dharlow

I was an Indian Health Service scholarship recipient way back when and I had to do my payback at an IHS hospital/clinic. This was in the mid-late-90s. I found stuff that had been expired from when I was in high school in the 80s! as stock meds. SMH Still being used...

NO Kidding! Bad enough that you rarely get a break let alone a full uninterrupted meal! Where is the house supervisor? I transported plenty of times when the ED, ICU and M/S were being slammed.

I took over a M/S unit years back after being the house sup for the hospital. I was overloaded with LPNs (19) and 3.5 RNs for a 34-bed unit. I was a working manager. I started with surgeons yelling at me from my office do - fast forward 2 years later and they were sitting down and having coffee with me on break. I learned quickly how to interview and hire quality staff and earned their trust and respect slowly but sure. I evened out the RN v. LPN ratio eventually because the 3.5 I had were on burn out mode. One was even a 72 yr old 11p-7a 32 hr a week RN! She rocked! Lead by example I always say. Even if I was having an "office" day and was in business attire, it would not be uncommon to see me relieving nurses if we were being slammed by changing into the set of scrubs stashed in my office or even noting their orders and such so they could take a lunch break. I would also float all over the hospital to start IVs. I also suggested to administration that in lieu of paying agency that we offer incentive that came to light and RNs, LPNs, CNAs would get so much over their base pay to work over their usual 36-hour work week. Plus, if they floated for extra hours then they would get float pay stacked upon the extra pay. Worked. It is still in place today (I moved on to Risk). The percentage of agency went way down but again that was 10+ years ago. My complaints went down and patient satisfaction scores went up. It takes time but is "do-able!."

Yeah, I'm with you there. Or if the call lights are going off and it wasn't a particular nurse's patient it would get ignored even if it was just to get some fresh water. God forbid they answer it because the patient might need a (wait for it...) bedpan or assistance voiding.

As a former Risk Manager, one of my first days in that role was shadowing my preceptor and she had a med error Incident Report she was following up on and the poor ED nurse had way overdosed a baby on Chloral Hydrate! No good!

So if they float you to peds - have they ever pulled you back to OB for any reason? I ask this because if you are being floated to peds and take care of sick kiddos and then they pull you to OB, I have a problem with that due to infection control.

Agree. M/S was my bread and butter for a lot of years both as staff and manager but have worked ED as well so I can identify with you. I briefly returned to work M/S PRN while I was in grad school but after years of lifting on too heavy patients without enough assistance and the fact that I've been (like many) pounding the floor for hours at a time without break - my poor legs and back couldn't keep up. LTAC was even worse. I worked LTAC ICU and was routinely given 3 (sometimes 4 if 1 was overflow) with multiple lines, TF, vents on all, IVPBs back to back and never ending, and ALL were typically in isolation and 200+ lbs requiring another person to help you turn q2 and no tech staffed and the other nurses who either were equally as overwhelmed or weren't team players. Totally unsafe conditions. That was a short stint and I was outta there!

Sorry for your rough night. Been there many times as m/s/t floor nurse, charge nurse and manager. Early in my career I took report on a patient that was a hospice patient but family couldn't bear watching him pass at home. Told the ED nurse "okay, I am getting a patient back from PACU can you hold off bring the new admit until I get my post-op patient in bed and quickly assessed...vitals, etc., for 10 minutes because they are en-route now from PACU? Small hospital - just got PACU patient in bed and walk out to see him rolling the new patient by on the stretcher. I watch from the doorway while that ED nurse and a family member "assisted" the patient into the bed (I was 8 months heavily pregnant and not able to do transfers when patients couldn't assist). So as I stood there in the doorway watching them put this poor man into the bed I see his arm "flop" when they put him into bed. ED nurse rolled on out with stretcher and I kindly asked the family member to go to the family waiting room with the other family members (large Native American group) while I got his loved one settled. Now at this point in time I had been a RN for about 1.5 years but I don't think it takes a person too long to figure out when a person has passed away. Just to make sure - did vitals. Nada. Pressed the call button and another nurse at station answered (she was charge) and I asked if she or the manager could come in and help me for a moment. Charge nurse walks in and shuts the door and looks at me with the DynaMap and the look on my face and said - "He's gone isn't he?" SMH She went and got our manager who came in and was like, "are you serious?" She tore UP that ED manager on the phone. Poor man died either before leaving ED or en-route and the ED nurse still brought him to the floor which was HORRIBLE on the family since they didn't get to say goodbye. I called the doctor and he was like "you're kidding, right?" Yeah, I've had a lot of bad experiences coming on duty with IVs run completely dry, patients soiled to the extent it was dried on and you knew the ED knew long before bringing them to the floor they were soiled. Not bashing ED nurses - they have their own nightmare issues in their departments - I know. I've worked ED and was house sup and helped out EDs, too. I just think there needs to be a time frame of when ED brings the patients to the floor when it is around shift change. I established that with the ED manager once I took over managing m/s/t. Patient safety should and always be #1! Hope you had a better night. 8 patients is too much anymore. When I first started I would have up to 13 (1 hall) of patients on a busy and TRUE telemetry floor with 1 tech. It was exhausting and a lot were there admitted for true cardiac pain and would be nothing to have 3 or 4 with true gotta go to the cath lab now and I'm pushing Morphine left and right. SMH I am glad I am out of that mess and work still as a nurse but in a different environment. Okay...lunch break over. :)

