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.

I kind of wonder if that's what I had earlier this year. Symptoms were similar but not as severe. It lasted about a week. It was before this "wave" though.

I put in several years in a Top 100 Heart Hospital. I loved it there. And boy, did I learn stuff! Sadly, because of financial mismanagement, that hospital no longer exists. ? I kind of saw that coming about the time I separated from my late ex and went on the road as a travel nurse. During my "travel period" I worked in several types of hospitals, from teaching to smallish community hospitals to large urban "name brand" ones. I found that you actually do have quite a bit of autonomy in the teaching hospitals, especially in the Summer months when the new residents arrive, because you're busy teaching them to be doctors, and sometimes that means you actually have to teach them HOW to do skills....like the time I walked in on a resident and an intern trying to put down an NG tube in a patient who was flat on his back. Really, guys? And no, they don't want to put in catheters, start IVs, or anything so mundane. What I found out mattered, in the long run, was how the unit was set up and what kind of manager it had...and whether s/he was competent. I also learned that "compact" states generally paid lower. Of course most of them are "right to work" states so that probably has something to do with it.

So why not just keep them in the stock room, for heaven's sake? Most places I've worked, the stock room is only accessible with a code anyway.

Especially when they're your manager. This has actually happened to me! Aside from that, and preparation, let's please get AWAY from the "business model" of nursing. In fact, let's get away from it in the whole healthcare profession, please. We are supposed to be about taking care of PEOPLE, not the bottom line. Let's get back to that. And let's go back to proper preparation. More clinicals. Less theory. The old diploma model had a lot to be said for it, and there's a lot from that which needs to be incorporated into modern nursing education. Please don't come at me with the "anyone can learn to blah blah blah in the year after they graduate but they need to learn all this theory first". No they don't. They can learn it concurrently. And you don't need to know calculus to be a good nurse when simple algebra will do, but you do need to know how to make a patient comfortable and how to treat that patient like a human being, not a piece of a profit and loss statement. Okay, rant mode off.

One hospital I worked at as a traveler had a year-long internship for new grad RNs, which I thought was great. When they got out of that, they were ready for anything that came their way. One was getting out of her internship when I was there and there was a big party for her. On the other hand, they gave travelers 8 whole hours. Yippee skippee. I got 3-4 DAYS everywhere else I ever went....mostly tele or stepdown units. Never recommended that unit to anyone after that, for a myriad of reasons.

I made a terrible error when I was a fairly new nurse. It was partly because I misread a doctor's handwriting. He had written an order for 10 mg. of Vistaril to be given to a severely vomiting child, but to this day I will swear it looked like 100 mg. At that small hospital the pharmacy was not open at night and the supervisor had to get the medication. She looked at the order also and signed off with me and went and got the medication. The child stopped vomiting and went to sleep and I went on about my duties (I was the only nurse on the unit because that was how it was staffed.) The next day when I came in to work I was hauled in to the DON's office and interrogated. We all looked at the order and I was told I "should have known" the medication. Yes, that was my fault, I should have looked it up. But I got the blame and the nursing supervisor, who had looked at the order and signed off with me, apparently got off scot free, while I got written up and was transferred off that unit permanently (which was a relief to me, really).

Heck no! I started traveling about that time, and I found that most travelers are either in that age group or quite young and without strings. Some of the older ones traveled alone, maybe were widowed or divorced, others with retired spouses. I had just separated from my husband when I started traveling, and I loved traveling. It was something new all the time. I found my niche in tele/stepdown and intermediate care, although I had worked ICU in smaller hospitals previously and then on a busy cardiac medical floor in a Top 100 heart hospital. You will find that you learn something new in every place, and most likely will be able to teach something also. I was pretty good at starting IVs, and in some of the places I went, they had IV teams up until 11 pm but the night shift nurses were not always real good at sticking so I got a reputation as a pretty good sticker and was usually in demand for that. You may find you have a skill that's in demand somewhere.

