MilliePieRN 4,344 Views
Joined Aug 18, '12.
Posts: 164 (45% Liked)
You'll likely have some air in the syringe. Pull back to pull the Med out of the needle so you can expel the air without expelling the Med first.
Also depends on how you feel about being put on call, cancelled and floated (which usually will be you as a prn)
Do you not have access to inr levels before giving it? I never give Coumadin without knowing inr... if the inr was too high, you'd be responsible for questioning the order to give it "tonight".
Vitamin k isn't given with all high inr levels, that should not factor into your equation.
I'm thinking going part time will cause more difficulties in adjusting to nurse life. The less you work and plow through the longer it will take you to become comfortable with your job. I foresee the stress on days you work to be even more unbearable. Stay full time where you are until you are over the first year new nurse he!!. You'll be a much more competent and happy nurse for it.
I'm pretty sure our pump asks for a bolus amount (ml) (or maybe just kgs then if I want the bolus) and then asks over how much time. I put in 60 seconds. Can't do it much quicker than that because it will exceed the rate of 999.
I do it all the time, but am not certain how I do it without it in front of me.
I don't see the problem with just monitoring and throwing on a lead apron in emergencies (they don't weigh that much). Monitors shouldn't have to do compressions anyway (in our lab, scrubs and md's would be the compressors), monitors handle airway. It's not that frequently that our monitors have to come in, just when we go pci to help throw out things. Our staff monitors while pregnant. The stress and rush of a stemi would be the biggest concern, I believe. Easy to strain in an emergency. I'm sure all labs do it differently, though.
I doubt since you've been away from nursing school for over 3 yrs and have (2?) failed attempts it would be as simple as finishing one semester. Ns comes with a huge amount of stress (which pales in comparison to your first yr working as a rn), only you know if you can handle it now. I would start by finding out what it would take to finish.
I've worked both Icu and Cath Lab. Hands down, you should choose the Icu internship. It will give you the most usable experience for your future plans. Cath Lab experience will help you very little in bedside nursing. It's just too specialized for your long term goals. (But if you want to stay a Cath Lab nurse, go for it. It's more of an end goal, not a stepping stone)
There's not a lot you can do to prepare for scrubbing. Learning cardiac anatomy more in depth will probably help you the most for the job in general. It's nice to be able to recognize lesion locations without having to ask. I still have a lot of trouble differentiating even the lad and circ because of so many imaging angles. Scrubbing all depends on the dr, we have an awesome patient dr (we run his table completely) and a testy dr who runs his own table; some docs will never be happy. Just be teachable. I think monitoring is one of the toughest to learn because it requires lots of knowledge about what's going on (where the anatomy knowledge comes in).
You will need to know code drugs and critical drips, along with being very familiar with moderate sedation and pt rescue. Be sure to know your pt histories, which is easy to gloss over when it gets busy. Our team works fantastic together; be a great team player! Makes everyone happier.
Will you be scrubbing? I've been in Cath Lab since July. I LOVE it. I read the entire Cardiac Cath Handbook (I think that's what it's called) before I started. It's mostly hands on learning. Do you have Icu experience? You'll really need to know how to manage and start gtts. In our lab, RN's do all 3 roles, so it's an enormous amount to learn. In many labs, RNs cannot scrub (which is becoming my favorite role). I wouldn't try to find an iabp class, I'm sure you'll learn what you need to there. Reviewing ekg/telemetry strips would be helpful, but you probably don't need a class; there is plenty of books and online resources for that.
Hope you enjoy it as much as I do! It's incredibly challenging but so rewarding! I hope to do this the rest of my nursing career.
Nursing school is brutal, mostly by design. It weeds out the weaker students and only the strong survive. I thought it was terrible as a student, but as a nurse I appreciate that I am well prepared and people who need handholding/coddling and folded under stress didn't become responsible for lives. It absolutely can be done, but it's a whole different world.
I work now with some non-nursing students (of a very technical/high responsibility medical field) and the low standards of acceptance and retention scare the crap out of me. Their board pass rates suck and they are graduating students who have no ability in their field. Glad nursing isn't so much like that (at least in the not for profit schools).
Yes... . actually nursing school and working as a nurse will strengthen some of those weakness. (And being afraid to make a mistake is a good thing). I'm much more adept at handling stress after becoming and working as a nurse. I quit doing hair after 6 months because it was too stressful for me (in my younger days). Started nursing school at your age, and now I'm a successful nurse who can handle it. Not saying my "weakness" isn't still there, I just manage to work through it.
No. And you cannot wear glove your whole shift. Wearing gloves outside of pt rooms is a no-no.
Look up Carpe Lotion/foot lotion. The stuff is incredible...
Sometimes it takes a few min for the Med to get ordered in the computer system. Sounds like you heard the verbal order before the doc sat down to actually put in the computer order? Iv, labs, then sent to radiology? If that’s the case, I can see where she would go eat while he went to have a scan rather than waiting for him to get back from the radiology if the order had not shown up prior to him leaving for the scan. I don’t know the whole story, so I’m unable to say what I’d do in this specific case. I will say I’d give the pain med as soon as I could, but I would not delay a ct scan. I wouldn’t have said the part about taking a lunch or not getting one at all. 30 min doesn’t sound too unreasonable, especially if during this time he got an iv and had a ct scan.
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