ScientistSalarian

2-point-something (ICU patient) ... needless to say, they did not make it

An assessment is an evaluation of the patient's current condition, so I don't think it's appropriate to include history just as a matter of course. Sidebar: I'm not a fan of the "WNL/WNL EXCEPT/NO" system. My hospital uses Cerner, so there's a "Systems Review" field at the top and a lot of nurses will, for example, choose "WNL" for HEENT and then leave that portion blank in the detailed assessment below. Quick, clean, easy - I get the appeal. But I attended a presentation from our hospital lawyer who made a really good case for ignoring the WNL stuff altogether and simply charting everything you assessed in the detailed assessment, system by system. It takes longer, yes, but when you chart "WNL" you're attesting that everything encompassed in that "WNL" was a-ok. If part of the reference material for that section includes checking a patient's ears or throat and it's not something you routinely check unless indicated, you're opening yourself up to liability for charting a false assessment. I know not everyone agrees on this but it makes sense to me ¯\_(ツ)_/¯

You have fewer patients in critical care, sure, but if thinking on your feet and dealing with the unexpected aren't your strong points then I don't know that you'll find the ICU to be a "low-stress" experience. Maybe do some shadowing there first to see if it appeals to you, otherwise it sounds like an outpatient setting might be a better fit. I ... can't even, haha. But on a lighter note, if you ever find a job in cosmetics with a nursing license please let me know!

I've been using Blue Apron for a few months now, and on the whole I'm pretty satisfied. The recipes have generally been delicious (there have only been a couple that were "meh," and none that were actually bad) and take about a half hour to prepare, though that includes a fair amount of time cleaning and chopping veggies. The price seems fair to me - $60/week for 3 meals works out to $10/meal between my boyfriend and I. I know that seems steep, but between Blue Apron and the gigantic (but cheap!) CSA box we get every other week our grocery shopping has been cut down to staples like coffee, yogurt, etc. The only downside for me is the calorie count (anywhere from 550-800 per serving depending on the dish) and the fact that many of the options are a bit carb-heavy (white rice, flatbread, potatoes, etc.). I wouldn't say that the nutrition is unreasonable, but due to my own personal eating/food issues I'm sort of glad that it's only 3x/week.

As a fellow introvert I can sympathize. Small talk doesn't tend to come naturally to me so joining in/avoiding conversations with coworkers can be a bit of a challenge. That said, it's worth weighing the annoyance of chit chat against building good relationships with your coworkers. You of course have every right to work in silence if you so choose, but the way you rebuff conversational advances can make all the difference. Making nice with coworkers isn't strictly a part of the job description, but whether we like it or not it's just a part of working alongside other people and can have a huge impact on the working environment. (But asking if you're bipolar? Invasive and inappropriate. And there is surely a special circle of hell for the "come on, give us a smile!" people ... since vomiting all over them probably isn't an option I'd just fix them with my most withering stare as I slowly and deliberately turned my back.)

If possible I would go straight for the BSN, that's where the profession's heading anyway so you may as well take the direct route. That said, BSN program admissions can be very, very competitive. If for whatever reason you're unable to pull the excellent grades you need you might have a hard time getting a spot once you're ready to transfer. Does your school have any admissions agreements with four-year universities? If you're really not sure what to do I'd definitely see a counselor/advisor to find out exactly what your options are.

Okay, I ... think I got all that? I'm sorry you're so miserable about all of this, it must have been hard to be thrown into a new shift without warning. Your night preceptor seems like he could definitely work on better communicating with you about your game plan, and steering you in the right direction when things need to get done. That said, I feel like you might be taking this way too personally. It seems like the main issues he's having with you are time management and prioritization. The educator told you to talk to him; you say you already did twice but have you actually asked him for feedback? From your description those "talks" were just you telling him that you needed to be taking on as much as possible. You asked your manager to change your preceptor, but did you ever talk to him about any of this? You ... you know "rushing things," and above all "all this paperwork" is pretty much the job in acute bedside nursing, right? It's great when you can take a minute and really check in with how your patient is doing emotionally, but that's just not going to be realistic most of the time on a med-surg unit where you apparently have 6-7 patients to care for. You seem to be fixated on having a nurse glued to your side and walking you through every step, but you need to focus on prioritizing and working as efficiently as possible while becoming increasingly independent. Talk to your preceptor, don't be afraid to ask the other nurses questions when you need to, and please, I implore you, add some paragraph breaks.

