mcclarke

Agree 100%! This is a wage and hour issue, not a "how can the nurse manager save a little money issue"! Report this to your local Wage and Hour Division before they get rid of the whole Federal Department of Labor!

Why rely on a bunch of strangers from all over the planet for this information? Why don't you open Google and search for this information at your Arkansas Board of Nursing website? I suspect the reason is that it is easier to gripe and be a victim than it is to make the effort to get the accurate information yourself. I suspect it was also easier to just leave the floor instead of getting some help from your manager and other staff with you on the floor that day. I mean this in the nicest of ways——Learning to proactively solve your own problems would be a good thing for you to do.

Coping with the death of a patient is part of the process of growing as a nurse. There is no way to get prepared for it ahead of time. The fact that you care deeply is going to help you sort this out and while a patient's death won't (and should not) ever be "run of the mill" you will find your own way to put it in perspective, to offer a prayer if that's what you do, and to offer kindness and condolence to the family if you can. Identify and reach out for support and insight from your "Short List" of nurse colleagues who are caring, trustworthy AND know what they are talking about. Finally as for the questions from management, this will always occur. In so many situations you will see what looks like panic from management, sometimes nurses seem to just like the drama, always everyone in the hospital will CYA. You should CYA too, but know that: as long as you 1. did what you know you are supposed to do, 2. asked your preceptor for help and instruction, 3. kept the preceptor informed and involved and 4.documented ALL OF IT, this management panic will pass without incident. The next event will arise and pass. Learn from all of it and Best of luck!!

Sounds like recently, the pt had a recurrance of his colon cancer, the ileo was closed, and new colostomy required to be placed. The small RLQ drain site was probably from a jp drain, placed during surgery, and removed at discharge. They (jp drains) collect surgical drainage, and are not permanent. Some ostomies are temporary, and then are reversed (some rectal cancers, pt has ostomy until the rectum has healed). usually the ones that are reversed are reversed sooner than 3 years, which is why I am thinking recurrance of coloncancer, in new site.

I went from MSW and 20 years experience to RN Diploma program. Worked as Nurse Aide during school-part time and borrowed $$$ to supplement my income. So ta-dahh!!!! I am an ACTUAL second career RN!! Your post has an arrogance that won't take you very far in Nursing School. Nursing is like NO Other Education. Nursing is art and science, and one had better understand the science if you expect to understand what is going on with your patients. Get over yourself!!! If your credits are outdated--yes---you have to take the class over again.Things have probably changed since you were 15. And don't you think patients deserve someone with current thinking? Some hospitals offer "Tuition Forgiveness" or other programs in exchange for 2-3 year employment committment. The classroom and clinical hours are what the states regulate that Nurses must know in order to give safe care. Or did you forget that nursing means providing competent safe care to other human beings? As for not paying for a second education, because you already paid for one before....Are you serious? Do more research on the profession before you waste your money and other people's time or harm some patient with your arrogant disregard for the knowledge a nurse must posess.

The idea of the screaming MD used to scare me too. I agree with the reply from hogan4736, above, who wrote: "I disagree w/ starting your call off w/ an apology...It makes us sound sheepish and puts us at a disadvantage...It's their job to be on call 24/7...Not MY problem you decided to go to med school......BE PREPARED...I'll take notes before the call...I'll lay out the labs in front of me...Read the H&P before calling...If the pt is dizzy, I'll have orthos already done...Think ahead...We work for the pt, not them..." This is, I think, SO WELL SAID!!!! The writer, hogan4736 has a great plan, and when I call an MD, I try to follow it myself. As a newer RN, I got over my fear of screaming MD's after the second time one of them screamed at me.... I realized that their "screaming" indicates a lack of self-control. The fact is, the screaming MD "pales" in comparison to all of the serious things that can quickly go wrong for a very ill patient. If an MD or anyone else screams at you, their unprofesional behavior says more (negatively) about them than it does you. Over time, the docs who want to work WITH you to help the patient will far outnumber the screamers. From a practical standpoint, and after I do the prep-work that hogan4736 describes, I make the call to the screaming MD. I find it helps me to remember that the # of hours in my shift is limited, and then I get to go home....but this patient is possibly dealing with a life changing event. It may be a long time till they go home.... So, do I focus on the screaming MD, or do I focus on the patient? Naturally, we all know, we focus on our patient. Another thought---Getting through Med School may entitle him or her to a Platinum Amex Card, but it does NOT entitle them to treat you badly!! Hold your ground, stay focused on the patient, be prepared with facts, and you will find that these screaming events are not so significant...You will see your own value! The MD really needs the info you have... You will also find that you are not alone, there ARE other RN's on your shift for you to consult as a resource, and a Nursing Supervisor always in any hospital. Again, documentation IS your friend, and as long as you say focused on the patient--the screaming will subside. Sure, it IS uncomfortable, but it is also TEMPORARY :-) And, it makes for a great story, much later, after you have taken good care of your patient, and the screamer is history... mccmaeve

