CeciBean

I had a temporary colostomy for 4 months after a partial colectomy where the reanastamosis failed. I hated it. Then when they did the reanastamosis I got a temporary ileostomy for another 4 months to allow it to heal properly. I hated that even more because it was impossible to get a good seal no matter how hard I tried and it leaked and was super messy. When I was in the hospital after the surgery that resulted in a colostomy, I asked a nurse on the second day after my surgery to please change my bag for me. It was not during the time when I knew she would be most busy but I felt she was unnecessarily nasty about it anyway in the way she asked me who was going to change it when I got home. I told her I was, but I still needed some help as it was new to me. She said, "You are a nurse, aren't you?" and I said, "Yes, and it's different when it's your own." I was tempted to speak to her manager about her attitude but I didn't. Please remember that even if your patient is "in the same business", so to speak, they are looking at things from a different angle and it is all new to them. Even if they have experience with something, it's different when it's them that's experiencing it.

30 years in grade in all kinds of units, mainly critical care/stepdown, and I've pushed Ativan a zillion times. Slow push is recommended. You did the right thing, helped her relax enough to let go. So often anxiety about leaving us behind makes our dying parents and loved ones not want to let go, and drugs like Ativan can help. And the fact that the morphine was making her sick was aggravating things. (They better not give me any, I will immediately puke all over everyone and everything!) You did right by your mom and you can be at peace about it. PS: That other nurse didn't have a clue what she was talking about.

I'm retired now (thank all the gods and goddesses!) but all that toxicity COMES FROM ABOVE and filters down. There is one word you need, and that word is NO. When I worked PRN I used it a LOT, especially at one hospital. I am a past master at it. The other thing to do is examine the entire system. Why do we need a BS in Health Care Administration, of all things? Those people are about as useful as a screen door in a submarine unless you reform the whole curriculum, and I have thoughts about that which I could write a whole article about if someone would like to hear it. Degrees in Health Care Administration should start with a Master's and should be restricted to people with a health care background and experience, plus a bachelor's in a health science field. Stepping off my soapbox, for now anyway.

Silverbells can do this, but since, as she noted previously, there seems to be some favoritism at play in regards to this nurse, it's possible that things would go badly for her if she did. I would suggest that she might need to be the one with one foot out the door....to go job hunting. If she has an exit interview when she's found a new job and given her notice, she can say why. Not that it is likely to make a whole lot of difference, but putting it out there sometimes helps correct the problem for the next person, especially if her work has been good.

No, no, no, and no....unless you absolutely have no idea what you want to do, and most of us do when we graduate. (I made a big mistake and paid dearly for it, but that's another story.) I ended up where I probably should have been in the first place, ICU, and did well from there, eventually going on to home health where I honed my assessment and people skills and then on back to ICU and into a rewarding career in cardiac nursing. In retrospect, here's what I really would have done, I think, all things being equal. You see, I wanted to be a midwife. I mean, really wanted to. However, at the time I graduated, midwives were having an awful time, getting beat down from every direction--the public, the OB/GYNs, even the educational establishment to a degree. The closest place I could get a CNM degree was an HBCU in a city 4 1/2 hours away, which would have meant leaving my family (3 school-age children) during the week. My late ex brought the hammer down on that, of course. Not only was I not doing that, I was not going to an HBCU for anything. So I chose another field which was a big mistake. I should have just gone on and done L&D at a hospital in a nearby city and bided my time until the kids got bigger, taken all the preliminary courses I needed, and busted out when they were older, because the CNM degree became available at a nearer institution later on. However, hindsight is always 20/20, is it not? And my other career enabled me to travel just as well. So my advice is, if you know what you want, GO FOR IT. If not, the Med/Surg year is an option, but keep your eyes wide open. You will likely find something else.

I worked for an agency that at one time leased a bunch of vehicles and required us all to drive one of them, even take it home at night. The nice thing was that they provided oil changes etc. The bad thing was that even though we had to record mileage, we didn't get paid for it. I think it was for 2 years. (This was at the time the agency was getting too big for its britches, but anyway.) I didn't like mine, it was a white Ford Escort and got dirty frequently because I was always out in the country, but it saved me from messing up my car. I am in the habit of naming my cars so called this one "Ancilla" (Handmaiden). When the lease ran out I told the director I would resume driving my own car. That way I got paid mileage.

