Stargazer

When I worked ICU, we had nurse techs who assisted with bed baths, but all nurses bathed their own pts. Since most of the pts were sedated/comatose/immobile, it took 2 people to do a bath, turn the pt and change the sheets. It was a good time to listen to lungs, check back dressings and assess skin integrity.

~sigh~ Apparently this needs to be stated yet again. I don't care what you do on an official break, whether that is a 15-minute break, a lunch break, or all your breaks for the shift combined into one, as long as this is accepted practice in your unit and institution. Breaks are breaks because (1) your patients are covered by other staff nurses during that time (2) unpaid, and (3) usually mandated by contract. I don't care if you eat, smoke, go the bathroom, go jogging, run to the bank, wash your hair, or crochet a doily during your break, as long as you return to the unit promptly when the break is over. I believe what people have an issue with here is people who sleep on the job, i.e., NOT during a break, but during their scheduled shifts.

I understand the impulse though. We can return SOME expired supplies for credit, but a lot of items can't be returned and we just eat the cost. It kills me to throw away perfectly good IV solution and ACLS drugs because they're, like, 1 minute expired. My company donates a lot of expired stuff to 3rd-world countries too. Our supplier has always told us that it's generally accepted knowledge in the pharmaceutical biz that meds are still fine for 6 - 12 months past the printed expiration date, if that helps you any.

I know that Doctors Without Borders won't take expired medical supplies as donations, so I suspect there are legitimate reasons for the product dating.

I know that our expired endotracheal tubes have to be replaced, even though they're just inactive latex or similar. When I asked our supplier (a trusted colleague for 13 years, not a sleazy company rep) why, she said that they are no longer guaranteed to be sterile after the expiration date.

Listen to Lausana, for she is as wise as she is bee-yoo-ti-ful.

Don't feel bad, Tracy. The more posts there are on this thread, the more it's making me laugh. Why yes, I am going to hell, thanks for asking.

W. T. F.????? The doc's never heard of stool softener?

As far as firefighters and cops never reporting each other, that's just not true either. My brother, a paramedic, once had to report a colleague when they discovered, cleaning the rig after a call, that the partner had given exactly the wrong med (lido instead of atropine or similar) to a cardiac arrest patient who was still being coded when they left her in the ER. My brother brought it to the guy's attention and told him he needed to call the ER now and let them know the pt. had this drug on board. Partner pretended he was going to make the call but never did, so my brother ended up calling the ER. The ER doc asked rather grimly why the medic who'd actually made the mistake wasn't on the phone, instead of his partner. Guy was written up by the ER doc. Can't remember if he was canned, but I know he was at least suspended. And just this last week in the news, a Seattle police officer was caught on tape extorting money and drugs from dealers he arrested. Said cop was under investigation in the first place after fellow cops reported their suspicions to Internal Affairs. Bottom line, if you're talking about penny-ante crap like "Jane left the pt's room a mess" or "Jane takes too many breaks" or something, then you're absolutely right, there is too much of that and it needs to stop. If you are talking about actually covering up for clinical incompetence/mistakes or criminal behavior like drug diversion, then that is just bullshit. Protecting the patient/public and the integrity of our own profession should be our first priorities.

Good point, Deb. Many religions try to make sense of, or take comfort in death by speculating that there is some form of afterlife, whether you call it Nirvana or Heaven or something else. For those of us who believe in reincarnation, it is probably just another way to believe that death is not the end of existence. And then there are some religions (I believe Judaism may be one of these, but somebody feel free to correct me if I'm wrong) where they don't believe in any kind of afterlife, and I can see where the comfort would be there also--you pays your money and you takes your ride, and you don't have to worry about heaven or hell, just the legacy that you leave among the living. just_wondering, it's great if your faith helped you through your grandfather's death; but faith and beliefs and comfort come in many different forms, and they are all equally valid. The key is to figure out, first, what belief system works for you, and second, what belief system works for your patient.

After working with approximately 100 different nurses over a 12-year period dealing with life-and death situations daily in critical care units, I can honestly say the subject of religion came up exactly once in all that time, and it was initiated by a Wiccan who told me she sometimes said protection spells (? sorry if that's the wrong terminology) for her sicker patients. As a lapsed Catholic-verging-on-agnostic ICU nurse, I don't ever recall thinking about religion when it came to caring for my patients. I did what I could to keep them stable or healthy, and when I couldn't, I did what I could to alleviate their suffering. I gave patients and families choices, respect, and dignity. In other words, I cared for them more from a holistic model rather than a religious one. As far as death and dying is concerned--as I said, I headed it off where I could. When I couldn't, I tried to make my patients comfortable and make their death as positive an experience as I could, letting them have as much control as feasible, offering them privacy and time with their loved ones. Working in a big-city teaching hospital and seeing technology often abused to keep patients alive no matter what in order to keep patients alive another day, or another hour, I saw very clearly that death is not always the worst thing that can happen to someone. I think everyone tends to see things through filters based on their beliefs and experiences. If you are a religious person, you will see everything through that filter. If you are a very political person, you tend to see things through that filter. I think that the vast majority of nurses see and treat patients holistically regardless of their religious beliefs or lack thereof, and therefore you're not probably going to be able to tell who is religious and who's not based on the care they give. And yes, implying that the topic of conversation was over Sunny's head was rude and insulting, not to mention entirely inaccurate.

