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.

I know this is a bit off topic, but since we are mentioning CHOP... All i have to say is that its too bad they pay their nurses peanuts. i was quite surprised with how little they pay their nurses, considering how specialized these hospitals are, and how well trained their nurses need to be. Boston Children's is the same way. And its definitely not the "difference in cost of living"...

Most kids in our PICU have art lines...so this is usually not an issue. If our kids come up from the ED, i know the nurses there will insert two PIVs, one for infusions the other for draws. in this case, they usually put in a 20g or 22g. Drawing from this PIV is usually short term...I've seen very abnormal results from blood taken off a PIV, so its definitely not ideal....it really depends on the situation. If these kids are very, very ill (as they usually are if they come to us from the ED), their PIVs wont matter, they buy themselves an art line the moment they get up to the unit.

Jan is awesome. She gave me advice for my interview (WOW, its been that long since i was last here! LOL)...anyhoo, i got hired

I am definitely all for teaching the RNs to know how to run the circuit. However, it is A LOT of work. IMO, I feel safer having the perfusionist at the bed side, making sure that all is running well. The circuit requires many safety checks, and if you have 2 assignments, that is a heckuva lot of work. Granted if the kid is on ECMO its usually a 1:1 assignment, but hey, nothing is guaranteed. The hospital should be hiring more perfusionists, as well as educating its nurses, so that we may cover them, should they run out of personnel. Better yet, they should stop sharing our perfusionists with the adult side... BTW, i think we work for the same place

i'm surprised no one has mentioned it yet...how about those chest compressions, eh???? I saw whats-his-face in ER doing compressions, and WOW...he wouldnt resuscitate a cockroach. I work at a teaching hospital...and the medical students/interns do plenty of stuff that has been talked about here (blood draws, cpr, etc). They'll even remove the hep locks when they are discharging them from the ER

thank you for explaining this to me. I realized that all they were doing is taking a poll, not making a definite decision. I am wondering why NYSNA has not made their position more public...because no one at work knew, and this thread sat here for awhile before you responded, leading me to believe that there isn't enough information out there for nurses to make an informed decision. I'm glad that it was only a "poll" because, after reading what you posted (and what a NYSNA delegate finally explained to me), i would have voted to disaffiliate. Its a shame that its all coming down to this... I also found out that the UAN loses $1 million per year should NYSNA disaffiliate...interesting...

The new CHONY building went up in 2003, i think. it houses all of the peds floors, for the exception of the peds ED (which is still in the old BH). The new building is referred to as the "tower". So, 4T is your med/surg (although everyone gets a little of everything), 5T is mainly oncology, 6T is cardiology/neurology, 7T is the NICU, not sure what 8T is...9T is the PICU, and 10T, i think, is L&D. Remember the old PICU (the one in babies?), that's still there. What they did when they built the tower was expand the PICU. So technically, there are 3 PICUs...the old one (9 north), the new PICU (9 central, which is actually in the tower), and 9 tower (the cardiac PICU). And, as you can see, they divided cardiac and regular PICU when the new building was built. BH is still there. A lot of it is used for doctor offices, clinics, etc. They really truly should knock it down and rebuild it...but that costs lots of money...LOL.

Oh awesome! i am doing the PICU nursing internship, and my inpatient rotation was on the cardiology/neurology floor...which, i'm thinking, was probably the old 8 south. small world. hey, if you have the itch...LOL. I am in love with CHONY right now...everyone is so nice and the new building is just beautiful...

I find that those working at NYP-Columbia are generally happy. Now, i work in peds so i dont know about how the adult side is... the patient population is a totally different story, though...the hospital serves the community its in, and that means that Cornell and Columbia have 2 very different patient populations.

yep, i would look into Rutgers newark program...not only will you be stuck with out of state tuition if you look in NYC, but you will also be stuck in traffic. You're better off driving yourself to a NJ school. I'd only look in NYC if i had a lot of money and lots of time