Latest Likes For Double-Helix

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Double-Helix, BSN 23,806 Views

Joined Apr 5, '11 - from 'New Jersey'. Double-Helix is a Nurse, Children's Hospital. Posts: 2,693 (50% Liked) Likes: 4,690

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  • Jun 30

    I've only been a PICU nurse for three months, but I have gained a huge perspective in that time! Being a PICU nurse is exciting, heart-breaking, frustrating, scary, and wonderful all at the same time.

    Imagine taking care of a child on ten seperate medication drips who is on a ventilator, has three central lines, arterial line, a CVP and a foley. You're drawing hourly blood gases and blood glucose levels, counting all of your I&O's hourly, monitoring the ventilator settings, constantly alert for any changes in vital signs, making sure your syringes of pressors don't run out, hanging so many medications that you are running out of lines to use. You're giving updates to the docs and making adjustments to your drip rates based on their orders. You need to turn your patient every two hours, which requires two other nurses to help move the patient and keep the breathing tube in place. To top it all off, you have angry family members scrutinizing everything you do and demanding that certain non-essential things be done immediately.

    Being a PICU nurse is never boring. There is always something new, something that needs to be done. I've taken care of kids with so many different diagnoses that I couldn't possibly list them all. Our unit is a 19 bed PICU that takes all different kinds of kids. Our hospital has a pediatric cardiac surgery program, so we always have at least a few cardiac patients with various congenital cardiac defects. Depending on the season, we usually have a couple kids with viral illnesses, particularly RSV in the winter months, one or two babies on observation for apnea, asthma exacerbations, ex-preemies with chronic medical issues and heme-onc patient. Most of the pediatric surgical cases bypass the PACU and we receive them directly from the OR. So we get tonsillectomies, thoracotomies, traumas, amputations, appys, cardiac cath's, neuro surgeries, etc, etc. Our general peds floor does not have monitoring systems, so any patient that requires continous monitoring of any kind (HR, rhythm, O2 sats, respiratory) comes to PICU.

    Skills:
    Solid assessment skills are crucial. Kids can't tell you when something is wrong. You have to know what's normal and what isn't and be alert for any changes that might indicate the child is deteriorating.
    Critical thinking: why is this patient presenting like this and what does it mean? What am I going to do if this kid goes south? What do I need to have on hand in the room in case of an emergency?
    Prioritization and time management: You've got a lot to do. You need vital signs on all your kids at noon time and you also have three IV meds to hang, several po/GT meds, one kid needs an enteral feed and the other needs labs drawn and another has an infiltrated IV. What's most important? What can you get done early?
    Communication: With docs, with parents, with the kids. Parents of sick kids are nervous wrecks. They have a lot of questions. You need to be able to explain what is happening in terms that they can understand. You need to explain things to the child. You need to convince a sick and scared child to swollow their medications. You need to explain to the doctor why you think one of your kids needs a different type of treatment. A big part of your job is communicating. And don't forget giving and receiving report.

    My day begins at 6:45am and on a good day I leave at 8pm. Most days I eat lunch at the nurses station in five minutes so I am never far away from my patients. If I use the bathroom once I am lucky. But these are "my" kids, as I refer to them. They are my responsibility and whether I've taken care of them for an hour or three shifts, I love them. There is no other specialty like PICU, and there is no other place I would rather be working.

  • Jun 28

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 23

    If you don't have the forms from the inservices, see if you can get a signed letter from the people who ran the inservices that states you attended and for how many hours.

    As far as the bioterrorism one, try to get it as soon as humanly possible.

    Oh, and please, keep all your tax documents. You never know when you might be selected for random audit by the IRS.

  • Jun 16

    Quote from gitanorn
    keep in mind is a "cartoon" therefore, don't let the "map 15" alarmed you...
    i am an icu nurse. it is impossible for me to ignore an map of 15. must.... assess.... intervene.... implement.....

    *searches for way to enter cartoon to fix patient's map...*

  • Jun 15

    Whether or not it is a HIPAA violation depends on whether protected health information was released to this teenager. It's possible the child was in the rooms performing tasks but not provided any health information. However, I'm sure this is a violation of facility policy. From a liability standpoint, the facility would be at a huge risk if something were to happen to these patients, or this child, while at the facility.

  • Jun 14

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 11

    As you said, this is really a personal decision. But since you asked, I'll throw in my .

    First, what are you plans for obtaining a nursing degree? From your post, it sounded like you were planning on taking pre-requisites and then applying to a nursing program. Since you have two years of pre-reqs and you said it will take 4 years to get your nursing degree, it sounds like you're thinking of applying to two year programs, which will get you an Associates degree.

    Just be aware that for the great majority of educator positions, you'll require a BSN. Which means that, if you do go to an Associate's program, you'll need an RN to BSN bridge program in addition to the two years of experience (diabetes related) in order to become a diabetes educator.

