Latest Comments by DesertSky

DesertSky, BSN, RN 2,640 Views

Joined Feb 21, '12 - from 'Missing the desert...'. DesertSky is a Critical Care RN. Posts: 87 (40% Liked) Likes: 81

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  • 1
    Sour Lemon likes this.

    Quote from Sour Lemon
    I work per diem and float among a few units. I feel I am treated very fairly. I've also worked on units where unfamiliar nurses were given slightly heavier assignments ...not to dump on them, but to leave regular staff more available to help with the things only they knew how to do.
    It seems like agency nurses probably get the worst assignments, if anyone does. They may or may not ever return, and people tend to feel little sense of comradery with them. I've gotten to know many of the nurses on the units I float to regularly and feel like an integrated part of the team.
    I'm glad to hear you enjoy working as a float nurse! I assumed float RN's would hopefully be treated better than agency nurses as you can expect to see hospital float RN's routinely especially if the unit is routinely short staffed, but I appreciate you sharing your experience with assignments.

  • 1
    Rocknurse likes this.

    Quote from Rocknurse
    ‚ÄčWe have a critical care float pool in my hospital that we utilize a lot, and I really like the float nurses...they're awesome. I considered it but the one thing I really couldn't stand is that they seem to have to change units every four hours. I don't know about you but when I take over a patient I like to know exactly what's going on, do a full assessment, change dressings, bathe them and make sure everything is followed up. Usually I feel like I'm getting caught up after about 8 or 9 hours in a shift and if I had to do that 3 times a shift I'd lose my mind. There's just way too much going on, and way too much to get to grips with in 4 hours just to change assignments and units again. Nope...give me my two patients and let me fly for 12 hours. I know we get admissions and post ops but still....I would just hate having to give or receive report up to 5 times a day. No thanks. I think they're abused to some extent, and they never get the really interesting acute patients which I really enjoy taking care of.
    Thanks for sharing. I can totally see how float pool nurses don't routinely get the sickest and highest acuity patients. It is part of my concern about taking the position. I enjoy the challenge of a high acuity patient and would find myself frustrated and bored if the only patients I got were the "stable" ICU patients who routinely get downgraded or moved out to the floor the next day.

    I will clarify in the interview about how often I can expect to get new assignments over the course of a 12 hour shift. Thanks for the great advice!

  • 0

    Quote from Been there,done that
    I have floated, both as agency and as a staff member. I got stuck with the more difficult assignments, only as agency. As Rocknurse said, being pulled during your shift is VERY difficult. Find out if you would be jacked around like that.
    Best of luck with your decision.
    Good advice- I will clarify if I can expect to be pulled during shifts, or if my daily assignments will be to the specific ICU unit for the full shift. I appreciate the advice!

  • 0

    I was recently offered a FT critical care float pool position. I am an experienced critical care nurse with ICU experience in cardiac, med/surg, and trauma ICU's. I have some experience with neuro from working trauma, but it's not my favorite.

    I would float between all the ICU's (med/surg, cardiac, trauma, and neuro) based on need. It would require 3 12 hour shifts similar to a FT ICU position. The pay is very generous and I think I would enjoy the variety of floating between the ICU's instead of staying in a specific unit.

    However, I have a few concerns. For those who have done float pool work, are you often stuck the the less desirable patients such as all of the isolation/cdiff, difficult family members, detoxing, confused, etc. patients? Or does it seem like most units treat you fairly and welcome the help?

    I would appreciate any personal experience or advice you can share!


  • 1
    WKShadowRN likes this.

    Quote from Riburn3
    I'm an FNP (and also will have my AGACNP later this year) and really just went with the FNP because it was offered at the public university in my area, and offers more diversity in terms of job prospects. My background is adults and I currently work cardiology and internal medicine, so I'm not exactly using all of my degree, but I like knowing that if I wanted to go work in ER, an urgent care, or go work in a family primary practice, I would be able to. A pipe dream job later on in life is to work for the department of state overseas as one of their embassy providers, and you also need your FNP for that.

    Overall though I kind of doubt I will ever use the full scope of my FNP, but I do like know I have more options. Also, even though I never worked in peds and likely won't, it was by far my favorite rotation in school, and probably where I learned the most.

    In terms of jobs, I think most jobs for NP's are geared towards adults, at least in my area, so I don't think you'll have too much trouble.
    Thank your for your response! Your current job in internal med and cardiology would be the kind of position I would love to do.