True!

Med/Surg isn't easy. Believe me, I know. Most of my career (20+) has been as a M/S nurse and I'm proud of that fact! I even managed M/S for several years. The one thing I tell newbies is go get your M/S experience because even if it is just a year or two you'll be able to draw from the experience for the rest of your career. A lot of people want specialized areas and that is well and fine but I'm old school and when I moved on to manage other areas, I looked for that nurse who had M/S experience. I firmly believe it sets an awesome foundation and personally, helps with at least my critical thought process and being able to multi-task. I worked a general M/S floor as a new nurse and I would always have a variety of patients I would care for during my shift. Medical, surgical, GYN, pediatric, geriatric, etc. Taught me how to be able to turn on a dime and switch directions at any given moment. Best of luck. If you stay, you'll get the hang of it. Just takes time to find your stride. Happy New Year!

Rigging your own version of a mist tent for a pedi patient using wire coat hangers and clear plastic (because you were RT at night and on holidays all day!) Setting up bili lights and using surgical masks to cover private parts. Being the only RN on the floor and admitting 14 patients in one shift on a busy med/surg floor! When you needed an RT you could usually find them out in the smoke hole!

I was privileged to retire a nurse in 2005 who graduated from a diploma program in 1956. She still wore her cap and everyone loved and respected her. I managed to secretly get her spare cap and had a glass case made for it with a placquard with her name and years of being a RN. She was in her 70s and worked 11p-7a 32 hours a week. I was honored to be able to present her cap to her. It was on display for years later at the hospital. She wore her whites proudly!

Dialysis is VERY busy! I worked at a Davita briefly and found it was not a good fit for me. I was up at 0300, drove 30 minutes to work, and from the time I entered the building I was setting up machines and accessing fistulas for the first round then started it all over 4 hours later for round two! Barely had time to use the restroom or even take a lunch. I worked med/surg for years and managed med/surg for a 34 bed unit at a community hospital. THAT was a good fit. Busy but not usually CRAZY! I've worked a lot of areas over 20 years of being a RN and took pride in bedside nursing. That was when it was true bedside nursing. I would have upward to 13 patients on night shift and around 7-8 on day shift. Keep in mind this was before EMR. I'm old school. I still believe in your standard m/s experience because it will definitely give you a baseline for the rest of your career. I always say a great med/surg nurse can turn on a dime and shift direction in a snap when needed (but that's just my opinion, lol - not bashing other modalities). Maybe find a smaller hospital where the pace isn't so hectic. I've also done correctional nursing, (huge jail) briefly, while in grad school. Not for me! I was assaulted (physically) by an inmate with psych problems who was left untreated for her illness while incarcerated for a misdemeanor. She just snapped after being off her meds. Good luck with your endeavors and hang in there! You'll find your way...

LOL, I hadn't been an RN for maybe 2 years and I had a male patient that when I went to insert a foley cath I couldn't maintain a grip on his member - I went to one of the older nurses who had been nursing forEVER...she came in, pushed down on the pubic area with one hand, took the other hand and got "ahold" of his member while at the same time retracting the foreskin all with one hand and then looked at me and said - okay, now! OMG I never forgot that and that was 20 years ago!!! And yes, I got that cath inserted!!!

I combined my nursing career with my paralegal career/risk management/legal nurse consultant and work full time reviewing medical records and assisting with plaintiff/defendant medical malpractice for a large firm. I love it! I was a paralegal before I became a RN (since 1989 as paralegal, 1997 as RN).