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  1. climbeRN

    When to give Narcan??

    I didn't page the MD, but in retrospect, I know I should have. I was just so unfamiliar with the situation and trusted my charge and critical care nurse (especially since I'm new to med surg, I tend to think, oh I'm probably just over-reacting), and they didn't seem worried at all. But in the future, I'll definitely try to be more proactive about calling the MD if I just have a bad feeling about something, which I did. Thanks for the clarification on guidelines for RR and level of consciousness to give narcan! this helps a lot!
  2. climbeRN

    When to give Narcan??

    I'm new to adult nursing so I haven't dealt with overdoses and don't know what they look like. Recently, I had a pt with an orthopedic surgery who had dilaudid ordered. I gave one dose and pt was fine; after second dose (4 hrs later), pt's RR dropped to 5/min. In my hospital we have critical care nurses that we can call to evaluate the pt/situation. The critical care RN came and I asked about giving Narcan. She said not to give it because it might reverse all of the symptoms (extremely high BP, high HR) that the pt was experiencing before. The patient was only arousable to voice after calling their name about 10 times (I would say, arousable to pain because I did a sternal rub and they barely woke up). I didn't give the Narcan and in the end the doctor yelled at me for not giving it when he saw the vital signs in the morning, but both my charge RN and the critical care RN said not to give it. Also, I put the pt on continuous pulse ox after the critical care nurse left and they were 97% on 1 L O2. But does that mean the pt is ok with a RR of 5? Or can CO2 still build up and cause problems? So my question is what are the criteria for giving Narcan? What respiratory rate? What level of consciousness? If they still open their eyes (even if for only a few seconds) does that count as alert enough to not give it? thanks!
  3. Thanks so much for all of the ideas and suggestions! I am definitely going to make a list of topics for conversation as a starting point, since I don't foresee getting completely away from small talk as long as I'm in nursing. I'm hoping to return to NICU if I can master talking to adult patients first, then parents which tends to be more challenging for me. I'm still a fairly new nurse (less than 2 years) so definitely plenty of room for growth. Y'all are awesome!!!!!!
  4. I was in NICU for a year and a half and I've been doing Medsurg for a few months. I am capable of doing small talk pretty well, I guess I just didn't realize there would be so much of it in nursing.. I think I do make families feel awkward at times but if it's just me and the patient it's a little easier. And I have no trouble connecting with coworkers I guess because I know that it's more of a long term thing when I get to know them. However after a shift I have to avoid socializing for a few days in order to recharge haha! Do you suggest dealing with introversion by just trying to expose myself to more social situations maybe?
  5. Hahaha yep I'm thinking of trying NICU nights to avoid all the talking with parents or giving adult ICU shot. Just no family drama please! It's hard enough to concentrate on a critical pt without the drama!
  6. Thanks Guy in babyland for the input!! I have been thinking I never really have night shift in the NICU a fair shot since I was on days almost all of my time there. Research is another thing I've considered but a little harder to find an opening! Will keep trying stuff until I find a niche
  7. I'm looking for suggestions from my fellow introverted nurses: what specialties have you tried or heard of that are a good fit for someone who is not so fond of small talk? I am currently working in a med-surg unit on nights and find even the small amount of interaction with families to be incredibly draining. Before I worked in med-surg I actually worked in the NICU, but the long-term relationships with families for 2-3 months at a time was REALLY not my thing (my hospital did primary nursing and picking up one patient for that long terrified me because of running out of things to talk about with the parents after only one shift.) I was hoping med-surg would not require as much small talk as the NICU did, but I haven't found that to be the case. I really admire those who can talk to patients so effortlessly, but for me, that is the most draining part of the job, not the acuity, business, patho, or critical thinking. Would love to hear what specialties are a good fit for us introverts!
  8. climbeRN

    Anyone gone from NICU to adult ICU?

    Has anyone who started in the Neonatal ICU gone to straight to adult ICU and how was the transition?? I worked in a level III NICU for about 1.5 years, but found the social/family aspects so difficult to handle that I switched to an adult surgical floor 4 months ago. I am really enjoying my adult patients but really really missing the acuity and total patient care. It drives me nuts when I can't focus on everything I want to get done for each patient just because I spend so much of my time passing meds and charting. Should I stay on the surgical floor to get experience with adults before moving to ICU or would it be better to go onto ICU sooner so I don't lose my skills with drips/vents/lines? Thanks for your input :)
  9. climbeRN

    How to become a school nurse?

    Hi all! I'm a pretty new nurse with 1.5 years of experience in NICU and 3 months experience in adult med/surg as well. I was a former teacher (everything from toddlers to college) and would really like to do school nursing because of A) the kids, B) more preventative health education opportunities, and C) a more regular schedule. I am also really hoping to do camp nursing in the summers which this would allow. I don't care about the pay cut at all. I am wondering what specialties of hospital nursing and years of experience you would recommend before getting into school nursing? Has anyone ever heard of shadowing a school nurse for a while in order to learn how its done? Im trying to imagine how I would figure out all the paperwork aspects and government requirements and contacting doctors without ever seeing how its done and it seems a little scary. Would love any advice for how to transition into this specialty! thanks for any advice you can give!! :)