wecan11 5,126 Views
Joined Mar 30, '11.
Posts: 129 (6% Liked)
I always thought I wouldn't like nights too but once I tried it I found I liked it.I am a terrible sleeper at night, but I found I can snooze just fine during the day.I also like working nights because it is quieter.No families, no managers,no doctors.
Extra set of hands will be worth it!
The best thing I can tell you is make sure you are heading NORTH!
I have a Sr., lady aged late 80's that I've tried to straight cath twice, failed twice. She has had enough to drink but I couldn't thread the needle so to speak. I'm a newbie, only saw males get cathed. hat am I doing wrong. It's easy to go into the VJ but i'm not. Any advice would be great! Thanks!
I am a new nurse working in a CCU/CVICU area and was wondering if some of you seasoned nurses can give me some input about how long certain IV's should go in such as calcium, potassium, mag, etc. I know a lot of this comes along with experience but these are the types of things i sit around and think about
Thanks, any input is appreciated!
On my rough days, I find myself wondering the same thing....and then I remember what I was thinking when I decided to be a nurse:
If a Twinkie falls in the woods, would it still survive a nuclear blast?
But enough musings about sunshine colored puffed pastries stuffed with stardust, rainbows, and the tears of angels all swirled together into some strange concoction like so much manna from heaven.
In my rough days, when the world has decided that rightSTATnow everything must short out, blow apart, crash over, try to die or just...go so wrong so quickly, I sometimes find myself daydreaming about what I would like to be when I grow up.
You see, I want to be a pirate.
A proper pirate.
I will have many minions, a stout fleet of ships, and plenty of stock of canons, shells and powder. I will pillage and plunder and terrorize the high seas. I may even consider growing a beard to offset my newly acquired snaggle tooth. I will be missing a leg. Absolutely. But my wooden peg will house a small cask of ale so I may take a nip to keep my bones warm on the most chilled nights at sea.
I be known to all lan'lubbers as the Great Captain BloodyMary the Frilly. But do not let me name fool ye.
I be merciless. Tyrannous. Yar! Thar be no name more afeared than that o' the great BloodyMary. Me parrot be named Tuttle an' his song can summon the Kraken ou' the chilled bones o' the blimey deep!
Not that I've given this any thought or anything.
I wonder what it would be like to be a ninja.....
Different day, different crap.
Today I was screamed at by a patient for mentioning one of his admitting dx; syncope, GI bleed, acute renal failure. No one had mentioned the ARF, he assumed I had the wrong patient info. I didn't. Proceeded to explain that ARF is a common result of dehydration, a byproduct of his GI bleed. Said I would review chart for plan of care and clarify ARF dx. Patient (hysterically) not receptive to communication so I offered to contact MD to clarify. Exit.
Paged admitting doc x2 in a half hour - no call back in an hour. Got house MD who graciously came to talk with patient. He claimed patient requested nurses to come in and say "hi" and leave the "medicine speak" to the MD... Prior to the house MD being involved I paged the nursing sup to talk with upset patient, as I couldn't get an MD to call back (I've learned the hard way crap can be kicked up too). After doing so, her sage advice: page the doctor....
This is where it's gets good. Attending shows up late morning and wants to know why the patient, and 5 of his family members at the bedside, are under the impression that the patient has a diagnosis of ARF. Explain exchange with patient, show MD ER note enumerating ARF as part of DX and recite supporting lab values. (BTW he did return the page, as confirmed with his iphone, one hour later. No clerk to answer his call. I was blamed for that too.)
His response: "YOU need to fix THIS"!!!
REALLY? (THIS being the component of DX on record reflecting ARF.)
When will it end? Now the nurse is responsible for the diagnosis too (FWIW admitting lab values did support ARF)? No, No, No!
Never been one to doctor bash as I have the utmost respect for anyone who puts themselves through that process, regardless of the motivation. Now I'm changing my tune.
NO - can't change a diagnosis.
NO- won't support the fact that you, MD, didn't explain adequately to your A&Ox3 patient what was happening to him physiologically.
NO - don't subscribe to the harassment mentality predicated on nurses today.
Learned my lesson. Keep a smile on my face, speak when spoken to, it's a task oriented job, play dumb.
Got it. Take heed new nurses.
I share some of the same concerns as was posted earlier by another poster. I check in here infrequently because of lack of post, and although I started checking this site with some enthusiasm that soon was replaced by dismay because of the lack of involvement and content posted.
I'm really surprised that a career such as nursing - so full with different options and talented and varied personalities - does not offer more support in having nurses become self-employed.
It is the problem with nursing - with all of the skills we have to offer, we still do not claim our independence and find a way to work outside of hospitals and agencies. We depend on doctors and jobs to tell us what to do with our lives and our careers. In most cases we can offer those same skills independent of MD's and corporate bodies.
Even when nurses do strike out on their own, our choices are often limited to starting some type of nursing agency, yes this is a step in the right direction, but we need more options in addition to health related companies. I know that you should use your expertise, but I would love to see that expanded to different areas.
I think this would improve the nursing field offering more choices, creating more jobs and opportunities and happier nurses.
I guess what I am saying is that I would love to see more nurses NOT afraid to think outside of the box. I believe we can.
My first job out of LVN(LPN) school was at the same pediatric hospital where my four year old brother was diagnosed with leukemia. (we had a mix of RNs/LVNs then) I had a different experience - but my unit was based on age for children 0-18 months so there were diagnoses across the spectrum. I have to admit that when I floated to the oncology floor it was a different story because I related more to my personal experience - the reminders were everywhere. I don't know if time would've helped me adjust to that or not.
