Galore

Precautions should have started months ago? I take precautions to prevent covid in my daily life this past year - I was specifically asking about what I should do if I'm asymptomatic, had high risk exposure from a patient, and still have to be home and providing care w/ young kids at home on my days off. I can't hide in a room all day for 14 days. I was curious if people who lived w/ others took extra measures like masking at home, distancing when possible or carried on until getting an actual positive test.

I'm looking for experience/advice on what to do after being informed of a high risk Covid exposure at work. Exposure occurred 3 days ago - I was wearing my own KN95, surgical mask, and eyeglasses. Pt has since tested positive, and I was with this patient for a 12 hr shift performing all cares/feeds (I work in a peds specialty area where patients are too young to wear masks, thus considered high risk). I had first dose of vaccine 5 days prior. My testing is scheduled & I'm asymptomatic - I'm just wondering if you took any extra precautions to protect family at home while waiting on tests and results? I'm pretty cautious because my kids have immune system issues, they're home w/ me all day on days off, but they've already been around me between exposure & being notified. I can't find guidelines on this anywhere, it's all in context of when the exposed HCW can go back to work.

So true! I can sometimes get away with starting an IV or doing blood draws without the baby ever waking up, but they pitch a fit when it's time for their temperature!

We just use the standard swaddling blankets as well, but most of the time parents will bring in nice ones or volunteers make the heavier quilted blankets to put over the giraffes.

My facility does cooling of newborns for HIE and I just went to a conference that covered this topic. Our neo who specializes in this said it's successful in helping 1 in 8 babies. Pretty crappy odds, but I guess if you're the one baby who it helped, it's important. The level of success will also depend on how closely the protocol is followed and ideally the baby should be cooled within 6 hours of birth.

Most important to me is good fit/comfort and pockets! I'm picky about my pockets - I really prefer the kind with 2 on the bottom and not the side-slit kind. I don't have to carry much around but it's much easier to keep track of my pens and calculator this way. I prefer soft fabric and a decent quality - I hate the really thin fabric that you can see through. I prefer to pay more for nicer scrubs that I feel good wearing and will get a lot of use. Lately I've been buying Koi, and I also have good luck at consignment shops (save a lot of money that way and then I don't have the same scrubs as everyone else).

I work at a teaching hospital too. Sometimes it is annoying having to run after the residents to get them to 'fix' the orders they write, but I have rarely encountered any attitude from them. Most of them are very receptive to suggestions or requests for orders, and they're a lot nicer than the docs when we wake them up at 3 am for something :)

I'm no longer a new grad, have now been working in my unit for almost 2 years, but it's definitely been a tough process switching to nursing (I also worked in another field first). I went through a really rought time too. The first thing I did just to get things in perspective was I went to a counselor through my company's EAP (so it was free). It helped me stop taking things so personally and taught me how to leave work at work. We also went over some simple strategies to cope during those busy shifts when you want to just find a corner to cry in because you're so overloaded. Finding good stress relievers and taking care of your health is also important - I don't think most people realize how draining emotionally and physically this job can be. I think it also just takes time to feel competent and comfortable in your new nursing career. I could have written a similar post when I first started out, but I am so much happier with my job now. I'm in the same unit I started out in with the same management and coworkers - the only thing that has changed is my perspective and coping strategies.

I would say, please don't forget what it's like to be a bedside nurse and treat them with respect. Most of the NNPs on my unit are great, but there are a few who talk to me more like an assistant than a colleague and they are generally just grouchy people. I think it is ironic since they started off as RNs and should know how it feels to be patronized. We all hate to call them on night shift after they have gone to bed, and I think for the sake of our patients, it's important for the docs to be approachable. Obviously, we are only going to wake you if we think it's crucial and can't wait til the AM.

I'm a NICU nurse too and when I saw the title of the thread I though maybe there was some over-reacting going on. Some of our patients can be very trying and we may have to deal with them for several months, so it's common for a doc or nurse to use dark humor to cope and we may joke about the babies' little quirks or shortcomings. However, I don't think there's any place for cursing in the workplace and that was unprofessional. I agree with above poster - maybe try confronting her first and pointing out that it's inappropriate to use that language.