I hated my first job in a big regionally well-known hospital (that I thought I would love) and ended up resigning after 4.5 months. I was so burned by it that I didn't work for 3 months. I then went to work in a smaller local hospital, but foolishly I chose to work in the same kind of unit. That did not work out either and rattled about that hospital a bit until the ICU manager saw something in me and took me under her wing. Long story short, I learned I was good at managing one-on-one and pretty critical stuff, and I learned some good critical thinking skills. I later took this into home health where I stayed for a long time. Fields like that, or possibly PACU, are good if you aren't happy in a med/surg setting. But stick out where you are until June and then make the jump. It's the dead of Winter now and everything looks awful, but things will brighten up soon.

EXACTLY! Seems like someone else fell down on the job...or got busy and just forgot.

I got fired from my last travel job on Christmas Eve. It wasn't exactly my fault either. I'd been pulled from the unit I normally worked in--there were 3 travelers and it was not my turn and I said so, but whatever. So I went where they told me and started my assignment, which was horrendous. Barely got report, but one of my patients was a really nice man who spoke Spanish mostly and we were having a good encounter with my rusty Spanish skills when the supervisor burst in and started hissing at me. She got me in the hall and started yelling at me that this unit was not where she had told me to go. I told her that my name was on the unit sheet (it was) and she told me to stop arguing with her and "just go home, get out of my sight!" I did...it was Dec. 23. The next night I went to work as usual and the charge nurse in my unit looked at me with surprise and said did I not know my contract had been terminated. I didn't; neither the hospital nor my recruiter had had the decency to call me. I went back to my apartment and started packing. It wasn't until two days later that I heard from the recruiter and then it was "We are so disappointed and you will never work for our agency again!" She wouldn't even listen to me. By that time I didn't even care. It was a horrible disorganized hospital and such a bad agency. I had only taken that assignment because my usual one hadn't come through yet and I needed money. I moved and went permanent after that.

It kind of depends on the hospital. I worked in a couple of hospitals on cardiac medical units where the ratio was 4:1. In one of those, the unit was divided into pods where there were 4 rooms. The other was a standard floor and the ration was 5:1 on nights. The first one, where I worked as a traveler, was kind of an aberration for me but I really liked it. I've never seen another one like it. Each pod had a pyxis and a supply unit. They were ranged around a central desk where the charge nurse and intake nurse were stationed and where the docs did their thing. Did I mention this was a teaching hospital? I totally loved it there and the regulars seemed to also. The other was the medical side of a dual unit that was king of attached to the CICU--the other was cardiac surgical and functioned mostly as the stepdown for the open heart post-op, but we both had post-cath cases. I liked it really well too, and the only reason I left it was that I separated from my late ex and became a travel nurse. Unfortunately that hospital was absorbed by a large corporation and is now no more. As a traveler I worked on a lot of cardiac/tele units and they totally varied. Some were stepdown and some were not. Stepdowns are the best kind and are generally less crazy. That's my experience. The other thing that will make or break you is your preceptor. Hopefully you get a good one.

Absolutely this. When I was new (and being bullied by my preceptor, but that's for another thread), I was trying to hurry because said preceptor was literally on my heels. I had two IV piggybacks of the same antibiotic, same dose, same time, different patients in adjoining rooms. Preceptor got busy with something, told me to hurry up and go hang them and meet her in a third room because that patient was having some kind of problem, I forget what now. Well, wouldn't you know it, I hung the bags on the wrong patients. It was so crazy that night and I was so stressed that I didn't even notice. Preceptor didn't check behind me either. Somehow another one of the new grads, also a notorious bully, found out about it and spread it all over the floor. Needless to say, the rest of my time there was not pleasant and I ended up leaving. Do NOT allow yourself to be bullied! By ANYONE! And if you are, speak up, and furthermore, report it. I applaud you for going to float pool. That's a really good way to learn, if a hard one. Hang in there.

