IntoTheUnit

40-50. I do 20 visits a week. Paperwork and charting has sucked up my life!

I left the ICU after two years, got totally burnt out(coding my coworker will do that to you). I've been in HH for about 5 months now, and while I don't love it and don't plan to be here forever, it's nice. No adreniline like the ICU, but also no codes, my patients actually get better, and everyone is happy to see me.

I have had chronic daily migraines for the past 4 years. In the last year, I've been trying to get pregnant, so I'm off all my preventative meds--and I was on 5 of them! I tried my hardest to hold out with just taking meds when I had a headache, rather than doing any long acting narcs or preventative meds, but couldn't do it. I started on a fentanyl patch last friday, along with midrin and MSIR to take when the pain overwhelms me, and I can't tell you how much better I feel. I'm not sedated, I actually have more energy now that I'm not constantly fighting the pain. The way I've interpreted the BON rules, if you aren't impaired, your liscense isn't at risk. I don't consider myself impaired, and my neurospecialist knows that I'm working and driving and doesn't consider me to be a danger to myself or my patients. I hope you find a good pain relief regimen soon.

Skin flakes! Oh god, the grossness. I can handle anything else--trachs, cdiff, anything. But peel of a pair of TED hose that have been on for a week and I'm gagging.

Beta blockers(atenolol, specifically) are showing some promise in "performance anxiety." I guess what they do is decrease the symptoms felt--the heart racing, shaking, sweating, etc.

I use a Wegner(they make swiss army knives!) bag that I got at Staples. I've only been using it for about a week, but so far it seems to be working well. Much better than the backpack for my neck and shoulders. It was a little expensive ($120, I think), but worth it and tax deductible.

Oh, boy, have I learned this trick, too!

The Grey's Anatomy Scrubs have a long size that fit me, at 5'9.

I just got a Garmin Nuvi 260 tonight, so far it seems to be working well!

I need the advice of any home care nurses out there regarding my bag. I feel like I'm missing some important things and that I have too many unimportant things. So, here's my list of what I'm currently carrying. Keep in mind, I'm in palliative care. Cancer, mostly, with wounds, IVs, ostomies, etc First pocket: Laptop Stethoscope BP cuff Thermometer gloves notebookSecond pocket tape measure(paper and plastic) tapex2 kinds lancets (not sure why, maybe these should go in the blood box?) 2×2s, 4×4s cotton balls (again, why?) Alcohol wipes Pill envelopes (I think?) Bandage scissors sharps box Squirty saline Paper towels Reference book: Mosby's HH Nursing Pocket ConsultantThird pocket: Sterile gloves x2 tongue depressors Qtips Aprons syringes c needles suture removal kit masks bottle of saline KYOuter pockets gloves CPR mask pens Purell soap barrierTrunk: Scale blood box cooler with ice pack stethoscope(I tend to forget mine) isolation garbWhat am I missing? What do I have that I don't need?

Hello all, I've just accepted a position with Visiting Nurse Service after leaving the ICU, and I had a few questions: First, does anyone know of good, relevant software for the Palm? I have Epocrates, but I'm wondering if there's any home-health-specific software. Along that same line, what about any books, websites, or journals? I was a member of the AACN and would like to find something similar, but any searches I do come up with out of date things. Second question: who uses GPS to plan their day? What system do you have? I can't read maps for the life of me, and right now I'm relying on Google Maps, but I'd rather have something I can take in the car with me. Thanks!

Coding my coworker. She drove herself to work feeling cruddy, sat down in a chair, and then went down. We worked on her for over two hours. Got her back at first; she was talking and joking with us. We did everything--everything!--we could, but she'd had a massive MI and died that night, surrounded by her friends and coworkers. I developed PTSD, wound up being hospitalized for 3 weeks, and was getting better. Then I was caring for a coworker's father when he coded, I had a flashback and panic attack, and got fired for being "unreliable." I had my first code in my new job last night, and now it's 4am and I can't sleep, thinking about all of this.

4 Weeks? Can I ask why--we generally withdraw care ASAP after a determination of brain death. And FYI, legal brain death must be declared by 2 independant docs anyways, no need to include that. However, I'm not sure if they need to be neurologists by law--my hospital uses neuros for it, but that may just be our policy.

