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just_peachy83 specializes in MICU.

I'm a Christian, happily married to my firefighter/paramedic high school sweetheart since July 2005. I'm a new nurse and loving it!

just_peachy83's Latest Activity

  1. just_peachy83

    Drove home in tears...

    I think you are absolutely normal! I'm a new grad, too, working in the medical ICU. I have 2 weeks left in my orientation, and I was talking to my preceptor today about how I feel bad whenever I don't get all my work and my report done in time to leave right at the end of the shift. My preceptor told me that she rarely leaves work on time, and she's been a nurse for 20-some years!! Plus, in the ICU we only have 1-2 pts per nurse. So, if that's any consolation, even the most experienced nurses struggle with time management. We have so many demands that an 8 or even a 12 hour shift is not enough to do everything that could possibly need to be done. :) I bet you are WAY more efficient than you give yourself credit for in your post! It will get better! :)
  2. just_peachy83

    vents and sedation?

    I work in a medical ICU and we have the same approach that the majority of others have already mentioned. Most of our patients are sedated on Fentanyl/Ativan or Fentanyl/Versed gtts, but that's only because most people get agitated when a tube and lots of pressurized air are being shoved down their throats. However, there are those rare few who do great without sedation, and we don't mess with them if they are. It's less weaning to be done, and better for them neuro-wise. For pts on continuous IV sedation, we "dose optimize" once a day - in other words, we turn off the sedation to observe how the pt tolerates it. If the sedation has to be turned back on, we turn it on at half the original dose, thereby gradually weaning them as tolerated. Plus, the docs have told me that studies show interruptions in sedation actually improves neurologic outcomes. Also, sedation and even chemical paralysis is always used on our unit if we have to use an unusual mode of ventilation, such as pressure control, volume control, oscillation, or even if we are reversing the inspiratory/expiratory times, etc. Anything that would feel extremely unnatural or uncomfortable to the pt (at least, more so than your "normal" modes of mechanical ventilation).
  3. just_peachy83

    New Grad in ICU...Looking for advice

    Hi! I am a new grad, too (I graduated back in June) and am working in a medical ICU at a large university medical center. It's a really exciting unit full of challenging, complex patients. I have learned sooooo much since being hired there, and I absolutely love ICU nursing. Reading your post reminded me of my own post from a couple of weeks ago! For some reason codes don't seem to bother me much. However, at the time I posted, I was dealing with the fact that several patients exactly my age had died very traumatic, unexpected deaths within a week on my unit, and I had helped care for a few of them. It's hard to look at someone your age who is swirling the drain right in front of your eyes, you can hear the family members sobbing around you, you are working as fast and as best you know how along with all the nurses around you, but the person still dies. It's a real letdown afterwards and I felt kinda down in the dumps about it for a few days. I feel great now and have an even stronger love for ICU nursing now that I have dealt with my feelings on death/dying/intense situations/etc. I have been in several situations since then that would have had more impact on me before thinking about all this, but now I am able to handle it and feel good about what I did in that situation when I reflect on it later. I think what helped me the most was realizing that the patients I care for every day are the sickest of the sick. Many will not live, and therefore dealing with death is a given. Plus, I think us new grads watch the more experienced nurses dealing with the stressful situations with maturity and peace and misinterpret their calmness as uncaring. But it's not that they don't care; it's that they have learned how to deal with it effectively. I talked about this with my preceptor and other experienced nurses on my unit and they told me that it's absolutely normal to feel upset and even traumatized after a rough case. It's not that you become uncaring and unfeeling in your work, it's just that you learn to deal with it effectively. You learn when you need to "hold it together" and when it's ok to let your feelings show. You will also get used to your feelings so that you don't cry every time someone dies. I've never been a really tearful person, but my pitfall is keeping my feelings to myself and not talking/debriefing afterwards. My preceptor is the same way and she recommended to me that after a tough situation, that we could talk about it and do some "therapeutic venting." :) I know that was super-wordy but I guess that's my way of saying I totally understand how you feel, and to let you know you WILL feel better and will find your own unique and most effective way of dealing with the pressures of working in the ICU. :) Good luck!
  4. just_peachy83

