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NICU, Vascular, Oncology, Telemetry
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nursetmj specializes in NICU, Vascular, Oncology, Telemetry.

nursetmj's Latest Activity

  1. nursetmj

    getting married and need advice

    First of all - CONGRATS on your engagement!! :heartbeat How long until the wedding (when will you legally be changing your name?) I recently went through this earlier this year -- and from what I understand, if you change your name legally, you must change your nursing license to accurately reflect this as soon as it's done, otherwise you can be accused of fraud (practicing under a different name from your legal name). I do know you must change your social security card first. Then you must contact your state board of nursing to complete the name change. It is a pain in the rear, but yes, you'll likely have to renew again anyways in 8 months when your license is up for renewal. The BONs don't care about what is convenient, they just care about what is legally right. The tricky part comes if you are licensed in more than one state, or if any state you are licensed in is part of the Nursing Licensure Compact. I am and it was loads of paperwork and follow-up. Plus, the different state Boards each had different requirements for what was "acceptable" proof of a name change. For the OH BON, I had to send in my ACTUAL marriage certificate, with the promise they would return it within 10 days. I was so nervous, but it was returned to me as promised. Good luck with all this, and just remember to protect your license with your life - you worked hard for it!!
  2. nursetmj

    Rituxan Spill... IV disconnected from patient

    I work in an outpatient Onc clinic and we give Rituxan quite regularly (whether it be rapid or long). It's a monoclonal antibody, so it's not as....what's the word I'm looking for? Destructive (??) as a true chemo. Also, we don't ever wear masks....this has never even been mentioned? You should be fine as long as you used a spill kit, followed the instructions and wore chemo-grade gloves. Your spill happened a few months ago I see -- how did everything turn out?
  3. nursetmj

    Am I being too sensitive?

    To the OP: The 3 biggest personal things I had to learn after I became a nurse were: 1. Grow a thick skin. This took time and was not easy! It could still be thicker 2. Stand up for yourself without getting emotional. Nobody else is going to do it for you. 3. As everyone has already stated, and probably the best advice, you have to laugh at yourself. It's the best way to handle/diffuse a situation and shows that you acknowledge your screwup without looking insecure. Sounds like you are doing a fine job -- hey, your preceptor even said so! That's all the matters. Welcome the constructive feedback and let the rest roll off.
  4. nursetmj

    Using Smart Phones on Your Unit

    Maybe they should amend the policies/literature to have employees agree specifically to not use the cameras on their phones, since that is probably the biggest threat. (Why would you??) There are many young, naive, easily-wowed students/techs/nurses/interns/whatever that think what they see is so incredible, it has to be shared. This reminds me of a true event that you may have heard about that happened about 2 years ago at a major medical institution in the country. A surgery resident, while in surgery, photographed a man's privates that had an interesting tattoo on it. Somehow or other, ther media got a hold of it. Not good. Was HIPAA violated? You bet. Was it the smartphone's fault? Let's just say the smartphone didn't get fired and kicked out of the residency program. Sorry if I've gotten too far off topic from the OP.
  5. nursetmj

    Using Smart Phones on Your Unit

    I agree with the previous two posts - it's people and their poor judgment, not technology, that violate HIPAA. Why is it that nurses aren't to be trusted with using the technology properly, but doctors are? Every hospital I've worked in allows the docs to use their phones to be integrated into order writing/patient info retrieval/etc. (I understand they also have to be on-call and actually have order writing privileges and nurses for the most part, don't). Most of the hospitals didn't have a problem with nurses and their phones, but we certainly weren't encouraged to use them as a resource. It's funny everyone is striving toward a "paperless environment", but yet don't want to always give us the tools to get there and prosper. It's the future.
  6. nursetmj

    has anyone ever made the switch to MD?

    My former Gynecologist was a RN, who then became a NP, and THEN went to medical school. After that, she did her residency and fellowship. She essentially spent her entire adult life in school (she had to be in her mid-to-late forties when I saw her). She was the BEST Gyn I've ever gone to. I asked her if it was a hard transition and she told me the two hardest things were that she didn't get to be with her family as often as she had in the past (she had one young child at home whom her husband stayed home with) and that she didn't get to spend as much time with her patients anymore like she did when on the nursing side of it. She also mentioned politics and red tape...but I think that is universal. One other thing to consider -- and this may have been mentioned -- but physicians LIVE their job. As a nurse, I get to say "peace out" at the end of the day and not be bothered. I can sleep freely not worrying I might miss my pager going off. But depending on what type of physician you become, you may have a lot of on-call duty. And also dependent on the type of work you do, the "average" workweek can be heinous, 65-85 hours with no day off for 12 or 13 days. (And then you hope like heck you're married to someone with reeeeallly acute hearing, like me, who will wake you and force the phone in your hand because you're so tired). This is all AFTER residency and fellowship, mind you (yes, once you become the "top dog"). Just something to keep in mind when you consider how you want to shape your life.
  7. nursetmj

    Working Paramedic & RN Graduate ~what speciality would be best?

