MKZ

There is some really good advice here. I wanted to emphasize report taking and giving. So far, these are my favorite kinds of days at work. When I get and give report I focus on the following: I.1) Name age and primary diagnosis. 2) Events leading up to the primary diagnosis 3) Past medical history II. 1) A brief overview of significant interventions (surgery, medication administration, intubation) 2) Tests performed (eg, EKG, CT scans, X-rays, cultures...) This takes about three to five minutes Then review the systems. How is the patient now? Discuss interventions as you go along...kind of like filling up your tool bag) Neuro: Alertness and orietation status, if they can move, pupils, grips, pain issues, reflexes, physical activity and limitations, significant psychosocial issues) Cardiovascular Temperature Hot or cold? Heart rythym. Sinus or not so sinus? Blood pressure conditions Fluid staus Skin Wounds Dressings and drains Lines Medication in the lines Labs, focus on the basic chem, AKA electrolytes Respiratory Mode of breathing, lung sounds, vent settings, plan of care with vent settigs, secretions type and color, cough reflexes, incentive spirometer Gastoenterology How they eat, and how the poop. Bowel sounds, abdomens shape, size, tenderness. Tube feeds, residuals, blood sugars, Urinary Ins and out via the kidneys. Kidneys not working? then creat levels, dalysis or CVVH schedule, how is this person filtering? Foley in or out? Describe urine (this is where one can be truly creative...describe how it is) I did not mean to write so much. This is a good review for me. I am sure I forgot something, but I hope this helps..)

I had six weeks orientation in the ICU. I have been there for ten months and despite my requests, I have had no formal evaluation nor have I been shown the fire exit. What is going on in this profession? Oh that's right, there is a Nursing shortage. Does not make it okay to condescend new nurses, treat them like they are totally a burden, nor does it make it okay to have to bear the brunt of what is lacking. Just because they hired you does not mean they will treat you well. When you are anxious and nervous, thats normal but no one should cry after work, no one should be made to feel inadequate after they have done their best and then some. Women put up with horrifying conditions. If you are not apalled, then you are not paying attention. If you want to quit, quit. Screw it...go to a place where your heart feels safe. And unfortunately, a good nursing job is far and few in between. Until more funky nurses unite, this job is going to suck...suck so bad its not worth any money at all.

I agree "nurses eating their young" are not prone to be in secular areas. However, I find the statement "you are going to run into jerks where ever you go" offensive. For one, I have been alot of places, worked a lot of jobs, and never have I ever been put down, scorned, or unappreciated as I have been in nursing. It's a job I proudly accept. . From the beginning my attitude was bright open and willing to learn, suck up and deal, work hard to become a very good nurse. Jerks don't belong in nursing. But hey, lo and behold, there they are. And if one is to put up with it, more than likely, they too, will one day think its okay to be a jerk themselves. It rots the proffesion.

Over here on the west side, California, I am making $43.93 as a new grad in the ICU. The mortgage is 3500.00 a month. Bills are around 1200 a month. I eat well and sleep warm. Its all relevant.

I have been on my own for four months as a new grad after six weeks of orientation. I am not required to be ACLS certified. I had to pass the EKG course on my own and I was frightened. I was dreaming of squiggly lines. Its good to take a class. I encourage you to talk to your manager and tell him the truth about how you feel. That you were under the impression you would have this class to enhance your critical thinking skills and become an even better nurse/ assessor/ intervener/planner. And if the excuse is no more places in the classroom, ask him kindly to make some room. Good luck and may the force be with you.