    OSU nurse internship/Columbus jobs

    Hi! I'm a recent grad who actually graduated from the OSU critical care nursing internship back in November, so I understand what you are going through with the application process. The OSU internship is very competitive and I know my program manager said she was hiring fewer nurses this time d/t the shortage of jobs (OSU Medical Center has a I can tell you from my experience that I applied for the internship in Oct. and was interviewed and hired the first week of January '06. The main reason I was offered an interview was that I called and followed up when I didn't hear back from the manager. So, I would strongly encourage you to call and find out if you can interview. Besides the OSU internship, though, I know the Mt. Carmel and Ohio Health hospital systems in Columbus offer internships in different specialties - I was just talking with a girl about that today at work. So, don't be discouraged - check out your other options. I don't know of any job fairs at this point, but if I see ads for them around the hospital I can send you a message here via the website. Good luck - Columbus has lots of nurses, unfortunately for us new grads.
  5. Hey everyone! I am a new grad RN and I'm working in a 25-bed MICU at a university hospital system. I LOVE my job and am done with orientation next month - WOOHOO! :) I am nervous but excited at the same time - I work with a very supportive, helpful staff. I wanted to ask for some advice, though, because these past few weeks I have come across my first real bump in the road as a new nurse, and I'm just kinda struggling with it. The past few weeks on my unit we have seen many very young patients, like my age or younger, die. Most have been withdrawal of life support situations, but it's been hard on everyone. I took care of a couple of these patients, and it's still on my mind. Does anyone else feel this way? Is this normal? I worked in an open heart SICU as a tech before graduation and witnessed several codes and many deaths there. It's not like this is new, but being the nurse resposible for a dying patient IS new and very emotional for me. Sometimes I worry about my family now, and worry that they will die a traumatic death like some of these patients. I am feeling much better this week and I did fine two nights ago when one of my DNR patients with pulmonary fibrosis was dying...I was okay afterward, too. I love what I do and my preceptor says I am doing fine. I don't want to change areas, but I didn't think I would be hit this hard. Any advice on how to deal with this more effectively?? I would really appreciate any words of wisdom. :) Thanks everyone.
  6. just_peachy83

    how does your icu perform shift to shift reports??

    I work in a 25-bed MICU at a university hospital system, and I think our RN to RN report system is very effective, and thorough, which is a problem I think on many floors. Basically the report on each patient goes as follows: basic data (age, race, code status, allergies), then past medical history, then a summary of events leading up to the patient's current status (i.e. date of admission to hospital, major procedures/complications this hospitalization, then the current plan), then a head-to-toe summary of the patient's current condition. Usually when I report, I start with the neurological status, then respiratory, cardiac, GI/GU, skin, etc. I finish report by showing lab results/ABG results and discussing family issues. After the verbal report, I check all the new doctor's orders for the past shift with the new nurse, and we do a double-check of all drips together. I know this sounds extremely detailed and tedious, but it is an excellent system and is used consistently by all nurses on our unit. It really helps me get a thorough picture of my patient(s) before starting the shift, and it's great because if something unexpected comes up and I don't get the chance to sit down and read the charts that shift, I already know enough to accurately discuss the patient with the medical team. I hope this helps. :) As far as the Kardex question goes, our charting system is almost 100% computerized. We chart all assessments, labs, vitals, etc. on computer and we actually have a computerized Kardex page that the nurses update throughout the shift as needed. It is really handy and very accessible from any computer on the unit. I love it!
  7. just_peachy83

    Shoe advice needed

    Hey everyone, I am a new RN who will be starting my first job in a few weeks & I want to treat myself to some new nursing shoes. The only problem is that I can't find anyone in my area who sells the brand/style I want, so I will be ordering them online and I can't try them on first. So I thought I would ask everyone on here if you have worn these shoes and what you thought of them (comfortable? painful? long-lasting? a waste of money?). The shoes I want are Danskos, and the style is "Marcelle." I think they are so cute, but I want to get some opinions before I just buy them! Thanks everyone! :) Here's a URL to a picture of them so you know what I'm talking about - I tried inserting the picture but it didn't work for some reason: http://www.emocs.com/dansko/marcelle.jpg
  8. just_peachy83

    New nurses in Med/Surg a must?

    I'm a new RN and I also asked lots of teachers and nurses I worked with as an aide before getting my job what I should do - work med-surg, or go directly into ICU which is what I want more than anything! The overwhelming response I received was to go directly into ICU, but only in a position offered specifically to new grads - one that offers more extensive orientation. Once I started job hunting, I found that internships for critical care nursing are really popular right now, and I was able to get a position as an intern that will allow me to rotate through the SICU, MICU, and progressive care units at the hospital before choosing which one I want to work in. The internship is 4 mos. long, and after that, I get a minimum of 6 mos. orientation to the unit I choose! So, I personally feel that a new grad who can find an internship or extended orientation could skip the initial med-surg time and go straight into a specialty area. However, if I hadn't been able to get in this internship, I would have definitely worked med-surg for the first few years to gain confidence and experience. Hope that helps. :)
  9. just_peachy83

