jamato8

Life is short and if you can get a second offer then you are ahead of the game of life.

For what we do, it is not enough but up here in northern CA you will make about that your first year and more after that. Get holiday pay at 75 plus and hour and double time at 100 with great benefits. Some areas are half this, which is disgusting, again for all the work we do. I work in ICU.

This is an old thread but interesting. Where I used to work we had the wound vac frequently. I had a sponge that I could tell had been looked over a few times. It was a bear to get out. Plenty of NS and care. I finally got everything cleaned up. I can see whey it wasn't done, due to the depth and size of the wound, but the reason was being lazy because you could see the sponge. The pt turned out ok. Yes the wound vac can do wonders.

Do what you need to. It can and often is healthy to cry. I don't cry very much but did when years ago my son ran away from home. I do tear up when someone dies and I can see strong connections to the family or it someone I have taken care of for a while and the death just didn't seem right at the time. Do what is right for you not what others tell you that you should do as in "men don't cry". If you don't need to then don't but just express what you truly feel is right not some preconceived idea.

It is out of our scope of practice. More grey area? I don't think so. If they want to give us more education, pay at least 3X as much and give a choice on who wants to do this, then maybe but the nurse scope of practice would have to be rewritten. We do not prescribe, and adding or deleting and giving reasoning jumps right into that arena.

Yeah, I worked in ER for a very short time. I was told get them in and out, fast. I had a pt who was a frequent flier and he and his wife had never had his heart condition really explained to them. I took maybe 3 or 4 minutes to give them some important facts and they were very happy with an explanation that finally answered their long lingering questions. I was pulled aside and told that there wasn't time for that. Well we didn't have any other pt's coming in at the time so there was time because I would have been sitting on my butt otherwise but they wanted to make sure I didn't get in the habit of giving explanations. I am in ICU now.

I scoop but most of the time we have some type of a capping device that doesn't require using the same cap. Otherwise years ago I watched in amusement and then, realizing how effective it was, to put the used needled syringe up in the air with my arm extended straight up and walk to the needle bin. It works great no matter what.

Normally you do not want to use the arm with the PICC line and this is a policy at anywhere I have worked. Hep can be given in the stomach area, just note where you give it. Since it was Lovenox there shouldn't be much concern. It can sting a little and I once had a guy get out of bed and start crying. His wife was disgusted and left after saying he always put on a show like that. Maybe he really was ultra sensitive. Anyway, I stay away from PICC lines as I have seen enough that are infected for one reason or another.

Do you really have time to stop and read that? You have seconds that develop into minutes. You have to know what to do and act. It is a good idea to constantly review though.

That is for sure. Even some hospital sections are not up on the current methods and still go with 3 stacked etc of past ACLS. Staying current is our job as professionals.

If your charge nurse was informed she/he should have stepped in, that is part of their job. I never back off calling a doctor and put it squarely on them. Call until you get someone in the chain and if you have to, get the nurse supervisor. It is tough at times with the pt loads and until you get the flow of things. Yes, ACLS is very important and get to all the codes you can as they help you see in a crisis the ebb and flow.

And what happens when it is a male doctor??

Well what happens if it happens to be a male doctor that needs to look in on a female pt? What determines that it is ok for a male doctor to do what is needed but not a male nurse? I worked in L/D for a while with no problems. I have done many foleys on females and again but with rare exception, no problem. I think it is often about being professional. I did have a female say she wanted a female nurse but was told by the charge nurse that the staffing was too tight and could she please work with us. At the end of the day she was very happy and thanked me for the care.

While you are ACLS certified if your hospital or unit operates safely they are not going to expect you to go beyond your ability and that translates into actual experience. With my first ACLS certification I watched a lot and then started to participate. I have been in many codes and pumped on many chests, one for 45 minutes (way too long a code). You should know what to do at first of course but as the code progresses it is time to watch and learn. All the nurses on the floor I worked had to be ACLS certified but not all were comfortable and with pt safety first, this was not a problem but they were expected to watch, and then start to participate.

If I can't read it I call them. I had one that I asked a couple of other nurses if they could read the order and then my clerk, who can read anything and nobody could read it. I called the doctor who got mad. I told him no one could read his order. I think it embarrassed him because he wrote clearer from then on.

