SheriLynnRN

In my facility, we do not use skin prep under ostomy appliances because it contributes to leaking. Just a very thin layer of stoma powder if needed. Also, you want to cut the hole to fit the size of the stoma, no the size of the bag opening. I think the best thing for this pt would be a consult with a wound/ostomy nurse since she already has skin breakdown.

it's only the "reality of things" because we allow it to be that way. it is unacceptable to ask someone to work for 12 hours without taking a break. if we don't demand that we be allowed our breaks, we are accepting abusive working conditions. occasionally, a break must be skipped due to unforeseen circumstances, but not routinely. as far as making coworkers uncomfortable by pumping breastmilk, my inclination is to say "too d*mn bad!"....but if someone were to inform me that i was making them uncomfortable, i would ask my manager to help me find a more suitable place to pump. i have every right to feed my child!

I think your letter does a good job of explaining why you weren't at work, but it doesn't address the issue of the manager changing the schedule without letting you know. If I were you, I'd be more assertive about that part. I can sympathize with you....this kind of thing happens on my unit a lot too.

Someday society may be more accepting of tattoos in a professional environment. Until then, I would do as the others have said and find an effective way to cover the tattoos. That way you can still pursue a nursing career without limiting your options. Some people may call that "selling out" but I just see it as being practical.

no, i've never been a manager. i may have mistook the intended meaning of what you posted. i was simply pointing out that your statement seemed to devalue to role of a staff nurse as compared to a manager. i would venture to guess that most staff nurses are dog tired at the end of our shifts...and not just from the physical work. the critical thinking takes it's toll as well.

I work with a nurse who mispronounces the antibiotic Zosyn. She says zoy-sin.... drives me nuts! I want to scream "It's zoooo-sin!!!!" And another nurse who says po-taz-ee-um. It's po-tas-ee-um lady!

wow. i'm sure you didn't mean that they way it comes across. i've really valued and respected things you've posted before. this seems to imply that staff nurses aren't using our brains in our daily work. if it's just sticking needles in people and handing them pills, what on earth did i go to school for?

I agree that some of the hoops we have to jump through make it a bit more time consuming and frustrating at times. I'm just saying that I don't think you have to be any "smarter" or have a higher IQ than other degree seeking college students. I think that most people who are "college material" are capable of mastering the knowledge behind a nursing degree. Now whether or not they actually have the drive, compassion and "guts" to be a nurse is a completely different story.

This is exactly how I feel. It's a self-fulfilling prophecy. If you think nursing school is going to be sooo hard because others said it will, then you will have test anxiety and freak out. Honestly, I think those that struggle in nursing school would struggle with any degree, especially those that are science based. If nursing school is reasonably tolerable for you, than you are probably a good student and would do fine in any other field. Nursing takes intelligence...but it is not rocket science. JMHO.

Not trying to pick on anyone, but isn't the nurse signing off on a chart ALWAYS supposed to verify that they were actually entered in the computer, etc? That's the way I've always been trained and seen it done.

Ok, so it's a New England thing! Good to know.... Here in Montana, where my hubby is stationed now, we call 'em gowns. I wonder where the term "johnny" comes from?

I went to nursing school and was a CNA in Maine, and we always called hospital gowns "johnnies". When I got my first job out of school at a hospital in NC, I sure got some curious looks when I asked people where the clean johnnies were kept, usually they thought I was talking about a commode...hehehe Anyway, my sister is in nursing school back home and we were chatting about this today, I was wondering exactly how regional of a term it is?

When I work in the cicu, I set my monitor to show the resp parameter. When I am working in the surgical unit, the CNA's routinely take vitals. If I do a set I do usually count resps. I wouldn't ever make up a number though. If I don't count, I just don't chart a RR for that set of vitals. If the pt is in resp distress, or I have any reason to be suspicious, i count resps.

I saw a pain scale that made sense to me posted on the wall at the Air Force base clinic where I get my GYN care. It's based on level of functioning...ie pain is present but able to perform activities of daily living..etc etc. According to that scale, no one could ever SAY that their pain was presently a 10/10, because a 10 means "You are unconscious due to pain." Sounds pretty crystal clear to me.. :)

Personally, I would want someone to let me know if I were saying something the wrong way. The reality is that a person who misuses words, or pronounces them incorrectly comes across as less knowledgeable and intelligent. There may come a time in the future when she won't be taken seriously as a professional because what she's saying sounds silly.

I was 20 when I graduated with my ADN. I turned 21 a couple of months later.

I'm not really bothered when pt's or family members say things incorrectly. There are some things that the general public just doesn't know....but I get really annoyed when healthcare workers/professionals don't use or say the words correctly. It's not so much that regional accents bother me, it's the addition or subtraction of letters and/or entire syllables that gets to me. btw, SONTimeter bugs the heck out of me too! lol

Doesn't it just drive you insane when someone tells you that Mr. Smith's O2 STAT is 96%? It's O2 SAT people! Sat, short for saturation. I even hear respiratory therapists saying this. I am sooooo tempted to say something next time, but I know it's just petty, so I needed to vent here. Thank you.

Yeah, if you're the ER nurse. Not so awesome for the floor nurse. It's nice to know you're getting a pt, and a little info about them...like their NAME, for example....before the doc is on the phone trying to give admit orders. Geez.

That's exactly the type of memory aid I was thinking of! Thanks!

At my last job I had to constantly reach over the charge nurse's shoulder to look at my charts, and annoy the heck out of her...or rely on the less than dependable unit secretary to let me know when I had a new order...A lot of orders were missed, or just not seen by the nurse in a timely manner... The unit I work on now has a much better system. When a new order is written, the unit secretary scans it and a copy is made for the nurse. We have a magnetic bulletin board at a central area in the nurse's station where these order copies are posted on clips labeled with each nurse's name. I really like it, because not only do I know right away when I have an order, I also get to see exactly what the doctor wrote, not just a yellow sticky note that says, "2 units PRBC's Room 702".

This sounds pretty passive-aggressive to me. IMHO, it's always better to be direct than to resort to cattiness. These are the kinds of behaviors that lead to a breakdown in communication and collaboration between docs and nurses, which leads to care that is less safe and of lower quality. Of course it's frustrating when they expect us to be their personal secretaries, but this way of addressing the problem is unprofessional.

It's amazing how difficult it can be to convince people to shower in the hospital....but in a way I can understand it. Some people just feel too rotten and don't have the energy, and other people just don't feel comfortable in a strange shower/bathroom. A lot of people will skip it because they are going home that day etc... But what I just can't wrap my mind around is the huge number of people who don't even think to brush their teeth! Very rarely, someone will ask me for assistance to get set up to do it, or ask for a tube of paste or a brush...and when I offer it to people, so many just look at me like they never even thought of it. I can't imagine not brushing first thing in the morning...it makes me feel human!

I was just wondering of any of you long timers had any memory tricks or ways to help remember which drips do what and/or what doses to start at...whether they are in mcg/kg/min or mcg/min etc. Or does it all just come with practice? Once I look the drips up, I have no trouble understanding what they do...just looking for a way to not feel like I'm fumbling for the action of each drug.. Also, are there any good resource sites out there? I've done the PACEP site...and I think ICUFAQ.com/org is down..... TIA!

One of the first steps in implementing this on our unit will be to go to the other unit in our hospital the uses it to observe the process "in action". I'm actually looking forward to that. It sounds like a great idea in theory..ie keeping the pt better informed and increasing accountability between shifts. I do have concerns about how it will play out in "real life" however.