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Insulin is double checked everywhere I've worked. But paralytics aren't? Are we nuts? My nursing career began in the 1980's, I'm retired now, but in all those years, one career ending error I've heard of consistently is med errors involving paralytics. I doubt accurate stats exist on the topic, but considering the danger to the patient and the horror of a single error ending a hard earned career, shouldn't we consider double checking this class of drugs? Paul Millard, RN, CEN, Etc, retired

Whatever works best for you is best for you. That said, two very distinct personality types, and where you'll find them, ER nurse = ADHD because of the constant change in priorities, moment by moment. OCD nurses do extremely well in ICU. I'm retired from decades of ER, so those are the units I was most exposed to.

"Oh, those boys! We thought they were crazy!" A new RN in the late 1980's, I was caring for a pt who was 8 years old when the Wright Brothers first flew an airplane. I asked if she remembered them, above was her reply.

"Professional differences" covers a lot of territory. If asked for details; "If I'm not allowed to give the care needed it puts my career in jeopardy." Or maybe "Non nursing personnel undermining my nursing care." If they push for further information, simply say you "wont get into the details of medical care to protect confidentiality." This should impress them. If they push you for more details, thank them for their time and say adios. I hope this helps. Interviewing at a school vs a hospital are likely much different. Accept that you may need to set limits, and some employers are not the ones you want.

"Any reason" has it's problems. One hospital would fire you for cause if they had solid proof, for "Inadequate charting" if the just want to fire you. This second one if it really existed, is totally subjective and hard to fight because you don't have access to pt records.

The beatings shall continue until morals improves! Seriously, if your management doesn't know how to retain nurses, the first change must be to change management from the top down!

Nope, nope, nope. I have declared by virtue of the powers vested in me by Bart and Homer Simpson that the "Political Correctness" fad has run it's course and has become farcical. Spread the word near and far that, from this day forward, we are all responsible for our own emotions!

It comes up on every site. Buy and keep your own malpractice insurance. The following should be written in stone and posted at the front of every nursing class. 1. You don't need to make a mistake to be sued. 2. Your employer will protect itself, first and foremost. The annual cost of malpractice insurance is about the cost of talking to a lawyer for 1 hour. If you can find a lawyer that will listen to you! When the lawyers circle your employer, you can count on some nurse spending a lot of time looking up at the bottom of a bus.

Often we learn more from errors. We already knew how to do it right. We thought.

Hmmm. 1 ER I worked was gigged by JCAHO because we didn't document enough med errors the previous year. Apparently they have a sliding scale for med errors based on annual census! How do we win?

That would scare me away from school nursing. The principal, et al, have no basis to question your judgement on nursing. It's like a chef telling engineers how to build a bridge! As for job interviews, keep it simple."I called an ambulance for a child experiencing a life threatening emergency. Non medical management questioned my judgement." or similar. Short, sweet, and factual. Be sure to ask the interviewers question(s) about similar situations at jobs you've applied for. Good work and good luck.

Studying early retirement NOT for financial reasons, RN's and heavy equipment operators topped the list. A rehab specialist told me they present to him with the same injuries! I'll provide a link to the study but defy anybody to get through the 60 mind numbing pages. Will mercifully provide the summary below. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/117396/wp331.pdf Just hit 66 myself. Been sidelined by back problems for 10 years. Would dearly love to return to work, but now just the cost to get re-edumacated to activate my license is prohibitive. My "Plan A" was to work in the ER till the day when they had a coffin waiting for me at the time clock.

The university of Michigan did a study of which careers have the highest "early retirement not for financial reasons" rates. Number 1 was RN's, number 2 was heavy equipment operators. Notably, these 2 had the same injuries preventing work. (I'd heard the same thing long ago from a rehab doc). Of course, all this was published after I was already disabled from back injuries. Nurses are just a commodity used to make money, which irks me because what other profession works so closely with people. Had I kept to my original plan of becoming a NP I would have been so much better off. I'll try to post a link to the study I mentioned. Be warned it's 60 pages of the most boring reading you can find. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/117396/wp331.pdf or you can read the synopsis below. I know of many people who became nurses as a stepping stone to other careers.

I've been impressed by less than 50% of the PA's who've treated me. Only once has a NP disappointed me. When my parents were alive they raved about NP's. NP's have more autonomy, too. Of course the PA's are jealous!

Talk to a NICU nurse. Babies die if they don't get human touching. All people need the occasional human contact. Anybody that is afraid to touch a pt without gloves might benefit from therapy. In the mean time, beware of door knobs! IMHO.

Ash, how are you doing? Been wondering. Paul.

Learning opportunites come in strange shapes and forms. In your shoes (I wish) I would turn to humor. When someone throws you a challenge about your age, run with it. "Yeah, due to the nursing shortage they're now giving candy stripers nursing licenses! A little poke here. # tubes of blood and you're out of here. I'm over 6 feet tall, male. I went into the lobby looking for a patient. As I passed one of the street people waiting he loudly said "everyone knows all the male nurses here are gay." I replied just as loud "that's true! And yet, here you are." This will get easier for you with experience. If you're losing sleep or having nightmares it may be time for a job change. No job is worth that. You didn't get this far without being strong. You can let people put weight on your shoulders, or you can find another way to handle it. After all you are a fully competent nurse, and that doesn't change because some people are rude. Find ways to manage it. In nursing like in life, there's always a new challenge. Challenges seem really huge till you come up with a solution, then they seem so small. Wishing you a long happy career. Paul.

This is Trump Care's new idea for an ambulance!

What did you expect from someone who saves lives? It's not like I throw a ball through hoops or hit balls with a stick!

Oh yeah? Well, have you ever considered nose reduction surgery?

Excuse me sir. I'm a nurse, not a cartoonist. Can you think of a funny caption for this?

Answer to your question is yes. I worked with a doc who insisted that there must be wheezing for a person to be having an asthma attack. I got him to listen to a patient in triage who had no wheezing. He failed to notice that the patient was barely moving air at all. After the first neb treatment, the patient was able to move enough air to wheeze. The doc conceded he was wrong. Anyway, the moral of the story is whatever you hear is what you chart. I'd charted breath sounds absent initially on the above patient.

Diagnosis changed from polymyositis to rheumatoid arthritis. I'd been taking motrin, Tylenol and ultram every 8 hours to keep working that finally my body had had enough. To paraphrase a sign I saw; once a nurse always a nurse. It's like being in the mafia. You can never quit because you know too much!

The University of Michigan did a study to identify the occupations with the highest rate of non financial retirement. Registered Nurses was number one, Heavy Machine Operators was second, and transportation (truck drivers) was third. The study is 60 pages long and very dry reading, but can be found on the university's web site. A rehab doctor told me that he sees many nurses and construction workers, and they have similar injuries and needs! Where have all the old nurses gone? They're disabled from the strenuous work they did. By my mid 50's my back was shot from arthritis. I loved ER nursing and always thought I'd work till the day I went to punch out and a coffin was waiting for me.

Thanks for the reply. The irony just dawned on me that now I need my fellow nurses to help me with my identity crisis.