Kebner

We have all been there, but years ago they didn't hire New Grads out the gate, like they do now. It's disrespectful of employers, treating seasoned nurses with same pay or less. Especially, when cleaning up after a new grad takes so much time. The mistakes are not evident on their shift, but on mine at 12am when I must call the doctor for incomplete orders on a patient admitted at over 12 hours ago. I had enough sense as a new grad to learn more before jumping into those positions.

Tedious isn't it?

A tip...something that has saved several patient lives. Always communicate with any person that provides treatment to your patient. Basically, anyone that touches that patient has information you need. This patient belongs to everyone that provides care to them. Other disciplines will have a point if view that may enhance that patient's care. I've followed nurses that have a vent patient on trials, didn't even know the patient was breathing on their own... It's crucial, would you administer 1 gram IVP Diladid to a patient weaning from a ventilator? ABGs! I live at 5280 ft..88-89 % saturation for COPD..OK! Sea level...different story. Context goes along way. I don't really have enough information to judge you. But, communicate, talk to anyone that touches that patient, and talk to the patient.

It's a type 2 HB, or 3rd degree. Can't tell if the p waves are marching through, if they are marching through, it's 3rd degree. 3 is bad. There are two type 2 HB..Mobitz and Wenkebach... Basically, Wider the complex, the sicker the patient. Less effective pump (heart) to circulate the blood throughout the resistance of the body. Especially, with bradycardia. Ventrical is doing all the work.. To dx this properly, I'd prefer to have this strip in my hand.

I've been a sitter as CNA. Worked as surgical tech, floor CNA, phlebotomist, EKG tech. And, now I've been a RN 6 yrs. As a person, who has worked so many hospitals, and technician positions..I can't feel any sympathy for this situation. Many hospitals have layoffs..I've worked as a sitter, and made 5$ a hour doing it. This is a poor me situation..suck it up. And, be greatful to have healthcare insurance, a job, vacation time, and getting paid entirely too much to sit. Listen to these complaints..just sad that some Nurses complain about having to sit. Many RNs have no job, and mouths to feed at home. Please, keep complaints a less tedious level?

Ja, kann ich es verstehen. Ich spreche Deutsch, aber wir sprechen nicht auf Englisch in Deutschland. I do believe that like all things in life, there are exceptions to the rule. Like "I before E, except after C", there are exceptions in real life too:) I loved to speak German in Deutschland, so because I was in Germany I spoke the language (not English). When in America, I speak English because that is the language (I want to speak English). So, I show my love for the country that I reside in by speaking the language and adapting to the culture. That is respect, and cultural acceptance, I find it is important to support all cultures and showing natives respect. Hope that this is something you find, no matter who you are in the world.

It should be something that is discussed in CNA school, and Nursing school. This should have been discussed at some point as a way of being polite and showing other people respect. However, raising kids ain't what it used to be, and parents themselves are poor at demonstrating any kind of self control these days. But, the professional aspect of talking in the patient room, without conversing with the patient needs to be a topic in hospitals, and all healthcare places. I agree, it is not comfortable from the patient's perspective.

When, I start an IV on an elderly person, whose veins pop like a balloon: 1. I use a manual blood pressure cuff pumped up to 60 mmHg - 100 mmHg Just enough pressure to see the weak veins start to bulge.. If, the vein becomes too full, a sharp needle will act the same way as on a balloon. 2. If, no manual cuff is available, then apply tourniquet look for what you want. Remove the tourniquet, then when all items are ready apply again, and stick fast. You don't want to wait for the vein to become over inflated again, the vein gets taught like a balloon and pop. So, apply and stick. 3. Okay, so every know and then, you have nothing to work with to make this easy. The elderly person's veins are just bulging, full already, they are thin and veins are looking like sausages wrapped in tissue paper. Apply hand pressure, like a tourniquet 3 to 4 inches above location, as noted in this article. You will see, the vein bulge a bit more. With hand pressure, hold, stick, and a second person can help out with attaching, taping. Before I start, after someone has had failed attempts. 1. Ask, why could you not get the IV placement? a) Did the vein blow/pop? b) Is it edema in the way? c) Could not locate the vein? 2. This way you can prepare equipment, and know what supplies you may need. a) Manual bp cuff b) Press many areas of the person's bony areas for edema, and under there, you may just see a very good vein. c) Patient may need to heat up, turn up the temp in the room (if patient is free of fever), get a warm compress (not too hot:), dangle that arm. Make sure that Tourniquet is tight. Long ago, I had no option, had to place an 18g in a thumb vein. Saw the flash, and floated it in with a little NS gently. I'm not good at getting IV's, I know people who are amazing. However, with these little tricks it is often, I do get it in. Thank you for reading:) It's so important that we share experiences, to improve the nursing we provide to our patients today.

