pcicurn7

It's not just about finding what areas have the hours you want. Bc the answer will most likely not be in the acute care setting, it will prob be outpatient clinic or doctors office. The pay won't be as good, and you'll need some amount of experience in order to get those jobs. and what if you hate it? my hospital is union, so we cannot be mandated to rotate shifts. Ever. I work days....I'm not a single mom...and I still have baby sitting issues. You'll make it work. A lot of moms work nights bc it works out better for them.

Well what do you really want to do? Do you want to see a lot of different things, or do you love cardiac or Neuro enough to specialize in it? I went into a cardiac PICU as a new grad via an internship program. Worked out well for me. Neuro and onc were never my thing.

Definitely not a myth. I actually like to glance at the arterial line waveform to see if my compressions are generating good perfusion. And I'm 5'1....it's all about technique. I hop on the bed, lol.

this is NYP columbia, right? i dont know what they do at NYP cornell. i did the PCICU internship program there, so i know for a fact that its the only way in as a new grad.

just fyi...i dont know about the NICU, but NYP doesnt hire new grads for their PICUs unless you go through their internship program, which hires once a year (aug) and is pretty competitive. NICU i think does hire new grads...not sure though. a friend of mine works a hackensack univ med ctr, and the pay is comparable to NYPs. EDIT: all my info is for the children's hospital. i have no idea what they do on the adult side :)

when i worked in the peds ED, there were some nurses who used lidocaine to lessen the blow. however, it is against our hospital's written policy, so most of the newer staff doesnt do it. i never saw it diluted with saline.

no worries... IMO: in my opinion :)

i think it all depends on your staffing. If you have the ideal number of nurses, then your kids who are intubated and on drips would have a 1:1 ratio. When we do 2 patients to a nurse, they can both be extubated, or one intubated/one stable. We never do 3:1 ratios...i think that would be very unsafe in the ICU setting. I personally have never had 2 intubated patients at the same time, but i guess anything is possible if we were short on staffing. typically, the assignment is 1 extubated/1 stable, 2 stables, or 1 sick intubated pt per nurse. The other thing to consider is that not all PICUs are the same. I have visited other PICUs at big hospitals...and their patients would go to our floor, not the icu. And, vice versa...if one of our chronics come through their ER, they would be prompt to transfer them out of their hospitals and into our icu. As far as RT goes...they are usually a phone call away, they come and check on our patients a few times per shift. The nurses do all the suctioning, most vent changes, ETT taping, etc. If we need them for any of these things, its pretty easy to get them to the bedside. I actually like that we can do these independently and not have to wait until a RT comes by, and that if we need them, they come pretty quickly. Its a good system, IMO.

yep, as has been previously mentioned, anyone with MRSA goes on contact precautions, gloves, mask, gown. what i dont understand is why ANYONE, let alone a nurse that has to go and deal with another patient, would want to even touch someone with MRSA without gloves. That's asking for trouble...i dont care how good your handwashing technique might be, its just not good care. As also previously mentioned, i dont know about your hospital, but our patient care director (aka nurse manager) makes the rounds in each room, talking to the family, making sure everything is up to par. This would be a great opportunity to bring it up, without having to mention names (if you dont feel like, that is). If he/she doesnt make rounds, then just go looking for that person. Its obviously a unit-wide problem that needs to be addressed, so that would be the first person i would contact. if no one listens, your next contact should be the infectious disease dept.

It truly comes with practice. occasionally my brain freezes over, especially when dealing with nanograms, LOL. i do the good old: mcg x kg x 60 x volume in mL/concentration in mcgs. So, for example...Milrinone...we use 20 mg in 100 mL. If the order reads 0.5 mcg/kg/min, and your kid weighs 10 kg, you go: 0.5 x 10 x 60 x 100/20000 (convert mg to mcg, so 20 x 1000). This is the same as was mentioned earlier...

NYP-Columbia hires new grads into the ICU internships only. There is adult ICU and peds ICU. Its a 1 year orientation, you need a BSN, a good GPA, a NYS license, and it starts in August. You have to be brand new grad. If you are interested, call human resources and ask what the deadlines are. Entry into internship is pretty competitive, so be ready with all your paperwork and requirements. Things get lost, so be ready to do a lot of follow up phone calls and visits. NYP-C is a union hospital, so our benefits come from the union (NYSNA). You get up to 10K per year to go to any school. good luck!

So funny you said that...we havent had one in a little while on our floor, and we had 2 within 24 hours. They were chronics, we knew the day would probably come, but...it was just so weird to see the rooms empty.

We do 2 pt soft wrist restraints whenever the kids have anything they can remove...ET tubes, RAs, chest tubes, etc. They require lots of documentation and a 2 RN check. We usually do not use vec drips for this purpose (though it depends on the patient).

i just PMd you, but i wanted to add...there are lots of hospitals that are doing this now, so its worth to look around. some places are finally realizing that its smart to invest in one year of training new grads, shaping them to what THEY need them to be, familiarizing them with the hospital system, etc. These programs tend to have a high retention rate. Whatever you wind up picking, just make sure that you have a long enough orientation. If you can, visit these hospitals and talk to those who have been through similar programs.

Look into a good program. There are many out there. I am 3/4 of the way done with mine, which was a one year orientation as a new grad. I did 3 months in an outpatient setting (peds ED), i did 3 months in an inpatient setting (cardiology floor), then i spend the last 6 months in the ICU. i dont count as staff at any point in time until i'm done with orientation. it is an excellent program, and if you are truly interested, look for the right opportunity for you. Make sure you are up to the task, the learning curve is quite steep. But, its do-able. Good luck.