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CandiceNTexas's Latest Activity

  1. CandiceNTexas

    Are 24-Hour Open Visitation Policies a Bad Idea? (Yes)

    We really need to inject common sense back into nursing, or we may as well be hospitality services, ie really expensive hotels! I recently had a patient ask me about her neighbor, she knew all the details of this patient, pmh,diagnosis, family business, everything, from the family talking in the hall. It was like she was missing her daily soap opera. another time, I walked into my patients room to find a family member taking selfies with my incubated ventric patient. How pretty do you think that pic was? and the best one was my h1n1 patient, grand kids, toddlers, crawling everywhere, barefoot drooling. Omg, imagine them going to daycare the next day. As nurses, we are responsible for educating and protecting the public from health threats, and I wish we were given room to assess some of these situations for ourselves, instead of following a one sized fits all solution to address the visitation policies.
  2. CandiceNTexas

    The use of LPN's in ICU CCU

    RnParamedic, I thanked you because you are truly one of few advanced titled nurses who seems to recognize that the value of a nurse can't always be ascertained by the number of letters after their names! I was a nurses aide for a few months, an LVN for 6 years, currently an RN for the last 12 years, and just now starting my BSN education. My critical care preceptor was an LVN, and she was the most experienced ccu nurse on the floor at that time, with a total of 30 years of operating room, recovery room, open heart recovery, and critical care experience. Sadly, when our hospital tried for magnet status, she left, only to be replaced by baby BSNs, and it left a gaping hole, as she was a wellspring of information. Physicians would ask HER what to do next! From this experience, I learned to open up and learn what I can from every nurse, and give freely what I know to anyone who asks.
  3. CandiceNTexas

    Will I get a raise after corrective action.

    LOL. Fess up Idaa, we're all friends here! Let's see; I have been written up probably twice a year, since 96. I'm that special problem child who management seems to love dearly. I also get plenty of positive write ups from patients and their families, so I figure it keeps the scales balanced in my favor. I have never, ever not gotten a raise, and I have even received bonuses for favorable reviews by patients/families. So it really depends on the policy of the facility you work for. But, come on, spill the beans! And whatever you did, DONT DO IT AGAIN!
  4. CandiceNTexas

    A possitive tb test

    A positive quantiferon is not indicative of active tb, it shows exposure to tb. Most likely your cxr will be fine (if you have no symptoms, ie coughing, night sweats, fatique, weight loss, etc). BUT you may still be prescribed inh forever, not really, 9 months, but it seems like forever, and you will always test positive on the ppd test. I was told I would not have to have a ppd test anymore. This happened to me a couple of years ago, due to exposure at work, and boy was it scary, I ended up having a ct, because of a "shadow" on the xray. It can be a frightening experience, but I didn't lose one day of work. Don't let your fear get the best of you, most likely you will be just fine!
  5. CandiceNTexas

    New RN starting in ICU Question

    Nurses do at the facility I work at. We pull cts, cordis/swanz lines, a lines, pacer wires. Part of nursing duties, and all ya need is an order and training.
  6. CandiceNTexas

    No briefs?! Is this an ICU thing?

    Several years ago we got new beds/mattresses that were supposed to reduce pressure ulcers. We were told in product training that we should only use 1 sheet and 1 chuck on the mattress for it to be effective. A few years later, our beds are covered in a fitted sheet, a draw sheet, a chuck, and a lift sheet routinely! People have amnesia sometimes. First thing I do when I turn my patient is remove all unnecessary layers of bedding. I rarely use briefs, for the reasons already stated, but this thread made me laugh.
  7. CandiceNTexas

    Is there a place for non-confrontational nurses in ICU?

    I work with a lot of new nurses, a lot of soft spoken nurses, and with nurses who are ESL. I feel sorry for them, because they get dumped on a lot! Your post says that the order was put in AFTER the er nurse gave you report, as a stat order, the mri dept called the er, the er nurse probably thought, "I already gave report, the pt is being moved", and technically, it was a ccu order. That seems to be the fault of the doctor, and they often don't have any sense of how it will inconvenience nursing or delay treatment, etc. You could have ASKED the er nurse if she would mind stopping at MRI, and offered to meet her in MRI to take the pt to icu, something I have done several times when the ED is slammed. I will say, I do understand how you feel, but sometimes you will have to stand your ground, and confrontation, in a professional manner, may be needed. You may have to even question doctors, especially residents, or they will eat you for lunch! Your patient comes first, and they need you to speak up for them. You did a good job by taking the pt yourself, in spite of the way it happened.
  8. CandiceNTexas

    confused ER or nursing resource team?