    I know a lot of ERs don't accept new grads (there are some that do, but I just wanted you to be prepared for that). If you are a Paramedic, and like the intensity/stress of responding in an emergency and work well under pressure, you might also consider ICU. But again, depending on where you live, some ICUs don't accept new grads either. It seems lately, in my part of the country, the ICUs and ERs all want ICU and ER experience (not even Med/Surg exp. is cutting it). Times are tough...hopefully they improve by the time you graduate nursing school. Good luck to ya;)
  8. I am (luckily in this economy) employed. I currently work in an outpatient clinic, but my hours keep getting cut back due to this poor economy. It is sometimes hard to even get 25 hours a week (I'm supposed to get 32-40). Nurses are quitting and not being replaced. Also, I've discovered after being in my current position for 9 months, there's really no room for growth and now no tuition reimbursement and no raises for the next year. Lastly, I'm not feeling challenged -- at all. So I've been shopping around a bit, trying to focus on what I really want to do because I don't want to continue being a job-jumper. Last summer my husband and I relocated permanently. Prior to this outpatient job I'm at now, I was in a position for 5 months. It was Med/Surg/Tele, straight nights, hell. I became so burnt out and thought outpatient would help me regain my sanity, if not a normal sleep schedule. I had done fine with nights in the past, and even miss that shift at times, but it was the floor I was on that was the problem. I knew I didn't want to continue on in med/surg when I took the job (I had been doing it for 2 1/2 years and swore I was getting out)....but it was the only job offer I had at the time. (It was one of those that offered me the position at the interview -- maybe should've been a red flag?) During my 5 months there, I spoke with the hospital's Nurse Retention Coordinator about my frustrations and transfering. They were all lip service..."We don't want you in a position you don't feel is a good fit for you." Nothing ever materialized, (the Retention lady never called me back and when I DID get a hold of her, she kept stringing me along by saying things like "I'm waiting to hear back from the manager of that unit and I'll let you know"). I was told by co-workers that I had confided in that transfering out of Med/Surg was nearly impossible at this hospital because these spots are hard to fill and they didn't want new grads. They shared their stories with me about internal interviews that went well and then they would never hear anything back. This led me to believe I would never be able to transfer. So I gave my notice and left after 5 months. This same Health System (not the exact hospital, but I was an employee of the system that is comprised of 2 hospitals) has openings in an area I really want to work. I have been thinking hard about applying; I was a good employee, reliable, got along well with everyone, left on good terms EXCEPT the whole less-than-six-months part. Any chance they'd give me another try? Does anyone have experience with this? (Sorry my simple question turned into a long post...thanks for reading)
  9. nursetmj

    How often do pain meds cause vomitting?

    You might also ask about getting some additional antiemetics on board. The N&V is most likely caused by the cancer itself plus the chemo (as a previous poster stated). There's a whole arsenal of things the patient could/should be getting to prevent all this N&V....sounds like he needs it.
  10. nursetmj

    Biggest Misconception about nurses you've heard

    Here's one I always hear: "It's not like you have to clean up poo or anything....don't nursing assistants do that?" Or "all you do is pass meds as a RN, it can't be that hard". Yep, that's it! People, the general public, heck even doctors sometimes -- have no clue.
  11. nursetmj

    Is having a ADN useless these days?

    I do know that by 2020 all Magnet facilities will have BSN-only prepared nurses. I'm starting to see some Magnet hospitals already acting on this -- here is a direct quote from a hospital job opening for an experienced RN: "Graduate of an accredited school of nursing. BSN is required within five years of hire. Current RNs must obtain a BSN or be actively enrolled in a BSN program by 2020. " Obviously this is Magnet specific, but I do foresee it becoming the standard. I myself have my ADN but have decided I better get moving on my BSN. I had a Bachelor's in another field and didn't really have much motivation to get my BSN, but have changed my mind. It's something I want for myself and my future. Is an ADN useless? Heck no! Only if you don't use it. ADN=RN=valuable.
  12. nursetmj

    How long can port-a-cath go without flushing

    I work in an outpatient Onc clinic; we set our appointments for every 6-8 weeks for routine port flushes. Of course you always have people who forget or just don't want to take the time to come in for it. I think I flushed one a few weeks ago that hadn't been flushed in a year! Not smart. I did get a blood return though :)
  13. nursetmj

    Cincinnati ICUs -- which one?

    Calling any Cinci ICU RNs: Which ICUs in Cincinnati are decent? Which would be a good place for a nurse w/3 years' experience? (Tele, Med/Surg, Onc, Newborn Nursery, Travel Nursing) Which ICUs to avoid? Thanks for any and all input!
  14. nursetmj

    Thinking about NOT signing another contract!

