TeleRN44

I'm always flabbergasted when sympathy for nurses, especially those with some kind of illness or disability, all but evaporates. Be kind and sympathetic to our patients, their families and ancillary staff but nurses? Nope. I lost all but 20% percent of my hearing (suddenly) in my right ear post radiation for a brain tumor five years ago. Now, I'm slowly losing my hearing on the left side. At one job, I had one nurse who would noisily sigh and roll her eyes at me when I repeatedly and politely asked her to give report on my left side. After one particularly vicious bout of eye rolling and sighing, I reported her. Her nastiness had gone on for well over a year and I felt I'd been more than tolerant, I'd been a damn Persian rug. She received a verbal warning. She wasn't the only offender, just the most vocal. In a few months, I am scheduled to get a cochlear implant. I don't think they can mention your hearing loss in your appraisal. I would consult with someone legally (outside your facility) and not HR. HR is not your friend. If they cannot mention it, ask to have it redacted. Worth checking into...laws regarding the hearing impaired and employment have changed. Those with hearing loss (not just the deaf, but those wearing hearing aids/HOH) are now considered a protected class. Best of luck to you.

I'm always flabbergasted when sympathy for nurses, especially those with some kind of illness or disability, all but evaporates. Be kind and sympathetic to our patients, their families and ancillary staff but nurses? Nope. I lost all but 20% percent of my hearing (suddenly) in my right ear post radiation for a brain tumor five years ago. Now, I'm slowly losing my hearing on the left side. At one job, I had one nurse who would noisily sigh and roll her eyes at me when I repeatedly and politely asked her to give report on my left side. After one particularly vicious bout of eye rolling and sighing, I reported her. Her nastiness had gone on for well over a year and I felt I'd been more than tolerant, I'd been a damn Persian rug. She received a verbal warning. She wasn't the only offender, just the most vocal. In a few months, I am scheduled to get a cochlear implant. I don't think they can mention your hearing loss in your appraisal. I would consult with someone legally (outside your facility) and not HR. HR is not your friend. If they cannot mention it, ask to have it redacted. Worth checking into...laws regarding the hearing impaired and employment have changed. Those with hearing loss (not just the deaf, but those wearing hearing aids/HOH) are now considered a protected class. Beat of luck to you.

Able bodied male patients who are suddenly incapable of using their arms to place their own twig into the urinal. I'm not referring to pleasantly demented older gentlemen or a younger guy post operatively. I'm talking about your run of the mill, alert and oriented, up and about, pees in a toilet but now on bed rest kinda dude. I want to ask THOSE guys these questions each time: 1) Who helps you pee at home? 2) Has your member mysteriously gained weight since your admission? 3) Do you have T-Rex arm syndrome? 4) Do you hear a Media music soundtrack playing somewhere in the background (because I sure don't!)? If the answer is "no" to all of the above, here is your urinal and your call light. Please ring when you're done and I'll be happy to come back to measure and dispose of your urine. í ½í¹„í ½í¸‚