I worked in home health from 1990-97. When I first started, home health and hospice were together. There was a pretty seamless transition if one of our patients was made a hospice patient; they had the same nurse, the same aides, everything. They just had a different level of care. It was much more comfortable for them and their families. We would also get some patients who were admitted directly as hospice patients. At the time, we had 7 nurses in our agency who had regular teams plus a weekend and an evening nurse who covered most visits that occurred during those times. That meant basically that every nurse with a team of patients usually had one or two hospice patients in their patient load. We received regular inservices on hospice topics as well as on other home health topics, and it worked well for all of us. I felt then, and I still feel, that the worst thing Medicare ever did was to make hospice a separate entity. Our patients did too. We had instances where patients would refuse hospice care because they didn't want to change nurses and I can absolutely understand that. As nurses, we would have group discussions about our patients, especially about those who were near death. Those discussions helped us handle our own emotions, because of course we were often pretty attached to patients we'd had for a long time. But also, I think, as home health nurses in those days, we recognized that death is a part of life. Most of us in that agency were experienced and were not young so that may have helped. With respect to my own family, my experience was mostly positive. Both my parents lived into their 90s. My dad had dementia and had been hospitalized with pneumonia right after Christmas just before his 91st birthday. We made him DNI at that time but did allow aggressive antibiotic treatment. (Since then, my brother, an internist, and I have agreed that we probably should have gone with supportive care and just let things run their course, but hindsight &c.) He got better and was sent home, but a couple of days later he fell and the home care aide couldn't get him up. At that point his doc and my brother decided he should go into the hospital and be admitted to rehab. Well, rehab, at a wonderful veteran's rehab center/nursing home, lasted exactly 3 days until he informed the therapist he wasn't going to do it...and when Dad said he wasn't going to do it, that meant he wasn't. So he was moved to the nursing home wing. Mom and the dog visited frequently. The last picture I have is of him asleep with the dog curled up beside him. He was DNR and died about a week later. Mom was able to stay home with live in help who became like family to all of us and still are. She declined slowly, went into multi-infarct dementia, and died at the age of 95, having been placed on home hospice about 3 months before her death. She had contracted some kind of viral respiratory thing and had stopped eating and drinking. I was not able to be there, but my daughter and her husband were with her. It was apparently very peaceful. That's how I would wish to go.

Sounds like a smart move. When I'd been a nurse for 20+ years and had a pretty solid cardiac/tele/ICU profile in my pocket (and was leaving my then-husband) I decided to become a traveler. I never regretted that move. I traveled for 3 years and loved it, learned a LOT in that time. Once I got in over my head in a unit that was poorly managed and I honestly wasn't equipped for, but I muddled through and didn't get my contract canceled, and all the other times, except the last one, were pretty great. You learn something new at every place you go and often you teach them something also. After the 3 years I relocated and settled down for a couple of years and thought I'd be there permanently, but the man I was seeing changed my mind for me ? I moved again but couldn't find a job here, and I was thinking about contacting my recruiter and becoming what's called a "local traveler" when I got sick and had multiple surgeries and ended up retiring, but that's a story for another time. Traveling is not a bad gig either. There are online forums that can help you decide about agencies and hospitals, and you can often get gigs locally or not far from home. Being able to take care of your patients and not having to be involved in hospital drama and politics is THE BEST.

Yes, hospitals absolutely ARE abusive employers! The farther away I get from them (now retired 6 years, volunteer work only) the more I see it. At my last job, I had joked with a co-worker about calling in on a certain shift because my gentleman friend (now my husband) was coming into town. I had fully intended to come in because he was going to be there for a couple of days, but as luck would have it, I woke up with a raging UTI (complete with nausea, vomiting, excruciating back pain, and fever) that morning and had to go to urgent care. I called in from there and was threatened by my manager that I would be fired if I didn't bring in a doctor's note THAT DAY. I dragged myself in with it and then went home and went back to bed. The same year, a co-worker was hospitalized with meningitis in that very hospital (on a different unit) for two weeks, and on her return to work was "counseled" and written up for "excessive absences". REALLY, people? Y'all talk about strong nurse organizing, but do you realize how many states are "right to work" (or as my late ex would say, "right to slave") states, in which the power of unions is slim to none, or there are NO nurses' unions whatsoever? That state was one of them.

I understand him wanting the social distancing, however if he is not showing supportiveness in other ways it may be time to re-evaluate your relationship. Is he still calling, e-mailing? sending flowers, or doing little thoughtful things, or is he distancing, period?? Look at that and then ask yourself if the relationship is worth continuing.