MichelletheRN

They should never make someone afraid to admit a mistake. All that will do is force people to lie out of fear. I can remember when we used to have to draw up our own saline flushes. We would draw it from a 50 cc bottle of saline, which had a green label. A lot of times you would see a bottle with a pink label on it, and it would be 50 cc too....looked identical to it, except a pink label....sitting right there next to the saline, looking ecactly the same if it was turned around. Of course it wasn't, that was pure potassium lol. My heart stopped every time i seen someone leave them both on a shelf sitting beside each other.

I just put RN on things. What is funny is when i sign a check and accidentally put RN.

I believe (and i could be wrong, but i don't think so) that nurses and doctors are not allowed to unionize in our state. This may include more health care workers, but i am almost certain at least these folks cannot. I guess i understand managers who have zero experience in healthcare as not getting it. But like our director....she was a staff nurse before she took over as director. She actually is slightly younger than and has slightly less experience than i do. Regardless, she has worked the floor and SHOULD understand how people are. The department head is also an RN, who has a masters in nursing and an mba, but has never worked the floor. Ever. Since nursing school. Why?? These guys need to work the floor at least once every 6 weeks, to keep up with how we are doing things and remain skilled. I haven't heard **** about bonuses this year, either, i suppose we are doing away with those, maybe to save money to buy stamps to send survery.

It is interesting with alot of variety. Sometimes things get on my nerves, but for the most part we have a lot of fun. I enjoy the nurses and doctors i work with. I enjoy most of my patients, there are a few who irritate me, but for the most part, i like them and want to help them. It seems like it runs in phases where it will be more chaotic, there is fighting, we have patients and families who are hateful toward us, and management is threatening to write us up because they found a charge sticker in the trash. Then, we are back to the, "go team! Yay us!" Train of thought, and there is a happy, productive vibe going on. For the most part, it is good, things are okay, we are doing our thing, and everyone is supportive and has each other's back. It pays well enough. It pays better than most things. I could probably make more, if i took a management position, or filled in somewhere else as well, but i don't want to, i am no longer a young woman, and no longer have boundless energy. The average household in my depressed part of the country only earns around $40k, and i earn by myself probably $75k plus benefits worth another $15-20k. In a bigger city, this would not be that much, and definitely on the east or west coast you would need to earn more than that. But around here, things are cheap. I live comfortably and buy whatever i want within reason. We are able to own our vehicles, a harley, a camper, and two houses outright, and i have some money saved for retirement. Of course our vehicles are not fancy or brand new, and our houses are not mansions, except this house we bought a few years ago is pretty cool, it is a big Victorian, and i would like to sell the other house. We do not live extravagant or fancy lifestyles, by any stretch. My husband likes money more than i do. I really do not care about having alot of money as long as i have enough, and enough to help our kids if they need it.

RN with 20 years experience. Live in a small, midwestern town (nebraska). Rural environment, depressed economy (average income for a family or household is $40k, or even less). I eatn about $75k a year plus benefits, so roughly $90k-ish? My hourly wage is like $35 something. This is average to slightly high average for a typical RN here.

If it's someone I am friends with, that's one thing, i will joke around with other people when we are chatting or whatnot. I don't deliberately try to annoy anyone, though, and i hope they don't try to annoy me. But yes, my coworkers and i joke around and are goofy at times. Sometimes we are quite rude and crude, have filthy mouths, and act the fool. This would only be when it is just us there. We are not going to cut up in front of a bunch of people. If it's someone i don't know that well, i am not going to joke around, because generally, i am socially awkward if i am not used to someone. So i keep our interactions quick, to the point, and professional. Why try to just annoy someone? Maybe i don't get it. Joke around, sure. Visit, sure. But not annoy, just for the sake of being annoying. If people act that way with me, i will tolerate it for a while, but eventually i will get mad and there will be a tangle.

