Nursing woes...

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neutropeniaboy

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So, here's what it's boing down to now...

1. I draw my own labs on patients during the day since it takes the nurses a) four hours to check the order or b) four hours to do the stuff if the order is checked.

2. I've started to send my own U/As and UCx's now.

3. I transport my patients to and from radiology because otherwise they'd just sit around.

4. I had someone teach me how to use all the IV and tube feeding machines so I could do all the changes myself (see bitch #1).

5. I generally hang up if they page me and don't answer after 5 rings or am on hold for more than 1 minute.

University hospitals...gotta love 'em!

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Sorry to hear your plight. At my hospital we have great ancillary services. We have 24/7 IV/blood draws. Nurses do all cultures, blood periph/port and UA/UCx. Only time I do bloods is for abg when a pt is crashing. Pt escort services are great. I LOVE MY NURSES/IV TECHS/PT and Specimin (sp?) Transporters. They are the best! No doubt! They save me 2hrs of extra work everyday! And things get done in a timely fashion. Other places I have worked were much much different. The nurses at other places in the city used to look at me like I have two heads or something when I asked them to do ANYTHING. SIGH, that sucked.
 
Yup, I'm with Voxel.

We are so blasted fortunate and, quite frankly, spoiled to have amazingly competent, attentive, intelligent, capable, trustworthy nursing personnel both on our surgery floor and in our ICU.

They know when to call you, when to let you sleep, when a patient's in trouble. They pick up on a thousand details that we take completely for granted. When I rotate at outside hospitals, I'm astounded when a nurse gives insulin to a patient with an accucheck of 60 "because there was no order to hold it if the blood sugar was low". Or I arrive in the morning to find that my post op patient has had tachycardia and no urine output all night long, "but there were no call parameters written, so I didn't call."

I think there's an environment of skill and trying to achieve excellence that is contagious. Some places have it and some don't. It's not that our nurses are less busy - they have 10 patients apiece at night, just like at the bad hospitals. They just take pride in their work.
 
I am currently a emergency tech at Vanderbilt UMC ER, and a pre-med student. We do blood draws, transport, caths, and other small procedures. We have none of these problems, because we have lots of staff that are good at what they do.
 
Neutrapeniaboy... i went through a similar thing during my internship... i hated every moment of it, but in the end (and this is the funny part) it actually got me out of the hospital faster... never had to wait long for labs, never had to wait for imaging (would transport them, hunt a rads guy down and voila), but i still hated that i had to do the bull****... The nursing situation in the US is absolutely horrible and unbelievably unbalanced. Not enough nurses are graduating - they get overworked, and even the smart/good ones get burned out quickly.... it is really sad, but as salaries are on the rise for RNs i think that situation will rectify soon... some of my RN buddies are making 90 to 100k a year (incl. overtime) and often have their apartments paid for and get sweet deals on car financing...

remembering back to the good old days of internship the two things i hated hearing the most from nurses were:
1) "i am just trying to be a patient advocate"
2) "are you sure that is a wise decision, doctor?"
I always just smiled and put up with it, but deep down i just wanted to scream out:
1) do you think i went through med. school, got >100k debt, getting no sleep during residency because i hate patients???
2) no, nurse, i like to make very bad decisions that could harm my patients... next question
 
The hospitals I did most of my 3rd year medschool rotations at is like Neutrapeniaboy's. Now I'm doing 4th year elective rotation at other hospitals in the country and am amazed at the high level of cooperation and efficiency there is with the nursing staff and all ancillary services. But the funny thing is, everyone else takes it for granted b/c they are used to it.

The good thing I can say about training as a med student or resident at a place where you have to do all that extra footwork is: you will be more prepared to do all these things on your own if you ever have to in the future. Like, when on the occasion that something doesn't get done on time, you will think to check for it and fix it, without getting all stressed out and upset b/c you appreciate that it does get done right 99% of the time and you know how to fix it b/c you have done it a million times before.

It sucks to know you are working like a slave doing the jobs 5 other employees should be doing in addition to your own, but in the end I do think it will make you a more concientious doctor from having to do all these things for a few years.
 
Yikes. A friend of a friend doing his medicine residency in Boston (I think this is at NEMC) has to do all that scut. I guess I didn't even realize that existed in the world. My school is very fortunate to have kick-ass nurses and other ancillary staff. I'll definitely be looking at the nursing situation at any place I interview for my residency.
 
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