RUNurse

Congratulations.....I think. I was in your shoes, sort of. I was an RN for only 1 year when I got my nurse manager position. Here is the kicker...I was an level 1 trauma center MICU/SICU RN for that first year who was then going to be the manager in a State run facility for the mentally disabled (weird set of events that got me the job...trust me). I was in charge of the observation care unit (3 beds for residents who just got back from hospitals, or needed more nursing observation), the Clinical Treatment Room (Dr's office), the 6 nurses that staffed them, as well as being the entire facilities infection controll nurse! YIKES!!! But at the time I said...no sweat, how hard can it be?? ....... (BTW, on a side and funny note...With 1 year being in the ICU, I never directly ran my own codes even on my own Pts (drama involved with this too...lol) and I was always either med pusher or documentator. On the 2nd day at the new facility I was was doing CPR and running an entire code on one of the residents (I was the most experienced). Irony....... Anywhoo.... I jumped head first and for the first 3 weeks or so, things were not that bad. I had the respect of my staff and I was getting what was needed done. Then things went downhill fast. My boss (2nd in command in terms of the nursing department) was beginning to make changes to the way things were being run. She was..for lack of a better term...a nazi...the "my way or the highway" type atitude. I on the other hand was the shared governance type of boss, the "lets all work together to achieve this goal" kind of guy. :) I was told to do things and repremand people that could in the short term and long term jepordize their jobs..etc. (some somewhat justified, other blatent attacks). I was in a moral struggle...to protect my staff, or to do what my boss told me. Well over the next 2-3 weeks, the workplace was becoming more and more hostile and now I was directly being affected by my boss (i.e. "you can't have those days off for a honeymoon, your unit is short a nurse, so YOU as the manager must fill that position...etc...(btw..I went on my honeymoon)" So what did I do in these trying times...I did what any new nurse/protector/manager would have done.....covertly fought AGAINST the administrators. In order to protect my staff, I would inform them of information discussed in nurse admin meetings, personel meetings with my boss regarding other staff, upcoming policy changes...etc. This way, with everyone in the loop about what was going on and what was being said; everyone could fight against the system that was being unjust to them. I became more openly objective to the way things were being done, and I would completly do the opposite of what I was told to do (not all the time, but with the important things). I also started to stage a coup against my boss to get her fired for being so unethical and abusive (it failed). In the end, I lasted 4 months as a nurse manager, and I got back to the bedised in an ICU (I resigned before I was fired). Was I over my head..yes. Was I cockey...YES. Did I do what was ethically right....yes/no depending on whose side you take. Did I learn a lot...YES!! Did I protect my staff...yes (all my staff still work there). Was I a good manager....who knows. All I know is these 2 facts 1) By the end of the 4th month, I have earned more respect and was more liked than the DON who has worked there for the past 15 years. 2) My boss (the nazi) was fired 4 months after I left....hmmmmmm...I wonder why. So, with all that said...Best of luck to you. In my opinion, a good manager does what is ethically right no matter what, and they protect their staff. Not let their staff get run over. I hope that the place you are working at has good people there, and that you will not have the troubles I had. Granted, a state facility is completly different than working in a hospital. BEST OF LUCK TO ALL NURSE MANAGERS!!!!

If there is a concern about the use of albumin due to concent or religious beliefs, there is always the option of using Hespan. The additional benifit of using hespan is that is it very cheap to use. I read that 1 250CC bottle of albumin costs about $250 while a single bag of Hespan is only about $25. Here is a chance for nurses to advocate for our patients.

Welcome to the world of the ICU! My first year as a nurse took place in a SICU/MICU and I started the job 1 month after I passed NCLEX. Here are some pointers for working in the ICU that I found out (some the hard way:lol2:) 1: As stated before, be yourself. If you try to put on an act, your coworkers will know (ICU nurses are good at reading people). 2: Stay Calm. The respect that you get while working will partially depend on how well you do in times of crisis (codes, etc..). It is not wise to loose control of yourself and start to panic. Stay cool, calm and in control. 3: Be assertive. I know it is hard to do this when you are brand new, but it will go a long way when you do it. If you think/know something is not right, say so. Many doctors would rather have you call them for something minor (that you thought was major) than not call them at all or not for the major things. You are an advocate for the patients there who (mostly) can't talk; stick up for them! 4: Use your preceptorship wisely. Your preceptorship is the best time to learn the attitudes and ways of the MDs and how things are generally done. Use this information to build your own style of care when you are on your own. Its not wise to be a "loner" on the unit. 5: Help your coworkers: Being a team player is essential for the ICU, if you aren't....starting looking for a new place to work. 6: Things to start studying: Ventilators (MUST), ABGs, Hemodynamics (CO,CVP,MAP..etc), Meds (sedation, VASOPRESSORS, and a general wide variety), wound care (JP drains, and other surgery related wounds). Main key in learning information is...Do not just know what and how...but WHY. Hope I did not scare you out of a job that you did not start yet. Best of luck to you and if you need any advice...just have fun posting.

My dad became an ER nurse about ten years ago. When I was a junior in highschool I did 3 12hr shifts with him in the ER...and I was hooked! I have now been a nurse for 1.5 years with most of it being in the ICU and now I am a nurse manager in a State facility. My younger brother is a junior in college and he is finishing his first semester of nursing school. My father started a male nurse legacy LOL. We all agreed that we should go on Oprah or something and tell the tale of the 3 men who became nurses.

I Passed! Oh man...so happy now.

Well, I took my NCLEX this past saturday and I am really kicking the *^%# out of myself with doubt.:selfbonk: I only had 75 questions (was prepared to take 265) which took me over an hour to do. Did I pass with flying colors, or was I so dumb that the test said "F*** you idiot, I am not even giving you any more questions" LOL To me, the test was hard, and other nurses that I know tell me that the fact that it was hard and only 75 questions is a good sign..saying that I was above the curve. (though I have no idea if a question on Cushing's Triad as a multiple-multiple choice is a level 3 question or not) (PS: I know I got it right) So I guess I shall See what happens...stupid Memorial Day pushing back my results a day or two..LOL Sorry if this sounded more like a rant than a thought out statement for the board...but really...you are all my new "family". Time for this Bad Boy to chill and live up his last day of sanity.