Bubbles_RN

Well, I've been ICU nursing now for 12 years. I still remember my first year. I remember thinking I was insane for doing this, that the hospital was insane for hiring me. I cried.....a lot!!! I worried, stressed and somehow got through it. You are not alone, we have all been there, or are there now. Nothing lasts forever :). Hang in there, keep going forward!

Well, I've been nursing for 14 years, and I still pretty much suck at IV starts. As others have said, it is a skill, and one that takes practice. In my clinical setting, we don't have a lot of peripheral IV's. Speak up for yourself, let your educator know, and work together to figure out a solution.

Hi Fiona, I work in Ontario, in the GTA. A full time weekend worker is allowed under our union contract. Also, I've been fortunate to work for some amazing managers, who will let nurses swap to work either full time days or full time nights. I do in fact realize that most nurses work rotating shifts, and I did my share prior to having my first child. Like I said I've been very fortunate to find a great life/work balance schedule.

I know a lot of nurses where I have worked have a shift buddy, so they are able to only work the type of shift they want (ie all nights or all days). Not sure if that may be something that would help. I have been a full time weekend worker for the past 7 years, and dread the thought of going back to a regular rotating shift schedule.

To begin with, figure out which ones are most commonly used at your facility. Then figure out what they do, how they work, and major side effects. Your facility IV manual should help with it as well. Ours is awesome, lets ya know how to mix it, what it does and what to watch for without info overload of a drug book.

Ok, yeah you made a mistake. I would go to my instructor with a plan around remedial action. For example, you could tell her you plan on reviewing allowed procedures, and perhaps a reflective journal entry on the situation. Be proactive in admitting your mistake and taking action to help prevent further errors. Oh, and as far as I know, unless there is a complaint filed to your local college of nurses, there wouldn't be a permanent record.

Go for it - I've gotten coffee for family members, scrounged up sandwiches and done emergency McD's runs when it seems needed. It may seem small but I bet to him it will be huge.....bless you for being a nurse through and through :redpinkhe

Ummm I convinced a friends signifigant other that his cramps were really ovarian pains......which he promptly reported to my friend (also a nurse).......oh dear we laughed until we cried over that one........

Well we have a scale usually 2 - 10 mg/hr with the option for the docs to write higher end points as required. Although if we can't maintain a RASS of -1/-2 with high dose versed/fentanyl we usually look at adding something else.

Yep I've had a couple o docs do that....the best was just last night give a beta-blocker and hung up......uhhh news flash a) I don't get to pick which one, nor do I get to guess how much and b) the SBP was already 70....so no beta blocker there :bugeyes:.

Our hospital is talking about it, and quite honestly I'd love it. Having been on the other side of the bed as both a pt, and a family member, it is quite annoying to ask every single person coming in your room who they are and what they do. I worked damn hard to become a nurse, and I want people to know that my role at work.

As a general rule we use valium not ativan for our ETOH'ers......and I had one guy that we gave something like 50 mg IV to in a 12 hour period. Most lorazepam I can recall giving was a guy we had on a gtt at 10 mg/hr + at least 2 mg IV push q1H.

I will give narcs within a 1/2 window on either side for prns. However if I find they are needing a fair bit of prn medication......or if the timing isn't working for them I usually re-assess thier medications. Maybe they need a change in narc or do they need an NSAID or something like gabepentin if they are having nerve pain.

My most heartfelt condolences for your loss. I am so sorry that you were treated so terribly in your time of need. If you are in need of something to return home I agree with others, go to the local ER and hopefully the nurses there will advocate on your behalf. Many hugs to you.

Yep an all too common issue in ICU. If you are new to ICU I would have suggested speaking to either your preceptor/nurse manager. They could have provided you with guidance as to what your next steps could be. If a situation doesn't feel right listen to your instincts...they were telling you the situation was wrong. There should be hospital policies on what to do if you don't agree with the treatment plan. Me - I would have directly asked the doc if he had discussed this with the pt. Alternatively I would have discussed why the pt wanted to be a DNR with the pt. Knowing why the pt made that desicion might have strengthened your position with the doc. Good luck, I spent many a shift as a new ICU nurse feeling like I should be beating my head against the wall.

I've had shifts like that as well, usually after I've been essentially coding a pt all day and my standard response is hey the pts alive - hope you do as well. Mean....well yes, but honestly who gives a flying rump if caps were changed. As a previous poster stated, nursing is 24/7.

No personal experience with using a line - we use a traditional cooling blanket to cool our post arrest pts......but here is my experiences with complications: Cooling - I've had a couple of pts who ended up being too cold, and developed symptomatic bradycardias. We treated with a bit of dopmanine while warming them to the intended temps Warming - we aim for a degree every 4 hours, so a very gentle re-warm. I've had one pt. develop hyperkalemia, which we caught early, and one who develped f-fib as soon as he got into the 35 degree range (sorry canadian used to C) that just had such extensive cardiac damage he couldn't deal with the increased metabolic demands.

That is an awesome answer!!! We are just starting to use SVV in our ICU and I've been a bit lost with it, as our educator got me going round in circles with what all the numbers mean.

I hear you - sounds like an incredibly tough spot right now. I've found that when I'm having a hard time letting something go that writing it down and then getting rid of it, either flushing it or burning it helps. I hope the blahs pass quickly, and that your old flame helps to brighten the season for you

Gotta agree with the full moon. When you get to work a full 20 minutes before shift change and your co-worker gives you such a look of deperate relief When you get out of your car and hear 2 codes called in your unit, on 2 different pages When you get to the unit and find the intensivist this week is the one that thinks sedation is evil and all pits should be awake.

Also a possibility is that he was in benz withdrawl - we see this quite a bit when docs turn off versed gtts that have been running at like 5 mg/hr for days. I don't think 7 mg is anywhere a huge dose, but I've given acute DT'ers somewhere in the neighbourhood of 40 mg of Valium and they still keep on ticking.

That MD's make the worst pt's That telling the nurses taing care of you that your friend who works in the kitchen at another facility is a nurse doesn't get you better care When your fresh huge anterior MI pt says I need to go to the bathroom, get the code cart on standby That yelling I can't breath over and over again is a good way to make your ICU nurse wonder how she tube you

With both my pregnancies I worked until 39 weeks. I had the cankles as well, and yep crocs were the only thing I could wear at the end. I work a med-surg ICU I had no restrictions (in fact I remember doing compressions at 8 months) but I work with a really awesome group of nurses who made sure I got a break everyday, and no way in heck were they going to let me lift anyone

We get this a lot in the ICU where I work too...no CXR and fluids running. We have a policy that states we (the ICU RN's) are not allowed to run fluids until CXR confirms placement. This came about because we had an incident of vessel perforation. So I agree with the nurse who wanted to get an x-ray.....it's her license on the line.