Billy_Ruben

I have what I call performance anxiety. I'm definitely introverted but I can manage social interactions just fine. It's giving a speech, or skills day, or speaking at post conference in clinical when I was in school, or check offs in school that were almost impossible for me. I went to my doctor and got propranolol for those occasions. It can be used off label for performance anxiety. Just took a small dose and it saved my butt. Might be something for you to consider.

I'm pretty sure that's a bit low for acceptance to an NP program.

I'm charge on my unit at night. Been a nurse for almost 2.5 years and there are other nurses who are far more experienced than myself that I work with. Some were asked to be charge but declined, one in particular isn't considered because of her attitude and demeanor. I get great feedback from my peers and manager that I'm doing well in my role. I feel like I'm coming along fine and I'm definitely learning along the way. Ive run into a situation more than a few times where I feel almost like some of the more experienced nurses are using my position to...thinking about how to put this...I guess, not do something they know they maybe should or buffer themselves from consequences. For instance, they'll ask about a lab and say, "I don't really need to call, do I? It can wait until the morning can't it?" I'm thinking well that depends on a bunch of factors. I know they know the answer. I know they know to look back at trends. To evaluate symptoms, watch the telemetry, whatever. I get the feeling they want me to answer for them so that if something doesn't go smashingly well (the doctor pitches a fit for a 4 am call or the doctor pitches a fit for waitin til the am) they can just say, "well, my charge nurse told me to do xyz." I know there's plenty of sincere questions being asked. I don't mind those at all. Am I being paranoid? I really feel like I'm a decent judge of when someone is really asking for true help or when what I've described above is going on. I'm not sure how to handle it when people are doin this. I don't want to blow someone off and feel like it's my responsibility to field all questions but I don't like this feeling of my position being taken advantage of. Thoughts?

I lurk more than I post. Esme is one of my favorites. Get well soon, Esme!

Also, if they relent and agree to the bar soap (Aveeno) and you can't find it in liquid there are ways to make bar soap liquid. A quick google search will show you how.

Maybe. My employer only screens for nicotinewhen hiring. I've since been drug tested and had nicotine in my system. I usually just vape but occasionally have a real cig. I never go into work smelling like smoke. I was tested as a random not due to suspicions about smoking. Anyhow I passed with plenty of nicotine in my system. In my case, I guess they only check for continine upon hiring. I guess all places handle it differently.

Again. This just seems so odd to me. All I can think when I read some of these responses is: Geez, get over yourself. Unless someone calls you something truly rude you have nothing to be offended by. I get the professionalism side of it but to actually be offended. Jut makes no sense whatsoever to me.

I always explain to my patients when I admit them that by using the call light their request will be paged out to the appropriate person and should result in a quicker handling of their need.

I can't fathom how so many people find this disrespectful. It's really weird to me.

Female age 32 at testing. Tested for continine. Light smoker, smoked maybe 1/2 pack a day if that. I got a home test and checked myself prior to the employment screen. Three days and it was out of my urine. I passed. Weight 130lbs, 5'6. In reasonably good shape.

I think you're being really uptight and I'm glad I don't work with uptight people.

My daughter is your age. You sound a lot like her. She volunteers her summer at our large teaching hospital. She's also taking some of the classes now that she'll need in college such as anatomy and physiology and statistics. We're currently looking into a dual enrollment program for college. She takes school a lot more seriously than I did at her age and makes mostly A's, some B's. I'd advise the same for you. Shadow a nurse if you can. When you're old enough apply to be a CNA. It will certainly help you.

I try to have my peeps ties up with a nice bow. That doesn't always get to happen. I've considered pulling the first set of meds for them but I figure some may not like it as I prefer to pull my own. This is a great thread. I'm always looking for ways to help out with my own shift and for the oncoming shift. I always ask before I leave if they see anything they need right away. I think the next thing I'm going to focus on trying to do is start electrolyte replacements if the labs are up in time.