Sure take the job, not. I was asked after being on the floor for one year and refused saying I felt I did not have the experience. Another nurse was also asked and took the job (same experience). I saw codes where the charge was supposed to take charge and I saw a pt die because it was not handled correctly. It wasn't until after the code I realized why. Experience is needed and the only reason we are doing what we are doing is for the pt and safety first. If not safety I move on fast.

I agree with the statement above. No, it was not right to treat the resident that way and it is a type of abuse. I could not work in the type of unit you are in though I get many pts like you describe do to our aging society. It is part of my job to help them, provide them with a safe invironment and treat them with respect. If I can't do that then I better get a different postion or job.

Yes, manny times men can be a bit baby like. I know that in some cases I am, with my own needs. When I was small and in school, I would pass out when they gave shots. When in the Navy I got used to that real fast and got over the needle thing, for a while. As a nurse needles are no big thing unless used on me, but to be honest I have some women friends who are the same way. Getting me to the hospital is a real chore. I am allergic to bee stings. The last time I got hit on the lip by one and within 10 minutes my face and neck where swelling real bad and breathing was being affected. In that even there wasn't much problem in getting me to the ER. :^)

What is your team approach? With a good CNA the pt load can be changed, without a doubt.

I can't remember that I actually have, though like most everyone here I have met some great people. I did have a patient, or I should say, I took care of a patient who was just a little "forward". She was in for a possible ischemic attack, that turned out to be nothing so I did not pay as much attention to her as she would have like. She was being discharged and I needed to take off the tele pads, which I normally do discretely, so she told her friend to leave the room, which was fine but when he did she said, ok take them off and wipped open her gown, with a sultry smile. I thought to myself, "I wish I had asked my cna to do this" but I proceeded. As she went down the hall by the nursing station she looked over at me with the other nurses standing there and said, "if you had come earlier, you could have had me longer". I got some interesting looks from everone and one nurse who knew me well just said, "well well".

With as sick as patients are these days I do not think 5 or 6 pts is a gift at all. I worked in a cardiac pccu and 4 was too much though we used to have 5 and 6 and that was over the top. With all the paper work to do now, the added responsibilities of the RN that have moved into the lower end of what a doctor used to do, I think the proccess of what an RN should do in relation to her/his pts needs to be overhauled. In 10 more years there is a projected shortfall of 500,000 nurses in the US, gee I wonder why? Not only is it becoming more difficult with an aging and sicker community, the requirements are increasing on what an RN is responsible for. Burn-out will only increase until there is some sort of real meaningful change. On the note of med-surg, I never cared to do it though in a cardiac unit, where I have always worked, you get everything. Safety first, right?!

I have drawn a number of times myself when blood draws could not be done by the tech because she/he could not find a vein but my charge nurse, if she found out, always got upset with me. Flush well, draw easy and flush well and I don't see any problem but again, where I worked they had a tabu against it. I have seen other IV's that nurse had drawn from clot off because they did not flush well with turbulance and this is the main reason we were not supposed to do it. From practice I agree it can be done without a problem but it seems, at least where i was, a number of nurses did not flush in such a manner as to keep the IV open. This was on locked IV's that I am talking about.

In my unit, unless there was no choice, we were not supposed to draw blood from an peripheral IV, only central lines or art line. A peripheral will clot off easily if blood is being drawn from it. I have seen nurses use a 1cc syringe to clean out a line that was clotted off and not only is this wrong, it can blow the line above the clot and now you may have a line that infiltrates. When I see a nurse do this I let them know. My concern is the patient and not if someone will get upset at me. I get along well with the nurses I work with and I help, even when i am swamped but I still give my opinion when I see anything that is not correct procedure. We also have an excellent educator and I consult with this person all the time for continual updates and edification.

I have used TPA on picc lines with a doctors order. What is he/she doing to flush these lines? If lines are flushed twice a shift (12 hour) normally there isn't a problem. It sounds like a standard for flushing lines needs to be set up.

Never had to do it. I had a friend who did and she couldn't stand it. She quite working at the place because she could never relax on her days off. I won't accept the pressure but I haven't worked where it was a situation, thankfully.