Hollybobs

Yeah, I respond along those lines too. I usually say that I think it helps if nurses are more intelligent in addition to being "caring" because of the complexity of clinical decision-making in modern nursing. I thought that before I trained, I think that now. I've heard it a lot too: from other nurses during my training, from doctors, from many people. It's usually meant as a sort of compliment and most people don't really know what a nurse does so I'm never offended by it. Becoming a nurse was a very carefully considered decision. I like my career, I'm never bored, which is important to me. I don't want my job to be my life. It was much cheaper and quicker to train as a nurse. We also have a flexibility to change specialities that the medical profession don't have. And it is a very powerful position from which to make a difference and help others. Sometimes I will explain these things if someone is actually interested in why I chose to pursue nursing rather than medicine. There have been a few times - not many - when I've thought I made the wrong decision- they are paid more, better respected and the work looks very interesting. Sure you aren't tempted OP?!

What Katie MI said. Also, if you can't afford it weekly, do it once a month or every 2 months. If it is possible, learn and understand the logic and principles behind the exercises you are taught then make your own routines between times. It is KEY for getting out of the pit of pain and decreased function (when that is a physically possible). Sell something, do without something else, do an extra shift per month to pay for it, anything. Personally, quality PT was essential and allowed me to remain in work. Financially, it therefore paid off long term. A good therapist will be all about empowering you and giving you the tools to apply correctly in your own time at different stages of your recovery. The bulk of my therapy was done by myself at home and out walking. I understand you may have different needs. I wish you luck.

I don't see any unprofessional conduct. She may have genuine and valid concerns about you as a prospective employee. She may not have given any negative feedback about you. The RN may have objected to you. Any history of passive aggressive behaviour may be because she doesn't like you or doesn't respect you. I wanted to offer a plausible alternative perspective as there a lot of assumptions in what you've said. To answer your question on conflict management I'd echo the previous posters. Be professional by focusing on getting a job then doing your job well. Even if someone is behaving needlessly maliciously (which she may well be) the best response to that is to be good at your job. People generally respect this whatever they think of you personally. Forget about her a little, don't let her take up any more headspace. If you want and you think it might help then you could speak to her directly. I don't think from what you say that it would have a positive outcome but if the situation really frustrates you, you could try to find out what she is actually thinking rather than guessing.

They complied and gave you a new post?! Very pleased to hear that. You've done really well, it's hard to fight when you are recovering from injury, nevermind win. I hope you enjoy your new job, it might be quite fun! :).

I saw this and found it very heartwarming... I found it a nice symbol of progress and just lovely. It doesn't make me less upset about Orlando but it was a little light in the darkness.The more people realise we have more similarities than differences the closer we get to a civilised society.

No probs! I really like the WILTW threads btw :)

Hi Ixchel, there's a few questions there, they might require quite a lengthy reply! In my experience, in the NHS (non-private) hospitals, patients don't often refuse to leave hospital but it can happen. It isn't that comfy in our hospitals, there are no fitted sheets or comfy blankets- everything is clean but minimal. There is often a lot of noise at night and during the day with new admissions or transfers taking place at any time in the med/surg equivalent. Patients are mostly in shared rooms, there can be 8, 10, 12, maybe more in a large area called a "bay". Bathrooms are often 1 per unit. TV is very expensive. Food is often not to people's tastes and there aren't always cold or hot drinks offered between meals, depending on staffing. Snacks are in theory always available 24/7 but not always offered. Water in jugs on bedside tables gets warmer throughout the day and isn't automatically topped up, again it is dependent on staffing and there often isn't ice. There are usually very strict visiting times. Our top priority as RNs is the patient's clinical/medical health and safety. There are rarely resources for more than this. However! Sometimes patients prefer hospital with regular meals and cheerful nurses for company to home. The nurses and Dr's explain to them that it is medically time for them to go. That they are better at home and there is a greater risk of infection in the hospital. They explain the bed is needed for another person who is unwell as they were. That they cannot justify the use of national resources when there is no medical indication. More and more senior staff are brought in to explain this and talk through the patient's worries until the patient agrees it is time to go. Security can be called if needed but senior staff have excellent communication skills rendering this unnecessary- I haven't seen this used. Sometimes "bed-blocking" occurs where it isn't possible to discharge someone as there is no appropriate place to discharge them. For example, a patient might require a nursing home after hospital and cannot safely return to their usual house. Relatives have been known to drag out the process of choosing a nursing home so the patient will stay in hospital for many months. Social workers are involved and many meetings are held to try to fix this situation. Sometimes people are discharged too early and return to hospital unwell. The incidence of this is monitored in an attempt to keep "unsafe discharges" to a minimum. If an RN feels the patients needs to stay for medical reasons but the MD says the patients needs to leave, the RN needs to produce valid concerns and a meeting can be held for a discussion. Ultimately, the Consultant decides and is responsible for an adverse incident that might occur after discharge if it could have been predicted to happen. The RN's role is to flag up any concerns and advocate for the patient. Physio's and OT's also play a very important role, they can assess and assist in planning as safe a discharge as possible. If your British friend were in the UK and had strong concerns about being discharged too early after surgery, they would be encouraged to voice their specific concerns. If for example the concern was pain management, their meds would be reviewed, they might be reviewed by the pain management team, expectations would be checked, the wound site would be inspected, an x-ray or scan might be called for if the pain was disproportionate to that expected, we'd work with the patient to see what helped or hindered etc. If something could and should be changed, it would be. If the pain was as normal for that stage of recovery, after advice was given we'd reassure the patient that was normal for many patients. That's just one concern, but it would work the same for anything. We don't discharge until the patient is clinically well enough (i.e. staying in hospital won't make them any better than being at home) and until they will in all likelihood be safe at home. If you considered a patient not ready for discharge in your opinion as an RN, we wouldn't either, for the same reasons as you. Edit: Just realised I had said nothing about medical bills. We do have some hospitals for privately insured patients in the UK and we have a very few patients in the NHS who pay privately- I don't know how payment works at all, I'm sorry. Who pays the bill for those in the NHS who stay over what is medically advised? The same people who pay for ALL the treatment and hospital stays; the tax payers.

