CrufflerJJ

Fading memories... I've been retired now for a bit over 2 years. Prior to that, I worked 10 years as a RN in a local VA Hospital MICU. Before that, I worked for 4 years in a high acuity mixed ICU in eastern KY (KDMC). LOTS of knowledge acquired during that time, by painful experiences. Sooooo.....now that I'm retired, I've noticed that I am gradually forgetting stuff that used to be super-important. This includes normal lab values for electrolytes & blood counts, names of typical ICU meds,... Last night, I was laying in bed, TRYING to fall asleep, when I suddenly found myself trying to remember the name of the biomarker that was frequently used for sepsis. NO LUCK. I had forgotten its name. As a former Type-A DRIVEN ICU nurse, I find this scary & sad. HOW DARE I forget something so "basic"! I just looked it up a few minutes ago.....procalcitonin, or "procal" for short. Stuff that USED TO BE "important" is now falling out of my poor decrepit retired brain. What I DO realize, though, is that emotion-based memories are embedded much more deeply in my brain. I STILL remember a former accountant at a >redacted...HIPAA< deciding to withdraw care on himself, knowing that it would result in his death. He's spent far too long in our KDMC ICU, on pressors to maintain his blood pressure. He got tired of the pain. After shutting off the drips, he passed quickly & peacefully. I STILL remember a guy at the VA who had been experiencing neuro symptoms. After being in our MICU for a while, the docs HOPED that it was something immune-related & treatable, but an excellent neurologist diagnosed him with ALS. He decided to withdraw care on himself. Room 286. His family members, all around his bed, FOCUSED on their PHONES rather than focusing on him. He passed on a weekend, when I was not working. I STILL remember a guy at the VA who used to work at a >redacted...HIPAA<. He's been in our MICU for >something< a few months before. He came back, in obvious distress. It turns out that he had terminal lung cancer of some sort. He told me words along the lines of "I don't mind dying, I just don't want it to hurt." Room 289. I'd settled him into the room/bed, dosed him with IV Dilaudid. His girlfriend was in bed with him. He bled/vomited into his airway, out his nose/mouth. At least it was peaceful.....except for me & his girlfriend. Strange how "important" stuff fades rapidly, yet emotion-based memories are still locked into my brain....years later. Maybe this is a sign of what truly MATTERS. Facts vs emotions....memories. I STILL remember....

On my fire department, we had an ancient MRL defibrillator with an aluminum case stashed in a closet ever since it had been taken out of service years prior. It would go up to 400 joules.

I wouldn't say "be afraid" so much as "be paranoid." If you're part way through your shift and everything seems to be going too smoothly, consider whether you're missing something.

I've been a VA nurse since February, after having worked as a (2nd career) RN for 4 years in the private sector. The hiring process is long & drawn out. Plan on about 4-6 months from application to actually working at the VA (assuming that you're hired following application). The patients are amazing. Very appreciative. Yes, there are some who are a pain, but such is life. My coworkers are generally dedicated, with a few mega-slackers added in for spice. In my ICU, I have seen no shortcuts compared to the patient care offered at my prior hospital. Yes, the VA did have a horrible reputation for pt care years ago, and the patients will tell you about it. My current pts, on the other hand, will tell you how the quality of care has improved over the years.

I LOVE your ADHD/OCD contrast. I've not done ER (but did volunteer in EMS x 19 years), and can see how the ER might be a triage/stabilize/move-'em-out environment, vs the ICU "What??? You don't know when your pt's last BM occurred" environment.

Congrats on graduating, and even more congrats on securing a job as an ICU nurse as a new grad!!!!! Your feelings of knowing "so little", yet being "eager to learn everything" are perfectly correct. You're miles ahead of the folks who assume that they already know it all, and will wow/impress their fellow ICU nurses with their schoolwork-based knowledge. You might want to check out icufaqs.org, and I HIGHLY RECOMMEND their book available at Notes on ICU Nursing: FAQ Files from the MICU: Second Edition by Mark Hammerschmidt (Author) . Another good resource (deeper, more technical details) would be Paul Marino's "The ICU Book", available at: The ICU Book, 3rd Edition: Paul L. Marino, Kenneth M. Sutin: 9780781748025: Amazon.com: Books ...although I dread paying $65 or so for a used paperback.... Congrats, good luck, and all that jazz!

You can always learn to curse in a new language. This might serve to relieve stress & is less likely to cause problems at work, unless your coworkers happen to speak Russian or Japanese or...

Despite what your preceptor says, SWEAT IT. Each & Every time you access a "controlled substance" from the Pyxis, make double-darn sure that you account for the amount used, and the amount wasted. To do otherwise leaves you WIDE OPEN to diversion suspicions. Take care!

Nope. Not weakness, but being open & honest about your feelings. Best of luck to you!:)

I'd be careful in talking about stuff other than your immediate med/surg opportunity. If you mention CDE (??Certified Diabetes Educator??) as a goal, then the med/surg folks might feel that you're just "using them" to get your foot in the door so that you can achieve your ultimate goal. I'd recommend that you be somewhat vague in discussing long term goals. Good luck!

Every unit will have a different style of interviewing. You may very well not have any clinical questions at all. Then again.... Be able to tell about the sickest pt for whom you cared during your clinicals. Be able to discuss the disease process, what you found interesting. They may throw questions at you regarding DKA, DIC, renal failure, sepsis. Obviously, the type of questions would depend on the type of ICU. You might just take a quick look at icufaqs.org . Good Luck!!

Your idea of shadowing is an excellent one. Contact the ICU's manager, expressing your interest. Good luck!

Apologies in advance, but this is going to sound a bit harsh.... Congrats on having been able to be considered for a position. It sounds like you're being seriously considered, given that you've made it through phone screenings, a phone interview, and you have multiple people submitting references on your behalf. If you are NOT serious about taking a job 4 hours away from your current location, then please stop wasting people's time. It takes time/effort to interview candidates for positions. It takes time/effort to give honest, meaningful replies regarding reference checks. If you were not willing to make the effort/spend the $$$ to interview for the position, then why did you even apply for it in the first place? This decision should have been made loooooong ago. If you decide to go ahead and interview tomorrow, and you do manage to get the job, would you be able/willing to uproot yourself, move, and establish a new residence 4 hours away? If not, then please stop the interview process now.

I'm a big fan of Gold Bond lotions. They are thick, not watery. Once they dry, your hands don't even feel oily. Good stuff!

It means that you made the first cut. There may still be multiple candidates for the available job(s). The folks interviewing you at the peer interview willl likely be your potential coworkers. Good luck!