Friday, December 7, 2007

Not a smidge of temperature

Okay, this is the last time I will request this. If you or anyone you know is a nurse, PLEASE COMMENT OR EMAIL ME very, very soon with your advice for a new nurse. It will go in a little book I am making for my cousin's Christmas present. God, I miss throwing money at the task.

So, again, working on it this weekend. Any advice you'd give a new nurse. Or? Also? I guess if you aren't a nurse but have had good or bad experiences with one? You can tell me about that and I can add some what not to do/please do this advice.

I have only 37 pieces of advice but was really hoping for 100. Thanks!


Karen said...

I'm not a nurse - yet - but I am in nursing school. When talking to a resident during my externship this past summer, I asked him what the most important thing he'd learned thus far was. His words were: "The first rule of medicine is, if you don't poop, you die." And he's right. That's why it's important to always investigate when your patient's last bowel movement was. There, thought I'd share something useful...:-)

Linda .. the Aussie one! said...

Stan recently had to have three major surgeries and one thing that I was thankful for is the nursing staff in the ICU .. where he spent a few days .. they treated me with compassion and respect and responded to all of my requests and questions without hesitation. If I was giving your young nurse-to-be a tip it would be to remember to be compassionate while dealing with the family of the patient. Remember they are very concerned for the wellbeing of their loved one.

mamacita said...

Don't know if this will help, but: When my dad was in the hospital in the seventies, he had an African nurse who had a pierced nose. That was back before piercings were commonplace. Anyway, my family has talked about that nurse for THIRTY YEARS. "Hey, you remember that nurse? The one with the pierced nose? Crazy!" So my advice is to be memorable -- let your personality come through. At least the family will be amused. A little personality and heart will make a bad time easier for everyone.

June Cutoff Cash said...

My cousin Katie used to HAVE a pierced nose, actually! I think it's gone now. Not her nose...

Anyway, that's good advice, thank you. And also? We have a lot of the same favorite movies. (Guess who went on your profile?)

kates said...

Hi, i'm a nurse, I've been in nursing for nine years. i started in cardiac (telemetry) and that was good experience because wherever else you work... your patients will have hearts and so it's good to have that background. Also... tell her to work on the floor, it's so stressful and crazy but it's the best experience she can get, and she'll learn so much that she can carry with her wherever else she goes. Definately, tell her to pack lots of snacks for when she works night shifts and to save some for her drive home so she can munch on them and stay awake. Tell her to try all kinds of nursing before she decides what she wants to do for her career, there are so many options out there. Consider travel nursing... you can go anywhere you ever imagined to live for 3 months, you may love it or hate it but it's an adventure. Tell her to be persistent with docs, they may try to brush her off... but she should always trust her instincts and keep bugging the doc until she gets whatever it is that is best for her patients. She'll regret it if she doesn't. Tell her when she's learning to start IV's, to try at least twice on every patient before she goes and gets another nurse so she can at least practice and eventually she'll get the hang of it. Don't tell the patients you've never started an IV before, pretend like you're an old pro... fake it till you make it! Always double check everything you do... especially meds, like HEPARIN. Remember when you're taking care of patients, to ask them what their agenda is.. not yours. Try to think about the little things that make a difference and might make someones day just a little brighter because of you. Always brush your patients teeth in the morning... you'll thank yourself the rest of the day. Don't be afraid to delegate and ask for help, no one is supernurse, not alone anyhow. Organize pot lucks for nightshifts, and break it out about 3am...mmm. If your nursing breakroom has a toaster oven, you can bring cookie dough and make fresh cookies for the middle of the night. Take the stairs so you can burn off all the cookies and potluck you've been eating. Benadryl works great for sleeping after a nightshift and diet coke with 2 excedrin is a great pick me up when you have to wake up and do it all over again. Get some dark curtains and ear plugs for sleeping during the day.

okay, if I think of any advice, i'll come back. Good luck! tell her to for sure enjoy the journey and when she gets burned out which she inevitably will... then it's time for change.

Stie: My Favorite Things said...

When I was a kid, I had like six surgeries on my arm (long story). I can remember this one nurse who stood by my bed, taking vitals, and she gently pushed all of my hair off my face (as I couldn't do it being in a big, long cast on one arm, and hooked up to a painful IV in the other) and it was such a simple thing, but made me feel so taken care of. I think nurses get stuck with the yucky, messy, gooey jobs, and taking time to make a patient feel less like a number is HUGE.

Kara said...

Hi June,

First, I just want to say I love your blog and the fact that you exaggerate everything (40 heart attacks...I love it). I do that too and it drives my husband nuts!

Anyway, I recevied this link a few days ago and thought of you. You may be able to pick up some tims and I know they have some discussion boards, so you could post your request there. Hope this helps!

June Cutoff Cash said...

You guys, thanks! It is so nice to 'know' so many people. I am so going on that site; it's just the kind of thing I'm looking for!

June Cutoff Cash said...

And p.s. I do not even NOTICE that I exaggerate like that. I probably drive like 10 million people a day completey nutty.

sister in law said...

Did I give you my advice already? If she ends up working in obstetrics she should remember to take care of the mom as well as the baby. Over the course of three deliveries I easily saw 25 nurses and only one really took the time to take care of me.

Michelle Dawn said...

Am I too late? I've been working as licensed practical nurse for seven years now and here's what I have to share:

1. Take care of yourself. This is ESSENTIAL. Most nurses keep crazy sleep schedules and work at least some 12 hour shifts. If you aren't careful you will end being one sick-and-tired puppy. And nobody likes a drained and cranky nurse, plus it's dangerous. Pay attention to the basics -adequate sleep, good nutrition, a little exercise, etc.

