Tephra

Did you have some sort of daily task checksheet you worked off in school? If that was helpful to you, you can modify that to help guide your work. If not, maybe you can make up a form that includes typical tasks/assessments needed for your shift and work off that. Only problem is, papers tend to get lost LOL. (After time, the routine becomes imprinted into your brain and you won't need the checksheet but it does seem to help the new grads.) Many hospitals work off a computer-printed Kardex/MAR (mine does) -- I have a place on it that I make notes of things that will need doing during the shift (dsg changes, labs to be drawn, docs to call, questions/advisories for the next shift, etc.). I cross them off as I get to them.

Hi Charmed -- welcome to allnurses. :) I loooooooove my ICU night shift job. You don't say how long you've been doing this... is this new and you're just adjusting? Or has it been a long time? Now for the hints (nothing you prob don't already know, just getting the behaviors in place is the hard part: 1. Hydrate well. I bring a small cooler with bottles of water now, dump ice over them to make it a treat. 2. Eat well. Healthy light main meal, lots of veggies, healthy snax (sliced fresh veggies, fruit, granola, low fat cheese/crackers). DON'T graze from the vending machine. 3. Avoid the coffee (and other caffeinated drinks). Acidic and likely contributing to the nausea, belly ache, and dizziness. Also makes it difficult to sleep when you get home. 4. Make a small ritual of relaxation when you get home (quick soak in the tub, quick shower, massage your own temples or feet, spend time with your cat/pet, quick relaxing nookie LOL, whatever helps you rest). 5. Get 30"-60" of exercise when you wake. It'll give you energy for the day once you get into a rhythm (if you don't exercise now, build up slowly). Walking is great and centering. Well that's a start. Let us know what else we can do to help! :)

I was very impressed with the "Magnet Hospital" concept when the first few hospitals were announced. But...... ..since then, the concept seems to have been "diluted". My hospital was named this year. Woo. Hoo. Although I will say my hospital is one of the better ones locally, their recruitment, retention, and recognition efforts are abysmal. During the Magnet visit, multiple breakfasts/lunches/meetings were arranged... at every one, there were management folks and/or unit "cheerleaders" who always wear the rose-colored glasses (I saw the schedules and who was to attend). Although there were short times scheduled for individual talks with the Magnet reviewers, I can't say what the attendance was (I work weekend nights myself, not much scheduled for our availability -- although if I thought it mattered, I'd have come in). And as for why I don't think my opinion matters... for one thing, Magnet status is simply a marketing tool nowadays. I see no need to block it with what the reviewers would likely see as "isolated griping," I'd rather patients come to our hospital. But despite yearly nursing interest surveys, despite management frequently asking what we want ("More money!" "Retention bonuses!" "Better benefits!"), we don't get them. I see new grads complaining about their "low" $3000 one-year completion bonuses.. the nurses that continue to have low productivity and results even after a year on staff and with continued education and reinforcement. And yet my 8 years loyalty with this place merits nothing more than my piddling annual raise.

Listen, hon, my nursing instructors told me (first semester), "If you meet a nurse who tells you she/he has never made a med error, they're either brand-new or they're lying." Been there, done that, got the t-shirt (LOL! or is it a hair shirt...because that's what we all feel like we're wearing when we realize what we've done!). I use my mistakes as examples to help teach the new nurses. Better you realize that you made the mistake than never realize something happened at all. :)

32 weeks... holy carp!!! Sheepers, I've heard of training your replacements/filling a schedule but you're being YANKED. Most units that realize you're burnt on them, will be willing to let you out to another area w/in a month- 6 weeks. Speaks volumes about your institution that they're not. Is there another viable alternative in the area?

LOL I am LOVING this thread! :) Hmmm... Don't show up intoxicated on alcohol, cocaine, or other detectable drug, when you finally get "the call" for your solid-organ transplant.

We have an acuity system in place. It's mostly a *retrospective* classification, used annually to justify staffing. Although it generates numbers that are used to determine "load" in M/S, i.e., "Susan's patient crew is a total of 58 points, while Jenny's group is a 67 -- Susan gets first admit" -- it didn't seem to make a difference in staffing. The grid that we followed recommended staffing levels per total acuity but staffing still depended on number of warm bodies available. However -- acuity was used against us in ICU -- we didn't fill in the numbers high enough one year and we lost one FTE the next year, based on that. I'm no fan of acuities. If you hold to guidelines based on them, they *might* work. But how many times have y'all been told, "Just try to 'get by' 'make do' 'get through the shift' with what you've got, and dang the acuities?

Sheepers... I just want enough frickin pillows without having to steal them from CCU or Dialysis... LOL! Oh, and that physicians and families let dying people, well, die, in peace, love, respect, and comfort. Please, please, love your loved ones, all the way, till the end, and let it be sweet. :) Nice thread. :)

Hey Kevin, way to go! Enjoy your career, it's one of nursing's many ways to represent and advance yourself. I'm working on the NP degree myself, and finding the role transition very weird and fascinating at the same time. Personally? I like working with our CRNAs. Most interact/interpret well in that gray area between doctor and nurse (perhaps the reason why your instructors had a strange response). Neither fish-nor-fowl, as it were. But I think maybe some see the CRNA as "using" nursing to achieve near-doctorhood (even though that's not how it is). Molly

Jeepers...I've been reading discussions at this site for more than a year now, but this topic finally made me jump in and register! My worst grossout was just this past weekend...while cleaning a blood-covered GI bleeder (upstairs and downstairs) my colleague began cleaning the _huge_ blackheads off his back while I helplessly held the patient over...squeeze, pop, extrude, squeeze....she kept saying, "Just one more, just one more." Aaahhhh! Great topic!