    Recent NCLEX test takers

    No, I used the Diane Billings' Lippincott 8th ed. But, I have heard that the NCLEX only changes questions every 2-4 years, so one edition's difference probably won't matter. Good luck studying!
  10. just_peachy83

    Recent NCLEX test takers

    Hey everyone, I just found out today that I passed the NCLEX at 75 questions. I am quite happy right now :) but also wanted to pass some advice on to those who are preparing. As far as the priority questions go, I got lots of those on my exam and probably the best information I was given on how to answer those came from the review course I took. The instructor said that to answer priority questions, you should always ask yourself which patient is experiencing s/s that are UNEXPECTED for the diagnosis. For example, a patient recovering from a bronchoscopy who is complaining of a sore throat is less of a priority than a patient who is post-op from a TURP and having red blood in the catheter. Also, someone was talking about percentages they are getting on their practice exams. In the same review (which was taught by a man who used to work for the big-name review companies, so I trust his word) I mentioned before, the instructor said that Lippincott is one of the hardest NCLEX review books to use. He said that students who achieve 67% or higher on their practice Lippincott exams are NCLEX-ready. So, 70-80% is a great score in Lippincott! That's what I used and the highest score I got was an 87% once and I passed the first time with 75 q's! So, I say go for it and get the NCLEX over with - I bet you'll pass w/ flying colors!
  11. Congratulations, fishinNbanjo!! Now you don't have to think twice about the whole "45 days" thing. :) Enjoy the rest of your weekend & best wishes for your nursing career!!! You did it! :balloons:
  12. just_peachy83

    HELP I can't take the wait~!

    Congratulations, Healer!!!! I just read your post that you passed, too!! I'm so happy for you and I am so glad that we were both wrong when we said we thought we'd failed. Enjoy the rest of the weekend and best wishes for your nursing career - you did it!! :) :)
  13. just_peachy83

    Poll for those who have already taken NCLEX..

    1. how many questions did you take on nclex? 75 questions 2. what study materials did you use? did you take a test review course? i used lippincott's 8th edition book and cd, the nclex-rn made incredibly easy book, and medspublishing learning system rn q&a program. i took 2 review courses - one was free & offered by my school. the other was from a nursing instructor named mark klimek. he was awesome and i highly recommend his course- he teaches reasoning strategies and just makes the information you need to know very basic and understandable. he increased my confidence level by 200%!! 3. did your son offer any testing (eri, ati, hesi)? my school requires all seniors to take the hesi before graduating. i had to get a 850 to pass and 900 was recommended. i only got an 866 but that was without any studying. 4. how long did you wait for results of the test, or are you still waiting? i found out my results (i passed!!!!!!!!) exactly 49 hours after walking out of the testing center. i used the quick results feature on the pearson website. 5. what were your thoughts coming out of the test (total disbelief, certainty you had failed, confident you had passed)? i was certain i had failed. when the computer shut off at 75 questions, my eyes totally filled with tears!!! however, i tried to be positive during the test; even if i didn't know the answer to a question i told myself i was doing a good job and that i needed to stay focused. afterwards i kept reminding myself that i had worked so hard to get ready that i couldn't have failed. 6. was this your first attempt at nclex? yes! good luck to everyone who is getting ready to take the nclex and to those who have taken it and are waiting for results. believe in yourselves - you have been through so much hard work in nursing school & you are prepared to take this exam!!!! :spin:
  14. just_peachy83

    I Passed (unofficially)!!

    Congratulations - what an accomplishment!!! Now you can enjoy the rest of your weekend. Best wishes for a wonderful career as an RN!!!!!!!!!!!!!!
  15. hello fishinnbanjo, and everyone else!! just wanted to let you know that just a few minutes ago, exactly 49 hours after taking the exam, i found out on the pearson website that i passed!!!!!!!! :balloons: :balloons: thanks to everyone on here who has supported me and encouraged me these last 48 hours. i came here because i needed to know there were other people out there feeling like me. thanks for all your posts and i will be back to talk to other people and encourage them while they get ready for the nclex and wait for results, too. you guys are awesome and be sure to share your good news as soon as you get it!!!! :)
  16. just_peachy83

    HELP I can't take the wait~!

    just wanted to update you all.... i passed!!!!!!!!!!!!!!:balloons: :spin: :spin: so, have faith - you can, too! i just looked up my results on the pearson website and the wait is over. thank you, lord! :spin: