MollyMo

PCU is a catch-all phrase. Usually it means that you will get overflow from other units. Or the doc will admit to your floor so the patient can be watched more closely than on Med/Surg. The PCU's I've worked do two head to toe assessments per shift, vitals q4. There usually is a monitor tech who runs and measures the strips every 4 hours. You will need to have or get EKG experience,BLS,ACLS. Lots of meds and drips to learn. You definitely won't be bored. Cardiac changes almost daily. Always something new to learn.

"IVCU,Renay,may I help you?" They do tell us that we are supposed to "smile" while talking so the caller can hear it. And end the call with "thanks for calling" or "have a good day." If you have to put the caller on hold you have to explain that you're putting them on hold and why.

I went from traveler to pool(per diem,PRN). The new director got rid of all the travelers and I wasn't ready to move on. I make about $4 more than staff. All I'm required to work is 24 hours per month. They say that we have to work one major holiday, but my unit closes on the holidays, and I don't want to float. Pool is the first to float and the first to be called off for low census, but I haven't been called off. I've only floated twice in 4 months. The rule is that charge doesn't float, and more often than not when I work, I'm in charge. My biggest concern is that they will start to bring in full-time nurses, I will have to orient them to the unit, and then I will be out of a job. Of the five nurses that staff the night shift, 3 are pool--2 RN'S and 1 LPN. The 2 pool RN's are the preceptors. We've got the most experience. We were hired specifically for our unit. The others transferred over. I hope they keep that in mind.

When I was traveling, how I was treated varied by location. Some used us as slave labor. Some treated us as a much needed addition(albeit temporary one) to their staff. Some expected us to work all the holidays so the staff could be with their families. Some rotated us just as with regular staff. And I have taken vacation in the middle of a contract, but I still worked my 13 weeks. It isn't necessary to be between contracts to take time off. I negotiated everything I wanted before the agreement was made. Travelers get praise because of our ability to adapt quickly. We get little or no orientation to a facility but are expected to fully functional. (That's what a manager told me.)

Mandi, just be you. Don't try to be someone you're not. I have a quiet personality. I don't say much but am very good at what I do. One of the "bubbly" nurses asked (or rather, complained) about my being so quiet. So the next time we worked together, I assumed a "bubbly" personality. Laughing, cracking jokes, grinning a Kool-Aid grin, etc. She didn't know how to take it. She asked me what was wrong with me. I told her that this is what she wanted. She said she thought it was, but actually seeing it scared her. I said," so I can be me now?" She said yes. I told her " good because this is giving me a headache." Just be you. And Belinda, there is nothing wrong with stepping back and taking deep breaths. It's actually a very smart thing to do.

Our policy is that agency/pool/travelers float first, then regular staff. Charge nurses don't float. So, if you're scheduled in charge and it's your turn, the next person on the list has to go. So my situation is this--I am pool. I usually am in charge when I work. It was the same when I was a traveler on this unit. We have 2 full time employees. One only works Fri/Sat/Sun. The other had been on medical leave. He made out his October schedule back in September before he got sick. He wasn't scheduled to work one Monday,but was released by his doctor to return to work. Sonia and I were scheduled. The supervisor told this guy that he would work our unit and somebody would float to CVICU. Sonia was in charge, so she wasn't counted. That left me. I told the supervisor that I was scheduled to work and I wasn't floating. The supervisor tried to tell me that the male nurse was written in. I told him I didn't care. The October schedule came out on Sept 9th and his name wasn't on it. If he wanted his hours he could float, but I wouldn't. The supervisor said" whatever you want to do, guys." The male nurse came in and was told that he would have to float. He said he was told that he was working our unit and if he wasn't needed he was going home. I told him goodbye and said talk to the supervisor before you go. I told him I was scheduled to work, I had taken report and done the assessments by the time he came in( he was and hour and a half late.) He finally went to CVICU after blowing a lot of hot air.

For us, it's not making a point of asking. It's written in our admission database to ask if there are any cultural or spiritual preferences that would affect care. There is even a chart with a breakdown of the most seen cultures to our area: country of origin;native language;religious and/or spiritual beliefs;responses to pain;treatment modalities,etc. You need to know so you don't accidentally offend someone when you're trying to help them.

Before my check-offs, I would find a quiet corner to go to and clear my head. The first time I did it someone spotted me and started poking fun. That is until that person saw how well I did on my checkoff. It is stressful. Congratulations on making it through yours.

Standard vented tubing. The only special tubing we use is for blood products.

I was taking a break in an empty room. I was in the recliner. The lights were off and the door partially closed. I remember I sat in the recliner at 3:30 am. I dozed off. The next thing I know, I hear someone in the room, then feel a hand wrapped around my right wrist. I sat bolt upright. No one was in the room. There was no way they could have gotten out without me seeing somebody. I looked at the clock. It was 3:40. Just to make sure I came out and asked my coworkers had any of them come in the room. They had not. Same room different night. The automatic blood pressure cuff was alarming low pressure. The problem was the cuff wasn't on the patient's arm and I had changed the setting from automatic to manual. I checked the settings to make sure. It was still on manual. The cuff never should have inflated.

Oopsie!! I like Meditech. You can edit,amend or undo your notes(helpful if you document incorrect information). We have unit specific and diagnosis specific care plans. If your second assessment is unchanged from the initial one you can just recall the information rather than re-typing the same thing. If the patient is less than 30 day readmit, you can pull up the old admission assessment and update it. The system I work with in Virginia-they even charted the meds in the computer. I like computer charting.

pappy, if you just want to be one it goes like this: babe !n total control of him/herself some people say it like it's a bad thing.

Tell them if they wanted banker's hours they should have become one.

God Bless you all for your support. Monday was uneventful. I saw the surgeon in CVICU. He averted his eyes and said nothing. I think the supervisor wrote him up as well. He called me that night and asked for specific details about the patient and what the surgeon said to me. I am woman, hear me roar!!! Thanks, all. Be Blessed. :kiss

....so I hung up the phone in mid rant. I had 2 hypotensive patients. One was orthostatic; one was due to exsanguination. I'm on the phone with 4 doctors, CT, blood bank,the nursing supervisor,CVICU, and this jerk surgeon. I'm trying to talk to family and control my hot flashes all at the same time. He's yelling at me because orders from day shift weren't carried out. I very calmly and politely put the phone down and went back to work. The supervisor called me and told me that the surgeon wanted me written up. I told my supervisor what happened. He told me to write up the surgeon. So I did. Monday should be interesting. :angryfire