    That depends on what your goals are. Do you like the rush of er, the controlled chaos, adrenilin rush? Or do you want to work in several areas, to gain experience? Does resource pay more? Would you have specific areas you would work, ie er, icu pcu, or would you have to float all over the hospital? Is resource first to go home? What are your long term goals?
  9. CandiceNTexas

    Alone as a New Grad in the ICU

    I take offense to that statement. I have almost 20 yrs nursing, with my little ole ADN degree. I also have a teaching degree and a BFA degree. You are assuming an awful lot, based on what? I am not easily intimidated, and I love to share what I have learned from patients, doctors and other nurses. School and books don't always teach you everything. It takes time to develope instincts. Also new grads have their own issues. . . for the most part, they don't know what they are doing. It is stressful to be responsible for your patients and THEIR patients. It takes time to get the hang of the culture. The nurses who act in a demeaning way to new grads, most likely do the same thing to their patients and all the other nurses they work with. And remember, YOU will be a dinosaur someday, if you are lucky!
  10. CandiceNTexas

    Alone as a New Grad in the ICU

    Really? Nurses still eat their young? The facility I work at doesn't seem to have this problem, maybe because we are so short staffed, we look at every able bodied nurse as a godsend! I do confess to coming across as, well witchy, rarely, but only because of the stress of the load. . . I feel bad when I am not a perfect example of a bright eyed, excited bushy tailed, rally round the troops kind of nurse, but real life nursing is, lets face it, not school. The other day, I lost it with a new nurse, but I had a good reason, not an excuse, but a good reason: in icu we each had 3 very sick patients, I actually had 4, one patient w/ a mother, who needed as much care as he did,mom was early stage dementia as well. . . we had 4 codes, and lost a 20 something pt. . . she's getting report from me, she kept inturupting me during report, to ask things I was in the process of tellnig her, just being all super special. Then we went into the pts room, to do a quick bedside, pt was getting a breathing tx and this nurse says help me turn her so i can look at her back. Well, I came unhinged on her, because it had been an awful night, she was rude, and demanding. Well, that's how you are trained to do things maybe, but A. the patient is not going to die if we don't turn her to do her skin assessment, B. she was still with a preceptor who could have assisted her in turning, C. no one had done any charting, and D. she was being all anal and super duper at a time when I was just wiped out! There are times when a newbie just needs to chill and observe and absorb the unit.So, maybe a self check is needed, just to make sure its not YOU, being super duper and ruffling feathers of us old hens. It will get better, I promise.
  11. CandiceNTexas

    What Grossness Is Cool?

    God as my Witness you can! Think pinworms. . .no one is sure how he got them, the family tried to blame the hospital staff. . .it was summer. . .there may have been an open window. . .but we pointed out that we did not have the patient long enough for a hatching cycle to occur. If I remember correctly, the patient had a hx of IDDM, ETOH abuse, liver problems, gi bleeding, and renal problems. When the nurse caring for the patient told the Dr. what she had found crawling off of the patients face, I don't think he believed her, she started catching them in sterile cups. . .eeeewwwuuhh! Later the CRT said, " Come here for a minute", and pointed them out in the vent tubing. As we turned the patient for pericare after a loose stool, the nurse pointed them out. Good Lord, we all had the creepy crawlies! The primary nurse showed the family the cup-o-maggots and they finally decided to do a terminal extubation, may he rest in peace. I've seen them in decubes too, but nothing grossed me out like this case did.
  12. As a nursing student, I found the concept approach that Teach1 mentioned to be very helpful. Many students are cognitive learners, as opposed to verbal learners, and right brained, thus needing to look at a situation from a very different pov as the left brained. Critical thinking involves much more right brained activity, and can be stimulated by music, art, poetry etc. I also found it helpful to have a sense of, well, balance in learning critical thinking; for example learning ABCs, prioritization and pathophysiology at the same time. Situational learning was a wonderful learning tool, particularly during the final semester, a kind of what would you do and why scenerio which allowed brainstorming without fear of criticism. One very simple example that seems silly now: during management we were given a situation: your neighbors' husband is c/o cp after cutting the grass and she asks for your. What do you do? My answer: have him sit still, take an aspirin and call 911. Wrong answer my instructor says, you are practicing medicine w/o a liscense. What?! I don't get it. If I don't do what I know to be the standard of care, won't I be liable? This simple discussion went on for 40 minutes, but the lessons learned were very important to us then. I may be inappropriate to reply at all, as I have never taught nursing, but I did teach 1st grade for several years before going to nursing school, so please forgive my impetuousness in replying. God Bless the teachers, I do not envy you your task! Keep up the good work!
  13. CandiceNTexas

    What Grossness Is Cool?

    In the CCU that I work in we had a patient with a REALLY BAD maggot infestation of the respiratory and GI tracts. Maggots while suctioning the vent patient, maggots while doing peri care, maggots crawling out of his eyes!!!! I was nauseous for a week, and didn't find it cool at all, just gross! The worst part was that his family kept him a full code for days, which was cruel, and the doctors said there was nothing they could do about it, which was cruel! NOT COOL, JUST CRUEL!
  14. CandiceNTexas

    I took my boards ahhhh!

    I remember the anxiety well! I passed LVN at 75 questions and RN at 85. I think the LVN boards were harder, or maybe it was because I had 6 years of experience by the time I passed Rn boards. Someone told me that if your questions were hard, you probably passed, if you were like. . .duhhh, and had very easy questions you probably didn't. But keep in mind you may have had lots of the "test" questions that don't count towards your score. Don't panic!!! You can check in like 3 or 4 days now, as opposed to having to wait 2 weeks like we used to have to do. Good luck, fingers crossed!