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Critical Care, ICU, Rehab
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TheLastUnicorn has 4 years experience and specializes in Critical Care, ICU, Rehab.

TheLastUnicorn's Latest Activity

  1. TheLastUnicorn

    Non accredited ADN, accredited BSN

    At this point with a BSN I don't think anyone cares about your ADN. I wouldn't even mention it. You're an RN with a BSN. That's all employers care about and all that matters.
  2. TheLastUnicorn

    Boyfriend wants me to stay away

    The first thing I did when I was exposed to COVID at the hospital was call my husband and consult on whether I should come home, or stay away from the house by getting a hotel room for the foreseeable future. Coming home means I would knowingly expose my husband and our children to this virus, also anyone else he comes in contact with because he is considered essential at his job. He wanted me home. Had he agreed that a hotel and keeping my distance from our home was in the best interest of our family, I would have done just that. I wouldn't have felt unsupported, unloved, or felt shunned from him or any of this other BS that's being prattled about. This is what real relationships look like. You make sacrifices, and if that sacrifice is having to physically be near someone for their own well being and safety, so be it. That all said, as some have told you, this will likely be a reoccurring theme in your relationship. What happens when you tell him about the patient with bed bugs? or scabies? Those are quite popular in the hospital setting. You will come across them. That and a hundred other potentially communicable diseases and illnesses. You need to have a discussion with your boyfriend on how this affects the future of your relationship. It's not just COVID you will be exposed to (and yes, you have been exposed, caring for the patients with it or not), there will be other things you will be exposed to and you need to know from him if he can handle that.
  3. TheLastUnicorn

    Cannabis nurse certification?

    You don't have to "take" the medication yourself to test for it. You can absorb it through your skin, and can breathe it in second hand. There's a reason for the whole USP 800. As nurses we are exposed to drugs, those drugs affect us. So yes.. You would total test positive for insulin, no need to ever even be exposed to it! (just gonna let you think on that one there). Keep in mind, this is still a federally illegal substance. You can anything a certification now. What can you do with it? No idea. I don't see where an RN is needed in this field. We can't prescribe it. And a dispenser would have no need for us. Not even medically dispensed from a pharmacy would need an RN. Sure you could work in the office of a Dr that handles cases for medical MJ but what purpose would a certification be in that setting? What is the cert even educating you on? I think you would start there. What are the specifics of the education, and how you can apply that to the field of nursing.
  4. TheLastUnicorn

    Opinions on how soon to float new nurses

    There's a difference in being floated, and being oriented to floating. I was oriented the months before I was even floated. Before I was even eligible to be floated. Didn't remember a damned thing by the time my turn came around. No one cared. The nurses in Icu were incredibly supportive. As for the drama. Nope. Stay out of it. I'm glad I'm now a float nurse. I no longer have to get involved or deal with any of that unit drama BS. Like someone else said: address it directly. Talk to your manager. Speak directly to said nurse. None of this he said she said they said BS. Don't fall for that crap.
  5. TheLastUnicorn

    Admin/Clerical Staff in Scrubs, Observing Procedures

    Have you discussed used these issues with your boss? Going above their head without taking to him/her first seems a bit extreme. Maybe the woman had permission to wear scrubs. Maybe she is working on a project or is in school and that's why she's shadowing. How do you know the patient want asked if it was okay for her to shadow? Also.. Not sure how you can be a nurse, or going through nursing school, without patients being exactly what you're trying to claim they are not; a learning experience.
  6. You may also want to inform him that chart checking another nurse is not his job and counts as a HIPAA violation. Assuming, he has no business being in that patient's chart. As the other's said. I do hope you have been formally keeping record of all of this, because if you haven't up to this date; none of it matters. You can't say "well, I've spoken to him on multiple occasions" unless you've formally written him up and had him acknowledge there was a verbal reprimand. You're management. You tried to be nice. It didn't work. This employee is toxic to your work environment. You can either protect him and his "first adult job because he's just young and new", or you can protect all your other employee's. If I was one of your other employee's and I kept reporting and having to deal with this nurse and nothing seemed to be done and he kept getting worse? I assure you they are looking for other jobs. It's very clear he's not going to change. Get rid of him.
  7. TheLastUnicorn

    Giving a life-altering diagnosis

    Our facility policy is that we can't discuss diagnosis', or any abnormal test results, including labs, unless the physician has already made the patient aware of the diagnosis/lab/result, or unless it's not a new diagnosis and we are providing further education. This has actually been a policy at both hospitals I've worked at, as well as the two different SAR's I've worked at. I wonder if it's a state thing, not too sure. I think it would be outside my comfort level to give a patient a life altering diagnosis, but kudos to you for having that comfort level. (Side note; I don't view informing family of a patient's death the same way as giving a life altering diagnosis.)
  8. TheLastUnicorn

    How does your hospital "track" patient baths?

