Warpster

Some jobs are just not a good fit. A transfer to another unit within that hospital might fix the whole situation or the whole place might be toxic enough to you that you'll have to leave and resign yourself to a longer commute. I saw that happen with new grads in my last job. The unit was a strange one, some of those people (male and female both) had been there and working together over 10 years. A few of those new grads just couldn't cope with things like verbal shorthand and not being in on the jokes. They transferred to other units and blossomed. Just don't be afraid to admit that something is wrong and it's irrelevant whether it's you or them. The job just isn't a great fit and you need to go elsewhere and try to stay in the same hospital if you can. Lateral transfers don't look as bad on a resume as quitting after just a few months.

I managed to hang in there for two years in a VA hospital but only because my rheumatologist wrote a note to my charge nurse that rotating shifts were making me much sicker and that I needed a permanent assignment. So I got put on permanent nights in a sister unit and that was just fine with me. Since raises for VA nurses have to go through Congress and Reagan was in office and supremely uninterested in signing things like raises for government employees and my rent kept going up, I quit after two years and went agency. I learned one hell of a lot at that job, the in house educational benefits were outstanding. I'm glad I clung to it for the full two years. I'm also glad I left when I did since agency money allowed me to sock away quite a bit in the bank that came in very handy years down the road.

As my name suggests, I'm a weaver. I also spin, dye, knit, crochet, sew and do just about anything with a handful of fluff that can be done. And now that I'm not exhausted from working 12 hour night shifts, I'm getting better at it.

Nursemares are something nobody talks about at nursing school but I think we all have them: the one when it's almost the end of your shift and you've been dealing with this and that and realize you haven't passed a single med and where the hell is the cart and why is the med list written in Sanskrit? Or the one where they all code at once, who's got the crash cart and what do you mean it hasn't been checked for six months? Or the one where you're just back for a per diem shift at a job you despised and you're ducking the unit manager because you know if she sees you, fur will fly... Nursing is stressful. Stressful jobs give us rotten dreams and the nursemare is just one type of those. They're often pretty funny when you wake up and think about them. It's just tough waking up and feeling like you've already worked a full shift.

Some of the best advice I ever got from an instructor in nursing school was always to have something outside of nursing that captured your interest enough to occupy your time when you were no longer able to work such an intensely physical job. I took that advice and now do my hobbies full time, able to hone them as I never could when I was exhausted from working. In other words, when you figure out what your bliss is, whether it's knitting or volunteering at nursing homes, follow it.

Lily Ledbetter ring a bell? It's still going on, too.

My parents tried to pull this garbage on me but I explained to them that the job was the same in both cases and it was much smarter to go through a 2 year program and come out debt free than to soldier on for 4 years at a name school and come out fifty grand in the hole, minimum because those were my choices. When they mentioned alternative fields, I still told them 4 years and incurring a massive debt to make women's wages was a very bad deal for me. Then they shut up. Anyone who says the type of intensive courses that are typical of a two year nursing program are for the stupid has never bothered to sit in on any of those courses. They'd likely be weeping within the first ten minutes. ADN programs are the farthest from easy there is.

In theory, competing diagnoses that focused on practice rather than disease were to help us compete head to head with other professionals. It just didn't work out that way, in part because of the cumbersome language you cited in your post. "Impaired gas exchange" sounds a bit cumbersome, but there's no earthly reason it shouldn't be "due to pneumonia," especially if that is the patient's medical diagnosis. Or COPD. Or status asthmaticus. There is no earthly reason that nurses should be prevented from using the words in the already established medical diagnosis. It's just plain silly and everybody knows it but the ivory tower theoreticians who devised it all. I could toss off 30 page care plans in nursing school with the greatest of ease. Out in the real world, we simply didn't do that sort of hoop jumping because we didn't have the time and this was a blatant waste of the time we did have. It's high time for the whole business to be revisited and streamlined by nurses who have actually spent most of their time in the trenches, not by nurses who remain in academia creating elegant theories. That's my opinion. {plink,plink}