i don't know if this works, because i never have seen it tried. every hospital has press-gainey (or other type) of patient satisfaction surveys. why not have the department who has the highest ratings for a quarter, reward each staff person-and i mean each staff person: rn, lpn, secretary, nurses aide, unit director, the designated dietician, and food service (delivery-person), the designated housekeeper, and every other staff person who is identified with the department on a regular basis. for example-every one of these who worked on the floor 120 hours in each month in the quarter receives a cash bonus. work is work. at best, people come to work in a hospital in whatever capacity because they care about caring for others. everyone is different, and every job and department brings its own problems. one thing everyone who works can agree on is that $$$$ is great!!! thinking twice before opening the mouth and behaving in an unprofessional manner may be easier when a possible $200-$300 bonus is attached.... wouldn't people work together better if we understood that each person's contribution to the whole may cause all of us to get more of what we work so hard for---cash??? then as all of the staff buy into the concept of customer service and we reap the financial rewards, the positive talk, behavior and atitude would become habit. the employees as a cohesive group would see and reap the benefits (tangible and intangible) of having a united, positive, and professional group. if anyone tries this-please let me know what happens-mcc

When I finish what I am in their room to do-flush a line, give a med, change a dressing, then I say, "What else can I do for you?" They tell me things they need and want, and that seems to let them know 'now is your chance, tell me what you need/want' makes for less time on the call bell.

I work with many very competent CNAs. Eager to provide good care to the patients. Twice I have sent my boss email about jobs well done by 2 CNAs. They are my eyes and ears sometimes, and I could not do my job without them. Like all other jobs-they are done by people, and people are all different. I also work with a few who I don't believe a word they tell me, and I might as well just do everything myself.There are nurses like that too.This isa smalller number-thankfully for the patients sake. I was an NA while I was in nursing school, I know how hard and unpleasant their work can be at times. For the most part-I appreciate my NAs

Agree! I always question the motives of people who want me to know what others say about me...Like I should care!?!?!?!?!?!!!! Focus on the big picture, and facts that are about issues that can be solved.

I did the same thing-Loved Micro!!! Sure it is hard, but it really does change how you look at things! Best of luck!!!!

How interesting!!-I seem to struggle with my 'N' and "p"-in how i gather info, and how I provide info. What is 'obvious' to me as 'N', needs to be spelled out for my colleagues who are 'S'. forget the whole 'P' thing-I just try to leavve that at the door:-) Any advice??

I took the test before Nursing School, in 2003. I am an INFP. My N and P are off the charts!!! Funny you bring this up, because I was just lately wondering how it may apply to my work. The M-B explanation of my personality type made so much sense for me. Being new to nursing, I have begun to think I should re-read Please Understand Me, (The name of the author is escaping me; the book teaches you what to look for in your communication style and preference, and how to listen to types that are different from you). I will watch this thread closely, thanks for bring it up!!!

So glad I found this thread!!! I've been considering a move to Baltimore for several reasons. My sister, age 54 came down with an autoimmune disorder of her retinas, with considerable vision loss. We live in Pittsburgh, and her doctor here at UPMC (where I am a nurse) recently sent her to an ocular autoimmune specialist at Johns Hopkins. My sister works from home, (for a software company) so she can reside anywhere. We both fell in LOVE with Baltimore, and JH. We talk about moving there. Both divorced, and absolutely NOTHING happening for us in Pittsburgh....Love the idea of a vibrant, diverse, progressive, urban setting, and Nursing in THE world Class hospital. I check out their employment website often, but have not applied yet. Is it hard to get interviewed? I just graduated from a diploma school (UPMC School of Nursing) last year, 6/2005. This year I turned 50. For a year, I have been an RN on a Surgical Oncology Floor at UPMC. My interest is mostly skin,wound and ostomy work, and I want to eventually specialize as a certified ET/Wound Care Nurse. This will take at least another year, as I owe UPMC another year for my 'free' tuition :-) In any case, enough 'me about me'---What is it like at JH? And at University of Maryland Medical Center? What are the best sources of info?? Does either place hire energetic, middle aged nurses, with youthful enthusiasm? Any info, or guidance will be appreciated. I am so full of questions, I don't know where to start. As for a neighborhood-Someone said Fell's Point, Butcher's Hill, or Canton, are neighborhoods close to JH, diverse, and 'with something for everyone'. Again, any info about the general RN job situation, Surgical Onc jobs, skin, ostomy and wound care at either JH or Univ of Maryland Medical Center, Housing, relocation, etc will be GREATLY appreciated!! PS: If anyone thinks coming to Pittsburgh is for them-i will gladly share my observations, ideas etc. Thanks !!! mccmaeve