Kooky, you've "liked" my post- I didn't mean you. I'm not going to apologise for that because I think your posts have been offensive and at times, cruel. I don't know what has driven you to post all the things you have especially when speaking directly to DV and sexual assault survivors. Nurse after nurse has told you they are offended and/or sickened. I am both. Just stop it? Separately, I do wonder if anyone who needs the tea analogy to understand consent will never understand it.

Me too, I've checked this thread daily. It seems silly to use the word "proud" but I have felt very proud of my fellow nurses who have defended (and it should never need defending, it should be entirely self-evident) a person's right never to be raped. And maintained that defence in a passionate but articulate, logical and eloquent manner. Thank you from me as well.

I presume the weeks where you use four are ones where you don't see your dear sister-in-law?!

Yes, me too. I firstly try to listen carefully to what's being said. This can be hard, as you say OP, as strong emotions can rise up very quickly. I want someone to feel they can let me know something potentially useful again, I also don't want to miss an opportunity to learn from feedback even if awkwardly given. Feedback can be a real and unique opportunity to improve, the blunter the better sometimes. So I focus on nodding and listening. If I don't respond instantly and just listen it gives time for any anger/hurt etc to die down. Secondly, what I've learnt to do is NOT automatically assume the other person is correct. I will examine what has been said carefully and potentially get another perspective if I am unsure if the criticism is valid. Then I change what I can change. In summary, it is easier not to respond emotionally, if the criticism/feedback is only allowed into a "mental antechamber" or "entrance hall" and put on hold until you can decide how useful or relevant it is. It doesn't go straight to your emotional core that way. If you're looking at the AllNurses site also watch how well posters can respond to even very blunt feedback, people can be impressively gracious at times.

I went looking for an applause icon. This was the nearest I could find...

Thanks NotAll, I have been sometimes going anyway more recently. I don't think anyone would mind really and I don't think it is snooty- just don't want to risk making a bad impression. I have always envied those nurses with that gut instinct thing. I don't have that. I see and can specifically identify slight changes in trends, resp/heart rhythms, colour, sounds, consciousness level, acute confusion, limb power differences, changes to speech, level of drowsiness etc. I wish I had that clever intuitive overall feeling which is, like you say, made up of the information you've received subconsciously.

Being a HSP doesn't indicate a lack of resilience, that's a separate trait. It isn't the same as shyness, fragility, introversion, anxiety or PTSD. Crying in cupboards could mean a wide range of things. I have loads of the stuff on the tick list and have been like it since being a child, whatever you call it I just accept it as part of my personality. It doesn't mean I'm not tough or can't work in any environment I want to. As has been said it benefits me greatly as a nurse. I pick up pain or discomfort quickly and can help correct if it is an environmental factor. I pick up deterioration early and patients rarely code under my care as I am highly alert to initial warning signs. As cani says, it is irritating because sometimes I can let the Dr's know the small signs but they won't respond at this stage. I do over identify with pain and distress and experience very unpleasant physical and mental sensations until my patient's pain is under control. Dealing with others' grief is something I have had to learn to manage. I have to do stuff like visualising scissors cutting an imaginary ribbon connecting me to the grieving patients or relative so that I can be there for them properly. Really firm boundaries and leaving work concerns at work is something I've only managed recently. Out of preference I'd have break time on my own, out of wishing to not appear snooty I have break in the communal area. I NEED my downtime/ alone time and my performance drops if I don't get it. Everything happening at once is not the easiest- I tend to evaluate those situations afterwards, break them down into their component parts and then the next time I can look like i'm a-okay. Pro's and con's. IMO, with adjustments, it makes me personally a better nurse. I hope so!

