coffeemamaRN

Thank you to everyone for your responses, I really appreciate the different perspectives. To me, it seems like all around, the doctor should have referred the patient to ER immediately. In this case, it was my youngest brother who went through this. The symptoms developed over a couple of weeks. His breathing was not compromised, just his ability to swallow and talk. I did not include the type of cancer he had, but it was a malignant brain tumor at the age of six. He was in remission for all this time until these symptoms occurred. The doctor was aware of his history, yet still prescribed Robinul and referred to GI. After almost two weeks, he went to the GI appointment, who was the one who told them to immediately go to ER. As to why my parents would take him to the outpatient clinic instead of ER...I don't know. I can only think that maybe it was a certain level of denial in hoping that it was a temporary ailment that would resolve, rather than a return of his cancer. Unfortunately, it was a brain tumor even larger than the one before, and it is terminal. He is on hospice care now. I guess I'm still trying to come to terms with the whole thing, especially trying to figure out why the doctor would advise my parents the way he did. He is also the same doctor who told them that he no longer needed follow-up CT scans, despite the high risk that his childhood cancer might return. So by the time he had his symptoms, the tumor was too large (plus there were other smaller tumors present). I know that if it were different, it doesn't necessarily mean that my brother would have survived. But I still do not understand the doctor's reasoning behind all this. Anyway, thanks again for all the responses.

Just curious to know what other nurses think. To me it sounds obvious, but maybe I'm missing something... Let's say you have a patient in an outpatient clinic with the following symptoms: he cannot swallow, cannot talk, and is drooling because he cannot swallow properly. He never had problems with swallowing or talking before this. He is in his 20s, and has a history of cancer when he was a child. No facial drooping or other symptoms present. As a nurse, would you recommend: A)the patient should go to ER immediately for further evaluation, and it is most likely neurological rather than a GI issue Or B)the patient should be prescribed robinul and referred to a GI specialist. To me, A seems obvious. But in this case, the doctor went with B, and I still don't really understand why. Any insights?

I have been a nurse for two years now, as a second career. I first got a Bachelors in psychology and then decided to go back to school for nursing (my ADN, planning to go back for my bachelor's soon). I am married with a 13 yr old, an 11 yr old, and a baby who is 8 months old. I am lucky that I am able to work full time while my husband stays at home with the kids, but I have many coworkers who have children and usually have daycare or a trusted friend or relative to take care of their kids, or they alternate their schedule with their spouse so that one parent is always with the kids. I am a worrier like you, so here'so my advice to you: first decide if nursing is really what you want to do. For me, I am like you, I really wanted a job where I made a difference. Nursing definitely fits that description. It is stressful and you have to deal with a lot of crazy situations (being short staffed, rude doctors or family members, confused and combative patients, etc), but you also have times where you realize you are making a difference and it is worth it (patients and family members who thank you for your help, coworkers who are supportive and work well together, doctors who respect nurses as colleagues, etc). Once you know that nursing is something that you really want to do, you can figure out all the details after that. If possible, finish nursing school and work full time first, before having a baby; it will be easier to go down to part time or per diem after working full time for awhile and getting experience. But even if you have a baby first, you can finish school and work full time (I did); it is very possible, just harder. :) I know a few women who had a baby while in nursing school, and they were able to finish school. Try to develop a support system of friends and family members if you can, always helpful during challenging moments in life. As for getting nervous under pressure, I am the same way. I did fine with lectures and tests, but during clinicals I always got so nervous passing meds while the instructor watched me. But you just take a deep breath and make sure you are prepared; as long as you are prepared, you should have confidence in yourself and your abilities. And the more experience you get after you start working, the less nervous you become. Hope that helps! I think nursing would be a good idea for you, it is a good job where you can make a difference, it pays a decent salary, and it something you can fall back on even if you decide to stay home as a mom later in life. Good luck!

Oops, sorry! Next time I will knock before coming into your room!

Only three more hours until my shift is over and I finally have a day off...after three days straight of 12-hour-shifts, can't wait to start drinking! :)

1. Some patients want their pain medications on the dot when they are able to have them, even when it doesn't seem like they are in pain; while other patients don't want pain medications at all, even when it seems like they are in pain. 2. No matter how long you've been a nurse, you don't know everything and there is always something new to learn. 3. Although there are doctors who are complete jerks, there are other doctors who are very, very nice. The same thing goes for patients and family members; some are awful and always complain all the time, but then it makes you grateful for the ones who are nice and friendly and seem thankful for all the work you do. 4. Many patients have amazing stories about their lives, and my favorite part of being a nurse is hearing those stories and getting to know my patients. 5. The best thing I've learned since becoming a nurse is that being a nurse is the hardest job I've ever had, but also the most rewarding.

Yes, I finally started an IV on my own without any help! Maybe I can make it as a nurse after all!

That their colostomy bag is leaking everywhere...again...

First I just want to say that I love being a nurse. I have been a nurse for almost two years now, and it is the hardest job I've ever had, but the most challenging and therefore the most rewarding. I became a nurse as a second career, after first starting off with a BA in psychology and then working random jobs that had nothing to do with my degree (from being a daycare teacher to working in a medical billing office doing data entry). I love the feeling of making even a small difference in someone's life, and I love the challenges and variety of experiences I have from day to day. However, there's no denying the fact that nursing is stressful. I work full-time in a long-term acute care hospital, and bedside nursing, especially med-surg, is crazy busy almost all of the time. I worry about the long-term effects of stress on myself, and I'd love to hear more experienced nurses' advice on how you deal with it. I'm already starting to get high blood pressure, and I'm only 34! Plus, I'm married with three kids, including a baby who is four months old, so my days off aren't as restful as I'd like them to be. I see nurses who have some bad habits, even though they know better (smoking, eating junk food, binge-drinking alcohol on days off). For me, I tend to eat more junk food than I should, and I sleep a lot on my days off. How do you deal with the stress of being a nurse, and how do you balance work with family life?