In my area (coastal CA) we only have one 16-bed inpatient psych unit run by the county as its own facility. None of our hospitals have dedicated inpatient psych units, and it's a huge problem imo. We see patients all the time who could benefit from a psych consult at the very least, but the vast majority are medically cleared and discharged without having their psych issues addressed in any meaningful way.

What?? No. Not only is that a completely bizarre expectation, it's totally inappropriate, unprofessional, and ethically squishy. I don't know if it's somehow more acceptable in a LTC memory unit, but hearing that directive in the workplace - any workplace, really - would make me incredibly uncomfortable. Boundaries, people!

I came to nursing because I like healthcare, was sick of working in a pathology lab, and couldn't deal with the amount of time and and life real estate being a physician would take up. It's a profession that fits well with my knowledge base, skill set, temperament, etc. and offers adequate compensation and mobility within the profession. Basically, it's a solid, flexible job that I know I can excel in and (bonus!) happen to enjoy. Is it my "passion" or "calling?" Nope. It's my profession. I happen to love my job, but it's still just a job, not the entirety of my life's work. To be completely honest I'm still kinda baffled by how many people ~*dream*~ of being a nurse, or speak of their "call" to nursing as if they're entering a convent.

If I'm off that night I try to nap only until 12-2ish and then go to bed at my normal time. Granted, even before working nights I don't tend to get sleepy until around 1:00 or 2:00 am so it's not such a huge shift in my sleep schedule.

Hahahaha stop that. As far as I'm concerned, the day I stop being carded every time I buy alcohol and people stop assuming I'm a baby fresh out of college is the day I will CONSIDER being "too old" for something. Besides, this might be the push I need to get that lounge act off the ground

Fair enough! While I wouldn't be breaking any rules I would hate to spend a bunch of time and money on attaining the perfect shade of purple only to be told to dye it back. Just curious about how other nurses view hair color in regards to "professionalism" and how tightly staff appearance is controlled at other hospitals.

What are your thoughts on unconventional hair colors (purple, pink, turquoise, etc.) in the workplace? I'm 30 years old and I've always wanted to try out a fun, totally unnatural hair color but until recently I've always been far too timid to actually go for it. For a while now I've been dying to try out the gorgeous silvery lavender or baby pink hues I see on other people. My nursing school had an explicit "natural human hair colors only" rule, but now that I'm working for an employer that has no set hair color policy in place (and is also not referenced at all in policies relating to hygiene, general appearance, etc.) I'm wondering if I could actually pull this off. For reference, I work on a tele/step down unit in a moderately conservative area. I ran this by my favorite house supervisor (for generational reference she would be a gen-xer) and she wasn't excited about the idea. Her position was that the hospital environment is where appearing to be "professional" is paramount, and that a huge chunk of the patient population is 65+ and might not look kindly on it. In short, pink hair would undermine my professionalism. I understand her reasoning there, but I also feel strongly that hair color (or tattoos, for that matter) have absolutely nothing to do with competence or professionalism. If everything else about my appearance is boring and conservative as usual what difference does hair color make? Additionally, I think she's underestimating the older generations she's worried about offending. It's a bit of a stereotype to assume that all of our older patients would be clutching their pearls or eyeing me with suspicion just because of purple hair, right? Thoughts?

Heh, my floor director runs a tight ship But honestly I get where they're coming from with the overtime thing. I work tele/stepdown so we can only take up to three patients, and all of the new grads/new hires start out on nights - given those circumstances I could see how it would be concerning if someone routinely wasn't able to chart on three patients over the span of twelve hours. Besides, they're running a business first and foremost so it makes sense that having someone continually accruing overtime would be a big ol' red flag.