Latest Comments by Oh'Ello - page 3

Oh'Ello 5,093 Views

Joined: Jul 24, '14; Posts: 228 (68% Liked) ; Likes: 935
Specialty: Heme Onc

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  • 1
    OrganizedChaos likes this.

    I'm confused. You say that you don't know what to do, but you don't want to go to another area. So do you want to go or not? You say you've come up with other options that involve a paycut...what were those options?

  • 2
    tacticool and cocoa_puff like this.

    Quote from cocoa_puff
    I hate being the one responsible for everything! When trays are late, food is cold or patients dislike their meal, meds haven't been sent from pharmacy, dietary wants the patient on a diet but needs me to contact the doctor for the order, rehab works the patient too hard and the patient complains, the doctor didn't explain something to the patient well enough, endo canceled the procedure, cardiology didn't look at the patient's EKG and the hospitalist wants to know why, the TV stopped working, the RT took the patient's CPAP machine for some reason - and guess who gets blamed??
    Anytime something goes wrong, guess whose fault it is? Yep, that's me, the RN
    You need to learn to tell some of these people to go F*&! themselves. That'll make your days a lot easier.

  • 3

    I literally walk away from them mid sentence. Nothing aggravates, arrogant people more than not giving them attention.

  • 2
    ktwlpn and poppycat like this.

    As a nurse, who myself had surgery requiring anesthesia last week, I am totally shocked that a PACU nurse of all people would have this expectation. Simply shocked. I can barely remember anything from the entire day after my surgery, let alone what kind of dumb **** I was probably saying in the PACU.

  • 0

    Quote from mistymae22
    Patient got admitted with the PICC and had antibiotics given during outpatient the day before admission, through the PICC. It was in the physician notes. Last Chest Xray for it was the beginning of this month when it was first placed. I forgot exactly where they said it was but if it was deep in the heart, the heart rhythm would be out of whack. He was on a tele monitor and he was sinus rhythm the whole time. His vitals were stable and there were no signs or symptoms of any respiratory distress or discomfort. I asked him at the end of the shift if he felt any different than before he got any blood, and he said he didn't feel any different. He was getting blood and plasma through the PICC. And then antibiotics outside the hospital. Would the reactions come way after the blood and plasma were given? Anyway, he's HGB ended up moving up 2 points. So the body absorbed it even though PICC was not in the ideal place.

    We rarely if ever, verify PICC placement on admission. Unless there is something wrong with it, like has crappy blood return, sluggish flush, looks infected, or has an excessive amount of line coiled under the dressing. I can tell you this, if you worked where I work, you would be a-ok. Nobody would think twice about this. I guess just know your hospitals policy on the matter. PICCs migrate. And most of the time, when they do, they are essentially just fancy peripheral lines.

    That said, the timing of a blood product reaction would have nothing to do with whether or not the PICC was in the right place.

  • 0

    Just say that your long term goal is to advance your education as much as possible. You don't have to get into specifics and if they ask what education its perfectly OK to say that you don't know yet. I always use the phrasing "I haven't decided on a specific path yet, I'm still trying to identify what I'm really really good at"

    Half-truths are ok sometimes.

  • 9

    Ok. Step 1. Chill

    If every nurse had to know everything about medicine and nursing and pharmacology to be competent, this forum would not exist..because there would not be any nurses.

    Step 2. Get interested

    What interests you? What kind of nursing would you want to do? Have you had a dream job? Is there anything you're good at? Do you feel compelled to do any particular kind of nursing? I think identifying what your interests and wants are will help you quell some anxiety. Contact a nursing recruiter and ask if they can set you up with some shadow dates, so you can see different units and find out where you might feel comfortable.

    Step 3. Chill

    Everyone sucks at nursing when they start. Damned near everyone is an anxious mess at time during orientation. You're successfully keeping a newborn baby alive, You can probably handle a myriad of patient care situations.

    Step 4. Praise yourself

    YOU GRADUATED FROM NURSING SCHOOL...PREGNANT, BIRTHED A HUMAN AND THEN PASSED THE BOARDS. That right there is freaking anxiety inducing for me. Nursing is a piece of cake compared to that scenario. You're tackling something right now that a lot of people couldn't handle. Just because you're anxious and professional nursing is new for you, LOOK AT ALL THE NEW STUFF YOU JUST DID. Slay.

    Step 5. Apply yourself

    Apply for jobs. All. Kinds. Of. Jobs. Put yourself out there and get some interviews under your belt. Wash the baby puke out yo hair, slip on some pumps and start talking adult stuff with adult people. The more interview practice you get, they easier they get and the better you get at them.

