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ljo28

ljo28 BSN

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ljo28 has 25 years experience as a BSN.

ljo28's Latest Activity

  1. 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.
  2. 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.
  3. ljo28

    Low Stress Specialties

    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.
  4. ljo28

    New to Cardiac Cath Lab

    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!
  5. ljo28

    Difficulty with respiratory issues as a new grad?

    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.
  6. ljo28

    Helpful Information for the Critical Care Units

    Very helpful links.Thanks for posting.
  7. ljo28

    What is Your Nurse Hero Story?

    Nursing - My Calling, My Passion, My Profession I am a nurse. I have been a nurse for as long as I remember. Nursing has been my calling, my passion and now my profession. In these difficult times of global pandemic, I have been detailed to help out in the most needed areas, which is taking care of COVID patients in the ICU. Although I don’t currently work in an ICU, with my long-standing critical care experience, I feel comfortable in taking care of the critically ill patients. My Responsibility This is my job and my professional responsibility as a nurse, and I am more than happy to do my part. Initially, I had mixed reactions including anger and frustration to my deployment, I now am able to see the bigger picture, and have a whole different perspective about the situation. I consider myself fortunate to be a part of this global pandemic response efforts in my own little way, and am grateful for the experience of a lifetime, knowing that my efforts are making a difference. Nurses Being Taken For Granted I do however, have an issue with how nurses are being treated. While being beyond happy that now, nursing as a profession is globally recognized and elevated to a level like never before, the fact that the nurses at grassroots are taken for-granted is concerning. We are required to work with minimal supplies. When I say this, I am not referring to the specific institution that I work for, because thankfully we have a steady supply of necessary inventory. I am talking about the global and national situation affecting the entire frontline workers. I am talking about the plight of all the nursing friends and acquaintances far and near, who are forced to work with minimal supplies. The infection control guidelines are being constantly changed and lowered to accommodate the scarce supply of available PPEs. The hospital policies are changed to what we know do not align with the best practice guidelines that we have been following before the pandemic. This is very demoralizing for a profession which has historically been known to stand up for the ‘right thing to do’ principle. Besides, nurses are being given nominal monetary incentives just for the sake of it, which I consider very degrading and undermining to the amount of risk and stress that we are going through. Some institutions, are giving a one-time incentive, which is equal to or less than what a nurse would typically earn in one week. We would have been just fine without this namesake monetary incentive. Discounts and Freebies Many companies are offering discounts and freebies for the frontline workers, which is very much appreciated by the entire nursing clan. We all are aware of our love for free stuff. These freebies also include the much-needed meals during the difficult times, and collectively we are thankful for every bite of it, because we are tired, stressed and have no strength left to cook. We are thankful for the generosity and outpouring of love and encouragement from the community that we serve for. We are grateful for the acknowledgement of the risky work and appreciation parades by the police and firefighters, and are thankful for the generous donations from the community, and please know that every bit goes a long way. All this cheer does make this misery a little bit bearable for the moment at least, but in no way does this make the reality of the situation go away. Day in and day out we walk into our work areas speculating what lies ahead of us, how are we going to get through this day, and this feeling does not end today nor will it end tomorrow or soon enough. Heroes or Just a Nurse My rant is also about being labelled “a hero” for doing my job. I am not “a hero”, or “a warrior.” I am “just a nurse” (pun intended) doing my job. Is it affecting my life- yes!! Both professionally and personally. My life is turned upside down. My family is put at risk because I am in the thick of the sickest of the sick. My schedule has changed drastically. And it is not just me. Nurses all over are dealing with situations like this. I know a lot of fellow colleagues who are staying away from home, sleeping in a camper or staying at a hotel (thanks to AACN for their partnership with Hilton group to provide free room to their members), to avoid exposing their elderly grand-parents, parents, immune-compromised family members or children and the trauma they are going through on a daily basis. The professional standards that nursing has operated on forever, are being challenged. Compassion and caring have a whole different meaning. Calling us “a hero”is for doing my job? I am not a hero. Give me the love, support, compensation and recognition that I deserve. Nurses Uniting to Face COVID and Supporting Each Other We as nurses have come together to face this, and stand as a team helping, supporting each other emotionally and professionally. But for the better good, I hope that we learn from this as a community and globally, so that never again will human race find itself in a situation like this.
  8. ljo28

    Is the grass greener in ICU?

    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
  9. ljo28

    Should I Transfer to ICU?

    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.
  10. ljo28

    CRRT

    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.
  11. ljo28

    Thoughts on Charge RN

    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.
  12. ljo28

    Multiple preceptors

    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.
  13. ljo28

    Multiple preceptors

    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.
  14. ljo28

    Multiple med errors

    Hello, I am so sorry to hear this. While I don't know what errors you made, but be assured that not all errors are person related. Your inexperience could be a reason for the error, but there should have been policies in place to prevent the errors. You said that the patients were OK. I would advise you to look into what exactly happened and take actions not to repeat them again. Hope this helps.
  15. ljo28

    Orientation debacle

    Hi With the benefit of doubt, is there any chance that this individual is just trying to make friends to fit into the new work environment. New job with new commitments can be stressful. And the fact that you don't know any one adds It. Just because now that you are assigned to them, they feel comfortable with you and as you said that they feel latched to you. I would say give it some time. Once they are done with orientation, things might change.
  16. ljo28

    VA proficiency nurse III frustration & appeal

    Hi Anybody who has Nurse 3 and is willing to share their proficiency, please send it to leena_johnson28@ yahoo.com thanks in advance