All Content by Propranolol
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What's the task you like doing most on the job?
Haha. I thought I was the only one who enjoyed this. Also, looking back further into the chart (orders) and understanding the story of the patient. You learn a lot by just skimming 2-3 days of previous orders.
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Code Blue Experiences
I've only been a nurse for 2 years. Every code I've attended never made it. One patient after 30-40 minutes of CPR and lots of drugs finally went into a rhythm. Transferred to icu. Later, heard two code blues on the page system. dude didn't make it. At my hospital, besides 1. CPR 2. Lots of drugs 3. intubation 4. Paddles, there is not much we can do for them. sad.
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What do you fear most on the job?
Making a medication error that kills someone.
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Scheduling on your unit
We schedule ourselves on a spreadsheet. After i'm done, i make a copy of it. some people try to be sneaky, but they usually get caught and are confronted about it. simple as that.
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advice for a soon to be burnt out night shifter?
I work nights too. it was difficult switching from days to nights. I don't know how your schedule works, but i work 12 hour shifts. 4 days off. once a month i try to take 5-6 days off in a row. i feel refreshed when i get back. It took me about 6 months to get used to working nights. took me a year to find my groove (i.e. working out my schedule, sleeping/eating habits, etc). good luck.
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Who starts IV's at night at your workplace?
Everyone on my floor starts IV's. PICC lines are done during the day with the interventional radiologist. we don't have picc teams, unfortunately. i remember just one time when anesthesia was called. they placed an IV in the foot. i believe the patient was seizing or something along those lines. If we can't start it, we just call the house MD. our house MD who use to be a pediatrician (now emergency medicine) is excellent. one stick wonder.
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IV start question.
If the nurse wasn't in the vein, when she flushed it, she should have seen the skin blow up with saline. I've seen it done ONCE where there was no flashback on a #24. Patient had tiny veins. no problems after wards. Even when there is a flashback on a #24, usually don't see blood return after the catheter is properly placed within the vein. just my experience.
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New Grad Jitters
quoted for truth.
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MDS nursing as a new graduate????
i'm not a case manager but i do see what the case management goes through. some of these managers have 10-15 years working on the floor or other management experience. its a very tough job trying to convince physicians to discharge patients or get them the services they need to get them out the door. i've been asked by one of the case managers to come work with them and they asked me how much experience i had (1.5 years) and they said to come back in 2-3 years. no thanks anyways. haha. its a HUGE learning curve. they teach me stuff all the time and its stuff i wouldn't think of. i think it comes with years of experience. i can't decide for you, but if it were me, i would try to get floor experience somewhere. good luck with whatever you do.
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Eliminating the Charge Nurse on a Med-Surg unit
i work noc. med/surg. we have a charge nurse. wait, we have a nurse who is responsible for making assignments. she has the same amount of patients and does her own admissions, just like the rest of the nurses. whether you have 3 pts or 8pts. everyone has their night. -good day.
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ER handoff report to floor
We typically get verbal report. recently i've seen the ER just sending a faxed report. the pt comes to the floor and we scratch our heads. rooms not ready. patients need to be moved. its embarrassing when the pt has family members who are AAO and look visibly upset. the hospital doesn't look good. Sometimes the reports are half correct. in medicine/nursing, communication is the basic foundation for proper patient care. period. sometimes the ER just wants to bounce the patient out of their area, ASAP (annoying family), for whatever reason. this happens in other departments too, not just the ER. unacceptable. PERIOD. -good day.
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4th day off of ED orientation...what have I gotten myself into?
I felt the same way as you when i started. 1.5 yrs ago. I felt like crap when i left and was dreading coming in. My stomach was always upset. My preceptor was really nice and helped me along the way. Find someone you can trust (hard, i know) and ask them. Nurses of 30 years practice come up to me and ask for my advice on things i find simple. Nurses who ask questions are the best kind in my opinion. I work at night and it seems like a different environment than the day shift. When i see someone who needs help, i always volunteer to help them. whether its helping inserting an IV or running all the way down to pharmacy/central supply to pick up something they need NOW. I do it. they remember it and will be more willing to help you insert that Ngtube/foley/iv etc when you can't get in it or stop and answer a question for you. I'd wish you the best of luck, but you don't need it. rock on! ps. look back in a year from your post date, you think you haven't learned anything. it was quite the surprise when i did this.
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Got written up today
yeah. how did she "fix the count"?
