Roz, RN

Eighteen months ago, I retired from a 40+ year career in nursing. I absolutely loved what I did. I did not like the toxic environment I worked in. Management demanding way more than one human can do in a 12 hour period, meager pay in return for the responsibility that is taken, lousy hours, short staffing, and the perpetual blame game that usually winds up in the nurse's lap. One evening, my coworkers had a discussion about what is wrong with nursing as a career. All of the above were listed. One nurse pointed out that "It's the same no matter where you go.". I have worked in 3 different states and in every area except OB and Peds. That point is true. No matter what state, facility, shift, or discipline is chosen, nurses receive a disproportionate amount of negative feedback. A pizza and "We appreciate all that you do" during Nurses' Week does not make up for the crap we endure for the rest of the year. Why do we put up with it?? Not everyone can retire when they've had all they can take. I think that, if you want to get out of nursing completely, you need to decide what you want to do. Once that decision is made, develop a plan for leaving your job. You may need to go back to school in order to pursue another career. Will it be worth it for you to work and go to school for the short term? Will you be OK starting out at a lower pay rate and work your way up? What will you do if, after a few years, you hate this career path, too? Will you want to start a new career of go back to nursing? There are a lot of things to consider, so take your time. Good luck.

Keep your sleeping area on the cool side. People tend to sleep better in a cooler environment. As has been stated before, arrange to work yourshifts in clusters, blackout curtains, white noise machines, limiting caffeine are all helpful.

I, too am looking forward to early retirement. In the nearly 40 years that I have practiced, I have seen tons of change. Most of it has not been for the better. We are mandated to use our old paper charting system for trauma patients, even though there is a template for traumas in our EMR. Same for conscious sedation. If we don't copy everything from the paper chart into the EMR, we get dinged by medical records for not documenting. I spend more time charting now than I ever did with paper records! 2.5 years and I'm done!

I had an extremely demanding and obnoxious patient (I drew the short straw that night!) who demanded that I bring him some coffee when I went in to assess him at the beginning of the shift. I had 8 patients (on a PCU) and no tech. I told him we had no coffee on the unit at that time. He told me to go make some. I explained to him that I needed to see all of my patients first and that it might be a while before I had time to make coffee. He told me that I was a "damn sorry nurse". I smiled at him and said that his comment just lengthened his wait time for coffee!

I graduated from college 2 years before we had kids. The day care that my older two went to was wonderful, but each age group had their own fenced in portion of playground with age appropriate toys. I swear, it looked like a kennel! When our third child was born, day care became prohibitively expensive. I went from full time with benefits to part time no benefits. We scheduled my work hours around my husband's. I could still work full time hours, but I could pick and choose which days/shifts I worked. If our shifts overlapped, my parents would watch the kids. We didn't see much of each other for a few years (that may be why we've been married for almost 40 years!), but one of us was always at home. This worked out well for us. Very rarely did one of us have "kid duty" after a day of work.

I earned my BSN in 1980. Back then (Lord, I sound old!), freshman year was basic degree requirements. Sophomore year we learned basic skills; bathing, occupied bed change, physical assessment in the fall and moved on to first year med-surg in the spring. Junior year was OB/Peds, Surgery/Med-Surg II. Senior year was research, Critical Care, Psych. We were well prepared for NCLEX and the beginning of our careers. We got six weeks of orientation and then..... good luck! I cried, threw up, had headaches, you name it! I learned early on that keeping myself organized was the key to happiness! I made myself a graph: on an 8.5x11 sheet of paper, draw lines one inch apart the 11" length of the paper. You should have 8 one inch columns and one .5" column. Now, turn the paper and make one column 2" wide. Space the rest of the columns 1" wide. You should have one 2" column and nine 1" columns. In the 2" column, put room number, pt name, physician, diagnosis. In the first 1" column put any IVs, tubes, O2, stuff you need to be aware of for the whole shift. Oh, that left over 1/2" of space on the 8.5 width of the paper? Number it for each hour of your shift. You may need two pages for a twelve hour shift. At 8, 12, and 4 write "BP" with a line. Put q4h vitals there. In the last box put "I&O". With a red pen, write an "M" with a circle around it each hour that a med is due. I would write treatments in in a different color ink. Three color pens are fabulous! New IV bags and tube feeds got written in when they went up. This sounds time consuming, but if you make a master of your flow sheet, then make several copies, it takes very little time to fill in the blanks. This sheet comes in handy when giving report, too. Keep in mind that we all have days when we go to the bathroom to cry, yell, beat our heads against the wall. Then, we splash our faces with cool water and go back to finish the shift. Good luck to you.