    You do raise a good point about your FNP opening the door for urgent care, ER, and other opportunities. I am glad to hear you enjoyed your peds rotation because it's actually one of the reasons I was shying away from FNP as my professional experience has all been with adults.

  • 0

    I am a nurse with a critical care background. I am not interested in becoming an Acute Care NP as I would prefer to treat patients in the primary care setting vs. the acute care setting.

    I am torn between FNP vs. Adult/Gero Primary Care NP. In my career, I have only ever treated patients aged 14 and up, so I'm not crazy about treating children. Though I feel pulled towards the Adult/Gero Primary Care NP role, I have heard it is much easier to find jobs if you have your FNP as you are not limited in ages you can treat.

    I would love to hear from both AGPNP's and FNP's regarding their experience in the matter. Was it easier to find work in one role vs the other? Any advice for someone trying to decide between the two?

    Thanks in advance!

  • 0

    Quote from Meriwhen
    IMO, the more important one to disclose it on was the application. Your resume is, as a PP put it, your sales brochure or pitch to get their attention. The application is more detailed and when submitting, you will have to attest (via checkbox, radio button, or just plain hitting Submit) that everything on it is complete and accurate to the best of your knowledge. To have omitted that job on your application would have done you more harm than good, especially if it came up on a background check.

    That being said, be prepared to field any questions in case you do get an interview and they ask you about that short-term job.
    Thanks for the advice! I definitely disclosed it on the application so I'm good.

  • 0

    Quote from Flatline
    What is often confusing is that a resume is a piece of marketing material that you develop to communicate the qualities and experience that you wish to communicate. It is not a comprehensive application or work history. It is not only desirable to leave off short-term or unrelated work history but can even be seen as unprofessional or irritating by the person reviewing the resume.

    Resume=your sales brochure
    Thank you Flatline. I totally agree which is why I left the short term job off my resume.

    However, I also understand each new employer does a comprehensive background check and I did not in any way want it to seem as if I was concealing a part of my work history which is my I list it on all applications. Will this be sufficient so when an employer does a full background check it does not seem as if I was attempting to conceal a form job?

  • 1
    Wolf at the Door likes this.

    Hi all,

    I have a question. I am a nurse with about 3 years of critical care experience. I have my BSN, CCRN, TNCC, PALS, ACLS, and BLS. During this time, I had one job where I was only employed for 6 weeks. I left quickly as I realized the unit was chronically understaffed and the ratios were unsafe. Due to the short time of employment, I do not list the position on my resume, however when I was recently filing out a job application I was sure to list the position in the employment history of the application. Is this an appropriate way to verify I did work there without highlighting it on my resume?

    Thank you in advance!

  • 1
    Shineyfam likes this.

    Quote from Shineyfam
    And it it seems each state adds one little caveat that is impossible. For example, Kansas requires that your out of state fingerprints be sent to them directly from the Sheriff's office. Hello, the Sheriff's offices DON'T DO THAT! My fingerprints don't change if I send them to you! Uggh! So frustrating! And don't even get me started on states that require a PAPER written application. It IS 2017!
    As a nurse who had to go through the hassle of getting licensed in Kansas I feel for you. I was moving to Kansas from another state and had to navigate the process from miles away. The Kansas Board of Nursing continues to be a thorn in my side as they are my original state of licensure and they are one of the only states not to participate in the Nursys electronic license verification. I continue to cross my fingers they decide to join us in this century....

  • 5
    nitenite, TriciaJ, kiszi, and 2 others like this.

    I have worked in critical care the majority of my career, so I have experienced a great deal of death. As others have mentioned, it is often not the deaths that are most traumatizing, but the suffering you witness leading up to the death of a patient or the reactions of loved ones when they find out their family member has passed.

    When I worked trauma ICU, I often joked going to work made me scared to leave my house as most of our patients were young, healthy, and just going about their daily lives when they were a victim of an accident, violence, or some tragedy.

    When I worked in medical ICU, it used to make me sick to see families who said "do everything possible to keep them alive" when their loved one was never going to recover. I suffered some serious moral distress when I witnessed patients subjected to painful procedures that were not going to reverse their impending death from chronic illness and disease.

    Now in cardiovascular ICU, I do still see death, but not nearly as much as in other areas of critical care. It's rewarding because most of my patients recover and do well after open heart surgery, valve replacement, etc.