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cruelest thing I heard a nurse say
sticking to the topic.. I work on a med/surg floor. we had a long term patient there. meaning, he would not leave. no insurance and he was homeless. can't just kick him to the street. refusing medical treatment for his original problem. etc etc. anyway, he gained somewhere between 50-75 lbs. just sitting in bed eating and taking morphine all day. one of the nurses, who isn't a nice person overall, took a mirror and told the patient to look at himself. look at what he became. I thought cruel and bold at the same time.
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Calling briefs "diapers"....*vent*
didn't read the responses. but here's my take.. I remember being a new grad and being uncomfortable with the word diaper. then i saw in the computer to order them, it reads, "Small Diapers" or "Large Diapers." hmm ok. then i talked to the patients, and they called them diapers. So, i guess they are diapers. Whatever the culture is on the unit, i just go by that. ps. i work in acute care, not ltc.
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Highest INR....
30. i'll never forget it. he broke his hip and had a small laceration of his hand that kept bleeding. i was really concerned. lots of FFP/VitK and he actually made it to surgery 2-3 days later. i remember the surgeon coming in and i told him about the inr. he said, "oh you mean the ptt." ahh, no. haha. nice guy. hope he's doing ok now.
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Dirty Needle Stick
i understand how you feel. it happened to me last year. i was completely in shock. i talked to the infectious disease docs and told me the same thing. very slim
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New Grad Freaking out about jobs
hello. i know someone who lost their job and couldn't find work for 6 months. she applied for a job in texas. got the job and they paid for her moving expenses. yeah. theres jobs out there. the places that are hiring seem to be in the middle of nowhere. good luck.
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Nurses not speaking english at work
People at work speak tagalog all the time. Recently at my job, they sent a memo around stating that english is to be spoken on the units. Didn't read it personally, but thats what others told me. People still speak their languages on the unit. My mother and father are both americans (puerto rican/mexicanamerican). First language is spanish. They hate when someone tries to speak spanish to them when there are people who don't understand the language around. they say its disrespectful.
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Handling New Admits in a Fair Way
We have a board with new incoming admissions/transfers. If everyone has 5 pts and one nurse has 6 pts at the beginning of the shift, that person is last on the list to get an admission/transfer. Thats ridiculous that they would give you all those admissions because you have open rooms on your side. Sometimes i'll have 2 admissions and they are on the opposite sides of the unit. Not a big deal.
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How much is too much?
Typically get 5-6 patients with a new admit or transfer from tele. have had 7 patients with transfers lately. we have one aide, possibly two. i usually have 2 complete care patients. we have good aides that have great time management skills. for the past three weeks, i had 3 patients at start of shift. it felt like a gift. good luck. you'll get use to it, unfortunately.
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Cannulation Blood in the Flashback Chamber
I like seeing the flashback in the chamber. thats just me.
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What's it like working as a male nurse?
i can say i've had a good experience on my unit. then again i'm the only guy and the youngest. but it does surprise me the way the women treat each other. i've noticed this type of behavior where a nurse will be really nice and the moment the person walks away she is calling her the C word to someone else. i just stood there and had a *** moment. a lot of the women on my unit are frienemies. nice to each other then talk crap on others. i noticed this behavior also when i float to other units. i just keep my mouth shut. i'm not naive, i know they probably talk about me. but as long as it doesn't affect my career or my patient care, i don't care. some of my patients like that they have a guy. sometimes i will get report that a patient is being disrespectful or acting weird. the moment i walk into the room, it seems they switch. i don't tolerate it and they see it on my face. overall, i work with great people. theres always that one person though. its everywhere. its funny. cause if i float to another unit and theres another guy working also, its almost instant understanding of everything and what we go through. good luck with everything!
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Pt Bites Nurse
when i accidentally stuck myself with a needle, they sent me to the ER IMMEDIATELY to get blood work done. They took blood from the patient also. I have follow ups and blood drawn 1 month, 6 months and 1 year after. They get consent from the patient for HIV/AIDS rapid screen. Everyone was supportive. This is from a 250 bed community hospital. Shame on your management. sorry to hear that. hope all is well with your co-worker.
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Gunners in Nursing
I associate the term gunner more with medical students than nurses. Gunner will go out of their way to find stuff that you missed and point it out. Try to take the best cases, etc.. I tend to find nurses to be borderline sociopaths as a past poster pointed out. Ready to cut your throat for not giving a good report. Next thing you see them about to burst into tears. Yikes! I keep these people at arms length away at all times. It seems to me that i see more of these types in day shift than night shift. just my observation.