All Content by mjscan_07
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MSN CNL Sacred Heart University?
I also have been looking into Sacred Heart University. I am from the Midwest and really do not know much about the school. Is it a reputable school, those that are attending how is the program going? What do you like or dislike?
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Orientation-Staffing
I work in a small 5 bed ICU with fairly low acuity staffed with 2 nurses. Our hospitals newest staffing policy is that to avoid any overtime they send Med/Surg nurses back to the unit so they don't have to pay overtime. Unfortunately these nurses have never had any orientation. We have one RN that is actually on the schedule frequently in ICU but has not had any orientation to our unit or previous critical care experience. When asking my manager for orientation I was told to orient while she was working if possible. I was just wondering if this is becoming common practice elsewhere for budget/staffing reasons and what others would do in this type of situation. Thanks
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ICU Orientation
Just wondering about orientations to ICU. We orientate for 2 mths and that is working with our preceptor in the unit. I thought my orientation went very well. I feel like I don't know enough and some form of critical care course would help out alot. Just wondering what type of classroom/online education other ICU's required for new ICU nurses. I'm in the process of finding a book or online class that will help me out, so if anybody has any good recommendations I would appreciate it. Thanks!
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Trying to make a good impression
So I am a new ICU nurse about 3 mths now in a small 5 bed ICU. I was a float med/surg nurse in a larger hospital for about 1 1/2 yrs prior to moving to the ICU. Last night I feel like I just questioned my judgement alot. We had a pt. that was on a dopamine gtt that I should try to taper off, well whenever I thought about turning it down the pt's blood pressure would drop and she already wasn't making any urine so I really didn't feel comfortable to turn it off. This morning the day nurse asked me if I shut it off and she is an outstanding nurse and I really want to make a good impression on her. Well I explained my reasoning and I could just tell she thought I should have just shut it off. Then as I was leaving this same pts blood glucose came back as 30. I don't know what I was missing, she was not diaphoretic, not shaking, not lethargic, confused but she always was. She looked worse but that seemed more respiratory than anything. I can't believe I missed something. I just want to make a good impression and I want to be a good nurse. I just feel so unsure of everything I do when I work back there and unfortunately there is little for experienced nurses on nights. Sorry this is so long, just frustrated with myself.
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Frustrated with self
I had a patient the other night that I was discussing the case with the doctor trying to figure out what was going on with the patient and trying to treat him. We kept him stable throughout the night and as I was giving report the day nurse asked a question and all of a sudden I realized what was wrong with the patient. I'm so mad at myself that I didn't think of it before because it was so obvious once I thought about it. I hate it when I make dumb mistakes. I feel like the day nurses probably think I'm not taking care of my patients. So frustrated.
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DNR Question
Thank you so much for your responses. I believe the same thing. Just because they are DNR does not mean do not treat. I couldn't believe I had three different nurses tell me, after my pt was transfered to the unit for Cardizem drip that we shouldn't be doing that because she is a DNR. I'm glad that other nurses belive DNR does not mean do not treat heart problems. Thanks
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DNR Question
Obviously I know the basic of what DNR is, but I was wondering when a person that is a DNR should they be placed on telemetry?? Alot of people at my hospital seem to think that because they are DNR we should not have them on telemetry. Also if the patient is in uncontrolled a-fib 160's should the treatment plan include a Cardizem drip etc. Just wondering what people think, I am a new nurse and this wasn't an issue we discussed alot in nursing school. I personally think we need to treat, please let me know what you think. THANKS for your opinions.
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Would part time work be better?
I graduated nursing school approximately 1 yr. ago. I started out working 80hrs per pay period and did that for 8 mths. I was extremely stressed and always tired, I work nights and felt that I never had any free time. I now work 64 hrs. per pay period and although it is still very stressful I at least have some time to myself and I still have full time benefits, plus the added bonus of I can pick up shifts and make more money for coming in extra. I definitely think part time is the way to go.
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Vent care question
If I could do it all over I would never take a float position again as a new grad. Way too much information overload. Extremely stressful. I had approximately 3 mths. total orientation to the hospital and the 6 areas I float too. Sad part is the only nurses who have vent pts are supposed to be rehab or ICU nurses and the rehab nurses do not take competency tests. Not sure about ICU. During orientation no one bothered to tell me they could even take Vent pt's down there. much less teach me a thing about them. This is the first they've had in over a year. I talked to my manager about it and she told me we'll just make sure it never happens again. I don't believe that but like I'm looking for a "home" floor anyways.
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Not picking up extra shifts
I work at a hospital that is always short staff, suprise, suprise since most hospitals are. Anyways I work resource and am scheduled 64 hrs/2wks. I also have joined agency which is an extra scheduled shift every 2 wks for extra money. Yet staffing calls me every day and asks if I can come in extra. I always feel so guilty saying no or just ignoring the phone call. I rarely call in sick, 3 times in 10mths to be exact. This past weekend they gave me low census which I was glad to accept but of course they started calling now right away again on Monday. I just feel horrible but should I really be expected to pick up extra hours. It doesn't help that I truthfully hate my job and am searching for a "home" floor/unit. Also just the idea of work completely stress me out. 2 of those 3 sick days were because of panic attacks due to work. I just can't handle the ideas of going in any extra. Should I feel guilty or just go along with it???
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Vent care question
I have a question about my patient assignment last night. I have been a RN for 9mths, doing float nursing the entire time. Last night I floated to a Rehab unit where it was myself and a LPN. We had a patient on a ventilator. In our hospital Ventilators can only be in this Rehab unit and in ICU. I had never taken care of a Vent pt. much less that this pt was 12yrs old and her parents were very, very particular. Our policy is that LPNs cannot care for a Vent pt. Also in my orientation they never once mentioned that I would take care of Vent pts and had absolutley no orientation. I immediately called the House Supervisor and told her that I was not comfortable but knew there was no staffing to help cover the shift. The LPN had volunteered to help me out as much as possible, but overall it was still my responsibility. I was extremely nervous almost to the point of tears of what would I do if something went wrong. I had six other patients as well. The house super called in the unit manager to cover the pt, which she was upset about. Did I do the right thing. I didn't actually refuse to take the pt, but if I would've if I thought there was anyone else to cover. Did I do the right thing?? I did spend the night trying to find info on vent. pts but would still not feel comfortable taking care of one. Our policy and procedure basically states respiratory takes care of the pt, if alarms sound call resp. stat and manually bag the pt. If alarms were not sounding there was no other policy for assessments I should be doing. What should I do if I am in put in this position again??
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Adequate Staffing
Hi, I was just wondering what typical staffing for other hospitals. We do team nursing at our hospital. I just feel that our staffing is inadequate. I am a float nurse so this is typically what we run on the floors. LPN's can do assessments and give PO meds. No admissions, IV's, or orders (can receive orders and call doctors although none do even when asked) RN only can give report to the next shift. Oncolongy/Hematology, Cardiac/Renal, Neuro/Ortho, and general surgical - 1 RN, 1 LPN, share a CNA with another team for 12-14 pts. per team Skilled Nursing: 1 RN, 2 LPNs, 1 CNA for 25-30 pts. Often with numerous central lines, TPN, IV antibiotics etc. As the RN, I just feel completely overwhelmed. I am a new nurse and maybe that is why I am still so overwhelmed or do I just have a reason to be. I feel that 12-14pts. that I am responsible for is alot on my license. Thanks for any and all input
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Job Application
Hi, I applied for a job at a local women's health clinic approximately two weeks ago. I'm not assuming they would have called me yet, but I was wondering about how long should I wait until I do hear a response. I would like to be able to call and talk with someone but the application was online and there is not contact name except for the human resources number. Thanks
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Women's Health Position
I was just wondering if this is a really a good idea. I am float RN that has been working at a hospital for 8mths. I graduated May 2005. I've always wanted to work in labor/delivery, postpartum. Unfortunately jobs in those areas are hard to come by where I live. There is a position open in the Women's Health Clinic for a RN. I love the teaching aspect of nursing and I feel I would get to do lots of prenatal teaching in the clinic.I know the pay would be less, but would it be a good move for my career. I eventually want to go on and either be a nurse midwife or a women's health nurse practioner. What does everyone think. Thanks!!
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Did I make a mistake in choosing nursing?
I'm really starting to have doubts if I made the wrong career choice. I have been a nurse for about 8 mths. now. I work a combintation of 7p-7a and 11-7. I work resource at a 300 bed hospital, so I cover a ortho/neuro floor, gen. surgical, med/oncology, general medical, skilled nursing, and special care rehab units. I rarely go back to the same floor day after day. I just hate going to work. Even on the good nights, I don't want to go back and the bad nights I absolutley don't want to go back. I just feel so overwhelmed and stressed. I had one major anxiety attack so far. I feel like I do a horrible job, even though the staff that works with me tells me I do good work and they enjoy working with me. I just feel like they talk about me negatively behind my back like they do everyone else. I've made a couple minor mistakes nothing major thank goodness. My supervisor tells me I am doing fine whenever I ask (I had to ask for my three month eval) and am still waiting on our mid-year eval that was supposed to have been done awhile ago, but everyone says that she won't say you are doing something wrong until it is too late. My major concern is I work all these different floors and not one is something that I can really see myself doing and enjoying. I also get stressed because I often carry 10-14 pts with an LPN as the team lead. We do team nursing at our hospital. I have started to look for other jobs, but there is just nothing open in areas besides the floors that I already work on. I am just really doubting right now if I made the right choice in becoming a RN. I dread the thought of going to work. I worked as a CNA and a restaurant and enjoyed work there so it not that I hate working. I dont know what to do.
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How would you handle this patient.
At our hospital we do team nursing and basically the only thing the person that is designated charge does is to assign which rooms get the admissions. Our House Supervisor did talk to this guy about his sleeping med he was so upset about becasue she was the one who had to call pharmacy, but he was nice to her and told her he would leave AMA in the morning.
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Patients always needing something no matter what.