I was a care tech for six plus years before I became an LVN/LPN. I was an LVN/LPN for eight years before I became an RN. I've wiped my fair share of butt, given baths galore and will continue to do so as I work in the ICU and care techs are like unicorns...especially on night shift. I've never asked my care tech to do something I couldn't or wouldn't do unless I had to due to patient needs/tasking. Those individuals who make patients wait while they hunt down an aide to get the patient up to the BSC or on the bedpan or to give the patient the urinal make me insanely angry. It's a dignity issue. When we have to go...we go, right? Patients have so little autonomy and to make someone wait to do something so basic and important is just cruel. Now, that said...I want to know what nursing utopia the OP believes exists where all I do is pass meds and chart and assess? I don't usually call people out on boards but I don't think the OP paid close attention in school or listened to your nurse preceptors during clinical. While you're getting that patient up to potty, you're assessing their gait, their skin, how well they move...do they grimace/are they in pain? Do they strain to use the bathroom? Are they able to void immediately or is there hesitancy? What color is their urine/stool? Does it have a strong smell/is it bloody? Is the patients rectum tender? Do they have hemorrhoids? Is their BM formed? Is it loose? Does it smell like c-diff? The list goes on and on and seriously? It's running in the back of the RN's mind while they talk to the patient about other "things". It's how it's done. Same goes for bathing the patient... As far as patients being mentally "unstable"..welcome to nursing! As more and more psychiatric facilities close, hospitals and nursing homes are faced with handling these patients. Some safe and others not so much but as an aide it's your responsibility to report the "unsafe" patient behaviors to the RN so that they may notify the appropriate physician. Nursing/the profession of caring for others where you're working as an RN or as an Aide is physically, emotionally and sometimes even spiritually demanding. Period. If there is any part of that someone looking to enter this profession finds too unbearable, distasteful or demeaning to try their damnedest each and every day ...for the sake of patients everywhere: please consider another line of work. Sent from my iPhone using allnurses

I've had a few patients say some truly shocking things. One truly heinous patient managed to alienate the entire staff, not just myself, with her racial comments. She was a handful and would shriek a constant flow of cuss words as her mother stood by and watched with a serene expression on her face. I understood why the patient was angry...she was dying. It didn't stop me from wanting to slap the mother, however, for creating and failing to control the monster she created. Typically, it's the guys who get my goat. The able bodied ones who come in and are suddenly no longer able to do for themselves and call you to help them use the urinal. They were texting/drinking from their water pitcher/using the TV remote two minutes ago...now they're unable to lift either their member or the urinal. For them, I have a special list of questions prepared. Have your arms shrunk since your admission? Do you suffer from T-Rex arm syndrome? No Has your member suddenly gained a massive amount of weight since your admission to the hospital? No Does anyone assist you with peeing at home? No Okay then, this isn't a Mediao, I'm not wearing fishnets or a push-up bra and I'm not here to help you live out a fantasy. Here is your call light, please let me know when you're finished. Is there anything else you need right now? Sent from my iPhone using allnurses

I understand not liking long ED waits and all, BUT lying simply to be seen faster and wasting the ER staff's valuable time is a pathological condition all by itself. Someone with a true medical condition and legitimate need could potential end up waiting while they determine whether not that woman is telling the truth or not. I'd have outted her to the triage nurse. We've had folks sign out AMA, go down the road to a gas station and call 911 with the misguided assumption they'd be seen faster if they came in by ambulance. Yeah, that's what triage is for...regardless of how you arrive in the ED. Some things just cannot be explained to folks. Sent from my iPhone using allnurses

