LifeCrisis

I don't know specifically about that hospital but I will say I work in the NYC area and the consensus is we (the nurses) make more than the residents. I don't know what they make but we make 39/hr on nights. Which is like ~75,000/year or so (37.5 hours weeks) My hospital only goes to PGY-3 as far as I know, but Im only medical floor. Maybe other specialties (surgery or?) go beyond 3 years. And to consider, how about the doctors tuition. I don't know how salary and tuition work with each other. If they are getting 60k and tuition paid that is quite a bit of money. However, if they are paying 40k/year tuition on 60k salary that is TOTALLY different scenario... Maybe one day I will ask a doctor how it works, but I am usually busy enough and don't care enough to do so lol

Just started an AC line today that made me proud. It was a restrained alcohol withdrawal patient. I found a fat vein just above and slightly adjacent the AC, at the base of the bicep. I had just started to stick the patient when another nurse came in the room. She saw the patient (agitated alcoholic) and what I was doing and started putting on a pair of gloves. As she was donning her gloves I struck gold and retracted the needle. Blood started flowing like a midsummer fire hydrant despite my fully depressed thumb on the catheter. Her reaction was priceless. "oh my god. are you sure that's a vein [as opposed to an artery]? If he pulls that out he is going to die [bleed to death]." That feel was priceless.

I would say you are right on the money. While the care is heavy I would say we are understaffed (although I don't have the title to make that decision). Never more than 2 PCA on the floor despite the census up to 39 patients, unless we have a 1:1 and then it doesn't matter because that person can't help with care. I wish there was some kind of standard on how many people are needed for care based on a patients weight. Can you link me some evidence based studies on employee injuries? We have a union here so if anything I can work through them. Also I will bring up to my floor nurse manager about getting an air mattress for this patient.

Ok, first off let me say I know this topic will probably generate a lot of strong opinions. I will also state that I am not a perfect person and don't take care of my health 100% so please don't think I am trying to be an elitist or something in posting this. Disclaimer aside, I want to know if other nurses sympathize with me. I am going to try and be as brief as possible in my story. First of all we have 2 resident patients on my floor that have been there over a year. They are obese and have suffered strokes. They require total care. These particular patients are about 250lbs and 1 has hemiparesis and the other has use of 1 arm (not sure what to call that). The patient that really has me over the edge is one that is over 300lbs, vent dependent, unstageable sacral (of course, no one wants to turn this patient which is a whole other issue), lower extremities contracted with knee replacements, on dialysis, PEG feeding, restrained because she pulls any tube in sight, and contact isolation for c diff and acenotibacter. This patient has been on the floor for 3 months so far because no LTC facility will take her (understandably). Not to mention all the cellulitis patients and other comorbities we deal with on admissions. I am a 25 year old male and starting to feel back pains. This really has me over the edge as a combination of lazy/uneducated coworkers and heavy (literally) care. Please share how you deal with these kinds of patients and what I can do to reverse my growing animosity towards these patients.

Honestly it sounds like you failed. If you passed it is by the skin of your teeth. Everyone I know that passes was in the minimum questions, not 265. I don't think I could sit through 265 questions... Why didn't you pay for instant results?

First of all I would say this sounds like high school problem which is sad. Second I would say why did you not just go to the student and ask her first why she didn't give insulin. Third I would say giving sliding scale insulin seems like a minor thing to make a big deal out of when you are a student. Fourth I would say, as sad as it may seem, it is probably best to worry about yourself while you are obtaining your licences and securing a job. Fifth I would say even if you have the best intentions, being a rule nazi is going to gain you SO MANY enemies in your carrier. I think it would be prudent to weigh "policy violation" against the potential for adverse outcome before reporting people. There are many times I don't cover patients for insulin when their glucose is 200-250 at midnight and when I check at 0600 they are less than 100. Good luck.

Night shift, 8 hours 11-730. I get 6-8 patients. Standard night is 6-7 plus an admission. Floor maximum is 39 patients. Usually have 30-33. Usually we have 2 PCA, even if we have 39 patients, 15 total cares. We will get 3 sometimes if we have a 1:1. Over a year here I haven't seen more than 3 PCA no matter the census or amount of 1:1. The only thing that gets me frustrated/mad at work is when we have heavy care. We (the nurses) have to do the morning care and sometimes it is very heavy taking at least an hour. It gets in the way of giving meds and calling doctors before they go home and such. I don't know if it is the same at all hospitals but when I finish heavy care at 0630 and have 30 mins to give meds and the doctors are gone to check out so I can't call them for anything, then I have to give report 0700 to 0730 it makes me hate my job.

That's what I'm talking about. This guy ******* gets it!

I am not that experienced but I have had a lot of success with the teaching I received from several experienced ER and ICU nurses. Basically what they showed me is approach at a 45 degree angle, once you receive blood return stop and advance the catheter. I have seen a lot of nurses that like to insert a large portion of the needle before they start advancing the catheter and I think that is what causes many failures on attempts that would have otherwise been successful. For me personally I deal with a lot of patients with DTs and so getting a good line for ativan push is imperative. I have found the best places the start lines are not the AC per se but there is usually a good vein to the left or right of the AC. My absolute favorite spot is the bicep. I'd say about 50% or more of patients have a nice straight vein running up the bicep. That is my go to spot for anyone on restraints.

Thank you for the reply. What other things could I do to make myself more appealing to employers?

So I will reach the 2 years experience mark in February 2014. I am planning 2 things once I reach there, get my board certification and look for a new job. What advice can you give me on studying and obtaining my certification? Right now I am just planning to study this program and then take the test: http://store.healthstream.com/product.aspx?zpid=36279 Also, how much, if at all, does this certification help in finding new work? I am planning to move across the country and want the best opportunity I can.

Thank you for the info, I may have to reconsider since I only speak English

LOL last night this patient was on CBI and I needed to irrigate the bladder because it wasn't draining. The blood clot in the foley so when I pushed the irrigation syringe the CBI tubing popped off and covered me in hematuria. Note to self always wear a plastic gown when irrigating

Part of the reason I love my night shift. When I was trained on days I see how many nurses get shortened or no break at all. But is also your prerogative. If your contract says you are entitled to X amount of break time, endorse to someone and TAKE YOUR BREAK. My job is union and we are contract 2 15 min break and 1 hour lunch. I know a lot of people on day don't take all their break or will skip it, but at night on my floor we lump it t breaks of 90 minutes. No one will do your admission or charting but we cover any scheduled meds, call lights, or any other task like monitoring blood transfusion. It is up to YOU to take YOUR break.

Calling people yanks doesn't give me positive view of how people might embrace me in Texas, lol I'm young and single. Don't expect or plan on having kids for some time if at all. Schools is probably the last thing on my list of priorities. #1 is a good place to work I can stay at for a long time #2 affordable housing for a single income person. A private house under 200k, would love if under 150k. #3 having that good housing close to that good job Besides that I don't really care at this point...