I do five a lot. Right now I'm scheduled six in a row on, two off, eight on. I work nights. I have two older kids (16 & 12) and I'm married. It's exhausting but something I need to do for now. I try to make the best of it and have a good attitude. I work a busy telemetry floor. I've been a nurse for 18 months. Hey, I'm there so much that I learn tons and am getting super efficient. I'm also learning the role of charge nurse right now. I do miss my family.

You go on Monday the 4th at 7pm.

I think that's the key thing I missed here. I mistakenly thought since we had cultures a call wasn't necessarily needed. It's a mistake I won't make again. I feel pretty bad about it.

Thanks for the replies. I guess my reasoning wasn't too far off base but I probably should have called. I hate making poor judgement calls. It makes me feel so dumb.

I called a doctor just the other night regarding out heparin drip protocol. Protocol states call the MD before starting the drip if baseline PTT is less then 50 (it was 25) or if INR is less then 2 (it was 1.1). I got yelled at and hung up on. Sometimes I feel like we're going to get chewed out either way. It wasn't late at night either. It was 8:30 pm.

Several nights back I admitted a patient that had a temp of 105. Blood cultures were drawn and they were positive. The patient was put on IV vanc. They also removed his port-cath two days ago because it was infected. The patient had been plodding along doing relatively well. No more high temps, white count 12. Last night his temp shot up to 103. This occurred around 4 am. I treated the fever with Tylenol and it was down to 99 by 6 am. The doctor was furious enough with me for not calling that he went to the nursing director. I had to explain to her my rationale for not calling which was blood cultures had already been drawn and he's been on vanc. I'm not sure what else would have been done at this point. She told me to always call the doctor in a situation like that. But this wasn't a new thing. He came in with very high fever. I feel like if I had called at 4 am the doctor would have said, "He's been on vanc and we've already done cultures. Why are you calling and waking me up with this?" Is my like of thinking wrong? I feel like I am never for sure when to call in situations like this is the middle of the night. Also, I forgot to mention. This am his white count had jumped from 12 to 16. However, that info wasn't available to me on my shift. Labs came in right at the tail end.

What is the policy regarding this where you work? We have a patient that is a regular. When she is with us she always signs "the form" that allows her to leave the floor. She's a smoker. It's never been an issue as long as she signs the form. Recently, she was with us again and I was told not to let her leave within an hour of pain medication administration. This supposedly came form the nurse manager, but I can't be sure as I work nights. The following morning the DON for our unit was in and asked me how the patient had done the previous night. I explained and she asked if the patient had been leaving the floor. I reiterated what had been explained to me and the DON said no leaving the floor period. Honestly, I hadn't had time to read the form closely the previous night and didn't stay over to look at it before I left. I plan to look at it when I go back to work. It seems a bit off to not allow a patient off the floor period. Curious as to others policies.

I wouldn't do it. You are being set up to fail. You have to protect your license. If it came down to it, I would leave and find something else. It's not safe for you or your patients.

I recently had the same sort of experience. Had been this patients nurse for three nights and he went form joking and kidding with me and asking to sit in his chair on the 3rd morning, to eyes fixed and admitted with hospice not expected to make it through the night on my fourth night with them. The family and I had gotten close and I just really loved this patient. When I came back for that fourth night I was told in report about this patient's decline. I found myself welling up with tears and just so saddened. I kept thinking how could this happen so fast. And then thinking, did I miss something? I've had one night off and am back tonight. Don't know if he'll still be there. He's under hospice care but still staying with us. I found myself just really bummed and thinking about him all last night during my time off. I'm a new nurse and haven't had one pass yet but I've seen people decline and have had others that weren't expected to make it through the night and I wasn't affected in this manner. I guess sometimes it's just what happens.

He did have peanut butter with it.

I feel like I made a bad choice now. It bugs me that I felt confident in my decision until it was challenged.

Thanks. You mentioned some things I hadn't thought through.