I graduated from nursing school in 1986. Out of the 104 students in my class, 5 were male. The only gender bias issue I noticed was that the guys were not allowed in the delivery room, which I thought was weird, since the OB/GYNs in all the clinical settings were almost entirely male. I mean, excuse me? When we started applying for jobs, the guy who was in our study group was getting really depressed because he wanted to start out in Med/Surg and everywhere he went it was assumed that he wanted critical care or ED. One of the females said to him when he was complaining about it, "Now you're getting a little taste of what women put up with every day!" which I thought was pretty valid because that definitely was gender bias. (He worked a couple of years M/S, then transferred to a big teaching hospital CCU and eventually to their cath lab where he is now in hog heaven) Since those days I've worked in a variety of settings and have almost always had from one to a bunch of male co-workers. I usually like it when the ratio is close to 50-50, especially in a critical care or cardiac setting. It just seems more collegial and less (if you will excuse me for being sexist here) catty that way. I've found that majority female settings tend to get fractured and clique-y and I am not a big fan of that. I wish women wouldn't act that way, especially since we are all in this together.

I agree pretty much with everything that has been posted. I'm retired now, but the "nursing shortage" was predicted many years ago when I was in school. So was the BSN-only. And my thoughts about that, after 30 years in the field, 28 active, are this...I trained an awful lot of brand new BSNs, and they mostly came out with heads stuffed full of book learning and not one clue about how to take care of a patient. Oh, I'm sure they could write a beautiful care plan, much better than mine from my ADN school days (I remember mine, they were full of red ink when I got them back!), but when it came to putting that into practice, most of them hadn't the first idea where to start. The exceptions were those who had worked as CNAs, and those were darn few. They had watched and listened, and they knew nursing from the ground up. Now when young people ask me about nursing, I tell them to try CNA work first, or maybe even EMT if they're really gung ho, and they if they still like it, go on and get their ADN and *then* work while they get a BSN, maybe even online. A BSN is a nice thing to have for advancement, but not necessarily a good thing to have for a starter. You don't learn how to take care of patients in a BSN program. You learn how to take care of theory. The last place I worked had a good partnership with the state university in town so that your work counted as clinicals. They also reimbursed you if you got a B or better in your courses from anywhere. As far as a shortage, maybe if our workplaces treated us better, there wouldn't be one. I saw so much when I was a traveler that really made me sick and disgusted with the whole business. I could write a book about it, and maybe I will someday :) What I will say is that the best place I worked had a CNO who had literally risen through the ranks....started out as an RT, went to nursing school and worked the floors, eventually got the advanced degree and went into management and rose to CNO. The nursing culture was completely different at that hospital, and I believe it was *because* they had a CNP who knew what it was all about, from the bottom up. Would that it were like that elsewhere.

OK, here's my POV. If, during initial rounds, for instance, I would find a patient lying in poop but otherwise in no distress, and the poop wasn't all over the bed, I might tell that person I'd be right back to help get them cleaned up, *or* ring for my tech if there happened to be one (I didn't always have one!). If it was a total mess, of course I'd have to attend to it right away and the rest of the rounds would wait a bit. It kind of depended on how many patients I had too--bear in mind that I usually worked in critical care/tele/stepdown, so no more than 5 generally. I often, though not always, found that family members, if they were present, were surprisingly willing to help! But there's a story attached to this. Several years ago when my father was in the hospital one of us stayed with him constantly because he had dementia. We tried to do pretty much everything for him without calling for assistance. He was very weak and required assistance to the BSC, which my brothers could do but I couldn't without help because I am quite a bit smaller than they are. So this one particular day, his nurse was a guy who, years ago, had been a nursing supervisor at a hospital where I was new grad and had chastised me one night for "expecting techs to do things which i could do myself" such as changing patients or helping them to the toilet (never mind I was still trying to figure out then how to do my job and was still always behind!). I recognized his name but he didn't recognize me after 25 years. At one point I rang for someone to help me get my dad to the BSC and was told someone would be there shortly, but no one showed up. meanwhile, this nurse was outside the door in our pod, I heard him chit-chatting with another nurse, and I heard his phone go off....but neither he nor anyone else showed up. I rang again 5 minutes later and it ended up almost being too late before a tech showed up. She apologized, saying two of the techs on the floor had called in. She also ended up having to clean the floor as Dad was in such a hurry. Think I was mad at that nurse? You bet! It would have taken just a couple minutes of his precious chatting time! I almost said something to his charge nurse but didn't. I did, however, leave his name out of the thank-you note I sent to the floor, where I mentioned the other nurses and the techs by name. I know, little revenges aren't nice.