Swing shifts are crappy. Thank God we don't do them on any kind of regular basis. I would not call in "tired", at least not saying that. If you are so tired you don't feel well, you could call in "ill". If you were sick to your stomach as you mentioned, that could actually be why you felt so yucky and couldn't sleep. If it is a possibility to come in and work through the busiest time, and then go home, that would be an idea. Our busiest times are from probably around 10 am to 10 pm. I have let people go home when it is slow, or go home on call. Of course, this is a guarantee that all hell will break loose, and you will end up there the whole 12 hours, plus another 3, and you won't even get a chance to pee. It is hard to constantly change your sleep schedule. I don't want to encourage this if you don't absolutely need it, but taking benedryl or an otc sleep aid at these times would be appropriate. I, and most of the nurses i work with, have ambien, or remeron, or lunesta on hand. If i have trouble falling asleep, i find one benedryl and 1/2 an ambien will usually knock me out within an hour, and i can awake 6 to 7 hours later perfectly awake and alert, with no continued drowsiness.

I vastly prefer 12 hour shifts, and this is one, but not the only, reason that i am hesitant to leave bedside nursing and enter management even after many years. We do self scheduling, and when we are not short, about every 3rd or 4th weekend. So i like to give myself 3 shifts at the beginning of the pay period, and 3 at the end. In this way, it is not unusual for me to have 6 or 7 days off in a row in between. Of course this does not always work out, depending on what other people have going on, needs to trade, etc. However, it is a huge luxury and i dont take it for granted. They had a nursing management job open recently in our hospital, and i refused to apply for it. One of my friends did, and took it. She really likes it, because her husband teaches high school, so they have the same hours and days off now. All i see is five days in a row of getting up early, actually having to put on makeup and fix my hair, and dress clothes/shoes. Maybe for a raise, like a big raise. Like doubling my salary. Maybe. Ha ha ha no. Triple. I remember when i was in college, 8 hours was the norm, as well as every other weekend. This is sooooo much better.

I work with some very good nurses who happen to be men. Usually what i have observed is, that it is the PATIENT who wants the nurse to be female, not that the male nurse has any issue with doing whatever. And this is usually when it is an elderly female patient. This was really a thing in the 1990s, when i was in college, and worked as an aide in a nursing home. There were some patients, both male and female, who would NOT allow a male aide to provide their care. I don't think it is as bad as it used to be. Another thing i remember was some of the patients would not allow a person of another race to provide their care, and had no problem throwing out racial slurs. Now that i think back on it, it was pretty horrifying. I remember on more than one occasion coming to the rescue of a coworker who was trying to assist someone to the toilet or bed, and getting hit, bit, kicked, and called a "F-ing N". Very disrespectful.

I remember twenty years ago when i first graduated college and was an RN, getting 15 or 16 dollars an hour, and thinking i was living large! I was used to making minimum wage, so that seemed like a fortune by comparison. Idk, i am not really that upset about what i make nowadays. I mean, i only work 36 hours a week, and i make around $75k a year plus benefits, including pretty awesome insurance, and the hospital contributes 5% of my income to my retirement account, and i do, too. By the time you figure in all that, it is definitely up in the 90k range or so. It is not a bad gig for 4 years of college. Of course, i have been doing it awhile, so im sure 10k or more of that is due to experience. And i maintain ACLS, PALS, TNCC etc. But that is kind of standard i suppose. That may sound like not alot if you are in California or New York, but here in a town where the average family income is 40k or less, an individual making twice that definitely isn't impoverished. We are not "upper class" by any means, but we are quite comfortably middle class. Nurses would make more if it wasn't a female dominated profession. Sad but true imo.