More staffing sounds like a simple solution but not every facility, especially considering the ever growing culture of doing more with less...to include people, is going to jump at the idea of hiring more staff because it means spending more money. The things I've seen, both as a nurse and as a patient, that I really liked and that seemed to work are as follows: 1) A designated liaison who regularly interacts with the patient's family, friends, caregivers (yes...HIPAA, HIPAA, HIPAA LOL) to keep them in the loop whether the surgery is one hour or significantly longer. They introduce themselves as the patient arrives and checks in. Later, they let those waiting know how the surgery is going, whether or not there are delays and later, when the patient has been transferred to recovery. This generally decreases anxiety all around while additionally keeping those pesky micromanaging loved ones from crawling up someone's sphincter like a suppository because they've been regularly informed and involved in the process. As a veteran of 15 surgeries and three of those surgeries over a five week period this summer? This was much appreciated for my family while they waited. 2) Thank you cards count! When I worked tele this was something our floor excelled at doing for our patients. It literally took less than 30 seconds to write your name and maybe a quick note like "Get Well Soon!!" in a Thank You card. It doesn't have to be everyone...that would be pointless. If you were directly involved in the patient's care...sign the card. We had tons of patient and family feedback...letters, phone calls to people whose opinions mattered. Those cards were important to our now discharged patients and families because they couldn't remember our names but they remembered our kind words, how gentle we had been with them and with their families when they hadn't been at their best and they had been scared. The cards were attached to the front of patient's chart and each nurse signed when the chart passed through their hands. Oh yeah, what are you thanking them for?? Their business, of course!! Even if you live in a town where your hospital is the ONLY hospital for hundreds of miles around...you're thanking them for their business....which is the whole stinking downside of the dang Press Ganey survey. No love...no $$$. 3) Surveys are good...but before surgery is bad. Honestly, before surgery I was in pain...all I wanted was to get into the OR and get under...that or projectile vomit like the little girl from "The Exorcist". If someone had approached me with any survey questions after being questioned about the 693 other things I'd had to answer just to HAVE the dang surgery? I don't know if I might have said nice things about the smart, wonderful and friendly nurses who provided me with compassionate care while I lay there feeling miserable. But I know I told the nurse who asked me about my care the next day during my follow up call! She asked all sorts of survey questions regarding management of my care/pain/nausea, did my family/friends receive updates, if there were delays...were they explained to me and so on and so forth. In fact, I had experienced a delay for the second surgery...completely unavoidable, they APOLOGIZED! The hospital apologized, the surgeon and his office apologized...said my time was valuable. I was stunned...mainly because I'd never heard that happen before and I guess maybe should. I was quite appreciative. 4) Explain the plan for pain and nausea before surgery. Post-anesthesia, patients are loopier than a roller coasters at Six Flags. What they'll remember or comprehend is debatable as they're busy trying to clear the anesthesia out of their system. I have first hand experience with this one too. LOL Just my two cents...

I wish you the best of luck and I pray that your luck changes or holds (perspective, I guess.) Just as the Dean at your nursing school gave you the benefit of the doubt and allowed you to prove the true worth of your character...I have no doubt you will demonstrate to the BON your integrity and high level of responsibility borne from experience. You have a lot of courage. I admire the grace with which you have presented, what had to be a private hell, for others to scrutinize and judge...so that they might learn from your unfortunate mistakes/journey. I don't know that I could or would have put myself under the same microscope. I will be eagerly waiting to hear how things go for you in a few weeks...:)

Wow...you couldn't be more judgmental OR more wrong if you tried! There certainly isn't anything wrong with MY time management skills as it is the Physician who is running 1 1/2 to 2 hours behind. He ran that far behind BEFORE he hired me and he runs that far behind NOW...that's not MY time management problem. To address your second comment, when I have stopped for that few seconds you've described is just so simple to come by; that just everyone under the sun with half a brain should be able to accomplish such a simple task...the medical assistant appears and informs me that Dr. Soandso says to get back to seeing patients (because he just finished reaming her.) We are/were well staffed...my boss used his staff poorly. I'm sorry if I come off as defensive but your comment strikes a nerve. Never, ever assume that folks are whining about something and then blame them for not seeing or choosing the solution by oversimplifying the solution.

I am too...especially due to the lasix and topamax I have to take for chronic health issues. I recently changed positions and my new boss (an MD) expects us to work for hours on end with no break...no drink, no potty. Insane. It's one of the (sooo many reasons) I just gave notice and will be making sure that my new job actually follows their own break policy.

I love your list and actually have a playlist on my iPod named "Going to Work" that has several of the songs you mentioned. I would add the following: The Freaks Come Out At Night by Whodini "And nine times out of ten they drive you nuts" Insane in the Membrane by Cypress Hill "Who you tryin' to get crazy with ese? Don't you know I'm loco?" Head Like a Hole by Nine Inch Nails "I'd rather die than give you control" Lunatic Fringe by Red Rider "'Cause you got to blame someone for your own confusion" Another Brick in the Wall by Pink Floyd "We don't need no education We dont need no thought control" That's all I got for now...but I'm sure more will come to mind on my way to work tonight...LOL