    This has literally never been a concern or issue that I've even thought of. The last thing I am worried about any of my patient's is when their last bath was. It's never a question I've asked or have been asked outside of LTC/SAR. I dont think we track it at all unless the family is throwing a fit about the patient not having had a bath; but usually that's because a patient is refusing and then telling their family how neglected they are. Our MAR's don't have a spot for tracking baths, unless it's on the PCT side of things or in ADLs. If my patient is mostly independent or mostly independent; they will be offered a basin to wash up in, or they can ask for one. We'll set them up at the bedside to wash up. Help where needed. This applied to tele patient's as well. If they are not tele and if the rooms are equipped with a shower, and they are capable of showering themselves, they are allowed to take a shower. If the patient is a complete care; they are given a bath every night shift unless they refuse. Sometimes depending on how much staff is available and what is happening on the unit, they might miss a night. Typically every other night is common. Bed baths/complete baths happen on night shift. Otherwise the patient can clean up whenever they want. In our facility ICU patient's get the CHG bath typically on night shift. It even comes up on our MAR for 6am but we sign of off at whatever time the we get around to actually bathing the patient. Most independent patient's either will do it themselves or refuse, but by that time they are downgraded so it doesn't even apply to them anymore.
  9. TheLastUnicorn

    Running the pump dry

    Depending on the pumps used, it really doesn't matter. I've used pumps with a back prime feature, so you can hook up a 250 of NSS and use that to back prime the secondary tubing and hang a new bag. I've also had pumps with out that feature, that have only a secondary option and learned that when you unclamp the secondary while the primary is running, it will back flow up the secondary line, essentially back priming it when you unspike the old bag (be ready to clamp quickly). Spike the new one and good to go. Also, depending on the medication and the pharmacist; most our IV meds have an extra amount of fluid to prime the line with.
  10. TheLastUnicorn

    On FMLA, Can't Go Back To Old Job, Now what?

    Just... Random question... Have you asked your son? He too is greatly affected by this. He should understand and have some input to it. We parents always try to shelter our kids from difficult things but he is 12, he's old enough for some input. This is a great opportunity for learning and growth. Talk to your son. Does he want to move? What about school? Friends? How does he feel about your current job? Your hours? How does he feel about being alone for 12 hours 3 days a week? You lost your husband and he lost his dad. You need family. You need support. From experience, I say move and have those things but don't forgot your son in all this. What support does he have now? What will he have there? Moving, a new school, trying to make new friends is hard enough. Doing it after such a loss? It will be even hard. It will hurt more. Give him the chance to voice that. Listen. Take him into account, but make the choice that is best for you both, even if it will hurt for a little. Try to help him understand. Hopefully he will.
  11. TheLastUnicorn

    New nurse needs help finding a new non-bedside job?

    Try nursing home or skilled /rehab? Still bedside I know, but in skilled/rehab you can learn about at a slower pace. There are adults... They are gonna be understaffed and want you to work all the time. Usually they have 8 hour shifts not 12s. You might still not get days... But even nights at a subacute is 11-7.. For me that was go home sleep while husband is at work and then we had all evening together. Unless I picked up a double. The only thing we missed was each other sleeping.
  12. TheLastUnicorn

    How to count Narcotics?

    Side note; ask what to do about empty cards! Some places also count the number of cards in the lockbox (because someone could take the card and the sign out sheet and no one would be none the wiser). If you're place counts cards, you may not be able to just remove the card when it's empty. You may need a second nurse to sign off on removing the card, or maybe only a manager can remove a card.
  13. TheLastUnicorn

    How to count Narcotics?