After an hour the pain relief kicked in?? I think better post-op pain control for your PACU patients would reduce the swearing you find so unpleasant. It isn't really okay to ask him, no, not for the sole purposes of addressing your own comfort levels as you've reported. He wasn't swearing at you. Unless it was offending another patient or there was a child nearby, it's a small sacrifice to make. And interestingly, it seems it might help cope with pain as PP's have said. Also, bear in mind the meds given peri-op can lower inhibitions, decrease ability to make decisions, temporarily change personalities and also cause loss of memory. As a PACU nurse you must have experienced patients telling you intimate details of their lives that perhaps they wouldn't usually? Similar sort of thing.

Confidence? It will come with time and becoming competent. One month in and it is natural to feel like you do. Asking questions? It is tough when you feel like you're annoying someone but there is no way around it. Research the answers to questions you have in your spare time (obviously not not if urgent/emergencies) and any you can't answer then you have to ask. It is part of your role and you will always have "to bother" someone, whether it is asking a Dr or waking up a tired patient for an urgent reason etc. Bite the bullet and just do it. There comes a point when you don't need to ask many questions and voila!...you are a competent and well-respected member of the team. Focus and memory? These problems are partly arising because of stress and many thoughts and feelings whirring around. One way to fix this is mindfulness. So with each task, don't worry about the impression you are making or how well you are doing or any other worries. Just focus on collecting equipment, speaking with your patient and each step of the task. Between tasks, think about what order to do the next tasks. If other thoughts come into your head which aren't relevant, put them to one side until the end of the day. In your spare time do whatever you need to do to manage your stress and have fun- preferably in a healthy way. I promise this stuff helps! I've done all of this :).

Got a bit carried away once I started! Enjoying this thread :).

You are the circumflex, to my left coronary artery You're the RCA and LAD, to my triple surgery you're the VT to my shock you're the bundle to my block you're the node to my ablation you're the pacing to my maker You are the qrs to my every p, Without u? I'd have no t.

Definitely. And there is a really good thread on this forum from a nurse who also wanted to be really healthy and feel good. She goes into detail about how she managed it too. Found it! https://allnurses.com/general-nursing-discussion/from-night-shift-1046263.html

Absolutely the case. I was taught to practice so that if in a court of law we were asked "why did you complete clinical skill x in a particular way?" that I could respond with a sound, safe and logical rationale. You can rarely go wrong with local protocol as the foundation of your practice, you just have to become very speedy if you want to follow it to the letter. I've rarely met a nurse that does this and never anyone who is not behind at the end of the shift. You're asking a question that many good nurses ask when they start off and I think if you continue with this approach you'll become one of the much-beloved RN's you admire :). I've developed my clinical skills by reading theory: journal articles, recent and well-respected texts, local clinical protocols and the underpinning anatomy and physiology. I've also watched a lot of different nurses do things in a variety of ways and I try to pick the way that is safest and most efficient. I will also adjust for the effect on my patient, stay open to new ideas and I'll discuss the pro's and con's of different approaches with colleagues. It is fun :).

Why wouldn't you report it? That's not intended confrontationally, I am just wondering if you have extra concerns i.e.. you promised you wouldn't etc. I'd let the nurse in charge of the shift and the responsible MD know and send an urgent psych referral. Are these options? Ah, just read the "off-duty" bit. Do you mean a friend/relative/acquaintance or a patient? You can always ask their permission to tell someone. If they say yes, that makes it all simpler.

It depends what you want out of your career, I guess. I wanted to work with people, look after them and hopefully make a difference. I wanted a half-decent wage. It was really important to me not be bored- the idea of no day being the same and all the human stories you can hear really appealed to me. I like being challenged and needing to learn. If all those criteria are met then I am a happy bunny. I sometimes envy "abilities". As Tricia said though, it is less that I'm jealous and more that I'm inspired by others. I observe other nurses who do things better than me to try to copy them e.g. someone with cooler head in a crisis, someone more patient, someone more confident, even someone who can lip-read better than me! I don't measure mine or others' success by how glamorous-sounding their job is. If you are a fantastic nurse working in the ED, in ICU, in LTC, med/surg, hospice, community etc etc then you are successful because you are helping in so many different ways. You are making an impact on your patients, on their relatives, on other staff, on students and newbies. And that is pretty cool, non?

It is really expensive here. We do use it when clinically appropriate, it can be so useful as PP have said. We are instructed not to use it unless necessary, in order to keep costs down. There are posters up in hospitals to that effect. I tell the patient who is new to it that I am giving them "tylenol-in-a-drip-which-is-very-different-in-effect-to-the-tablet-and-some-patients-respond-really-well-to-it" asap. It helps to minimise that knee-jerk "tylenol won't touch my pain" response.

^^^. Yup.

I am, after due consideration, in favour of nursing students. They are a good idea. Stops us running out of nurses.