As a new nurse, you aren't held to the same standards as much more experienced nurses though (or at least shouldn't be!). Better to feel stupid for asking for help, then trying to do it yourself and having an accidental extubation. I remember being in your shoes when I first started out not too long ago, and deliberating asking for help. I know that it's something that all the other nurses can manage on their own, but if you don't feel comfortable doing something, you should trust your gut instinct and ask for help. You will develop a feel for which coworkers are more helpful and understanding than others. I usually don't bother suctioning first if I'm going to reposition. If there's visible water in the tubing, then you can tilt it down away from the baby and into the receptacle, or briefly disconnect and dump (ask respiratory if you don't feel comfortable doing this). I'm also not sure what you mean by flipping. I usually move their body first, then their heads so I use one hand to guide their head and one hand to stabilize the ETT. So if baby is prone, I would rotate their body first so they're on their back. Then move their head to the other side. Confidence will come with experience :)

That is depressing! Even on my busiest nights I can get someone to cover my kids for a minute if I need to use the restroom. We are allowed to have water bottles out on the floor. Even drinking water all night long, the air is so dry that I still feel dehydrated when my shift is over. Our unit is one big room with pods, so there isn't a nurses's station.

I graduated a little over a year ago, and I don't think it's true that hospitals prefer to hire GNs into med-surg if you are looking to ultimately do a specialty. The majority of my peers who wanted specialties (ER, ICU) were hired right into that unit. I do agree that once you specialize first, you are more limited than if you had some general med-surg, but personally I don't think I ever want to leave my specialty. Med-surg is probably also more "secure" in the sense that maybe there are more floor positions versus specialties.

Off the top of my head...strong organization and time management skills, ability to advocate for patients, communication skills (you will need to translate complex medical information for parents and do a lot of teaching). If you feel like browsing, there are lots of previous threads on this topic. I think one important quality though is being able to clearly define your professional boundaries and distance yourself somewhat from your patients and the choices their parents make. At least for myself as a newer NICU nurse, I have felt better about my job as I've gotten better about leaving work at work. A lot of these infants have complex illnesses and crappy family situations; it may sound awful to say it's bad to care too much but in this field I think it can lead to burnout. You may also want to shadow a NICU nurse to see what it's all about. If you work in a level III facility, you will probably do very little cuddling and interacting with the patients other than what's medically necessary, as they are too fragile and/or need their rest.

I was a new grad hired straight into the NICU, along with several other new grads at the same time. However, I was fortunate to graduate right before the economy went downhill and hospitals started doing hiring freezes. In general, I think the NICU might be a bit more competitive but I wouldn't let that deter you, especially if you're willing to relocate. In my unit, we have some degree of turnover due to people going part time when they have babies, moving away, etc. I suggest you find out if your local NICU has a "cuddler" program or some other way you can volunteer. Maybe you could even get a clerk position. This is an excellent way to get your foot in the door and also scope it out and see if it's an area you really want to work.

You will use math on a daily basis for drawing up the correct dose of drugs, checking drips, and checking drug dosages, but it's basic algebra type stuff. On my unit, the big things like drawing up PRN narcotic doses and hanging drips need to be verified with another RN so someone else is double checking the math.

I have occasionally had 3 baby assignments in Level III, but that's usually due to a baby in another nurses's assignment getting very sick so it's changed to a 1:1 midshift, or already having 2 babies and getting a new admission. Routinely having 3 (truly level III) babies seems unsafe and unfair to the babies and their parents.

UF has group tours available but they are mostly aimed at incoming freshmen and cover more of the college experience highlights - the dorms, dining facilities, admission/financial aid office, etc. The College of Nursing is at the southernmost part of campus and thus sort of isolated from the hub of campus life (Turlington Plaza/Library area). Since all of us have already been through undergrad, I assume you don't care about that stuff much? The College of Nursing is in a building which is open during daytime hours. There are basically only two or three rooms you'll ever be in, so a tour would be fairly quick. Almost all of your classes are in one classroom on the first floor. The nursing lab is upstairs, which has maybe 8 stations which are set up like hospital rooms with a bed, dresser, and curtains. This is where you practice your clinical skills and assessments and get checked off on them. This room is usually locked when not in use. If you're planning to visit, you could call someone in the CON and see if they will show you around informally. There is a separate bookstore and library for health science students directly across from our nursing building, and you can always eat in the hospital cafeteria or a little plaza that has Chick Fil A and Einsteins Bagels. Shands UF is adjacent to that area, so it's nice if you have clinicals there!