6800 cc's? I'm impressed. And having sympathy pains. Oy. My biggest "yield" was 3800 cc's--from a guy who hadn't peed in 5 days. He was so distended, I couldn't pass a cath for love nor money, and neither could the doc. The doc finally had to do a suprapubic tap just to get 300 cc's or so off, then we were able to get a cath in. You've never seen someone so grateful in all your life. :)

Okay, that made me laugh out loud, but I actually think the opposite. Life must be relatively easy when you're too damn dumb to even know how dumb you are. And ERNurse, the complete version of that saying is, "Too stupid to live, too annoying to die."

LOVE neo. We used to use it a lot more than Lethalphed.

A doc I worked with used to order the Levo be mixed with a small amount of Regitine--claimed it was capillary-sparing. It seemed to make the Levo a little less ugly, anyway.

Bio, some nursing programs, and some instructors, just suck. I don't know why, I just know that they do. After 5 quarters of pre-reqs and just 1 hideous quarter of actual nursing school with a psycho instructor, I quit, went home for the summer, decided it wasn't nursing or even nursing school I hated as much as it was that I hated that particular school, and spent the next 3 months doing the paperwork to transfer to another school nearby. Best decision I ever made. My new school had never before accepted/placed a transfer student into the middle of their program without making him/her start from scratch, and I was going from a quarter program to a semester program, but they were very kind and flexible, which turned out to be a good omen. I did a lot of paperwork, sent them my syllabi from the old school, challenged a couple of missing elements from the courses I was trying to get credit for, and started school in the fall. Uniformly nurturing environment at the new school. I was so glad I hadn't given up. Give yourself a few weeks to get over the hurt, anger and frustration, and then please start researching other schools in your area. Nursing needs folks like you, and I PROMISE you there are better instructors and better programs out there. Feel free to PM me if you need to vent or have any questions.

The problem with posting without reading anyone else's replies is that you end up giving your kneejerk reaction to the thread title or the initial post, without seeing how the thread evolved as other posters state their opinions and then incorporate prior opinions into subsequent answers. In other words, it's you getting on a soapbox, not you participating in an ongoing conversation. See the difference? If you'd bothered to read the entire thread, you could see other nurses bringing up legitimate issues such as legal liability and pay. Even the original poster admitted that after reading all the replies, she had a different perspective on the subject. Sorry, but this is one of my pet peeves. People who say, "I didn't read the whole thread, but..." are, in essence, saying,"I can't be bothered to read anyone else's opinion, but you all really need the benefit of hearing mine." Guess again. We now return you to your regularly scheduled thread.

For petty crap, I agree with you. But I don't consider this petty. Just because some docs are unethical and cover for each other's unprofessional behavior, we should too? Sorry, I don't find that a very compelling argument.

I must admit I have never understood this philosophy. It has never once occurred to me that it was okay to sleep while being paid to work. Maybe I've always worked very busy places, but I honestly can't remember one shift, ever, in 13 years of bedside care, where I couldn't find something pt-related or unit-related to do during downtime, even if that was just cleaning. fergus, I do think there's a difference in nurses being awake and reading vs. being asleep. Awake people can monitor call bells and phones and keep an ear out for alarms, falls, fellow nurses calling for help. Asleep nurses may or may not be able to hear and/or react promptly to these things, and as Ratched pointed out, people awakened out of a sound sleep usually aren't mentally up to speed for several moments (or minutes). 2 nurses were caught sleeping on our tele floor on night shifts. "Everyone" knew about it at first and didn't say anything, but someone finally got sick of it and started walking it up the administrative ladder. It didn't have to go up too many steps before they were both fired.

Our pinning ceremony was held a few hours before the university graduation ceremony. It was in the campus chapel, but I don't believe there was any religious service involved. We all wore white nursing uniforms and caps. I had to borrow a cap because I had transferred to this school from a college that didn't issue caps any more! I really don't remember whether we were given or carried roses. I remember that 2 of my classmates wrote and sang an original song they'd written specifically for the occasion. As a class, we had voted on which of our instructors we wanted as a guest speaker. She gave a rather--ahem--bracing speech about the state of the profession and what we would be facing. (As I walked out with my family, my oldest brother--sarcastic bastard that he is--said dryly, "Well, that certainly added a note of gritty realism.") Then we all came up one at a time and got our pins, and then had a group picture taken. (Afterwards, there was a reception which I attended only briefly. Most of us ended up rushing off to dinner with our families before the main graduation. A few of us might've had a drink or two with dinner--we were pretty damn rowdy before and during the actual ceremony. All the music and engineering and liberal arts wonks kept turning around to stare at us disbelievingly, like, what is WRONG with these people? It was hilarious.) I love my pin. I used to wear it on my hospital badge along with my 5-year pin, and people often commented on it.

Pain in the ass.

I had this happen twice when I worked ICU, both times because I was trying to be realistic and honest with the family, which was not what they wanted to hear. The first time it happened, the family wanted to replace me in the middle of my shift. My charge nurse took the family aside for a talk and they came back and apologized to me. The wife actually gave me a gift when hubby left the unit. The 2nd time, I heard about it the next day and since I was only working per diem at the time, it just wasn't worth the energy to pursue it. I have also had to be the lucky nurse who steps in and gets the assignment when the family "fires" another nurse. I had to change assignments one day after the charge nurse came up and told me that the patient's family got very upset after meeting the assigned nurse. We were about to withdraw support on the patient and the family felt the nurse was too abrupt, rushed, and rude. They were nearly hysterical when I met with them--it took everything I had in the first hour or so to get them calmed down. It stings a little, but you can't take it too personally. A lot of times it's just the family trying to exert some kind of control in a situation where they don't feel they have any, or grasping at straws that this will turn the pt's course around.

Woot! Congrats, fergus! :)