Cheever1 916 Views
Joined Nov 17, '12.
Posts: 3 (33% Liked)
You know, I guess I'm just hoping that I can bank on the idea that I'm not wasting years of time and effort for someone to tell me that everything I'm doing this for is null if I don't pass a personality test. I have such a wonderful rapport with all of my colleagues, and I have for many MANY years. So, forgive me if I find it incredibly amusing that even though I've clarified my expectations, I can't get a more straightforward idea of what it is I could be doing * other than character development * to be more available for my future colleagues to utilize. Is there no one out there who can communicate explicitly about my inquiry?????
Recently I was traveling in Florida with my family to Disney World and a cement truck traveling in the opposite direction, on I 10, had a catastrophic blow out of a front steer tire. He started flipping and went through the median and hit us head on. The impact threw our car 88ft and we landed in a drainage ditch pointing the opposite direction we were traveling.
To make a long story shorter, I had to be extricated with jaws of life, I went in to shock and while paramedics were medicating me for pain. I had an anaphylactic reaction to Fentanyl and lost my airway.I was airlifted to a trauma center and my kids were taken to ALABAMA to another trauma center because we overloaded the Panama City hospital with our wreck. I didn't know how my kids were doing for over 8 hours.
The worst part was hearing the screams from my kids asking them not to let their mommy die. I am an RN in the MICU and I it was so hard knowing everything going on and having absolutely no control. I was the one that gave paramedics report when they arrived on scene and I told them when I was loosing my airway.
Once I lost consciousness and they cut my clothes off and stuck things in every orifice I had, I became scared and realized I was no longer a nurse, I was a patient. I am used to doing this to my patients and I have never stopped to think how I make them feel. I rarely ever was told what was going on or that they were getting ready to do a procedure to me. I just wonder if any of you have experienced being a trauma patient and how did it make you feel.
This experience has taught me to ALWAYS, whether they are conscious or not, tell my patient what I'm doing. They may not understand but when you are having a rectal probe used on you and they just flop you over and use it..WARN ME that its coming! I never knew how much Lovenox burns when going in, I never realized how hard it is to "cough and deep breathe" with broken ribs, or how it feels to ambulate with a broken foot and busted knees. Also, DVT's HURT like heck! Yeah, I got one.
Needless to say I have learned so much from being a patient and if I can help one nurse realize that patients are scared and just to have a friendly voice or a hand to hold, MAKES a HUGE difference. Once I have recovered and get back on the unit my patient care will be quite different and I think my patients will be better for it.
MSTICU (Med/Surg/Trauma ICU)
I am a new graduate, this is my first job interview for nursing and I am very excited about this opportunity. Please give me some interviewing tips. Especially questions I should have and be prepared to answer. Strengths and Weaknesses, 5-10 year plan I am prepared for. That's just about it though.
Behavioral interview is very common in nursing and basically they ask you to give various stories of how you dealt with a particular type of situation. For example: Tell me about a time when you dealt with a difficult patient or difficult patient scenario and how did you resolve it? Tell me about a time when you had to adapt to a difficult/challenging situation or environment and what you did? Or tell me about a time when you were part of a team, what made that team good, and how you contributed etc. Those are just some examples of behavioral questions I've been asked.
Also, some ICU's give you scenarios when you interview so maybe think of how you would respond to that (example: you find a patient in resp distress - what would you do, a Dr. prescribes sedative for already zonked out pt - what would you do etc). A question like why the ICU is a good fit/why that floor/why that hospital is always a good one to prepare for. I also highly recommend making a career portfolio if you are doing an in- person interview - it helps you to stand out, and depending on how lengthy and nicely put together it is, shows them how much you want the position (i.e. put extra time and effort into preparing). It also shows them what makes you stand apart from other new grads, especially if you have extra experience beyond nursing school and/or some good accolades. When they ask you if you have any questions, I think its always good to ask something about 1. How does this program/residency go basically 2. What do you look for in your new graduate residents (when they say something, I would try to as subtly as possible get a word in about how you match what they are looking for). If it is a behavioral interview, try to frame your stories using the Situation, Action (you took), Result, and What your learned technique. Smile and try to find a way to let your passion show - not in a crazy way, but let them know this is the job of your dreams and you have the dedication and enthusiasm that makes you worthy! I had a panel interview for the ICU and it was very intimidating but I was successful, so I could maybe give you a few tips on those too, if you'd like.
Just my , but a patient who is 6 hours post-PCI (percutaneous coronary intervention - 'PTCA' is not used very much anymore) should be pretty darn stable, especially compared to the other patients in this scenario. The patient should be on hourly groin/vital sign checks and could very well be off bedrest at this point, too.
I would see patient #4 first, then 3, 2, and 1. Here is my rationale:
#4 is going to wind up coding if we don't address his breathing and IV situation right away. And I'm a cardiac RN through and through - get that guy back on the monitor STAT!
#3 needs a glucose check to make sure she's not tanking. She just came from ICU today, so it sounds like her sugars aren't very stable yet.
#2 received her PPM for CHB, so we need to check on her for three reasons: she has a fresh surgical incision following a procedure where a major chest vein was punctured, she probably received moderate sedation during the PPM insertion so her LOC should be assessed, and she received the PPM for a life-threatening dysrhythmia, so she's probably pacer-dependent. Let's make sure she isn't unconscious or bleeding out and that her pacer is still firing (which would be 'unconscious' for a different reason ). Also let's give her a quick reminder to keep her left (or right) arm immobile to prevent the lead(s) from being dislodged from her heart muscle.
