cold, rainy day), you made some great suggestions. I am not sure about your phrase "They will rise to this challenge :)", however. I nursed several children, some until they were pretty darn big, and while I always found I made plenty of milk, I haven't found that there was as much "rising" as "falling" as time went by... ;-). With such a high number of females in nursing, many of whom are in the reproductive age group, pregnancy and nursing is really not a big deal in most units. I know our unit has no problem hiring pregnant/lactating women. The hope is that you will stay in the unit long past this time of your life. Chances are the hospital has access to really good pumps, just keep an extra set of tubing in your locker and I think things will work out just fine. You will probably need to be proactive about arranging time to pump, but I think most nurses would be happy to step in for you while you take pumping breaks. Congratulations and good luck in your new job!

A lot of the equipment used at hospitals can be quite daunting. Don't worry about feeling overwhelmed! Honestly, your feelings are NOT pathetic, but demonstrate good observation of your environment and the knowledge that there is a lot going on for patients and their families at your hospital. You can use your feelings to better identify with patients--if this is overwhelming for you, imagine feeling sick and being the one actually attached to the equipment. Having empathy and understanding for patients can help them heal as long as it is kept in appropriate boundaries. Ask a lot of questions--staff may not be able to discuss patient diagnoses, etc., but explaining equipment is well within bounds. Also understand that even for nurses there is a learning curve, nobody is expected to know everything at once. More will come with time. Most importantly, look for the faces under all the equipment, that is why you are there :-). And thanks for your service. Volunteers rock!!

The thing is, as an RN, I have always checked on my patients all the time, one way or another. Charting that is the big time waster. When my elderly parents have been in the ER (generally for several hours), they've had someone come in hourly, introduce themselves, then they are never seen again. What's the point of that? The only people rounding should be those with the ability to actually care for the patient, the nurse or tech. I think it's nuts to have ancillary staff rounding--not because you aren't valuable (!), but because you have other tasks that are necessary to do as well and having to spend time to hunt down a nurse/tech is a time-waster. And just a thought, I certainly don't know your unit, but when I was a tech, I had no real idea of what the nurses actually did--even when I was in nursing school. I know there are times RNs can look like they are doing nothing, but they really are involved.

I am not a big ceremony person myself. I skipped the graduation ceremony when I got my BSN and don't regret that for a minute. I did go to the pinning ceremony and it was incredibly meaningful. I was there with the people I had worked so hard with and for. Our families were there and it was a wonderful way to celebrate the journey we had just finished. We were able to choose a person who had been instrumental in helping us through nursing school. I chose my mom (my husband agreed with my choice) and I think it was one of the happiest evenings of her life. She was honored. Just go. I think you won't regret it one bit.

We (NICU) try hard not to discharge on a holiday/weekend if possible--just in case something arises at home that parents aren't prepared for. Parents room in, get their home meds delivered to them at the bedside before discharge and have their doctor's appointments made before they leave and STILL there can be problems. When my kids and parents have been hospitalized, though, discharge is often chaotic. We'll hear it will happen sometime during the day--could be at nine in the morning or eleven at night. Frustrating. My friend's child was discharged from an ICU at midnight, no way is that a recipe for success. Blondy, I agree that people recently discharged in no way feel up to negotiating all that you needed to do--especially those who don't have a handle on nursing/medical knowledge. Also, since nurses are the ones who interact with patients most, I bet most discharges that don't go well get blamed on them. My mom has said, "I don't know why the nurses won't let me go home." I explained that most nurses would be more than happy to get her out, lol, but their hands are tied waiting for doctor's orders, one last lab test, one more dose of abx, etc.

Is this something parents have access to as well as staff?