    You count at the start of shift to verify an accurate count. Narcs are a big deal. When the count is off, the person with the key is to blame. Missing narcs can result in board and police involvement. Always count your narcs coming in shift. Accept no excuses. Saying "nurse b was in such a hurry to leave we didn't count narcs, I don't know why the count is off" is never acceptable. If the count is off, don't take the key. Call the supervisor. All of this is the same reason you count out at the end of your shift. You are proving that the count is accurate. No one can say that narcs are missing because you didnt count with them. Always sign out the narcs you give, this is where your count comes from. It's the paper trail and proof of what you did and where that narc went. It's your accountability. At the end of your shift, always double check your count. It will save you some stress when you're count is off because you forgot to sign one or in a hurry. Also, always check your math! Better to just get into the habit of signing first, then popping.
  14. TheLastUnicorn

    Career doom or new age of nursing?

    Honestly I wouldn't worry about "building skills outpatient". You're not able to actually build skills. You're just leaning about them. You can't practice phlebotomy by taking a local or online course for it. You need hands on for that. Honestly, I wouldn't even bother because for the most part, wherever you are going to be hired won't care that you took that course. Say you get hired at a hospital where labs are nurse drawn, they are gonna look at that certificate and go "oh that's nice, you're still required to take our 6 hour lab course on phlebotomy regardless." In other facilities where nurses don't do the draws and they have lab that comes and does it, that certificate won't matter. The same can all be said about IVs. Without hands on practice on the actual equipment that the facility you work for uses, some class or online certificate won't mean much and they will still require you to take their class and get a "certificate" through them. Look into skilled nursing facilities, like SAR, to build your skill set and time management. Do I think you jumped the gun up and quitting? Yes. I think you should have worked with your manager, worked with your facility educator, or stuck with it three more months in order to maybe see about transferring to another unit. Are you doomed now because of it? No. It's very easily explained; you didn't fit in, the pace was too fast, you needed somewhere to build skills and learn time management. You'll find another job, it just might take a bit, or it will be someplace you're just gonna have to deal with till you get the experience to get back into the setting you want.
  15. TheLastUnicorn

    I can’t get past orientation and want to be an aid instead

    Honestly, given SAR a try. Even LTC. Maybe even psych. I started in SAR. It was a LTC/SAR facility but they mostly keep their RNs on the SAR units. I drowned in LTC (the 11-7 wasn't terrible, but anything else was too much stress for me). I am actually happy I started in SAR. Sure, the patient load can be a bit much. Mine was a 20 bed unit with an average of 12-16 at any given time. I started on the 11-7 shift, picking up a lot of 3-11's just so that I could get more hands on with skills, disease processes, and learn who some of the doctor's were and best times to contact them, what protocols they had, and if I ever needed to call them, what information I'd know they would ask me for. 16 patient's in SAR, was an easier load then my 6 patient med/surg, or my 4 patient PCU loads. These are patients who, for the most part are stable, and are there for rehab (ortho's, weaknesses, post-strokes), or for long term ABT. Some are CHF management, and some of COPD. A few were palliative and hospice. SAR is a mixed bag now days. I still enjoy it and work PD at a sister facility to the one I began my nursing career at. You learn a lot about meds, a lot of skills, and one most important things I took from SAR was time management. After 8 months, I transitioned to a PCU/tele-step down unit. I didn't care for critical care and left there after 18 months. Too much stress. Too many bad nights. I work float pool now and I love it. Honestly. You don't really know what you might want or like until you try it. The hospital setting is often made to be this golden palace of nursing, but really... your golden palace is where you find yourself. There are so many nurses that come out of school and they want ICU, ED, or L&D and they get there and.. they are miserable, and they quit, or have to resign, or just don't fit.. and they end up someplace else they never thought they would.. and they love it. Find the place you love. So you can't go back to this hospital, there are plenty of others. You will find someplace and I assure you there are plenty to pick from. If you don't like it, thank them, resign, and move on. I interviewed and oriented at 5 different SAR's before I found the one I started in. None of them are on my resume. I resigned from them during orientation or shortly thereafter. Even so, if ever I needed, there are still 2298137 (exaggerating) SAR facilities in a 45 minute radius of me that I could have applied to. There are also about 6 different hospitals. This is not even considering dialysis, psych facilities, assisted livings, and various others. You will find where you fit in.

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