We don't really have a set policy in place, to my knowledge. We don't seem to have any issues with excess absenteeism, though. The way ours is set up, you earn a set amount of vacation and a set amount of sick time each pay period, and these are housed in separate hour banks. The rate at which you earn vacation is more than sick time is, though. We earn about 7 hours of vacation each pay period....maybe a little more or less. I am not sure of the exact amount. Sick time is earned at about 3 hours a period. In order to use sick time, you must first have used 2 days of PTO. I have been there a year and nine months, and i have called off sick twice. So, i have never used any sick time. I have like 6 weeks worth of it right now. It will be good if i or an immediate family member become gravely ill or need surgery. I do use my vacation whenever i want. If it is slow and i take on call, or sometines if i am getting really burned out, i will schedule myself for less days and take vacation. I have never got any static for calling off sick, or had them require any proof. Nor have i seen this done with anyone else. We always figure something out and cover it. In that respect, it is a good place to work, because no one wants anyone there sick. I have worked with sniffles or a minor cough, but i think if i tried to work while extremely ill, i would be encouraged to leave. I have had someone get sick mid shift, and i insisted that they not take patients, and just remain in the break room and answer the phone, until we could get someone else in. When i was in college, i worked as an aide at a nursing home, and was not allowed to be sick. We had to come in regardless and were threatened that we would be fired if we called off. I went in with the flu and 104 temperature, i was in a daze. We would have girls trying to work and throwing up in the trash cans. It was absolutely ridiculous, i would never allow such a thing now, but i was young and stupid. If we were really sick, we had to wear a face mask like that protected anyone lol.

It does not really bother me one way or the other to have a patient who is a nurse, physician, aide, therapist, etc. If anything, they are easier to take care of and far less demanding/more understanding than a typical patient. You can be more direct and they will understand you. I mean, as a rule. When i was in high school, i worked as an aide at the local nursing home, and one of my patients was a retired (and very confused, but able to hide it somewhat) surgeon. He was very nice, but this one night, i was helping him get ready for bed, and he asked me how old i was. I responded, "17." He then said, "well, that's about the right age to be getting some," and complimented me on my chest size. I was absolutely floored and speechless. He said it as matter of factly as if he had told me the sky was blue. And he didn't ACT inappropriate, he just randomly said horrible things. I was like, "Um, what?" And he already had no clue what he had said, and that i was freaked out. Poor old guy lol. He was a hoot, though. What i don't like is when some family member or friend wearing scrubs comes barreling in and tries to take charge of the whole situation. Wearing scrubs gives them "the knowledge", and they will be glad to come share "the knowledge" for hours. They may only work part time as a receptionist for a chiropractor, but for some reason, they wear scrubs for this, and they are on a mission. Expect monitors to be unplugged, telemetry patches to be moved around, and IV sites to be scrutinized carefully for the slightest hint of swelling. Total melt downs over a blood sugar of 153. "It's NEVER that high! What are you giving him different?!?" Of course not all people wearing scrubs are like this, and i am being sarcastic, and i WANT to know if there are any concerns or the IV is red, or even if they "just arent acting right". Because, i know, that can be a real thing. And i KNOW they are worried, and it's stressful. I therefore try to be reassuring, supportive, and teaching the patient and family. It's just, idk....it's actually kind of funny in a way, even though it isn't, and usually, i can get everyone calmed down and stuff fairly quickly. It's just kind of....funny-ish to suddenly see the doors slam open, and in runs a middle aged woman in scrubs, looking like she is about to lose it, turn around, look at me, and scream, " Where's Daddy?" And i try to figure out who she is, and which person is her Daddy. Who is 78, has pneumonia, and is sleeping...have a xanax. When my husband had surgery, and i am sitting at his bedside and the nurse comes to assess him, and then the hospitalist, and then an aide.....and he is like, "this is my wife, she is an RN!" And i am like, "aww don't say that....nobody wants to hear that..." Lol

