It's All YOU Baby!

Nurses General Nursing

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Recently I have been orienting a new hire to the SICU. The hospital is a large hospital in a small town. This nurses has 3 years ICU experience working at "THE World Famous Medical Center". She has been shocked at how we doing things here in the sticks. She asked me who comes and monitors the baloon pump?

I answered "you of course".

Q: What is the number for the IV team?

A: You are the IV team. (Turns out this RN had never attempted an IV in her life)

Q: Does the turn team come on odd or even hours?

A: You are the turn team for your patients.

Q: Who comes and places NGs?

A: you place NGs on your patients.

Q: Does the admission tream work at night?

A: Yes! You are the admission team and you work nights.

Q: Where can I find lab's number to come and draw this CBC?

A: You are the lab draw person.

Q: Who changes central line dressings?

A: It's all YOU baby!

Q: We need a STAT levophed gtt, where can I find pharmacy's number?

A: Here is a vial of levophed and a 250ml bag of saline. You get to mix them.

Q: Do I call RT to draw this ABG?

A: Here's your syringe with needle attached.

Q: How do I get ahold of the lift team?

A: You stick you head out the door and ask anyone you see for help.

Q: What resident do we call now that our patient has gone into rapid a-fib?

A: You deal with it per protocal.

Q: What is the number for the code team?

A: You ARE the code team, at least a good chunk of it.

This nurse is obviously very bright and knows her stuff. However it has left me wondering what RNs do at "THE World Famous Medical Center"?

Specializes in Critical Care; Cardiac; Professional Development.

A turn team? NG team? Never heard of those. Sounds luxurious.

We have an IV team but they only do PICCs, so they probably ought to be called the PICC team. I love doing IVs. Would irritate me if I couldn't.

We do have an "admission unit" and I seriously need to buy those people a pitcher of margaritas because I love them so hard.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

PMFB......if I ever get back on my feet, sounds like my cup of tea.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
PMFB......if I ever get back on my feet, sounds like my cup of tea.

*** Well every summer when a bunch of the RNs go off to CRNA school there are opening.

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

I've gone through this before and it's a difficult transition to make.After learning protocols/procedures I do admit it's easier most times to do yourself vs waiting around for another person to mosey on down taking there own sweet time.

Your post DOES come across as though your belittling the nurse and NOT the facility and now your back-peddling. Whatever.

I do admit it's nice to have another nurse drop an NGT, place a f/c, draw labs on difficult sticks, turn my 250kg pt, draw ABG's on squirrely pts and thus free me up to do other nursey tasks like hold a LOL's hand.

Doesn't mean I don't know how or want to do it but may as well take advantage of the resource getting PAID to do these tasks.

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.
I've worked at the small community hospital, and I've worked at the "world famous medical center" and I gotta say, when you have a code, or a question in the middle of the night, it's quite nice being at the "world famous medical center" when you have a room full of residents and an attending and a code team and a IV team and someone from RT there, a whole bunch of people who have got your back. Having done it both ways, I can't say that I'd want to go back to the small hospital again, especially on nights. No thanks.

AMEN.

I would much rather be in the "world famous medical center" than take 1 patient but have to be super-nurse. I would also much rather rely on our awesome docs and residents who are always around somewhere 24/7.

The only thing we get to do on my unit is draw ABG's and line draws. Don't ask me why since we have 3 RT's assigned to our 24 bed unit.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
AMEN.

I would much rather be in the "world famous medical center" than take 1 patient but have to be super-nurse. I would also much rather rely on our awesome docs and residents who are always around somewhere 24/7.

*** The really great thing is that we all like different things. For example I am thrilled that there are RNs out there who enjoy helping deliver babies. That means I don't have to do it. Different strokes.............

Specializes in Psych ICU, addictions.

OP: I had the opposite experience as your new hire: I came from a facility where I had to do nearly everything for my patients (usually because we were chronically short-staffed), to a place where there's tons of resources at my disposal and I don't have to do a lot of what I've had to. And they look at me like I'm crazy when I tell them what I've have to do at the last place and to how many patients I did it for.

My current job is at a great facility, I love working there, and I'm adjusting to the new work culture...though I'll admit I miss the chaos and the frequent getting my hands dirty.

I'm glad your new hire is working out well.

Wait till she hears that there is no transport nurse to take her patient to MRI/CT scan/Xray either.

Specializes in Adult/Ped Emergency and Trauma.

Hey, We're happy on the floor when we have a CNA, when there's a "Med" Nurse, we feel like throwing a Christmas Party!!

Hey, We're happy on the floor when we have a CNA, when there's a "Med" Nurse, we feel like throwing a Christmas Party!!

I heard that, Wow, a Med Nurse (all dreamy eyed).

Specializes in ACNP-BC, Adult Critical Care, Cardiology.

I'm an ICU nurse practitioner in a fairly large medical center that has some national renown (consistently in the Honor Roll on US News and World Report's Top Hospitals for 7 years in a row). While I never worked as a bedside ICU nurse here, I do believe that the nurses have it good compared to my experience when I was a bedside nurse somewhere else.

1. The nurses do place their own IV's but can call us NP's for difficult IV placements (PIV with ultrasound guidance, needs a PICC or a triple lumen or an arterial line).

2. There is a turn team.

3. There is no NG tube team. I actually haven't heard of that anywhere.

4. There is no Admission Team but the charge nurse helps nurses with admissions.

5. Lab does not come to draw blood. ICU nurses do them.

6. Nurses change central line dressings.

7. Stat pressors are easily accessed by overriding it on Pyxis (even Levophed). Nurses never mix drips in the unit. There is no laminar airflow chamber -- a no no per Pharmacy.

8. RT will draw difficult ABG's (or NP's will help) but nurses try first.

9. Bedside ICU nurses do not respond to codes outside of their own unit and there is a separate Rapid Response Team. The core Code Team is composed of the Cardiology resident on call (team leader), the ICU fellow/resident/NP teams, and the primary nurse and RT taking care of the patient. Everyone in the unit tries to help, of course.

10. All patients have a primary provider team assigned and a beeper to call for any issues.

Specializes in ER.

Wait til she finds out that she is housekeeping and maintenance too, on weekend nights. Show her where the plunger is, LOL!

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