You can tell what sort of nerve you hit by the number of kudos at the bottom of your post! The truth is that turning health care over to MBAs was almost as big a catastrophe as turning it into a profit generating enterprise: the former has completely destroyed the morale of people in the patient care professions while the latter has completely destroyed the delivery system. The "customer is always right" model favored by the business people because it works so well in hotels and restaurants is completely unrealistic in a health care setting. Nurses deal with people who are acting inappropriately due to stress or just plain mentally ill and setting limits is part of the job and invariably at odds with management's silly model. Of all the stupidity I saw come and go over my 25 years in nursing, this is absolutely the worst as nurses are caught between keeping things safe for themselves and their patients and obeying a bunch of asinine directives from the plush carpeted office suites, issued by medically ignorant men who should have been running supermarket chains, instead. I've managed to retire now. However, while these idiots are still doing everything in their power to undermine nurses and destroy morale, I think I'd rather self extract all my teeth with a small hemostat than go back, I don't care how poor I get.

People in serious pain who are not in control of their own medication via pump often display classic drug seeking behavior. I had a tomcat after surgery who also did, meowing at me and meowing at the fridge where the Stadol was kept starting about an hour before he was due. I tend to discount drug seeking behavior as such if there is a legitimate reason for the person to be in pain and the doctor concurs and has prescribed medication. If it's ordered and it's time, I'll give it. I'm not their judge, not even if they're frequent flyers for migraine and back pain.

I've watched too many fine nurses struggle with trying to quit and fail to think nursing programs should limit their student pool that way. While it would be nice if we were all prim and perfect people and an inspiration to our patients, it just doesn't work out that way in the real world. Besides, prim and perfect people are often annoying to be around. Besides, who's the better teacher when it comes to smoking cessation, somebody like me who has never smoked or somebody who's gone through the hellfire of quitting and succeeded? I can tell them what's available for help; the ex smoker can tell them how all of that feels and what to expect while they're going through it. While I'd hate to see smokers banned completely from nursing, I might like to see a compromise for nurses who work in sensitive areas like cardiac units: use a non smoking nicotine delivery system (patch, gum, vaporizer) while at work so the poor patients aren't tortured by the smell of smoke on their clothing. However, as an absolute disqualifier, it's a poor reason.

Yeah, one, a study in raging personality conflict. It was during pediatrics, a discipline I already knew I would not count as the high part of my nursing education. I knew enough to let her huff and blow and try to push buttons without reacting or rising to the bait, but it was still miserable. Fortunately, there was a whole team during that rotation and the others thought I was just fine, so her multiple team conferences got her nowhere, I passed pedi with a 4.0, and she went on to greener pastures the next semester. Bon voyage.

I remember MGH from a long time ago. They go through periods of this rubbish, thinking nurses can live on air and warm fuzzies. Or that if we're not all married and childless and married to investment bankers who can afford to support us, we should be, what the hell is the matter with us? I was pre scheduled on one of their floors as an agency nurse for over a year in the 80s because they simply would not pay nurses a living wage. Once a new CEO came in, realized the place was bleeding money on agency fees and hiked wages to a more reasonable level, all the agency jobs evaporated. Apparently the CEOs who have followed are back to their standard operating procedure of stiffing nurses. I can tell you some of who's signing up--Canadian nurses. They have to pay for advanced education in Canada instead of learning on the job here in order to work in specialty units. They'll live four to a room and eat beans for 6 months of training and 6 months of work and then go home and make a living wage there. I would imagine most of the rest are still living with parents in the Boston area and will continue to do so while being paid less than starvation wages. I have no idea whose big, bright idea this was. I just know it's shameful and seems to be part of a pattern there.

I think most people can differentiate between art and advertising photos and "Girls Gone Wild" rubbish and would only question someone about the latter since it usually involves alcohol and/or drugs. While you might eventually run into a stone prude of a DON and be refused a job, I can't see that it would threaten your license. Besides, in 20 years or so, no one will ever know that was you and probably won't believe it if you tell them.

Face it, hospital humor is vile. Just the various uses of KY alone would put a civilian off his feed for months. Finding a coworker on nights who has nodded off meant taping him or her into the chair and wheeling the whole business into the elevator for a trip down to the basement. Alone. Mechanical Halloween toys left in trays of instruments for newbie aides to clean are fun, too. Sneaking up behind somebody who is bending over with a Velcro blood pressure cuff and ripping apart the velcro is good for a quick standup and panicked feel of the scrub seams. Water fights on unit can be the stuff of legend, especially when they culminate in ICU tar and feathers: D-50 topped with talcum powder. But oh, that KY.