This applies to no particular patient but an occurrence: we get OODLES of phone calls from either 1) the hospital operator or 2) what I suspect is the 911 operator after sun-downing patients have made the ever popular "Help, I'm being held hostage/against my will!!" phone calls. I suspect that this (and our quiet hours policy) are why no outgoing phone calls can by made from any inpatient rooms after 2200. Now, that doesn't keep people from calling off their cell phones but it seems to cut down on some of the calls...LOL In response to the stories about mice...we didn't have any patients who hallucinated mice...we actually HAD an awful problem WITH mice not too long ago. It was the most disgusting thing I have ever seen! You'd be walking along from point A to point B and one of those brown, furry bodies would go shooting across the hall from one patient room and into an another. Oddly enough, the patients never seemed to notice the little boogers...but you could track the mouse's path depending on how loudly the nurse in question responded. We still have traps on the floor.

I'd have to say...in your position...neither. Both remind me of what we dump out of urinals/catheter bags (amount of head on the top, of course, varies on degree of renal failure). In your position? I recommend a nice Moscato d'Asti...live a little, the bubbles will be a nice treat and you'll be giggling like a patient loaded on versed & fentanyl before you know what hit you. Best of luck in your job hunt!!

I'll be honest, there aren't a whole bunch of places that are hiring THIS (Illinois) side of the river for LPN positions, unless you're looking for something in a physician's office or possibly in a nursing home. Many of the hospitals are moving away from the LPN's, I know it isn't fair for those who still carry the license, but it's the current employment trend here. Many of the hospitals near where I live are also pushing their 2-year/ADN RN's to return for their BSN. You may have better luck looking in MO and on the rare chance (although, this may have changed with the furloughs and hiring freeze) you may find something with the clinic on base. Other places to check out: the VA and Luke & Associates (they're a government contractor who frequently hires for medical positions on the base). I worked for them briefly before I returned to school for my RN. They're a great employer. Best of luck to you!

I worked on an end-stage dementia unit and there was a sweet little old lady across from the nurse's station with a serious poop fixation. I didn't realize how bad until Valentine's Day rolled around... The aide came out of her room and told me something stunk...like poo and I walked in and wandered around but all I could see was the very LARGE heart-shaped box of chocolates sitting on her dresser. Seriously, without scrutiny, it all appeared to be in order but that smell sure didn't belong, so I started to wander around the room and was following my nose to the source of the stench. Yet, each time, my nose brought me back to that innocuous looking box of chocolates. Finally, out of desperation, I glanced down into the open box and the only expressions that could have crossed my face were disgust and horror. It appeared each time she consumed a chocolate, she had been replaced it with a similarly shaped piece of poop. I would venture to guess that 25-50% of the box had been substituted when we had discovered her unpleasant little hobby. The box of chocolates was immediately disposed of and I spent the rest of my day fielding 101 questions by said resident regarding the whereabouts of her chocolate. I still have a difficult time eating chocolate out of those heart-shaped boxes... It bears mentioning this wasn't our first time dealing with this resident and adventures with poo...just the first time they involved food. Yes...the first time.