Wait, wait. Just doing some research here... There are multiple types of H visas. H1B visas "...applies to persons in a specialty occupation which requires the theoretical and practical application of a body of highly specialized knowledge requiring completion of a specific course of higher education. This classification requires a labor attestation issued by the Secretary of Labor (65,000). This classification also applies to Government-to-Government research and development, or co-production projects administered by the Department of Defense (100)" from here. This site states that " The H1B visa is an option available to a limited group of foreign national registered nurses." This site(the first one linked above) states that "H-2A classification applies to temporary or seasonal agricultural workers" and that "H-2B classification applies to temporary or seasonal nonagricultural workers. This classification requires a temporary labor certification issued by the Secretary of Labor (66,000)" Not sure what the quoted gentleman was talking about, but according to this, he's wrong.

My unit has a policy that only wedding bands can be worn, citing a study that shows ICU pts get 50% more infections if their nurses where more than 1 ring. I wear mine pinned to my shirt and through my bra strap so I can't forget them(when I remember; the policy isn't enforced very often).

That's a great rule! I just emailed it to myself(my way of remembering things online).

Schizo? How about "person with schizophrenia," if you know their diagnosis, or "extremely agitated person" if you don't? Otherwise, sounds ok. I'd also call the police/security.

Bethem-- Yes, Jen, SN was my old blog. Now writing at http://intotheunit.com , but having some writers block. Thanks for the encouragement. You're still in school? Heading for ICU?

Hello everyone... I just joined the site for the second time--I had been a member while in school, and lurked all over for the past few years, but now that I'm starting my work I feel a need to talk with people. I started working in a general ICU (we get just about everything: med, surg, minor trauma, neuro, etc) in the beginning of June, and now, 2.5 months into it, I'm desperate for some positive affirmations. See, here's the thing: I love my job. I knew I wanted to work in ICU since almost the beginning of school, and I was hired into it 6 months before school finished, and they have a lot of confidence in me. But it's not what I expected it to be. For the first two months, I had a preceptor who was...not the greatest. Constantly leaving for meetings, telling me that she'd teach me more advanced things (like why I was doing this or that thing, rather than just how to do it) later, making me feel like I was just filling a space, and leaving me alone for long periods of time. I was sharing her with another new grad, a situation that was absolutely horrible: if his patient crashed, I had no support and no one to go to (along with the fact that they spent an awful lot of time "just chatting" when I could have used her help). Now, I've got a new preceptor, and I'm the only person working with her, and it's a much better situation. But I still feel so in over my head. I cry just about every other day there. I can't stop beating myself up over minor mistakes--forgetting to unclamp a piggyback med, or getting behind on charting, things like that. I made my first med error the other day--a tiny, minor little thing that had absolutely no effect on the patient, and I cannot stop bashing my head in about it. I can't stop holding myself to these perfectionist, self critical standards, and it's really hurting me. I know that in time, this will get better. But I don't know how long it will take, and that's part of what bothers me. I could handle this a lot better if someone would say to me, "By the end of your 6 month orientation, you will feel so much more comfortable and competant, and these horrible feeling will go away." But right now, I'm just about to the point where I'm considering quitting my job, I feel like a failure, and I can't stop crying anytime anyone asks me how work is going. Another problem is that I'm sick: I have chronic daily migraines that I use several medications for, and I leave work everyday with my head throbbing. I also have severe mental disorders: bipolar type 2, currently in a major depressive state, and my psychiatrist told me yesterday that she thinks I have symptoms of OCD. So I'm also in the middle of a medication switch. My fiance and I are moving in two weeks, we're planning an overseas wedding, my sleep is completely out of whack, and...aaaah! So, when does it get better? What can I do to help it get better? I try to talk to my coworkers, and they help me out a lot, but I wind up crying all of the time. I carry an herbal remedy with my in my pocket and use it as needed(Rescue Remedy, and whether it's the placebo effect or not, it works for me). I work on eating and sleeping enough. I just need some encouragement that yes, this will get better....