    Step 6. Open Up and Reach out

    Use your resources. Friends you went to school with, instructors from school, nursing recruiters. Let them know about your situation with the behbeh and why you took time off. Network and try to get your feet in doors.

    Now get up offa that thang and get yoself a job girl!

  • 1
    Boomer MS, RN likes this.

    Most CRNA programs require Critical Care experience. While you are not totally committed to the CRNA route, if you do choose to go that way, the MICU will provide you with the necessary experience for your resume. The OR is not typically considered critical care, so you'd have to then secure a job in an ICU for several years prior to starting school.

  • 0

    I'm not quite sure what you're talking about but I'd use the one that is closest to correct. Additionally, I'd talk to the agency and tell them that the one that they edited to 4 years is not correct, as it may have been a clerical error or typo on their part.

  • 4
    lavenderskies, canoehead, Kitiger, and 1 other like this.

    We really only throw everything away if the patient was on contact precautions. Otherwise the stuff stays in the cart, gloves included. I always found this interesting though. If we're transferring a patient on contact precautions... why not just send the "contaminated" stuff with them, instead of sending them to another room where they will again throw everything away.

    I guess this is why my last health care encounter cost $300k+

  • 0

    At my last job on the floor, we had charge PCT's. Essentially the Charge PCT would handle the Unit Secretary/Coordinator role and be tasked with answering the phone and doing the patient flow tracking, update boards, print nursing paperwork, transfer calls etc stuff on the off hours or in the event that we didn't have a unit sec. They could also perform these tasks if patient care was "slow" or if we had a lot of discharges, transfers and admission and the unit sec was inundated and needed help. In addition to those duties they'd stock the doors and nursing carts in lieu of doing a whole day of patient care.

    Typically on off shifts the Charge RN handled those responsibilities in addition to having some kind of assignment, managing crises, dealing with central mgmt, doing narc counts etc. It was just too overwhelming to have the Charge RN also be the unit Sec, so we created the Charge PCT role, sent them to the unit sec classes and moved it off to them. It worked well especially because we always had unit sec coverage (even if there was a call off) and it was a nice change of pace sometimes for the PCT's on night shift. Our sister units loved it also because if they had a unit sec call off and we were OK with staffing, we could send ours, or a Charge PCT to do the job.

    The charge PCT took over patient care for PCTs for breaks and in a pinch could essentially perform any PCT role if needed while they were charge.

  • 11
    poppycat, canoehead, PolaBar, and 8 others like this.

    Step 1. Clock out
    Step 2. Get in your car
    Step 3. Drive
    Step 4. Never return

  • 6
    Kitiger, NurseMegBSNRN, JustMe54, and 3 others like this.

    You'd probably be a shoe-in to be a surgical instrument tech since you have OR nurse experience. They are the people that prepare the trays, sterilize the equipment for the OR. Where I live its a pretty good paying job, not as much as nursing but its skilled work that doesn't require a specific degree and you could definitely make a living of it.

  • 0

    Quote from ~PedsRN~
    That was a big miss, especially by the first nurse that started using it before the X-ray. :/ But don't they usually X-ray in interventional as it is placed? Or maybe that's a kid thing.
    Many hospitals place PICCs at the bedside now, with an ultrasound-y contraption. If the patient is low risk and the nurse placing the picc was able to visualize p-waves during the procedure, some hospitals don't require additional imaging. Some higher risk patients (obese, severely dehydrated, cachetic, elderly, etc) they still require an additional x-ray. Even so, PICCs are at high risk for displacement right after they are placed, because patients often require an additional dressing change d/t bleeding and haven't yet built scar tissue around the insertion site, allowing for mobility of the line.

  • 3

    It just depends on what med it is and where the displacement is. For example... if you're pushing chemo through a PICC thats recoiled and is in the mid axilla, you could have a nasty extravasation of the vessels in the armpit, If its advanced too far, like on a valve or well into the ventricle, and you're dumping fluid, you can have some arrhythmia issues. Sometimes the line escapes the subclavian and into the lung during insertion actually giving the patient a pneumo....but that'd be pretty apparent right off the bat.

    PICCs get displaced a lot. Even without ideal placement, they are often still OK'd to use, but sometimes with a restriction... like "No pressers, no chemo" because its essentially a midline. and you can't manage extravasation of the deep vessel if something occurs. Blood, most antibiotics and fluids are usually ok.