I agree it does get frustrating from time to time. Some pt's do need to realize we are a hospital not a hotel, but the way I see it, getting people what they need to be comfortable is a part of the job, whether it is pain pills or coffee. If I am really running behind and have lots to do, I will either ask my aides to help out or I will explain to the pt. I will be there as soon as I can or if they are able to ambulate themselves or if a family member is there to help out, I'll politiely ask them. It is the pts that you offer everything to them possible and they still are mad at you. Those are the pts I really get frustrated with. Overall though I think its part of my job to make my pt. comfortable and happy, they are in the hospital and not feel their best, I know when I'm sick I always want someone else to help me out.
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Up's and Down's of being a nurse and the cost
I'm an RN-BSN. I went to a 4-yr University and it took me exactly 4 yrs, with a pretty heavy load. I now an a float RN at my hospital. I was only a CNA for a few months during school and I would highly recommend it, even if it is just for a little while. Being a float RN was nice to see all the different areas of nursing in the hospital, but it's difficult because there is a ton of information to learn. Total it cost me for tuition only about $22,000 of tuition and books with $12,000 being the loans.I took out student loans my last year and a half becasue the hospital I was going to work at offered tuition reiumbursement, so I signed a three year contract and they basically paid off my loan. GOOD LUCK!!
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How would you handle this patient.
I'm a fairly new resource RN, I graduated in May 2005. I was working on a Medical/Oncology Floor last night 11-7 that was pretty busy. I had this patient who had knee surgery and left AMA a week ago, because he is a very noncompliant diabetic and the staff wanted him to take sliding scale insulin, but now was back because of knee pain. He was rating his pain a 15 when I came on so I called the pain specialist consult he had and got an order to increase his PCA. The pt had also wanted his sleeping med ordered so I talked to this Dr. about that but he didn't feel comfortable ordering it. So I immediately turned up the PCA dose. Then the pt kept going on and on about if I couldn't get this sleeper he was going to leave AMA, so I called his admitting physician who was upset with the pt to begin with after leaving AMA a week ago, and gave me the order if the dosage was ok with pharmacy. So then I called pharmacy who did not approve the dosage. This is getting to be like 2:00 in the morning and I have barely seen my other pts or started anything else I am supposed to do. So I went in and talked to him and he agreed to stay until morning basically saying he was going to yell at the doctor and leave. I offered him ice which he refused because he gets chilled and did everything I could think of to lower his pain. I got him food and anything he could need. This pt had no problem getting up and fairly quickly walk to the pop machine, but his pain was just horrible. Then what topped it off I heard him tell the aide working with me and his wife that I lied about turning up the PCA and was talking down to him. When I went to clear his PCA pump in the AM, I showed him how it was increased and what dosages he was receiving. His wife and him ended up screaming at me saying they were suing me as well as the hospital. I was mad, I had tried everything possible to make this pt comfortable, called dr's in the middle of the night. I also felt like I couldnt give my other pts as good of care because I had been so busy dealing with this pt. How in the world are you supposed to deal with a pt. like this. Sorry this got long. I was just frustrated.
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Questionable Position Change
Thanks for the advice. Those were good things to think about. The reason I didn't go immediately into that specialty is that there was not a position available in that field in any of the three hospitals in my area. Leaving the area was not an option because of my fiances career. He had just gotten a wonderful opportunity that neither one of us wanted him to pass up. The biggest stresses at my current job is being on a different floor every night and sometime switching floors during my 12 hr. shifts. It is very common that I work my first 4 hours on one floor and then at 11, switch to a different floor because I am a float person. I am not as stressed when I am able to be on one floor for a couple days. Myself and another float RN have talked frequently to our mangaers about the 12 hr. shift change from floor to floor and they said there is nothing they can do. Thanks
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Questionable Position Change
Hi, I'm a new RN. I graduated approximately 8 mths. ago and have been working at a large hospital as a float nurse for the past 6mths. I am very very stressed out with my job and have alot of anxiety. The stress has been affecting my relationship with my fiance and some of my other family and friends. There is another position at a different hospital in town in OB/GYN that I would like to apply for. Becoming a NICU nurse or working in some specialty of OB/GYN is why I became a nurse. Is it too early to change jobs in my career? WIll it look bad on my resume? If I were not to get I don't want my current boss to be upset that I'm looking for different employment. I have talked to her about my stress and we recently changed my hours, but I am still feeling just as much anxiety. If someone could give me some hints on what to do. THANKS!!!
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Changing jobs
Hi, I'm a new RN. I graduated approximately 8 mths. ago and have been working at a big hospital as a float nurse for the past 6mths. I am very very stressed out with my job and have alot of anxiety. There is another position at a different hospital in town in OB/GYN that I would like to apply for. Becoming a NICU nurse or working in some specialty of OB/GYN is why I became a nurse. Is it too early to change jobs in my career? WIll it look bad on my resume? If I were not to get I don't want my current boss to be upset that I'm looking for different employment. I have talked to her about my stress and we recently changed my hours, but I am still feeling just as much anxiety. If someone could give me some hints on what to do. THANKS!!!