Didn't you know?? Night shift doesn't exist! I've been asking the what about night shift question for years. When reps from our insurance carrier come, no consideration is given to night shift employees. When classes are offered and you have to work the night before and the night of the class, too bad. I was told that night shift gets a differential to compensate for the "inconvenience" of missing sleep to come to mandatory staff meetings.

In all of the Nurses' Week hoopla, night shift nurses are forgotten. We aren't around when management can see us, so we don't exist.

"This, too, shall pass." Whenever one of my siblings or I were having a "crisis" our mother would repeat the above quote. Ma always said it very calmly, but with a twinkle in her eye. There were times when that twinkle made me think "this" might pass like a kidney stone! It made me crazy that she could be so calm. She was 92 when she died. Her go-to quote taught each of her children to be patient. The storm will pass. Sometimes it does pass like a kidney stone, but I always felt better once it did. I think that thought often when I'm at work. This crisis will pass. Another one will come to take its place. Keep your head on straight, use the knowledge that you have worked hard to gain, work as a team. This, too, shall pass.

I was caring for an elderly patient in ICU. She was confused, combative, and loud! I had done the gentle reorientation and reassurance thing until I was ready to join her on the crazy train. I reached the point of total frustration and asked her if she knew where she was. "Of course I do!" She snapped. "I'm at the threshold of Hell!" One of my coworkers said "Well, at least she's oriented to place!".

They are never too old for a trip to the shed! My youngest (he's 31) loves to tell me that I'm old. My response is always "Not too old to kick your butt if I need to!".

I've been a nurse for a looooong time. I have never been able to deal with vomit. The best I can do is to close my eyes, hold my breath, and think happy thoughts! If you feel like you are being lead to nursing, you will do fine.

In most cases, a living will tattoo is not considered legally binding. Neither are tattoos with blood type or allergies. If the patient is unresponsive, how do we know that the information in a tattoo is correct? It is much safer to carry a copy of your living will and medical history; including allergies, blood type, and a list of medications (with dose and frequency) in your wallet. I carry mine with me and update my history about every 6 months.

I've heard the phrase "It's the same no matter where you go." many times. I wonder why we, as a group of professionals, tolerate "the same". Exactly who do patients, their families, and management think will provide complete care if we all decide to quit?

Once, I was assigned 8 patients on a PCU with no tech. One patient, who had already had an ugly confrontation with the hospitalist, demanded that I bring him some coffee. I explained that there was no coffee on the unit and I did not have time to make any right then. He replied " Well you're a damn sorry Nurse.". As I walked out of his room, I told him that his comment would add two hours to his wait for coffee! Set limits with your difficult patients. For those who think the call bell is a Nintendo controller, explain that someone will check on them every hour. Keep a list of all requests and take everything requested with you when you go to the patient's room. Before you leave the room, ask if there is anything else the patient needs. I know it's time consuming, but document everything. Explain to your manager how difficult this patient is. If you don't speak up, you will get dumped on. If the patient violates hospital policy, report it and document it. If the patient gets discharged because she was smoking in her room, it's on her and not you. Better she get sent home than to have that cigarette come in contact with oxygen and blow up that part of the hospital!