I guess the part of it i find most offensive is the lack of even a pretense of respect, the "guilty until proven innocent" thing. I don't understand why the actual floor nurses, PAs, and doctors can understand what a load of crap it is, but the administrative staff, who are supposedly our leaders and smarter than us, can"t or won't see it. And the move away from "patients" to "customers" and "clients". And i am all about good customer service. All about it. I want to provide the best, most competent care, with the goal of helping people to get better. That is all. I enjoy direct, hands on patient care, and interacting with others. I want to assess, treat, think, comfort, encourage, and teach. I don't mind getting you a can of pop, or a pudding cup, or changing the channel because you were too weak to do so, and instead pressed the other button so i could come and do it lol. Up to a point. But you have to take it for what it is. It's not a spa, and you're in my territory. Don't be ridiculous. This sounds terrible, but i honestly feel there is a direct correlation between innate IQ and being rude/fitting about everything. And the nicer i am, the harder they push. I will think, "But.....i let them use my cell phone/ipad/ipod/charger/ magazines/gave them $5". It doesn't matter, it's never enough. There IS (and i am going to figure out how to do a study on this someday) ABSOLUTELY a correlation between IQ and now well you protect an IV. Most people of average or above average intelligence know that even with the best of veins, getting an IV inserted isn't fun and causes at least mild, albeit temporary, discomfort. For that reason, a normal person will be cautious of the IV, and try not to pull on it or mess it up (unless they are confused or senile). You get an idiot, they can have such awful veins it takes 4 of you ten tries to get a 24 gauge IV inserted in their pinky or some ridiculous thing...takes 2 hours...lol. Five minutes later, they will have crawled out the side of the bed, pulling the IV and pole across the top of the rails by the tubing, and the room looks like a murder scene. That is when you know you have an idiot, so you better be in there every ten minutes, begging them to just stay in the damn bed, bribing them with ice cream (what, no chocolate sauce? You'll be hearing from my attorney!) In the example of the lady wanting more and more narcs, what on earth should have been done? Really? Norco and Percocet wasn't cutting it for a 2 year old knee scope? I had my knee scoped before. I know how it feels. It DOES hurt...for a couple weeks. If i was having enough pain i wanted narcotics years later, i would be getting ahold of the surgeon who did it, and saying, "hey...idk what this is about, but it isn't right!" So did they REALLY want us to give her dilaudid or fentanyl for that? That's beyond ridiculous. If we actually did that, and something went wrong, can you imagine? I mean, we hadn't even had a chance to really look at it, or xray it. She wanted IV drugs, NOW. Nothing else was satisfacory. And why does SHE get the benefit of the doubt rather than my friend (whom has been there nearly ten years, vs this lady we have never seen before or since, and don't know from Adam)? Why doesn't anyone stand up for us? I have been a bedside nurse for twenty years. If I was a manager, I feel like I would stand up for us. But honestly, after twenty years, if i was going to be a manager, i already would be. I don't feel like i would be a good manager, it's impossible for me to separate myself from the floor staff, or to tear them up. I feel like there is some part of my personality that wouldn't work in that role, and i would be bad at it. It's probably unfortunate as i am not getting any younger. One of the surveys we got back last summer, the wife said her husband had been in there 3 days and never received a shower. That is not true. I admitted him. We showered him before we even put him in a room, because he had dried poop and pee all over himself. He may not have got a shower that next morning (8 hrs later), but i am pretty sure he did the next day. It is charted that he did, anyways. What it amounts to, is he wasn't showered while she was there, it took place later at night and/or earlier in the morning, and he was too confused to remember. But boy, did we get reamed. An email saying how this is "unacceptable", "ridiculous", "how would we like our family member to be treated this way", "consider this a warning", "there will be disciplanary action next time", blah, blah, blah. What are they going to do, fire us? We are already short 4 or 5 RNs, and half of our staff is traveling nurses. We are skimming by on providers, but one MD or PA or NP away from utter chaos. We recently lost a great PA because she had a baby, and we refused to work around a reduced schedule for her. I don"t know why. She was very competant, sweet, and a hard worker. Why do we just let these people walk out the door? We have lost several bright, hardworking RNs as well. I don't know why we are just like, "okay, bye!" Instead of "what can we do to make this work? We value you and want you to stay". Obviously, i am developing a bad attitude, and i don't want to, but it seems so hard to stay positive. Despite how jaded i am becoming, i honestly do still like people and want to help them. It's just hard when no matter what you do, it's wrong. I am burned out, we are all burned out, and there is no end in sight. We are back to getting extra shifts again because some of the travel nurses' contracts are up. In my eval, apparently i have picked up 18 extra shifts in the past 6 months, completed God only knows how much continuing education, and attended over 80% of all the extra meetings (if you don't make 80%, you don't get your yearly merit raise). This earned me a score of "average". 3/5. How do you get a 4? Does it involve sacrifice and the blood of a virgin? (Guess i am screwed then. Lol.) I can't believe how long I went to college and how hard I try, to end up being a complete peon, who is one "diet coke instead of pepsi, and i prefer CRUSHED ice to cubed" away from some kind of "disciplinary action". I don't know what the disciplinary action is, some kind of vague horror that is threatened when i don't put miracle whip on a sandwich, or forget to lock the little drawer in the room that holds bandaids, alcohol swabs, and tape, because we must prevent the stealing of bandaids that is apparently an issue.