It's part of who I am - I guess - I pretty easily separate clinical from personal even with close family members. That isn't a bad or good thing, it's a "know thyself" thing. From my perspective I think there are subcategories of nursing that make us really adept in if it harmonizes with our personalities. If a different niche makes you feel like a fish out of water - it doesn't mean you can't be a fantastic nurse. You'll be busy with your job and your bridge program! Bless you for wanting to give back though and being such a good heart babydaddy.
I agree most PICU's will only hire RN's, because of the nature of the job. An LPN's scope of practise is too limited for most intensive care units. Most pediatric critical care patients will have multiple titrated gtts going, and many IV push meds. They are usually one RN to one or two critical patients, and there would be nobody else to do the RN stuff for you. Once you get your RN, I would say "go for it." I worked PICU for many years and absolutely loved it.
My situation is not exactly the same, but there is a parallel I'd like to share.
I was a psych nurse who frequently worked with kids and adolescents. We also had adopted a child with serious psych issues. As his needs intensified, I found myself feeling like my head was going to explode. With psych being the common denominator at home and at work, there was just no getting away from the stress.
I think I would have had an easier time of it had I worked in a different specialty. But because there was never any let-up, I had to actually take a break from the job until a crisis period with our child had passed.
When I resumed working, I chose an entirely different area and the changed environment and new learning helped me feel much better.
I wonder if you might experience something similar with the intensity present in the PICU. If there's a lot of overlap between home and job, it can sometimes feel emotionally suffocating and highly stressful.
I wish you and your family well with whatever you decide.
In your current situation, working in a PICU might be too close to your own situation for comfort. Additionally, many ICU positions are only open to RNs, so you would need to go back to school.
My suggestion is to work on your RN first, then decide what to do with it based on what's available in the job market @ that time.
We wish you the best in any case.
I am a retired LPN with both PICU and NICU experience. You already know that if you want to work in a critical care setting, its very important to get your RN. There are some LPNs who work in these units, but most of the time they are veteran nurses and the ones who are not are exceptions to the rule. I would also encourage you to obtain your BSN because it will give you the most options in your career.
I'm sure sure how much weight I would put in grades because I don't think they mean much in the real world. I knew a TERRIBLE RN who was so proud of her GPA that she brought in her transcript at work once. All As...so what...she was still a lousy bedside nurse.
If you live in a state where LPNs are given a broad scope of practice (can push IV meds, give blood products) you might want to contact a nurse manager of a PICU or NICU. You also might want to consider acute care peds, which is more likely for an LPN to be able to work in. The best way to obtain jobs is through real life human connections and relationships. The last LPN hired in the PICU from which I retired had been a unit clerk there and was hired when she graduated at a time when the PICU had stopped hiring LPNs and would replace retiring LPNs with an RN. Every hospital unit that I have ever worked on has had a "call in" list of nurses who are trained to work in the unit but have no scheduled hours. Perhaps you can train for one of these positions if you can make good connections.
Also, read and learn on your own. You like taking care of your heart patient...find out about peds heart problems and the surgeries and new treatments. You have to love learning to work in critical care because its constantly changing and there is always so much to learn.
Best to you,
You should have been provided a copy of the 485, Plan of Care, for your patient. It lists the meds and all orders for treatment, care, ADLs, etc. that are required during your shift. Sometimes there will be a new procedure that you can look up, or a med that you are not familiar with. Anything that you have questions about can be clarified by asking the nursing supervisor, the primary nurse who is orienting you, or the family members, before or after you have done your own research. You can get a 'feel' for the case by reading the POC. I once read one and immediately turned down the case. I was able to explain my reasoning to the staffing personnel and we didn't even bother sending me to the home for a wasted orientation visit. You should be given a copy of the 485 before you start each new case. It is your starting point.
There are several good youtube videos of people replacing both gtubes and trachs, so please don't underestimate youtube!
The cough assist machine was something that I'd never even heard of until I started doing ppd. You'll probably run into a few kids (esp. trach kids) who use one.
Troubleshooting feeding pump errors is probably one of the most aggravating things that I've personally experienced. (Next to troubleshooting vents, of course.) I regularly use both Infinity and Kangaroo pumps. Like systoly mentioned, reading up on forums meant for parents is a great way to learn little tricks.
Generally a good idea to review pediatric CPR procedures and maybe print out a copy of the current guidelines to carry around with you.
I carry around a pocket size medication reference book -- you can also get digital copies for your smart phone.
For my regular clients, I usually put together a sheet with important phone numbers. Parents cell/work. Home number. Number(s) of the equipment provider(s) - usually includes who to call to order supplies, who to call if something is broken, etc. Kiddo's primary care doc during hours and after hours. Any sort of PT/OT/Speech therapy numbers that might be relevant. This info is usually THERE, somewhere, but often gets lost when you actually need it.
The parents of the kiddo are almost always your best resource. They usually know what's normal and what isn't. I remember the first time I had a trach'd baby who had the hiccups. I was like OMG SHE CAN'T BREATH!111eleventy epic level of freaking out. Dad walks into the room and is like "Isn't that cute? She has the hiccups!"
I moved 1200 miles away from home 6 months after nursing school (when we took boards the same 2 days (1000 questions) , and waited 2-3 months for results). When I left, I LEFT.
It takes time to put down roots in a new place. Now, I'm stuck back here in my hometown d/t health issues of my own- but my heart is still back where I had moved to as a 22 year old.
If you have a job you like, adjust your family time. If you don't like the job, that's something else. Your family will always be your family; a decent job with possibilities to grow aren't all that common. jmo When I got together with family when I was living in the "good" place, it was great. I came back d/t some health problems w/my mom (who died 3 months later after getting sick during the winter south). So, I came back for nothing.
What do YOU need.....a decent job, or family down the block. 3.5 hours is doable.
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