    I will add that most nurses who have experienced any amount of death usually have a coping mechanism whether it be a morbid sense of humor, love of extreme sports, or some other outlet in order to blow off steam.

  • 3
    MMARN, sevensonnets, and Nurse_bre like this.

    Quote from Nurse_bre
    Hello all,

    I am currently going through the orientation process at a CVICU. I have one year experience on a med-surg tele floor. I am absolutely terrified when I'm on the unit. So many different equipment, lines, diagnoses and a whole new way of doing things.
    I was wondering if anyone had any tips on how to organize your day when you have what it seems like endless charting to do.

    On my unit, you can have up to 2 "stable" ICU patients. You do vitals, check IVs, check the monitor hourly, assess every 4 hours including a head-toe, measure CVP, I/O (unless foley then its hourly) and pacer settings. Stable LVAD is every 2 hours.

    If you have a patient with ECMO, IABP, CRRT, fresh cardiac surgery or a fresh LVAD... you only have 1 patient since everything you do is hourly or less documentation.

    They also want you to do a CHG bath daily, lotion the patient down, etc. (we do not employ aides on this unit)

    Then of course I have medications to give, labs to draw, other care in between.

    I feel like no matter how I try to consolidate, I always have something to chart and I'm always behind. (And this is me coming from a med-surg unit with 6 patients and having everything done by 10am)

    Any recommendations? Advice? Support?
    Take a deep breath and remember to be kind to yourself. You are still on orientation and are learning the flow of the unit on top of additional clinical skills specialized to ICU. Building your knowledge, confidence, and organization takes time.

    The best advice I have is to develop an organized approach to care. For example, after report assess both your patients before anything else. I always assess my more critical patient first.

    I always try to complete as much as I can as early as I can. Pass medications in the hour window before they are due. Stay on top of your charting! Of course this does not always happen in ICU when something emergent occurs, however if you can stay on top of your charting it will help. Realize that you will get faster as you gain experience and your comfort level will also increase.

    Always know who your resources are on the unit and do not be afraid to ask questions. You are a new ICU nurse and no one expects you to know all the answers. Write down concepts or topics that come up that you do not understand or do not know enough about and research them on your days off. Come to work with enthusiasm and a willingness to learn and you will do great!

  • 0

    Quote from HouTx
    It's not very relevant to ICU practice. I'm assuming you are already ACLS certified because that is usually a basic requirement, so if you're looking for additional development you'd be much better off working toward your CCRN.
    As a trauma ICU nurse, I have worked at facilities that use both ER and ICU nurses during the initial triage and trauma resuscitation in ED. When critical drips are used, an ICU nurse is a great resource to the trauma team. It is also important to have TNCC as a trauma ICU nurse because of the assessment and clinical indications discussed during TNCC.

  • 0

    I have a question for those employed by the VA system. Have you observed there is upward mobility and advancement in the VA system for those looking to move from a staff RN position into administration? Or is it difficult and very political to move up in the ranks of the VA?

    Also, it is fairly easy to transfer within the VA system between departments and locations (such as different states)? Is there a waiting period to do so?

    Thanks in advance for your help!

  • 1
    sevensonnets likes this.

    Quote from bauern5513
    I'm a new charge nurse in the ICU at our facility and have noticed a lot of friction between the CVOR nurses and the CVICU nurses especially when it comes to the information given in report when the patient is leaving the OR and coming to the ICU.

    The OR nurses claim they should not need to tell the ICU nurses which vessels were bypassed or what was done exactly, that its not important and it wont change the way we treat the patient anyways.

    On the other hand, the ICU nurses want to know everything down to the smallest minute details.

    What is the normal expectation for the report from the CVOR?
    Anesthesia and the CVOR RN's bring the patient to our CVICU recovery bay and we do bedside report. The only thing I care about is that the CVOR nurse call me when they are closing so I can call RT and pull my meds.

    Sometimes anesthesia doesn't even know the details of the operation regarding grafts, vessels bypassed, etc. And it really does not matter in your post-op care. How would your care differ if a patient had a CABG X2 or a CABG X3?

    I usually read the operative report from the CV surgeon once it's up in our EMR. I'm more concerned with hemodynamics, complications during surgery, labs, and things of that nature.

    Are these new nurses to the CVICU? Perhaps they are looking for all this information because they want to be prepared and do not realize the expectation during normal post op CVOR report. If that's the case, some education regarding expectations would probably be useful.

    Good luck and let us know how it goes!