    Thanks for the advice everyone!! So far, I haven't talked to anyone yet at either my agency or the hospital. It's been missed calls and voice mail messages. I didn't expect any resolution over the holiday weekend, but hopefully this week something will get decided. On one hand I want to stay, I'm familiar (I wouldn't use the word comfortable) with the facility/employees/etc. On the other hand, I'm ready to be done and not have to worry about it anymore. I'm also looking into doing some per diem work, have an interview/appointment this week to talk to the agency about which opportunities they have and where. I guess it boils down to turning down a contract (and almost guaranteed money) in this tough job market. I don't feel like I should be so risky...but I don't want to be miserable either. Hmmmm.....miserable with money or poor and happy?
  15. So the facility that I've been at (finishing up my 2nd contract there now) is not the most desirable. Let's just say it's been tolerable. Fine. However, as you all know, travelers don't usually get treated the best and are first to float. Fine. Travelers always usually get the crappiest pt. assignment (No exaggeration, I had 2 swine flu patients, a TB, and a R/O influenza one night last week. These were 4 of the 5 Isolations on the floor - hey, why not give 'em all to the traveler?) This is my first travel assignment and I knew all of this going into it; I've been handling it alright and actually have come to enjoy the my "home" floor and the people I've been working with. But lately I've been floating all the time, and more frequently, it's been to the "hell hole" of the hospital (aka, the 5th floor). The place NOBODY wants to go. The floor that when the manager tells you they have to send you there, they apologize. I've tried to have a good attitude, but two nights ago was the last straw. Without boring everyone to death with all the horrendous details, the nurses there are just plain VICIOUS. EVIL. Unkind human beings. Nurses who rip you apart and try to throw you under the bus, (while you are doing the very best you can and all patients are safe, clean, and comfortable) all within the first 5 minutes of report, should be tarred and feathered alive. Better yet, they should get OUT of the profession altogether. I decided right then and there, when this contract is done (7/11), I'm 95% NOT signing on for another. The only way I'll stay on for another 8 weeks is if they put a clause in my contract stating I do not float to the 5th floor (I'll float anywhere else). My recruiter has been assuming all along I would sign on for another, we have even discussed the dates I will need off. She even put my contract online for me to sign. Which I have NOT YET SIGNED. When I spoke to her telling her of the issues I've been having, she was very sympathetic, but basically said I need to call so-and-so and talk to them, then I should call so-and-so, and talk to them and get advice. NO. I'm not calling all around, whining about how horrible this place is. I can't fix a broken system. I can't change rotten nurses' attitudes. I'm telling YOU because YOU are my advocate and if you want ME to sign up again, so that YOU can make money off of me, YOU will help me fix this problem. I shouldn't have to dread going to work -- or decide it's just NOT worth it and instead call off and pay my agency -- so I'm not subjected to the torture of the 5th floor. Here's the kicker: When I told her I am seriously considering being done after this contract, she said something about me having to pay cancellation fees and we don't want to get into that. I reminded her I'm not obligated to anything after 7/11, that I've not signed my contract and I will not until I am comfortable with my contract. She said "Yeah, but you've verbally committed so we have you contracted with this facility." SO???:icon_roll Am I wrong that I'm not obligated until I sign?? Any advice??
  16. nursetmj

    Mayo Clinic and Rochester Area Questions!!

    Let me start by telling you I used to work for Mayo for 4 years and am in the process of trying to get back there - I moved to Chicago for a bit and decided home (Rochester) is where I need to be. If you are raising two children, Rochester is DEFINITELY the place to do that! (As a side note, that's actually a complaint for the many young singles that end up there - a great place for a family, but not so exciting when you're young and looking Seems all the night life is up in the Twin Cities.) As for surrounding towns, MANY people make the short commutes in to Rochester from Byron, Stewartville, Kasson, Chatfield, etc. All nice communities. Byron seems to be really up-and-coming w/lots of new construction and a nationally famous newer golf course, Somerby. I can't say too much for pt. ratios other than what my fellow nurses have told me so far: Days usually 1:4, evenings and nights more. But I think Mayo has a very low turnover and that nurses are for the most part, satisfied. Charting is all electronic; in fact, everything is electronic. Mayo is at the forefront of technology. It is also a teaching institution, meaning the nurses interact with many residents and fellows regularly (some of the brightest in the world). The culture there has been said to be a bit on the conservative side. Some other unique tidbits: The nurses do NURSING. They also focus a lot on patient education. They do not start IVs (there is an IV team for that), they do not start catheters (there is a Cath team for that), they do not draw labs (there are phlebotomists that do that), they do not do 12-lead EKGs (there is an EKG team for that). Some nurses have a problem with that. Now all of these "nurses do not's" apply to general floors, not some of the ICUs, ER, and PACU, mind you. The place functions like a very efficient machine. It has to for all the many people that it serves. There are politics and some very strict rules, but you have that any where you go. I can't say enough good about the place Best of luck! Hope this helps - Let me know if you have any more questions and I'll try to help! Oh, and one last thing: It gets VERY cold there in Winter, but then coming from PA you can probably deal with that