2. Watch out for the nurses at work who have negative attitudes. They usually huddle together at breaks to complain. Their energy is poison and contagious. They can bring down the morale of the entire team. Don't be intimidated by their bitchiness and lack of professionalism. See it for what it is.

3. NEVER discuss personal matters or chat with coworkers in front of patients without involving them in your conversation. It makes them feel invisible. If your coworkers start a conversation with you while you are with a patient find a way to involve the patient in the conversation.

4. Come in a few minutes early and stay a few minutes late. Senior staff and supervisors notice those who start the shift fully prepared and those who rush out the door at the end of the shift. These extra minutes will really help build your reputation as a responsible employee and help you get into the position you want more quickly.

5. Never be afraid to ask for help if you don't fully understand something. It is going to happen A LOT for the first few years. Get over your ego and do the smart thing.

6. If the smell of certain bodily functions is horribly offensive put some Vicks VapoRub just below your nostrils before entering the room. I carried that stuff in my pocket when I was training, but you do get over it eventually.

7. Buy really good shoes.

June Cutoff Cash said...

Michelle, thank you! I spent seven hours writing Christmas cards yesterday and never started the book. I would have added more pages for this great advice, tho!

StotheL said...

Don't forget to tell a new patient your name when you meet her! Even if you're wearing a nametag, they get turned around and the patients aren't of the clearest mind when they meet you. Plus, saying "Hi, I'm Debbie" before, say, prepping her for a pelvic exam will make the whole thing go more smoothly.

Nancy said...

Here are some more tips...

Peroxide will take blood out of clothing.

Always, always wear gloves. I cringe when I see older nurses not doing this.

Live on straight pay without the shift differential figured into your living budget. When you get a chance to go to day shift, the need for extra money won't stop you from skipping happily to a sane schedule.

Don't try to wear both a new bra and new shoes in the same day at work. 'Nough said!

Nurses eat their young. They will chew you up and spit you out before they accept you.

Some doctor's will mess with your head until you challenge their authority. Once you stand up to them if they are rude, they start to respect you. PS: They aren't God, no matter what they would like you to believe.

Don't act like you know it all with
your coworkers. This will ruin your reputation faster than anything.

Iron your scrubs, you will look more professional.

If you aren't scared to death about the life and death responsibility that you have taken on, you will kill someone. Have a healthy fear and respect of the work you do.

ICU families don't comprehend but a smidgeon of what you tell them... they are too stressed. Be prepared to repeat yourself.

Prepare a family about what they will see before taking them in to see a very ill family member.

Use plain english to explain all the tubes and their uses for the family to understand.

Apologize profusely after stepping on someone's foley catheter and know deep down in your heart that it will never happen a second time!

Encourage the family to rest at home as much as possible while their loved one is in the ICU because they will be in great demand once the patient comes home and needs care.

Miserable patients might be too embarrassed to tell you what is really the reason they are in agony.

Not all patients deal with pain in the same way. Believe them even if they don't appear to be in pain.

If something doesn't seem right, use your intuition and ask other nurses. Sometimes we have a sixth sense about things.

Drive very, very, very carefully home after working a night shift.

Chart everything as you go. On a bad night, it is impossible to go back and remember what was done and when (with much accuracy).

Don't be afraid to walk away from nursing if and when you have kids. There will ...always... be patients but there won't always be the tiny pitter-patter of little feet.

Don't let your licence lapse even when the little feet are pitter-pattering. You can take a refresher course later and go back to work.

Remember in all that you do, it will make a HUGE impact in how the patient sees his/her experience.

You become a much better and more caring nurse after you have had a hospital stay of your own.

If a patient says they are going to die, believe them. They aren't kidding around and many times are correct down to the very day.

Sometimes letting a patient go is the kindest thing that a family can do.

Prayer does work.

Remember you are God's hands caring for his children.

June Cutoff Cash said...

How much do I heart you, Nancy? This is SO GREAT. Each piece of advice will be a new page. Thank you thank you thank you.

jtcosby said...

My sister in law is a nurse so I got this from her:

I have been a pediatric nurse for 3 and a half years. My best advice
for a new nurse would be, "if you start to feel that you are unhappy
in your career choice, give it a year and a half before you quit.
remind yourself on a daily basis that you are helping people and
making a difference. there will be hard times and times you wannah
quit, but hang in will get better."

jtcosby said...

As a patient, my advice would be to always let the long term patients get to know YOU! if the approach you, get to know them...they are probably going insane having to be at the hospital!!!

eggandcheesesandwich said...

My aunt was a nurse for years in pediatrics. When she became ill with breast cancer and had to spend months on end in the hospital the nurses on her floor routinely ignored her requests for pain medication. My mom, my sister and I would arrive at the hospital to find that she'd been waiting sometimes as long as an hour in agony. Time and time again my mom would go looking for help only to find the nurses standing together, drinking coffee and talking. There was no sense of urgency on their part and if my mom hadn't been there I don't know what my aunt would have done. I feel terrible when I think about the days she didn't have any visitors to stand up for her. I know that nursing must be absolutely exhausting but every second in pain is like a lifetime to a patient. It's the people who are too weak to cause a fuss that need help the most. Please keep that in mind and know that every kind action you make means the world to your patients - even if they don't have the strength to say thank you.

Kelly Garrett said...

I'm not a nurse, but as someone who has worked undercover as a nurse several times, my best piece of advice is to never, no matter how cute and charming they are, become romantically involved with the interns!