Hello, its MKZ again. It has chilled me to read the insight you all have provided. There is too much truth to ignore. And it bothers me I made the mistake of thinking this is okay...this is what I want to do. I always wanted to be a good worker. I wrote a resignation letter and carried it around for a few shifts. That was about three weeks ago. I got sick (surprise!) and called in sick, I had a full week off. I show back up and somehow the floor is lighter, the patients I got were usually well enough be transferred out to another floor or they were not on the brink of death (the senior nurses got those.) The new orientees would usually report off:and me not being the only one super freaked out and insecure, would usually give good report organized structured information...admiiting diagnosis, past med hx, neuro, CV, resp, gi and gu. Then labs relacements, trends. The stress made us acutely aware of our situation and we all just wanted to do good for the patient. I took a good look around, the place was cluttered, stained in some areas. I found a blood smear on a monitor, on the floor, on the nurses tables. BLah blah blah, as I write this the realization of how much this sucks comes reigning down upon me And I am sick of complaining. I love nursing. And have. I believe in every person being a healer, I chose this career because it feels good to help this way. And its a good job. I just spent the last four years getting ready to do this. Once again, it scared me to read some of the replies. Why did it scare me? Because it's the cold hard truth. Thank You. MKZ

Thanks for the suipport. I really had the wool pulled over my eyes when I had gone in for my interview. I was told orientation would last for three months, that I would work the night shift and quality of patient care was their utmost priority. (I have been put on the day shift) I was told many things that did not come to fruition. However, the idea of a unit council is something I will look into tomorrow when I return to work. I always knew in nursing school there would be a major transition between the school world, the n-clex world and the real world. I was ready to soak up the changes. And unfortunately, I ended up on a floor that hired fourteen new grads and not one of us received a proper orientation to the facility. I asked the unit mananger during a meeting when we were going to be shown the fire escape plan or what to do in case of a natural disaster. It was during the anniversary of Katrina. She told me there is a walk through every six months and we had just missed the last one. Great.

Hello to all. I am a new grad in the ICU. I have been on my own for two weeks after SIX weeks of orientation. Needless to say, I am not only swamped by the miracles I am expected to perform with two heavy patients, I am disheartened. I can't believe how overworked and miserable the conditions are in my non- unionized hospital. On a good day management is "kooky"...on a bad day, certifiably insane. I have been reading these posts for two years now...I have always found strength in reading about similar circunstances I have gone through. It has helped enormously to relate my experiences to others. I really need some help now. From the firts day I hit the floor and met the first of my five preceptors (it was scheduled that way), I became suspicious of the quality of care. In and out..are they septic...what's the Mag..didn't you check the MAG!!!assess the patient, determine what's needed...find the young md right out of school who like me, has no clue how to run the archaic DOS system in order to print me out an order (as a new grad, I wait until the order is in my hands- I have to cover my bootie) In the beginning, I chalked up all my frustrations on being new and overwhelmed. But now the fog is clearing (somewhat) and I am looking up and seeing the nurses around me miserable. Fabulous, wonderfully smart witty nurses with plenty of years under their belt being overworked and stressed. BECAUSE...get this...there is NOT enough time in a shift. Surprise? No? I didn't think so...But why is it we need to suffer the effects of a nursing shortage when we are the nurses the hospitals so desperately need. The distribution of roles and responsibilities are all on the nurse. Florence Nightingale would be appalled if she stepped onto the floor I work on. It's nuts. I need to leave for the safety of patientsa and the sake of my license. The resources I need as a new grad are NOT reliable when I am on the floor (NO time to look up a protocol..too busy looking for a thermometer, finding a glucometer, or reordering the missing med...nurses say"not now...I am too busy) I am not proud of the work I do. When I feel there is a serious problem eg bp goin down to the 70's I say in my man voice " I need some help here" firm and direct and no bs. Nurses do come help, overworked nurses who I know I am pulling them away from their precious moments of doing their workload. I get the vibe. "Sink or swim" is a direct quatoe from management. I got better orientation in a video store. And its the ICU. My goodness...if the world only knew the reality...not simply "nursing shortage" but nursing abuse. I don't want to take this crap. It stuff like this that turns nursing from a proffesion to a joke. Any suggestions on how I can help my unit from continuing on in this disorganized chaotic manner?