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  1. RNperdiem

    Hired On a Floor That Does Mostly Lumbar/Cervical Postop

    I think the reason you are not getting much response is because it seems like you are taking care of an unusually specific patient population. Now if you are working orthopedics, that is familiar territory. You need to know about activity restrictions in ortho. There are all kinds like- full spinal, cervical spine precautions, sternal precautions, hip positioning devices, clamshell braces and various splints. In orthopedics you get familiar with pain control, especially when it is time for physical therapy. You also need to have a good working relationship with your CNAs because many of your patients will need 2 people for getting out of bed.
  2. RNperdiem

    Part Time Job

    In my department, there are people who work an overtime shift every week. They typically are paying down student loans. For a bit more money, in my hospital you can sign up in another department (that you are qualified to work in- (other floors for floor nurses or other ICUs for ICU nurses) where they are so short of nurses that there is a critical staffing bonus on top of your regular wages. Look at what your shift differentials are in your hospital. Weekends pay substantially more than weekdays, and the night differential is good too (at least in my hospital).
  3. Eat lunch. The workload on this med-surg floor is crushing and you need your strength. You come in a bit early and leave late every day. Even if you only take ten minutes to sit down and get something to eat and drink, you will perform better.
  4. RNperdiem

    Pre nursing student has a question for current RNs

    You don't need a big underlying drive to help people, but you do need some basic empathy and a sense of responsibility. Nursing is a service-based job and we need the soft skills of communication, getting along with others and being able to work as a team to thrive.
  5. RNperdiem

    Why do you love your specialty so much?

    Sometimes it is not entirely up to the specialty. The love can come from a good group of coworkers, good management, a shift that works with your health, and many other small variables. Each individual nurse brings their own expectations and coping skills to each job. In a hospital there is a lot of overlap in bedside hospital jobs. I started out in med-surg because that was the department that was hiring. I saw the job as a good entry-level job to get started.
  6. RNperdiem

    ICU nurse vs PCU nurse

    I wonder if your progressive care job providers were not entirely empowered to make big decisions. Dealing with crosss-covering services, NPs and PAs who cover nights and weekends gives you the feeling of your patients being "band-aided" until the surgical or medical team (who are empowered to make big decisions) arrives. I work ICU dayshift and have to trouble getting my patient the orders they need.
  7. RNperdiem

    What if/Is it possible?

    I could pass the written part of my driver's license test without actually knowing how to drive.
  8. RNperdiem

    Pain management in nursing

    It is probably department-specific, but surgical ICU does take pain seriously. Getting hit by a car or being beaten with a lead pipe or dealing with necrotizing pancreatitis does hurt. Burn injuries are a whole different classification of pain control. PCAs for the awake and able to use the pain button, sometimes combined with non-narcotic prn meds are common. Most sedated and intubated patients get a Fentanyl drip. Every once in a while a patient with chest injuries and rib fractures gets an epidural. There is an anesthesia pain team available for patients with complex pain needs (often chronic pain/ hard to treat pain). Part of rounds every morning addresses pain control. In an ideal setting, the pain meds are gradually tapered down from IV to oral, and from high doses to lower doses.
  9. RNperdiem

    RN switching specialties....indecisive, unmotivated?

    I used to dream about OR. No call bells, one patient at a time, no room full of demanding family members stirring up drama, no having to call security when visitors get out of hand. Maybe you should do some shadowing for a shift in the areas you find interesting.
  10. RNperdiem

    Is a pension really worth it?

    Trouble is, nothing is guaranteed in the long run. A company can decide to phase out pensions, change conditions or water down benefits.
  11. RNperdiem

    Applied for a position that is now on hold

    As long as your life is not on hold waiting for this job which will likely never happen, then there is no need to withdraw your application. Keep looking for other opportunities.
  12. RNperdiem

    The ballad of the lonely educator

    Maybe that is why inservices (at least short ones usually involving new equipment) tend to involve getting cornered at work, gathered together with a small group of staff and getting quickly inserviced before being released to get back to patient care. I think of it as a "catch and release" inservice.
  13. RNperdiem

    Is it a bad idea to return to the hospital?

    Since you are employed now, you have the time to look around at hospital jobs, shadow and apply to areas you think you can thrive. The extra money you make at the hospital can be put to good use- college tuition, vacation, savings. The learning of new things will lift you out of boredom, and meeting new people brings some nursing peers into your life. After a long break doing school nursing, finding a hospital job might take a while, and not be your first choice of job, but in many places you can transfer to a different department.
  14. RNperdiem

    Phlebitis management. Was this handled correctly?

    I guess it depends on what else is going on. In my ICU, the policy is for a patient to have 2 peripheral IVs at all times unless there is a PICC or central line. If this patient is on Vanco long term, a PICC is a good idea; vanco is tough on veins. The thing is, it takes time to find the provider, convince them a PICC is a good idea, have them place the order, contact the IV team(lucky if they work nights and weekends), and get better IV access. In the short term, the nurse might have to start a new peripheral IV. The nurse might want to have a new IV placed first and delay removing the old one until a new IV is in, just in case.
  15. RNperdiem

    Day Shift vs Night Shift

    Rounds. While the doctors are always available, during day shift, formal rounds with residents, the attending doctor, pharmacist, RT and nurse take place early in the day. A day shift nurse needs a list of issues to be addressed and what you want for your patients. This is usually a busy part of the day where you juggle assessments, first round of meds, rounds by doctors, incoming visitors, charting, and that page of orders that appears after rounds.