Tomascz ASN, RN

Money is what admin respects. Talent and ability come second. Quite seriously; the more you cost somebody, the better they listen. The value of your input is directly related to your paycheck. That does need to be backed by ability. It also helps if ...

I've only ever worked in a union shop, 12 hour shifts, 4 or 5 to 1 ratios (ideally). We were expected to have our charting done by end of shift and never worked un paid OT (if you ended up staying late it needed to be emergent pt care, and for that w...

Just throwing this article out here. I've been an RN for about 5 yrs now working in Med/Surg Acute Care but I've been a curious human for 67+ yrs and a student of human behavior for not quite that long so I find these kinds of discussions fascinating...

And that's the real issue working a chopped up schedule. I always liked to get "my" patients back if they were still there but sometimes another nurse had been working with them for the last couple days and considered them "her" patient. Continuity...

Got experience or an opinion about the vaccine? Tell Medscape. The comments are pretty interesting. They're all over the map too! https://click.mail.medscape.com/?qs=680d3715acc75d2e1b11e0461fe92ed1f57a27b61364b8fa57ef0dffdedbf9a09dd28f2f5f771...

OK, WOW! Just found out where all the traffic went. 41 pages! If I go back through and find out it's just been ten of you arguing with each other for 41 pages I will dump this group and never look back. I don't blame people for not wanting to get v...

I worked a 3 on,2 off, 2 on, 3 off for several years (3s being weekends; all being 12hrs, 84 hrs a pay period) and I really enjoyed it. I worked a 5 on 2 off, 2 on 5 off for a while which I liked because I could get 9 days off using 2 annual days. I...

I don't know where to start. First off, I haven't heard the phrase "LPN" mentioned once here. Did they become illegal? Anyway. The whole field is a compromised mess as far as certification, academic requirements,professional stratification, innate p...

https://www.amsn.org/certification/certification-review-course This isn't the NCLEX (which I passed in 75 questions first time out). Like the NCLEX, this is aimed at a specific audience and you need to learn to think like that audience, eg; "What abo...

Number one get yourself a couple therapists; one physical and the other for talk therapy which has equal or better results than SSRI's for mild to moderate depression. Those pills don't listen worth a d**** and you need to talk this out with somebody...

There are a whole slew of things that make nursing difficult and staffing ratios are one of the things we can have some control over. What we can't help is that our patient base is becoming sicker, fatter, older, more violent, less respectful, and ge...

I've been working for IHS on an acute care floor for 4 years now and started as a new grad (GS5). The work is challenging and often frustrating but looking at my end of year pay stub, while it says I make $29+ an hour the total I'm looking at is 89K ...

I guess whoever is responsible for the grocery bill will have the most say about what gets served. I certainly applaud the nod to healthier eating with the caveat that simply eating a diet devoid of animal products is no guarantee of better health or...

Managers work to fulfill the needs of management. Management at the floor level has an impossible job trying to mollify JCAH, Medicare, Infection control, burned out nurses, etc etc etc. Beyond that they have to deal with trying to keep up with the i...

Apparently we get along better with our Docs than most of you. We're a relatively small critical access hospital with an acute care/med surg floor that admits from our ER and clinics and we deal with a lot of the same patients over and over, some wit...

https://www.msncb.org/exam-preparation Everything you could possibly need can be found under this link. If you're a week or two away and you aren't prepared you need to re schedule your exam,or, just go take it, and if you fail, spend a couple months...

Try this on for size. I started nursing school at 57. I've been a nurse for three + years now. I was a carpenter in the 2008 bust in the poorest county in Missouri so my wife encouraged me to go back to school. She was doing home health as an aide. I...

Thanks for sharing, Jane. It takes guts to stick it out there. I've found my experiences to be helpful in dealing with what seem to be a majority of my patients; if not for them, certainly for me. I've had to learn a lot about forgiveness and kindnes...

And how many patients have died from untreatable c. Difficile infections? The patient was immunocompromised and the fecal samples contained antibiotic "wise" bacteria. Was the treatment used as last line or first line? Last line if current standard p...

So by now you have a record of the areas you're weak in but not the exact questions you missed, of course. You also know this is not the NCLEX. NCLEX style strategies don't necessarily work with this test. What I did do that you didn't was listen to ...

And the difference between this and PTSD is what?

Thanks for this!! I've been following research on gut microbiota for about the last 10 years. What the public lacks is exposure to reduce social sensitivity as well as education about how their bodies work. I share this stuff on Facebook all the time...

As I opened this issue of Allnurses I saw an article titled in the sidebar to the effect of "New Grad (BSN no doubt) RN, absolutely hate nursing". How many times have I seen similar sentiments here? That quoted above is, in my opinion, the exact crux...

So, #1, I'm glad I don't work in WA. I work in a "small" hospital where our "Med Surg" floor w/ 20 beds sometimes resembles a NICU in a Memory Unit in a Psych Ward in a Drunk Tank in a nursing home. Today we have 6 RN's taking care of 13 pt's. Yawn. ...

OK; so, I work with a lot of "CIWA" pt's (CIWA is the algorithm for assessing withdrawal where I work), and it's pretty much of an art. Lose whatever attitudes you have about addiction and substance abuse and focus on the pathophys of withdrawal from...