I really like some of the new material which is stretchy a bit or has some sheen to it. I think, though, that they are cut ALOT different. Tops are shorter in length, tighter in the chest, as well as the hips. I don't notice it as much with pants, but I have always had it be a thing where if pants are big enough to fit me in the hips and thighs, they will be really baggy in the waist, sometimes to where i have to actually roll the waistband. And when i lean forward, they will gap in the back, ugh. Why doesn't someone invent scrub pants that fit like yoga pants? Tight enough for the waist to stay up, and stretchy enough to fit bigger hips and thighs? I am about to go on a sewing adventure and try to make some. I can't stand my shirts to be too short or snug, either. Has anyone found a brand they really like? I am a bigger woman, 5'7" and a size 20 or so. It is hard to find something comfortable. I have given up pretty much on looking cute since i have gotten heavy and now being in my 40s. But i would just like something to fit decent and not be skintight or falling off.

Do you think it is ever going to get better? Or will it just get more and more picky and petty? I have long believed surveys are useful, but must be taken with a grain of salt instead of as gospel truth. For one, frequently the ones filling out surveys are 1) people who are upset about something, and/or 2) people who are hoping to get something out of it, something free, special treatment, etc. I would also bet you that people who have nothing better to do are more heavily represented, as busy people are more likely to misplace or forget them. To me, this is just common sense. I guess i don't have any proof. I guess i could say, 94% of statistics are just made up. Lol. Another thing, my facility is SMALL. Like 12 to 15 bed critical access with a 2 bed ER. So of the patients we treat in a month, we are talking at most, several hundred....we may only get back 10 surveys. That isn't enough to draw any correlations from. So why do we get emails reaming us out because our "satisfaction" scores went from 98.3 to 97%? It's essentially THE SAME. Why would anyone be mad at getting a 97%? Well, because...it used to be 98%! Obviously, we are not trying enough. And we get them emailed to us, so we can see just what was said, with additional notes telling us it is "unacceptable!" Or "explanations????????" One of mine was, "there was too much noise from the street and i couldn't sleep". What am i supposed to do to fix this? Go flag down cars? Forget the fact we are in a town of 3000 on a residential street. About 4 cars go down it a night. Someone else got, "only had diet coke, need diet pepsi" *****!?!? I am sorry our free pop isn't right. There is, however, a pop machine where it's available for PURCHASE. I know, it's not fair. Also, apparently it is commonly known, that no one ever lies on these. Like the patient who reported that her nurse, "just gave her the call light and said she was going to find something better to do." Yeah, that happened. Granted, i wasn't in there, but i would be willing to bet any sum that did not occur. For one, that lady was baked out of her mind on percocet and xanax. She probably thought the IV pole said that. But it was accepted as FACT, and that nurse got yelled at over it. If you can't trust your nurses, who CAN you trust? We had a chick show up on a friday night wanting something for knee pain. She was already on norco and oxycodone. For a knee scope TWO YEARS EARLIER. A. Scope. But you know, some dilaudid or something. My friend who is a primary care physician saw her, and said, "no, let's try some toradol, and maybe getting ahold of the surgeon, you need to see an orthopedic surgeon..." and this chick tore my friend up and left AMA, cussing all the way. And you can bet, SHE filled out her survey, and the PCP got pulled in the ADMINISTRATOR'S office, about not helping the patient's pain adequately, and having a bad attitude (she did not have an attitude, i was standing right there when it happened). She denied it, but why would we believe her? Will any sort of common sense ever return? Should we just set out bowls of percocet that say, "help yourself"?