Biffbradford 9,155 Views
Joined Sep 23, '10.
Posts: 1,117 (48% Liked)
3 words: Ready for step-down!
Speaking from first hand experience, I can't say that going straight from school to ICU is a necessarily a good idea. Irregardless of how brainy you are, or 'worldly', the first few months for you will most likely be like a deer in the headlights. I'm not knocking the idea, but just suggesting that you stay open to the possibility of some med-surg first where you will still learn a TON without all the stress of having patients trying to die on you right out of school. FWIW
I'm in the exact same boat as you, except substitute in the month May. Just today, I see that a local hospital, less than 5 miles from me, has opened up 5 ICU positions and I have found them advertised AROUND THE NATION. So, I apply and send them my resume:
... and in less than 1 hour, I get:
We have identified an initial group of candidates that we are pursuing; at this time you are not being actively considered for this role. Should the situation change, we most certainly will contact you.
That's complete BS.
I'm trying to find the email or phone #s of the unit manager since HR obviously is clueless.
Hang in there, we will WIN THIS FIGHT!
I would say that 8 weeks orientation is on the short side, but to be frank, you never stop learning in CTICU/CVICU and it takes several years to get really comfortable. Fresh post-ops are heavy on fluid replacement as they third shift everything, as well as bleeding management (giving lots of PRBCs, FFP, Platelets, managing clotting chest tubes), while at the same time, dealing with confused/restless/intubated patients, multiple inotropes/pressors/insulin drip, rhythm changes/pacemakers, family ... and hopefully you're one-to-one and not managing another patient at the same time!
Good comaradere with solid team members is key to survival.
It's very challenging so say the least.
READ YOUR ORDERS
Every surgeon will be specific as to what will need to do.
You cannot do chest compressions, the chest is open so it would have to be direct cardiac massage. Only saw that a few times and always by the surgeon.
As far as defib, our surgeons always left a metal retractor in place to hold the sternum open, so there's no way you could use external paddles. We had internal paddles in the bottom drawer of our code carts right along with a chest opening tray that had all kinds of nasty goodness inside.
LVAD/RVAD - READ YOUR ORDERS. In most cases - no compressions. Depending on the type, if the VAD fails, there is usually a hand pump or something as a backup.
I don't remember any of the details (thankfully), but I DO remember getting to my car, driving off the property, rolling up all the windows and SCREAMING $&(@(*#!! BLOODY MURDER and slamming the steering wheel.
Don't beat your self up over it. If you're unable to get an SpO2 or ABG's, or even a real blood pressure, then you're really fighting a loosing battle, it was their time to go. Pat yourself on the back for doing the best you could on that day, and move on.
Hopefully, they didn't have you pick up another patient right away once you cleaned up that disaster!
I left, took 2 years off because I got burned out, went back for another year and a half and got burned out again. The 'medical' part is still interesting, but am totally sick of the politics which is getting worse and worse and tired of the highlight of my day getting a patient to finally take a crap after surgery. Look what I accomplished today! Whooo Hoooo! Yeah, the money is pretty good, but I also don't want to fall asleep driving home anymore.
There are times though, when patients ARE on their lights too much. Their families tend to their every whim in day to day life, and now it's YOUR turn.
"Oh, straighten the wrinkle out of the lower corner of the pillow. Nooo ... the other side!"
"Okay, wait, don't go away .... give me a minute to see if that's okay."
Here's your Percocet, it's time for you go for a walk in the hall. When you get back, brush your teeth and sit in the chair for a FULL HOUR to do your coughing and deep breathing.
I know, that's not the case every time, but there are times when you need to lay down the law. It's your job to help them get better, and if it's a kick in the a** they need ... then that's what you give them.
When they've done their part, then I'll give them a back rub. Not before.
I stop being a nurse the second I leave the hospital. My job is not who I am, or even a part of me. Who I am is reflected in my job though.
I am not new to the health care, CNA, LPN, RN world. Really? Is this common practice where you work?
My first post here because this topic fits my situation perfectly.
I worked in a local CVICU at one of the major hospitals here for 12 years. We took care of anything involving surgery in the chest: CABG, valves, aneurysms, lung transplants, heart transplants, VADS, Total Artificial Heart, EVERYTHING. In addition, the nurses were all trained in ventilators, IABP, CVVH, about 7 different VADS, ECMO, cryogenic therapy after MI's, the works! I floated to all the other ICUs (cardiac, medical, neuro). The unit had always had a high turnover rate, so being one of the more senior nurses, I kept getting the harder assignments, and they just kept coming. We had some pretty tragic deaths, some real ugly post-ops, and having surgeons that were, quite frankly, mentally handicapped when it came to working with others, it all just built up to be too much. I was also working 3rd shift. I couldn't sleep anymore, wasn't eating right, had no energy to exercise at all ... so I gave my 3 week notice and split. My manager never said a word to me. I worked there for 12 years and I never even got a "Later!" My co-workers were great though and very supportive (take me with you!), and while I hated to leave, I'm glad that I did. The hospital paid me my 400 hours of vacation time that they would never give me (no, we can't give you a week off. You can have Wednesday off, but you'll have to work Saturday!) and I used most of my savings getting my health back (mental and physical). It is such a shame to put all that experience to waste (+ getting my BSN), but the hospital does NOT CARE. New nurses are cheaper to pay wages for, plus - get this - recently the hospital has been firing doctors for low productivity! Yes, the hospital is so big, that it bought out all the physician practices so now the hospital owns the MD's. If you don't bring in enough really sick patients to make lots of money ... out you go!
Anyway, I've spent the past year and a half scraping by making a living doing photography which I really love. However, with the economy the way it is, it's just not cutting it. I've kept my nursing license current and am now considering applying to the same hospital to work in the hyperbaric chamber / wound care unit. I don't think too many people die there. I need the insurance coverage and the pay would still be pretty good, but again it's back to every other weekend and ?? holidays. In the CVICU I swear I worked 3 out of 4 weekends and 80% of the holidays because "We need machine nurses!" (new RN's don't learn all those machines immediately). I'm NOT looking forward to that.
So, there's my story. Maybe I'll do it for a year and bail. We'll see. I'll get my resume together tomorrow and decide by Monday. Maybe some other job option will pop up in the mean time.
You go shopping at Walgreens and someone opens a fire door out back or something and you think they just called a code!!
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