ljo28

Don't be so hard on yourself because you did not understand the orders. Technically the MD should have clarified the orders and there should be a written order of what she verbally told you. And if the patient was seizing back to back, the doctor should not have left the floor before the patient is stabilized. I don't know if she ordered anything for the seizures besides Tylenol to control the temp, but that should have been the priority if the patient was actively seizing. Everybody has a learning curve and you are no exception. Even a seasoned nurse who transfers to a different work area may face challenges. You just take them as stepping stones and learn from such experiences.

How many Hrs/week will you have to work as a casual employee. If you have financial cushion for 6months then it might be worth taking the risk. But consider the uncertainties before you make that plunge, considering that you will need benefits and given the current job market. How likely is it that you will get a FT position after the 6months.

Agree with ICUman. Stresslab, or out patient cardiology. PACU, ambulatory surgery, IV team etc. are some other areas but it will take at least 6months to get comfortable.

There is a lot to learn in Interventional cardiology, but don't loose heart. You will get there. It is a very cool and rewarding experience. I am sure there are a lot of books available. Medtronic Academy has some free online educational activities with CEUs that you can start with. I want to mention that a procedure area operates at a different pace as compared to an inpatient unit, but you coming from ED might be an advantage. You will learn the different catheters as you go and in no time will be a pro. Good luck!

In my opinion, on a med-surg floor if you heard a wheeze, as a nurse it is your responsibility to address it. You cannot just document that the patient is wheezing and move on. And you are the licensed personnel. You have to follow it through either by notifying the RT or a resident or someone because ultimately it is you who is responsible for the patient. Because if something happens and the patient decompensated, you will not be at fault. Once you tell someone, you can document it, and you are covered. You continue to monitor and follow up and as your shift goes on. Things are different in the ICU or step-down units because the patients are closely monitored, those nurses are trained and have a little bit more autonomy in practice based on their skills and experience. In the units as long as the patient is breathing and able to protect his airway, has a decent SaO2, and not SOB, a CHF or a COPD patient wheezing can be tolerated, but still has to be monitored for decompensation. Nebs may not be the only treatment option available. As far as the rude behavior of the RT is concerned, you can talk to his supervisor. You did the right thing of involving the charge nurse, and it will also help to bring it up to your nurse manager as well. And if this behavior continues, it needs to be addressed. There is a lot of demeaning behavior that goes on in the healthcare setting, and by any means don't let it stop you from doing what is right.

I think it was wrong on the part of the management that they order 1:1 and don't tell staff why the patient needed 1:1. In order to provide the best care, the staff need to know the reason for the 1:1. It could be for suicide precautions, agitation, drugs, physical violence, or whatever reason it might be, but the staff taking care of the patient should be aware of it. Especially if it was all nurses covering the 1:1, it is all the more reason that the they be aware. Him being high profile does not have any thing to do with it. The staff need that pertinent information, and that is it. What if the patient was high profile. He was in the hospital for a reason and the staff who is taking care of the patient should know that in order to give the best care to the patient safely and effectively, regardless of his social status. I think the management is at fault here for being secretive. This is like putting the staff and patient at risk.

If we forget all the racist allegations being going around for a minute, we all can agree that the involved officers should be arrested. The fact that they are public servants, and in one way or the other we are all paying them. No one should be behaving in such a criminal manner leave alone the ones who are responsible for public safety. What ever the reason may have been for Floyd's arrest, there was no evidence of retaliation from him and hence no need for such insensitive fatal force. And to add to it, no feelings at all. And the administration not arresting them is what is adding fuel. The officers should be arrested and charged. Why is it so difficult for the administration to do that. The message they are sending out is more like " we are going to do whatever it takes to protect those officers at all cost". Having the National Guard, police force, all the riots etc. Racism exists, and we cannot deny that, but here it is just plain humanity if you will. Nobody, yes Nobody should have to be a victim of such inhuman treatment and hope we all can agree on it. Nurses are known to stand up for the truth and truth is undeniable in this situation.

Very helpful links.Thanks for posting.

Moving from a Med-surg floor to an ICU is a normal progression. Very few people can work in med-surg for an extended period of time. If you feel ready to make that move then I'd advice to go ahead and do it. Don't worry about what you know or don't or what you can or can't do. Think about what you know when you started in nursing and where you are now. You will learn along the way as long as you are willing to learn. ICU isn't any less stressful. There are times when you'd be busy all day with only one patient. But it is more controlled and you can do way more than what you can do on the floor. So if you are ready for the move then go for it!! Good luck

What is the patient assignment like in the PCU that you are currently in. Also, what is the patient population like in the ICU that you want to transition to. Since you have more experience now than you had before, is certainly an asset, but it should be all about what you want for yourself, what your future goals are etc. There will always be some hiccups initially. Your decision should not be based on the people who are telling you to make the switch unless you really want to give it a shot.

In my facility we usually hang 4 bags at a time and the machine supposedly pulls evenly from each bag. If you changed one bag and forgot to mix the solution should not be a big deal. No this is not good enough of a reason to fire you or even a disciplinary action because first off, you were not given a proper orientation. You were not in your regular area of work. Secondly those bags are electrolyte solutions, and the patients on CCRT usually are ordered frequent labs. If there was any critical lab results, they would have been taken care of. So, if you'd ask me, I'd say learn from your mistakes and move on.

Stepping into a charge role in an ICU with out any ICU experience is not that good of an idea. If you are leaning in towards leadership, it would be more productive if you try being charge on the floor that you work on. If you are looking to move to a unit, then I'd suggest to apply to an ICU nurse position, and then transition into a charge role once you have a good understanding of the critical care. Charge nurse should be more like a resource nurse, and the staff should be able to look up to the charge. There are a lot of things that go on a regular basis in the ICU for which you need trained and experiences personal to over see.

That is wrong. They should have had a regular meeting with you and your preceptor to discuss progress. Orientation time is very valuable and every effort should be taken to utilize this time to the max in favor of the orientee.

I'd say that this orientation program should be well thought of especially for a new grad. While it is good to have a structured orientation schedule with assigned preceptors, this should be reassessed based on the orientee's progress. Sometimes it is just a issue of personality clash which can be easily fixed by changing the preceptors. Other times it may be the learning curve. In my experience the unit educator should be more involved in the orientation process.

I have used web-scheduler and loved it. I don't know how much it costs for the hospital though. Before web-scheduler, we just did paper schedule which worked well too.