Could not agree more!!! Got my RN at 50 years old-perimenopause and all!!!! It is not the profession, it is the coping that we have to do in our fast paced, 'changing by the second' world. I have had 'treatment resistant depression' since 1994. FINALLY--- My doctor found a combination of meds that get me through each day-bathed, dressed, on time, not in tears, able to concentrate, interested in socializing with others, and actually thinking of something other than how 'loathesome I [probably] really am'! Without the meds, prescribed by my psychiatrist (who patiently tried every combination of antidepressents until he found some that kept me awake, and alive), I may not be here today. As others said, maybe nurses take the meds, because they understand the benefits (and the personal losses of untreated depression). Then we should spread the word-No matter what your job is, there is no shame in taking care of yourself, with meds, yoga, diet-whatever. There is a great loss however, in not truly caring for yourself- If you don't, how can you care for others?? mccmaeve

Ask him/her how their "day to day" is different from what they expected when they started school.

i have no words of wisdom, only much empathy-because this happens to me on a regular,(daily) basis...busy floor, not enough nurses, I am a 'newer' nurse, and it really can be a mess. I read the replies to your post with much interest-as you and I are in the same boat. i hope it will get better for us!!

This is a tough one for me. I am a new nurse, 7 months as a nurse at age 49. I have had other careers, Social Work 18 years, and (oddly enough), Banking 3 years. so I have education, worked lots of places, with lots of people. I always wanted to be a nurse, and when I got laid off from my last position, took the opportunity to go to Nursing school and here I am. I am very aware of how much i have to learn, probably overly cautious, well liked by patients and my manager says i am doing well and "right where I ought to be for a 7 month RN". It is a very busy Surgical Oncology floor in a major Cancer Center. This floor is known as 'the best floor in the hospital' I love the patients, the science, and since I want to be an ET Nurse, it fits my goals to be on the floor. I think most of the staff on this busy floor with VERY ill patients are very good nurses. I ask lots of questions, and I am a team player. My problem is this-Many staff are very negative. There is a lot of 'back-stabbing'. There are cliques. Nurses complain about other nurses; What was not done on the last shift, What a mess the patient is because the last nurse did not do their job. Who 'lied' about what they did. People are frequently whispering, about other people. (I am sure they whisper about me, too) The negativity is an added stress to an already stressful environment. I have seen 'office politics' before, but this is more like 'cattiness'...I don't really join into too many conversations, because people seem to be cliquish, and i am not into that. I have in my mind identified people who can be trusted to be helpful, and those who should be avoided. Depending on the people on the shift, I don't have anyone that I feel I can get or give support to, as a result I feel isolated, and that is not so nice either. Sometimes I just feel like-"Come on, can't we all just get along?' Does any one out there know how to fit into an environment, without taking on the negativity, and letting it become part of me? I am starting to feel the negativity in my own attitude, and i don't want that, Please tell me any ideas for how I need to either change my thinking, expectations, or what? Thanks!!!

i have only been a nurse for about 8 months..still at times overwhelmed by how much there is to learn every day on the floor. A nurse whose opinion I respect said, "Remember, NOBODY was born a nurse".

i absolutely agree. owning a marijuana plant is NOTHING like child abuse, or elder abuse. the report was a breech of trust. and even though we are professionals in the home to provide a service, we are guests; we can be asked to leave, and nobody is required to to open the door to our smiling faces. reporting the plant is the top of a slippery slope.....

glad things worked out, i guess i replied to hastily, just wanted to be of help, and maybe this helped another person. Good Luck to you!!!!

I suggest-Ask for specifics, Ask for a learning plan, ask for measurable goals and identify who can help you nail down what your boss wants.(a care plan :-) here's why-my manager suggested this, as she was not 'seeing me progress'. it is a very busy surgical oncology floor in a major cancer center. i love it. she suggested a different, smaller unit, she manages, to help me with time management. we met- my manager and i, (who i really respect, and trust her judgement) and she listed about seven time management areas for me to focus on over 2 weeks. she appointed the daily charge nurse (same one every day) and an APN Nurse Educator to meet with me. I met the charge RN daily, the APN weekly to review and refine waht happened in the day and the week. The APN spent about 2 shifts with me refining my planning and time management techniques, showing me useful and legal shortcuts. By the end of the two weeks I was doing alot better. had my 6 month review, the Manager said I am "right where she would expect me to be". Also that she suggested the other unit so that i would not get so burned out, and quit nursing all together. Make yourself a 'care plan' like this and see if they can help you stay where you want to be.

not relevant, not an advantage, just another experience. your patients are individuals, their experiences are different from yours and each others. maybe it gives you some perspective, but the patients are probably not all that interested in hearing about your personal life. I doubt it 'makes you a better nurse'.

Find a Career Counselor. A professional, Career counselor who knows the job market in your area, (wherever you plan to live). This person will help you narrow down what skills you have, and what jobs you like, dislike etc. You have a vast experiences, and only you, with the help of a competent, paid professional will find the answers. Good Luck-you will do well!!!

WOW--thank you, Belfry, I will appreciate your sheet-you can send it to me at [email protected], I created one, but I'm always looking for what I might have missed :-) what a resource this b-board is!! I had a couple 'good days', expect more 'not so good', everything is a process. Thank you again ever so much! mccmaeve