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Thanks for the info, I have found some websites that will be helpful with my search.

It kind of sounds like you have management problems. I don't know the situation but they shouldn't move you to another position without talking to you about it. If they do and you are in a position you hate, what prevents you from leaving. Nursing covers such a broad range of areas and help is needed everywhere. Also stand up for yourself, if they put you in a position that you hate, tell them why you hate it and why you will leave if change doesn't happen.

While I was writing my novel ilostu12 posted one. I agree with seeing a diabetic educator. We have been seeing one and she is very helpful. They have a lot of insight that sometimes an FP MD doesn't have.

SCRN1, I will share my story and see what you think. My husband is a diabetic, started out in the 400's. Would usually get hypoglycemic symptoms when he dropped to the 300's. He was initally started on Actos which brought his A1C's down to 6 (He refused to check his blood sugars). However the actos caused him to retain fluid and started having difficulty breathing. Our MD would not listen to us so he (one who does not like MD's in the first place) quit all his meds (he was also on vytorin) and deceided he could do it with just diet and exercise. Three months later he started having chest pain (not related to DM but WPW) and got freaked out and deceided maybe doctors aren't that bad after all. We found another doctor who starts him on Amaryl as his A1C was 13. He starts taking his BG when he wakes up, but can't get his fasting below 250. Despite increasing his doses and adding Avandia his BG's don't budge. In the meantime he has an ear infection that won't go away no matter what we throw at it. We finally deceide maybe it is time to start insulin. If nothing else to give his B-cells a rest. Our MD thinks he might be able to get off the insulin at some point if he hasn't totally destroyed all his B-cells by overworking them. Anyways, he started levemir at 5pm and regular before meals. We both work nights so he has a similar issue that you do. He always takes the levemir at the same time each day-5pm. Then he has sort of a sliding scale that he uses before each of his meals. The time of his meals changes on a day to day basis but with using insulin we have been able to keep a good control of his blood sugars He now ranges from 89-150, which for him is great. He is also getting tighter control as we experiment with his carb to insulin ratio and levemir dose. I know it feels like a big step to go to insulin but I think it was worth it for my husband. He feels so much better now and his ear infection cleared up quickly. He also stopped his oral meds, which he enjoys not having those side effects and not having to take so many pills. By the way I think symptoms depend on where your blood sugar levels live. Initally my husband was in the 400's without symptoms and could have been there for years. His body finally quite compensating and he started having more symptoms. Also we have noticed that no matter what his starting blood sugar is, if he drops much more than 70 points in a short amount of time, say 2 hours, he feels hypogycemic. So if he goes from 300 to 220 he is about ready to pass out. Good luck with your diabetes. Going to days would probably help things out but I know how hard it is to get a day shift sometimes. I had worked my way to a day shift on my prior unit only to end back on nights when I moved to another unit. I love where I work but it has a 2 year waiting list to get to day shift. At this point I am not willing to find a new job just for a day shift.

I may need to go to Canada for 3 months for my husband's job. Thought it would be a great opportunity to try and pick up a travel position. I have been trying to research it on the web but have not come up with anything. Can anyone point me in the right direction? Do they even have travel positions in Canada. It would be in the Vancover BC area.

Always seek out learning experiences. If someone is doing something you have never seen before ask to watch. Ask lots of questions. Anytime you don't understand something, ask about it. Don't worry about looking like you are incompetent. It is much better to ask and learn than to pretend you know and cause harm because of it. Most hospitals offer classes ie Rhythms, 12-lead EKG, diabetes management, ect. Even if it is not required for your unit, take them. Be proactive in your nursing development. Another thing to keep in mind is a couple of years into your career retake some of those classes you took at the beginning of your career. The learning curve is so big at first and you can't retain everything. When you retake those classes you learn things you missed the first time around, and it is a great refresher. I have really benefited from this. I also know a nurse on our unit who has been a nurse for 20 years and she retakes the classes every so often as well.

I don't think you need to worry about missing an opportunity. Positions open up all the time. If you don't like where you are you may be able to go to the other hospital later on. Personally I think the CCU/CSU sounds great. You can get some med/surg exposure on the step down side and be able to work up to the critical care side without having to change positions.

"But the night shift nurse who I gave report to was clearly frustrated with me for pulling it. She said I should have simply kept it all connected but taken it off the monitor entirely, for blood drawing purposes. " I agree with a lot of what has been said. Keeping a line for frequent ABG's (have you seen an arterial site after multiple sticks-soon you can't find the artery anymore) is definetly a reason to keep a dampened art line. Widening the alarm parameters is the way to go. Disconneting it from the monitor is waiting for trouble, I've had my own experiences where pt's would have bled out if it were not for the alarm. But one thing I must say about the nurse you gave report to. Even though she may have more experience than you, stick by what you know. Always put the patient first. Don't let the fact that she has more experience than you waver your confidence in what you know to be right.

Our orientation requires going through pacep.org. And it is great to go back to for referrence as well.

I personally think that if a woman was to be offended at that comment she would more likely be offended if a male said it than a female. I also personally think that males are more likely to crack a joke in a stressful situation.

All you can do is talk with the family about what the patient would have wanted. The family needs to ultimately make the discision, they are the ones who have to live with that choice. You shouldn't urge the family to withdraw. You need to present them with the facts and options and let them make the choice. Our hospital actually has a pallative care team that has doctors who will review the case and sit down with the family and talk through all the issues. They then also address the issues of comfort during the withdrawal time and make sure we have plenty of pain medication available to keep the patient comfortable. Anyway you look at it, it is not easy.

Tele is generally an awesome place to start. You get the cardiac side and experience with EKG readings as well as an introduction into some drips. You also get a wider variety of medical conditions and issues than on a CVICU or CCU unit. At least that is what I have seen where I'm from. Also take initiative, seek out learning experiences, never be satisfied with how much you know. The saying-The more you know, the more you realize how much you don't know-is very true in the nursing world.