    How much research have you done into nursing school? It sounds like there are better options for you. There are direct-entry ADN and BSN programs, which will include the needed prerequisites in order to graduate. A BSN program will be four years, like you've planned, but will eliminate the two years of pre-reqs, as they will be included in the program. By taking to your local nursing schools, you may even be able to enter the program as a second-year student, as the first year of most BSN programs is solely dedicated to pre-reqs, which you may be able to transfer from your BA.

    There are also Accelerated BSN programs for people with previous bachelor degrees. You'll need some pre-reqs to enter these programs, but once you're in the program is usually about 12-18 months. So even if you need two years of pre-reqs (which you could cut down on by doing summer courses and online courses) you'll still have a BSN in less than four years.


    **

    Now, as far as the pregnancy is concerned...

    Family trumps career, in my opinion. Nursing school will always be there. There were several students in my BSN program who were in their 40's, and many students in their 30's. While you do still have many child-bearing years left, keep in mind that once you're in your 30's things can become a little more difficult. What it really comes down to is how much you want children right now, and whether you're willing to be a full time student while you've got a baby/toddler at home.

    From a logistical standpoint, it's much easier to take a break from pre-reqs than it is from nursing school or your job. You can also complete some of your pre-reqs through online courses, which you could do while staying home with your baby. The difficult part will be when you are in nursing school and still have a little one to care for at home. But this is a task that many other nursing students have done successfully. This would probably be my choice, but I never could have waited until I was in my 30's to have my first baby.

    If you do wait until you're out of school, then I'd suggest waiting until you've been working at least 6 months, so that when the baby is born you are eligible for FMLA and have plenty of PTO saved up in order to take a nice maternity leave without being strapped financially.

    As I'm sure you know, there is no right or wrong answer here. There are pros and cons to each option, and whatever you choose, I'm sure you'll be able to manage it successfully if you are dedicated and have a strong support system. I like to use myself and my half-sister as an example of the different ways things can be done:
    Me- I met my husband while we were in high school. I went to a BSN nursing program directly out of high school and got married when I was in my third year. Then I graduated, got a job as a nurse, and after about 6 months of work, am expecting our first child who is due just two months after I'll have been employed for a year.
    Sister- She went to college right out of high school as well, but then spent some time working in a few different carer paths and traveling, met her partner, went back to school for her masters, got a better job, and is just now thinking of starting a family. She is 10 years older than me, and we are both having children at about the same time.
    Different choices, different timelines, different priorities. Both right.

  • Jun 7

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 7

    Short and simple. Does your facility do an exit interview (basically, an interview when you leave to find out why)? If so, that would be the place to bring up your issues. You can also schedule a time to speak with the DON before your notice is up, but I would leave it out of the resignation.

    Something as simple as

    Dear DON, Date

    Thank you for the past five months of employment. I feel that it has been a significant time of growth and development for my career. At this time, I have been offered another position that better suits my employment needs. This letter is my official two-week notice, effective immediately. My final date of employment will be (two weeks from addressed date). Again, I appreciate the opportunity to work of this facility. Please don't hesitiate to contact me if I can be of any assistance during this process.

    Sincerely,
    Name

  • Jun 6

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 5

    Quote from pinoysn
    Thank you for the reply! Did I hear you right? You said you don't need fingerprinting to get ATT?! Cause I actually had my graduation on Friday and my school said they would send my letter of completion yesterday (Monday). So I can schedule/register/pay for NCLEX w/o the fingerprinting?

    No, you don't need the fingerprints. The fingerprints are for the BON, not for pearsonvue. The BON can issue your ATT without the fingerprints, but I think you need them done to get your actual license number, just not to take the NCLEX.

  • Jun 5

    Whether or not it is a HIPAA violation depends on whether protected health information was released to this teenager. It's possible the child was in the rooms performing tasks but not provided any health information. However, I'm sure this is a violation of facility policy. From a liability standpoint, the facility would be at a huge risk if something were to happen to these patients, or this child, while at the facility.

  • Jun 5

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 5

    My first question is- what text book is your INSTRUCTOR teaching from? That's the book that you should be using to study for the exam, as that's where the information will be based. The Saunders book may be good for NCLEX prep, but I doubt it is covering the exact same material in your syllabus.

    Second, as your instructor if you can sit down with your exam and go over the questions that you got right and wrong. Evaluate what kinds of questions you're getting wrong and see if you can identify why. Did you not understand the content? Did you fail to prioritize correctly? Do you understand the concepts but fell down on applying the information in critical thinking situations? This might help you see where you should focus and adjust your study techniques.

  • Jun 4

    Out of curiosity, how old is the Saunders book your using? It may be out of date. Also, you used it for a PN course. Is the book geared toward the NCLEX RN or the NCLEX PN? The two may be quite different in terms of appropriate interventions and scope of practice.


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