Paco, I waited until early January to take the GRE since I decided at the last minute to apply to UF as a backup. You will be fine if you take it by November. However, I bought a prep book and halfheartedly crammed for it. I've always been pretty good at standardized tests, and only got a few wrong on the verbal section of the SAT in high school. I was surprised by how hard the GRE was! I had to study while working fulltime too and taking pre-reqs at night, but if you are serious about getting into UF, know that they place a lot of weight on your GRE score and try to allow time to study.

My unit has a protocol on Vital Signs, frequency, and blood sugars on new admits. As a new grad, I also received a checklist of things I should have at my admit bedside and I added in every single item I would need to start an IV (tegaderm, needles, male adapters, saline flush, etc) so in the rush of an actual admission, I don't have to think about it and everything's already there. Also, I usually get duplicates of things like saline flushes, alligator clamps, etc to avoid running back to the supply room for simple stuff. If I were to do a list, it would be something like: 1. Prior to admission arriving, set up bedside and all supplies. 2. Once baby arrives, hook up blood pressure cuff, attach leads/probe, and take temperature so you can take first set of vitals. 3. Do a heelstick (per our protocol). 4. Get a weight (docs usually want this right away so they can order proper dose of meds) and other measurements. 5. You've probably been assessing already if it's from the delivery room, but I would then complete any other assessment stuff. 6. After this, I play it by ear. The docs don't always order that we start an IV or want an ABG. When I first started, I experienced the same thing where everyone would flock around the bedside and sort of take over, and I would do more observing. Now I still always have people just automatically come over, but they tend to ask what I need now. I do more of the hands on stuff, and they will do things like faxing orders to pharmacy or printing lab labels. Maybe just try delegating from the get go when people come over, so you can practice the skills you want to work on and feel more in control.

I work 7p-7a, usually 3 12's in a row. On my first night back, I can take a quick nap beforehand and usually be ok (sometimes it's only 30 minutes or so, I aim for an hour but it's hard when I'm not sleepy). My next two nights, I try to go to bed by 9 and sleep as long as I can. Usually I wake up by 3ish, I just don't sleep that well during the day. After my last shift for the week, I take a several hour nap then I'm back to a normal daytime schedule. I like working night shift when I'm at work due to the more relaxed atmosphere, less procedures, etc, but I hate the toll it takes on my body and my social life.

My hospital is on a hiring freeze also. Technically there is not supposed to be overtime but due to staffing situations, I was able to get an extra shift just a few weeks ago.

Why wouldn't you use sterile water in the tube? I don't need to do that very often but for example, I had a baby that was NPO except for meds which were given by NG tube. I used sterile water to flush the meds down, otherwise they'd would be sitting in the tube since there were no feeds running.

I sent out emails to those who inquired about books, I do still have them. I made the mistake of searching for all white shoes, but once we started I realized that most instructors don't care if they're all white. A little bit of color like the Nike logo is ok. Now that I work I just wear athletic shoes with good insoles. Shoes really seems to be a personal preference, some wear the traditional nursing clogs and most wear athletic shoes. One thing I would warn against is Crocs. Those were the only shoes that some teachers had problems with, because of the holes. If money is tight, you don't need a lot of scrubs for the first semester. I had one white top and two pairs of white pants, since you only have clinical once a week, and you're probably not going to want to wear white scrubs ever again. I had 2 solid sets of colored scrubs and 1 or 2 print tops for lab. If you're going to buy scrubs locally, bring your student ID. Both stores in town give you a discount, I think it's 20%. Goodwill also has a section for scrubs but they are usually pretty basic and well-worn, you can also try Sandy's Consignment on 13th St.

Since a few of you have already requested the charts, I'm going to see if it will let me upload the charts here. Hopefully it works, and you can all just download them from one central location. I will point out that while I think studying off the charts is helpful, I think it is most helpful when you make your own charts because it forces you to go through the notes and pick out what is most imporant. Let me know if you can download them from here, and then I'll see what pharm. charts I still have on my computer. patho cv.doc ELECTROLYTES CHART.doc BLOOD CELL DISORDERS CHART.doc patho diseases.doc patho pulmonary.doc PATHO RENAL & GI DISORDERS.doc NEURO.doc