Every state, I've lived in has had more than enough nurses. Is there a shortage where you are? I want a job, acute care!! I must be out of it here, but the nurses I work with are some of the finest people I know. They are a great team that pulls together in a code, when the call lights are out of control we dig in! It is attitude! It starts with every one of us!! I look forward to seeing every nurse I work with do their best, I know not every Nurse is perfect. But, when we come together, it can be pretty darn close to perfect!

Congratulations!! I believe you have done what so many of us dream about doing. Follow your heart, find peace. Anyone who makes you feel that the decision is wrong should have their head examined. If you do not want to be a nurse, then you struggle every day and every moment. There is a big world out there, and it is waiting for you to try it out. You have inner strength, you are still a Nurse, but you now need something else. I know you will find the right thing for you! This is exciting, it's scary, but no more scary than what you have already accomplished.

It is a horrible field! I started as a PCP in 1995, became a CNA in 1997. I worked harder than most people that are CNA's. I worked telemetry, transferred to General-Surgical, then to orthopedic-spine surgical. I was the first Certified Nurse Assistant at Littleton Hospital, trained at Porter Hospital because there was no one to train me at Littleton. I called in maybe once a year from 1997 - 2004, other than the time I contracted chicken pox from a patient with shingles. I reported to my manager that I had to have two weeks off, doctor's orders. She said to me, "It's not possible for you to get Chicken Pox virus from Shingles". Not kidding, this was a great manager! My sick-time being used. When I transferred to Ortho unit, I started weight lifting to decrease my chances of on the job injuries. I changed my life style for my job constantly for my co-workers and patients. I knew when palpating a pulse if it was irregular, and which beats it occurred. I trained other employees how to set up a CPM machine, and how to set the degrees, they are heavy. I reported low outputs, and monitored it closely. Any changes in the patient, low b/p and elevated hr, confusion....Epidural lines that were not intact, PCA's that were looking as if pt was tampering with them.... I also worked as a CNA for agency (2 full time jobs) to pay my bills. On Fridays, I'd work both jobs that's 24 hrs. Here I am a nurse because after a couple of decades of working as a CNA, I finally got a place to live and enough money to start school. I graduated, no jobs for New Grads. I have given so much of myself to this profession, sacrifice. No one would hire me, for months and hundreds of applications. No one would hire me as a CNA even, ridiculous. Finally, I got a job. It was luck at a job fair. Not at any dream job, LTAC. Still, I apply at acute care hospitals. No chance, they would hire a "New Grad". They have no idea what I do at the LTAC, I work harder than the RN's with less support staff at any "Acute Care" setting. Yep, I push, pull schlep drinks, drugs, and pumps. I never do enough for the patients, I never do enough for my employer. I have a hernia, that I cannot prove was work related injury. My insurance at work is terrible. I feel pedal pulses so weak a Doppler is used to detect them, report green goo coming from trachs and so on. My doc says, what's new? Well...could you support me? fluids? antibiotics? Got patients that sound like they are gurgling with edema every where, LASIX please. Patients care less about their incredibly high blood sugars, they want their ICE CREAM NOW... I guess, when I'm busy suctioning a patient while the others scream my name...it's not that my patient is unrealistic that bothers me. It's that my sacrifices have been great. 1. I don't have children, I could not afford any on a CNA salary 2. I have worked hard...hard work should pay off 3. I'm sorry, I do not have a bachelors degree ( I could not afford it) 4. I do have a 4.0 GPA 5. I moved to the first program that accepted me from Colorado to California, I had to move my stuff, my life 6. No jobs in California, had to move to a cheaper apartment, then back to Colorado because that is where I got my job. Here I sit, burned out because hard work and self sacrifice should pay off. NOT IN NURSING...RUN FAR AWAY FROM THIS FIELD. Read this story, it is true... You will never do enough to get that job, the employers don't care. There are some that are lucky and get that great job, they will tell you wonderful stories. But, there is no loyalty. I worked for years as a CNA, do you think that I could get a job from any of those hospitals? Nope. I will continue to work hard, complete all my education for work, and treat patients right. I answer call lights fast, bed alarms on, vital signs before sedatives, give blood and monitor lung sounds, draw my own labs, watch K when Lasix given.... I do this for my patients who scream at me, because it is the right thing to do. I do not have the ability to do it wrong, I cannot do it half way...I just never have because I have integrity. The world of nursing will break you. But, if you do not know how to be broken despite the circumstances, welcome to the insanity I deal with = my personal struggle to not work hard. Still looking for a job in acute care, maybe it will happen.

Good Day, I've noticed that my fellow workers communicate often in Spanish. Which is fine with me as long it's not negative communication. Or, as long as it's not in an English speaker only patient room, with 2 staff members speaking Spanish to each other. What are your thoughts? Do you encounter this event? How do you communicate what is appropriate or inappropriate? Thank you������