A PCT came to the nurse's station and stated that she needed help down the hallway. It was just after midnight and things had just quieted down. We had just started to open our charts and frankly, there was nothing in the tone of her voice that raised alarm or made our nurse radar tingle. So, when she repeated the request a few moments later, but this time managed to sound a little more urgent, several nurses got up and followed her down the hall. The PCT hadn't said what she needed help with, so we were dumbfounded at the scene we walked into. The patient was snoozing away but was slathered in blood. So much blood in fact, it was congealing in puddles on the bed next to him, on the floor...just everywhere. The patient had painted his face with it, wiped it on the curtain dividing his bed from his neighbors, it was all over the side rails of the bed (deep into the cracks) and here he was deep asleep...vitals signs stable as can be...oblivious to the gaggle of frantic nurses freaking out around him. The room looked like a crime scene. What caused this bloodbath? The patient pulled out his peripheral IV! The story was that he was fine 30-45 minutes before during rounds and must have gotten up to no good during that window. His roommate was laughing hysterically on the other side of the curtain, saying "I knew he was up to no good over there!". I remember lamenting my decision to wear a white top to work that nights and the fact that the dang bloody curtain kept touching me. Those curtains are gross under ordinary circumstances but I could see the offending filth in this conveyer of germs and nastiness. While we waited for lab to show up and draw some STAT labs, a few nurses amused themselves by picking up clots (huge, they were flipping HUGE!) of congealed blood and shaking them in the palms of their hands while singing the jello song. I decided to pass on the cranberry sauce at Thanksgiving the following week; the resemblance was just to similar. We got the patient cleaned up and vigorous scrubbing from head to toe. Lab finally arrived and drew blood and still the patient slept. He woke up in the AM with no recollection of what took place. I'm pretty sure that I'll NEVER forget and I'm thinking cranberry sauce is off limits. LOL

Hospitals...the only place where we can, more or less, tell what might or might not be growing in your bodily fluids based on smell alone...or whether or not you're bleeding. C-diff poo? :poop: Pseudomomas pee?

Thank you to the OP for an insightful article on what, sadly, appears to be a insidious problem. I went nursing school with a student who it was discovered, shortly before graduation, was not only telling a few online communities that she actively HAD breast cancer but was passing herself off as a nurse practitioner and doling out advice (which was how she got busted) online. I don't remember what the consequences were for her because this transpired days before graduation but I hope she got help she clearly needs. As a cancer survivor, I try very hard NOT to get mad when people lie and say they have cancer but I will be forever confused what it is about cancer that sounds so darn glamorous. I am completely baffled why it becomes the go to disease of choice for attention seekers. It sucks. It sucks when you're diagnosed with it...while you're being treated for it...what it does to your peace of mind and your family and then even when it is gone you worry about it coming back. Why in the world would anyone, exercising free will, WANT that??

In my experience, dementia seems, more often that not, to exacerbate the less flattering attributes of an individual's personality. On our floor, when they start to sundown...they hit, scratch, kick, bite, scream, punch, kick or weep hysterically without end. Some of them are just pleasantly demented...kindly and confused. I hate to be tongue in cheek about it, but in so many ways it is like Forrest Gump's box of chocolate...you never know what you're gonna get. LOL

Ouch, while I can understand this point of view, I don't feel that this response is at all fair to the OP. She, too, is trying to do the best for her patient population and her co-workers. If there is blame to be directed at someone or something, then blame the system. I realize it sounds like a lame response but I seriously doubt she is attempting to "dump a patient" on you. It sounded as though she was attempting to have a patient who who wasn't appropriate for HER level of care and whose needs could not safely be addressed at HER facility get the care they needed. Unfortunately, it meant filtering them through a ED first, so they COULD receive a higher level of care. Surely, it is not being disputed that a Nursing Home is the appropriate venue for this kind of violent individual? I know that the Nursing Homes I've seen are poorly equipped to deal with this type of patient that any ED I have to in recent years. That's the sticky wicket of using the word "you're". There are rules. We all, more or less, are forced to play by these rules. That means that we're all on the SAME team. Why nurses tend to forget this annoys the heck out of me...it's futile to rip into the OP for following the rules and trying protect those in her care. If we don't like these rules...GET INVOLVED. Don't be bystanders when it comes to state/local legislature. For example, when they start making noise that they're going to close a local inpatient psych facility...start writing your local reps/congress-persons...instead of simply wondering what and how you're going to cope or who you're going to blame when someone in your ED gets the tar beaten out of them by one of the crazies. Shredding a fellow nurse for venting her frustration and blasting her that she is in turn making your work place unsafe? Not playing well with others...for shame.

