One year later as a nurse what have I learned?

24 So I've been a nurse for a year and I still cannot shed the new nurse title just yet but I came up with a few things that I have observed over the first year when it especially came to changes. The stuff is probably going to be either ok with you guys or I'm gonna get my head bitten off.

• I still hate calling doctors if the patient isn't looking like they are going to be sent to the ER (I work 3rd shift)
• My Clinical Instructor was so right that I was not ready to go out on my own upon graduation and that my best bet was to find a preceptor that would take me under their wing. One of my preceptors ended up being a family friend that treats me like her own son.
• Being liked by your coworkers makes things a lot easier.
• This may start a shift war but, I really feel like 2nd shift has it the worst. They get the admissions and phone calls. They have no charge nurse and their nurse staffing ratios are closer to 3rd shift's.
• I know customer service is very important and all but I have patients that are just flat out liars. I used to pay heed to every word a patient said, and I would waste time trying to please them. I actually spent 20 minutes looking for a specific order when I was new because a 350 pound patient that eats said he was allowed Jevity 1.5 shakes only to find in the physician progress notes that "All supplemental feedings should be kept away from patient, due to manipulative behavior and recent weight gains."
• I can see why my pay is so horribly low sometimes (key word sometimes), the amount of indigent cases our facility has been getting has been extremely high. How is the facility supposed to pay us if most of the patients that come to stay end up not paying a dime?
• Long Term Care is indeed soul crushing. I've had moments where I have indeed snapped at a patient due to the nature of the stress. (See 350 pound patient's manipulative behavior)
• My mom is right that I can't stay at the floor forever. I just can't imagine all this bedside drudgery for the rest of my life. (Sorry to all those bedside nurses that love doing it)
• I honestly like taking the leadership role if given to me, it feels weird when you've only been there for less than a year and people are already asking for your help.
• RN vs LPN doesn't really matter especially if they are more experienced than you. My 2nd shift regular nurse is an LPN and she is fantastic to work with. We just have different approaches and ideas to care.
• Why must I be a patient's punching bag? I got in trouble when I responded to a overhead page about a patient being violent and punching people in another floor. Everyone was afraid to get near the patient to give the IM Ativan. So I decide to put the patient in a wrist lock while another nurse gives the med. Administration thought that was excessive and I got warned about it.
• Whoever invented the call bell should be dragged out into the street and shot.
• Everytime I see an order for a bed alarm for a patient that is capable of walking own their own, I die on the inside.
• Vancomycin is a first line drug for everything! (Hey Doc, maybe you shouldn't repeat your 12 week order of 500 vancomycin 250mg 4 x a day again if the patient's C.Diff and UTI isn't going away) I'm serious it seriously is the most common antibiotic I see.
• I still hate "poop". I every once and a while have Bob Saget's reaction to the stuff from Dumb and Dumberer.
• I think nurse's notes are incredibly repetitive and have so much fluff. Is it a wonder why no one reads them except when we get sued or investigating us. I can seriously write a PAGE of a 3 minute encounter of a patient who was sleeping peacefully.
• Just because I'm a guy doesn't mean I'm your personal hoyer lift. I ended up responding to a nurse's "code" and all it ended up to be was one of her patients on the bathroom floor, still conscious. All she wanted was for the other nurses to put him back to bed for her. When I left she said: "Thank you ladies so much!" Hello? I was there too lifting your cow of a patient and you didn't even help!
• The nursing shortage is bull. The only shortage is, fools like me that are willing to deal with the risks.

And that's all I have at the moment
I agree w/ you- no head bitting from me. Its the reality of the beast- helps to vent!!

Quote from Catch22PersonifiedWhoever invented the call bell should be dragged out into the street and shot.

Catch22 I work on a med-surg floor and can NOT stand the ETOH withdrawal patients who demand IV dilaudid very 2 hours for their extreme pain. Why would a dr. even write that order?

Omg. Bob Saget's reaction from Dumb and Dumberer. Thank you that is the BEST.

Quote from Catch22PersonifiedWhy must I be a patient's punching bag? I got in trouble when I responded to a overhead page about a patient being violent and punching people in another floor. Everyone was afraid to get near the patient to give the IM Ativan. So I decide to put the patient in a wrist lock while another nurse gives the med. Administration thought that was excessive and I got warned about it.I still hate "poop". I every once and a while have Bob Saget's reaction to the stuff from Dumb and Dumberer.

Quote from Catch22PersonifiedJust because I'm a guy doesn't mean I'm your personal hoyer lift.

http://www.youtube.com/watch?v=w6C9RBMCJOYahahahaha. i cant stop. this is too perfect.

Catch 22 - you are wise beyond your years, personally and professionally! You may be new, but boy are you so spot right on about so many issues. You rock re: RN vs LPN, and 2nd shift (3-11) should be wearing angel wings. I think you know that facilities are paid by insurance and federal/state per diem reimbursement rates - not pts. But it is true that so many charity and "caid claims affect the rates by which facilities so pitifully pay us. I just cringe when pts tell me "I pay your salary". I am very appreciative of your muscles when you resond to help. But you will learn in time that confused, demented and combative pts respond better to men. It's a male authority figure thing. I think female cops experience the same phenomenin in reverse - of course, they carry guns. And the call bell person and the bed alarm person are fom the same litter. And documentation stinks. But you've learned early - please keep your sense of humor and coontinue to share it.

I would love to see Admin handle a physically challenging patient. There is something to be said for having a large male on your "A" team. Keep the Faith!

I agree with most of this. I am coming up on 2 years. I am one that enjoys bedside nursing but rarely have time for it (LTC).Sometimes what gets me is when my aides try to get on my ass about call lights. REALLy? I will answer as many as I can, I don't mind, BUT not while you sit on your butt! I also have a job to do! I know I don't have to explain my job here, but it seems as I they think my only job is to sit and scratch my behind all day! But it's not, they fail to realize that when they leave after report, I'm still there dong what couldn't get done!We don't have male nurses where I work (not that we don't want them, just nt many in our small town) so we are used to the heavy lifting (even though we are a "no lift" facility). I have come to find that I love what I do! Is it demanding? ALWAYS! But I love it. Just wish I could find a different area other than LTC to work In. Thanks for you post, it gave me the chuckles

I think you have a lot to say after only one year of nursing experience. I hope you find a job that suits you better. I think you sound like someone who has been a nurse for one year and already knows everything there is to know about everything...nursing and otherwise.

"...Sometimes what gets me is when my aides try to get on my ass about call lights. REALLy? I will answer as many as I can, I don't mind, BUT not while you sit on your butt! I also have a job to do! I know I don't have to explain my job here, but it seems as I they think my only job is to sit and scratch my behind all day! But it's not, they fail to realize that when they leave after report, I'm still there dong what couldn't get done!"I never mind answering call lights either, but you're right: our nursing duties are higher priority than making sure a res. has water or their favorite pillow, etc. While I was working LTC, I never quite got good enough at it to actually sit down, much less pick my butt. 2nd Shift is very hard in LTC, and I have a lot of respect for the nurses and aides who are so good at doing it. With 1 meal and 2 med passes, I was often staying over charting for an hour or two after my shift ended..without answering many lights. Plus, it seems like if people are going to die or fall, they tend to do it in the evening when there is shorter staffing. LTC is very hard work, but in our area, it actually pays as well or a little better than clinics, and about the same as the hospital.