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0.adamantite

0.adamantite

Acute Care - Adult, Med Surg, Neuro
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0.adamantite has 3 years experience and specializes in Acute Care - Adult, Med Surg, Neuro.

0.adamantite's Latest Activity

  1. I don't particularly care either way unless it's clinically relevant. I think we do need to know the patient's biological gender. However if I get in report that they prefer to be identified as something else, I'll respect their wishes and go on my way. I don't have time to worry about these political issues on the clock and I don't care to discuss them at work. I'm paid to care for the patient, mind & body, despite my personal beliefs. It would not be healthy to the therapeutic relationship to go against the patient's wishes, especially on something that is not really going to influence the plan of care. Cellulitis etc doesn't care if you identify as male or female. We have bigger fish to fry as nurses.
  2. 0.adamantite

    Sure to Get Flamed for This

    I give a big :rolleyes: to posts like this. I've been a nurse only a few years, but I worked my tail off. I started on day shift with many very experienced nurses. And yes, there were more experienced nurses who were rude to me. I had one call me at home to apologize for her behavior towards me. I didn't grit my teeth and bear it, I learned to stand up for myself, and I didn't accept a hostile environment. I also switched shifts and now work with a good mix of co-workers (both experienced and newer). Please don't pigeon hole everybody as a whiny baby. Even though I'm young, I'm tough as nails now. And YES, older nurses can be rude to their young and downright nasty. I would never work day shift again. But if I did, I'm not taking that crap anymore. There are also experienced nurses who are absolutely fabulous. One of my mentors has been a nurse longer than I have been alive. I can go to her for anything, and she is extremely valuable to us newer nurses with her wealth of knowledge and experience. You nurses with years of experience can help us so much and have so much to give to us newer generation. I hate this "us against them" attitude, which goes both ways. It's so pathetic. We are all here for our patients and for our profession, if we just cut the crap and learned to work together, this would be much better.
  3. This only works if you're forewarned. One time I had an admission that kept talking for 20 minutes, tears rolling down their eyes as they told me their life story. I felt horrible but was trapped, trying to look for away out without seeming heartless.
  4. 0.adamantite

    High-Value and Low-Value Patients

    This describes the patient population of where I work. We are often poorly stocked, with broken equipment, missing medications, and they under staff us. What we do and who we care for are not valued. Also, I was told that these patients are not "money-makers" for the hospital because many of them are under or un-insured. So while the specialty units get the best of everything, we are just scraping by.
  5. 0.adamantite

    What is a Medical-Surgical Nurse?

    It takes a strong person to be a medical-surgical nurse. I have been one for a little over a year. Many nurses are unwilling or very resistant to float to our floor. The patients we receive are complex physically as well as often have co-morbid behavioral or mental health diagnoses. We see patients who are very elderly, who are developmentally delayed, who are devastated neurologically, who are from nursing homes/long term care facilities, who have dementia, who have chemical dependency issues/acute withdrawal, who have complex endocrine diseases, who are on comfort cares/dying, those who are pregnant and have complex medical needs, and who have many co-morbities such as HTN/dialysis dependent renal failure/diabetes. We take the patients who have infectious diseases who other floors won't take (such as OB). There is so much to know, and on top of that, we often have to take 4-6 patients. And we have to have great instincts and know when someone is going downhill because we don't have the monitors to tell us. There are no doctors immediately available on our floor to help. When someone is circling the drain, we have to prioritize and advocate because things can happen slowly. Often our floor is over-looked, the doctors don't take our concerns seriously, equipment never shows up, and pharmacy takes 2-3 hours to get needed medications to the floor. We never get all the glory - that goes to the ICU nurses or ED nurses who provide immediate care. We have to work with old, beat-up equipment while other specialty floors get brand new things. So I say, utmost respect to my medical-surgical colleagues. I believe this is the complex and challenging specialty. I know that I won't be moving on for a long time, and plan to get my certificate. So to any who says we are a 'stepping stone' - I say, please take us seriously, because we work our butts off each day and get very little respect.
  6. 0.adamantite

    Top 10 List of Patient Survey Ideas

    When families call or ask for information, I always tell them, "Because of a patient's right to privacy, please let me check their chart to make sure you are listed as a contact." If they are, I give them brief, basic information. If they aren't, I ask if they would like to speak to the patient directly if the patient is alert and oriented. I get annoyed when it is an adult and another adult calls and says "NO, I want to talk to YOU," as if I am going to give more information then that patient. If they insist, I will enter the patient's room and ask if it is okay to speak with So and So regarding their status. I always explain everything thoroughly, even if the patient has heard it before. I've found that patients often forget information, even if the previous shift told them. For example, I will explain to patient's about the routine heparin shot for DVT prophylaxis and why it is important. I always allow the patient the right to refuse, as long as they are well-informed about the risks. Delays, I apologize and explain what is happening diplomatically. I will try to advocate for my patient if possible, but if the GI lab is behind because of an emergent case, then there is little I can do. The hardest thing is communicating test results. Patients often want to know - "what are the results of my chest x-ray?" If it is something as simple as a potassium level, I will tell the patient the value and explain the normal values. I will sometimes offer an explanation - for example, "your potassium may be low because you have been vomiting and having diarrhea, which causes you to loose electrolytes such as potassium." But even then, I feel like I may be toeing the line of my scope of practice. I often don't feel comfortable giving patients the results of MRI's, x-rays, and other scans. The reports are often long and sometimes I have difficultly interpreting them. I also don't want families and patients to panic. I will tell families and patients, "It is outside of my ability as a nurse to interpret your test results. I have called them in to the doctor. She will be able to explain them to you fully. However, there is nothing on the test result that indicates we need to take any immediate action at this moment." Does this seem appropriate to you all? How do you handle these questions? Often, patients and families want to know the results NOW, while the doctor may not be back to see the patient and give them the information until the next day if they have already rounded, and nothing emergent is found.
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