#1 (see above). This guy should be relatively stable since it has been six hours post-procedure.
hello all - i'm a new bsn graduate in the process of applying to a critical care internship, as my senior practicum with within an icu and i fell in love with it.
part of the online application for the critical care internship involves responding to a scenario and listing out how i would prioritize care for four patients. like most hypothetical prioritization questions, not nearly enough information is provided on each patient for me to feel confident about my selection. prioirtizing is one of my biggest weaknesses right now and one of the things i'm hoping the internship will help me gain a better handle on.
if you happen to have some free time, i would greatly appreciate the input from some experienced rns. i don't want anyone to answer the problem for me, but i'd just like to know if you think i am on the right path.
here is the scenario:
you are working your first week of night shifts on progressive care unit. you have received a report on four patients, and are prioritizing and organizing your plan of care for the night.
your patients include:
On a PCU you will see a wide variety of things. Chances are your patients will all be on telemetry, so know your cardiac rhythms and know your cardiac drugs. Know some drips, too. On my PCU, we can administer dopamine (up to 5mcg/kg/min), nitro (titrate for chest pain only, though, not BP), Lasix, Heparin, Amiodorone, Integrillin, octreotide, dobutamine (usually if they transferred from ICU and are being weaned) and cardizem.
Admitting diagnoses/comorbidities that I see a lot on my unit: acute respiratory failure, ARDS, COPD exacerbation (we often get a lot of those patients requiring BiPAP support), status asthmaticus, pneumonia, obstructive sleep apnea, seizure disorders, ischemic stroke/TIA, renal failure (both acute, chronic and acute on chronic, ESRD), electrolyte imbalances (patients get admitted a lot for hyperkalemia/hypokalemia or hyponatremia), acute coronary syndromes, cardiac tamponade, heart failure, cardiomyopathies, hypertensive crisis, pulmonary edema, DVT, PE, DKA, HHNKS, GI bleeds, acute pancreatitis, substance abuse, sepsis/SIRS.
Review chest tubes and how to properly manage one.
I love working on PCU. I did my preceptorship on a similar unit that also had a vascular ICU built-in. I ended up getting hired on a PCU after graduation. You definitely learn a lot on this type of floor. Good luck and feel free to PM me with any questions you may have!
good brain sheets.....to keep you organized
brain sheets.......here are a few.
mtpmedsurg.doc 1 patient float.doc
5 pt. shift.doc
day sheet 2 doc.doc
critical thinking flow sheet for nursing students
Thank you so much for your reply. I did some research about public and private system, from what I understand is in general the public hospitals are higher acuity, and I enjoy working in the teaching hospitals, so I think I would prefer public hospitals. Which hospital is the cardiac hospital in Brisbane? I would like to do some research on that hospital can you also give me the names of some excellent hospitals so I can do some research on them too? Sorry I have too many questions :P Thank you!
I just received my eligibility letter from AHPRA yesterday. From what I understand is my license is finalized and all they need from me is physically present in AHPRA with my passport and visa, and I should be receiving my license few days after. I'm a nurse in US with 1 year exp. The whole process for applying the registration is fairly smooth for me. I Fedex my application on June 9, they send me ane -mail on June 19 saying they received my application, time frame for my application is 4-6 weeks and they also requested some additional document. I Fedex my documents to them and they received it on July 4. I received an e-mail from my professional officer on July 25 saying they've mailed me my eligibility letter.
I passed NCLEX in August & applied to many jobs online with no results. With an ADN & no healthcare experience, I really had to stand out from all the others. In September, I finally started calling places & asking to speak directly to the RN manager, then following up with my resume via email. As a very shy & introverted person, it was really hard to do so but I'm glad I did it. I got 2 interviews out of it & was offered a job from one of the companies. My employer never even received my online application; I ended up filling out a paper one at my interview. I will admit, it is not the area I hoped to worked but I am grateful for the opportunity and intend to give it my all and reevaluate my situation in a year. Keep volunteering, stay in touch with classmates, network with everybody. Good luck!
Also, I found this article was really interesting. A bit depressing/scary for a new grad but a good reality check. Had I read this before I started nursing school, I may have changed my educational plan or at least had a better idea of what to expect when out of school.
Why Nursing School Grads Have Trouble Finding Jobs
That's a great point about what Malela says, status stuff like BMW'S don't seem too important here I live in Waikiki and it is more expensive, I pay about $1300 for a rather small one bedroom that includes security, parking, water and basic cable. Electric runs about 90 a month (yes it's high). Food costs are of course high. But some of the high costs are offset by other advantages such as not needing winter clothes. And the beach is free. I moved here seven years ago and I was well aware of the COL but it was a LIFESTYLE change that took a bit longer to get used to..coming from the mainland where I had a three bedroom house, and now I live in a small place in a high rise..but really all I need is a computer and a place for a surfboard, so if the lifestyle suits you, there's payoffs to the higher COL. I'm a single mom and I do case management, I don't have loads of money laying around but it supports me pretty good. But I don't have any debt, no mortgage, no credit card payments, and nothing fancy.
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