Students don't do prep at our facility...but I'm always stymied by the select few who wander through with Go-Go dancer make up and their hair down like they've rushed in from a shoot in a heavy metal music video. It soooo makes me want to drag each and every one of them off to the side and say "Listen hon, I don't know who exactly you're looking to impress looking like that BUT you want a doctor to be impressed with your BRAIN...not your bust/tarantula-thick lashes/life raft thick lips. The patient doesn't really care if you're pretty...they just want to know that you're competent, caring and above all else FAST when they ask for stuff. So, do us both a favor...go scrub your face clean in the staff bath. I'm sure you've got a scrunchie in your bag; You should put your hair up so no one pulls it...and we'll start ALL over in say...10 minutes?" Wugh.

Our facility uses those lovely "tracker jackers" (as we affectionately call them...NOT) and they're considered "part of our uniform" and therefore mandatory each shift we work. There are two philosophies behind their use though...the first is call light response time/rounding compliance. The second is covering our posterior end...because the pt complains "no one came in and took care of me all night! I sat stewing in my own juices for 12 hours and nobody did a thing...I didn't drink/eat/I couldn't breath and no one cared...nobody did nuthing for me!!" WE have proof-positive that staff was in the room. Do I like Big Brother watching my every move? Um, no but I'm very fond of them covering my bootie when Mista/Missus CrankyPants says I didn't do my job and I clearly did...Saves me from family members flaying off my flesh!

Thank you for sharing your story and I'm glad you were able to turn such a painful, frightening experience into something positive. I have come to believe that there is a certain perspective gained, when you've had to spend a little time on the "other side" of that bed, wearing the gown...using the bedpan, if you will. You hit the nail on the head when you stated the importance of explaining everything. What we as the RN may see as minute and mundane, may actually be quite major to our patients. YES, Lovenox burns like heck and so do the lumbar drains placed for CSF leaks when they're pulled (like flames down the tops of your thighs) without warning. I'm one malignant brain tumor, two DVT (one with massive PE's), basal cell carcinoma (I don't tan, by the way) and 14 various surgeries experienced on the "other side" of the bed. I'm not an expert...but I know that I like it better from the side I'm on more regularly. I'm alive and I'm able-bodied and I'm employed. I've lived longer than was expected and thus I am blessed beyond belief. I am where I meant to be... Sounds like you are too...:)

Yanno, Coumadin isn't all bad and this is coming from someone who has had to take it on a daily basis for the last four years. I like it a whole lot better than the alternative for me...death without warning. The upshot is that I get to give better pt education about the medication...stuff like get a medical alert bracelet, really good diet info and random ADL information from someone who lives with taking the stuff. People fear what they don't know and hearing information from someone who is actually using something rather than rattling off knowledge can help those few individuals who are hold outs. I don't know how many times I've heard "nurses don't get sick!!" Sure they do!! For what it's worth, Pradaxa works for a-fib but not for DVT prevention because there is no antidote (like vitamin K). If the level of Pradaxa gets too high, it's just a really bad oops.

Thank you for the valuable information on Kindred...I had been wondering about them as well. I'm all for a vigorous and thorough orientation but have no desire to be worked until I drop or quit in an environment where the philosphy the almighty dollar is more important than the patient or the quality of care being delievered. Been there...doing that now. Sigh. I second the notion that a facility offering a sign-on bonus ought to raise questions in an RN's mind about why they're doing it...a lesson I learned too late, but no less valuable. My facility offers sign-on bonuses but ONLY to new grads. Why? I'm sure there are several "official" reasons the facility offers but from what I've seen horrible retention of new grads who grow weary of being abused is a HUGE factor. No sign-on bonus comes without some kind of "hook"...how long they require you to stay, requirements you must fufill during that time and of course, how much of that you WILL be responsible for paying them back should you fail to meet your end of the contract. I know that I will never, ever take a sign-on bonus again...