lisa333

Thanks everybody. My hospital doesn't have a policy on this (or most things.) I've been trying out changing it down to the hub lately and it seems to work okay even if it makes a mess. It's definitely tricky on combative patients who are trying to arm wrestle you the whole time. They don't suture the a-lines at my hospital so it certainly makes the dressing changes scarier but I haven't lost a line yet. Thanks again for all the input, I'll try that BP cuff trick next time.

Thanks for your comment! What I find fascinating is that no one I've talked to is sheepishly claiming they disconnect it at the valve because they're lazy- they insist that's how they were taught to do it! It seems like both methods are just confidently passed down from preceptors and then each nurse just keeps doing it one way or the other for their careers. We don't have a policy on it and I can't find anything on my old nursing books. Thanks for contributing!

This question came up recently on my unit and I'm curious if anyone has any resource material to back up their position other than "this is how I was taught to do it!" Let's say your patient has an arterial line and the tubing is due to be changed. You get a new bag of fluids in a pressure bag, a new pressure tubing primed, and then you: A. Disconnect the old tubing at the hub of the catheter while applying pressure just above the insertion site to keep blood from spilling out of the exposed catheter. This is correct because you are changing the entire tubing down to the hub to limit the risk of bloodborne pathogens growing in the outdated tubing. OR B. Twist the valve closed on the extension tubing nearest to the hub and change the tubing only above that on/off valve. This is correct because it limits exposure of the catheter insertion site to potential infection and prevents unnecessary bleeding. Love to hear y'all's thoughts. Everyone in my unit feels very strongly about their personal position but I can't find anything to back up either side. Thanks!

I go to a free community testing site every 2 weeks to get tested for my own peace of mind. My hospital certainly has no interest in testing me.

How can these infrared thermometers possibly be accurate? I take my temperature orally every day before I go to work with a cheap thermometer and it always reads a believable number between 97.5 and 99.0. When I get to work, they check my temperature at the entrance and it's barely ever above 95 degrees. It seems like they're using the thermometer correctly based on the manual but everyone has a laughably low temperature. How can this be used as a diagnostic tool? I almost want to try pointing it at one of our super febrile neuro patients' foreheads and see if it's even possible for the thing to go up to 98.6.

We had a hospital-wide order that all staff wear surgical masks while on hospital property. About half the staff comply. Even in my ICU where about a third of the patients are COVID +, only about half the nurses wear a surgical mask at the nurse's station. Our manager doesn't wear a mask, charge nurses don't, security at the front door doesn't. No one seems to believe that they could be asymptomatic carriers. I'd love to wear one of the N95's I've saved from my fit tests through the years but that's not allowed. I guess I could just be paranoid but it scares me to get report from a nurse who is not wearing a mask.

Well they changed the policy so then we were each issued an expired N95 for each week to wear at the nurse's station. As long as you replaced the brittle elastic straps with new rubber bands, they seemed to work OK (they were just kind of smelly after a few days.) Nurses were still getting in trouble for wearing cloth masks. Now they changed it again so now we're supposed to wear cloth masks brought from home at the nurses station. Anyway, I definitely feel more protected in any mask at all. I just wish management could take a more supportive role rather than always just being on the lookout for something to punish us for. Thanks for all the input!

Hi all, I work in a trauma ICU. We currently have enough PPE to wear when taking care of COVID-19 patients or rule out patients. My question is about how you are protecting yourself in the hospital in general. I am practicing social distancing at home. I cross the street if another person approaches when I am walking my dog. I get my groceries only through no-contact doorstep delivery. I wipe down and wear gloves at the gas pump. But when I'm getting report, or in the huddle room before shift, or sitting at the nurse's station, I am completely exposed. Nurses are not allowed to wear masks generally in the hospital. I think it's incredibly likely that some nurses will be exposed on public transit, or at the store, and become asymptomatic carriers and could spread the infection through staff as if we're a cruise ship! What's your hospital policy on wearing your own mask when interacting with other staff? Our nursing supervisors, RT's, housekeeping, security all wear masks all the time but nurses are not allowed. What's your take? Thanks!

Hi all, I have four years experience in a rural community hospital ICU. I'm now trying to move back to an urban area, but have some concern about what to put on my resume. The vast majority of patients we care for are pretty basic. Mostly bipaps and urosepsis from the SNF down the street, or ETOH withdrawal for the local homeless population. Anything serious gets diverted from our ER, or else the palliative care nurse comes in to "discuss goals of care." Occasionally we get patients who are too sick to transfer, but the family wants everything done. At this point, we can do more complex skills in the unit - therapeutic hypothermia, rotation beds for ARDS, TPA, hemodynamic monitoring. These each come up maybe once or twice a year. Should I put these skills on my resume? On the one hand, I want to show off that I have exposure to these skills, even though I'm in a little hospital. On the other hand, I kind of feel like a fraud since they're not part of my day-to-day practice. To be perfectly honest, it really takes the whole team to do a lot of these things because none of us are all that comfortable with them. What do you all think? Thank you so much for the input. Lisa

Hi all,Well, after applying for hundreds of jobs, I never thought I'd find myself trying to choose between two hospitals!A little background- a year after passing the NCLEX, I took a job at an outpatient clinic. I stayed there for a year, but still dreamed of a hospital position where I could work with more complex patients and learn as much as possible.Last month, I accepted a position on the Long Term Acute Care unit of a small community hospital. I was initially concerned about the bare-bones orientation, but knew I had to get out of the clinic setting. After being in the LTAC for a month, I'm really loving it! I love the 12-hour shifts (my boyfriend lives 2 hours away, and we finally have the chance to spend 3-4 days together every week!) I love the family-like atmosphere, and the relatively stable yet extremely medically complex patients. It's a wonderfully supportive learning environment.Everything was going great until I got a call this morning from a very prestigious, massive urban hospital, offering me an interview. A month ago, I would have said this hospital was my dream job, but now I'm not so sure. The 8-hour shifts would mean less time with my boyfriend, and I'm enjoying my new job so much, I'm really conflicted about changing.I scheduled an interview (mostly so I could have time to think things over.) Everyone says I'd be crazy not to take an offer from the prestigious hospital- I'd get an extensive orientation, the pay would be better, there's state-of-the-art everything (compared to the small hospital's handwritten charting), and what a career move for my resume!Obviously I don't have an offer yet, but I'd like to have some vague idea of how I would respond to one.Anyone go through a similar decision? Any advice?Thanks,Lisa

It's for a Long Term Acute Care floor of a hospital. I wouldn't be cross-trained to the other floors, so I'd only be with the long term acute care patients. They're supposed to be the most stable patients in the hospital, but because it's technically acute care, the ratio is still 1:5. I was told my orientation would be 2 days in a classroom followed by 3 days with a preceptor on the floor, then I'd be on my own.

Hi all, I was wondering if anyone on here had received a shorter orientation than they were expecting for a hospital position. I've basically been offered my dream position at a local hospital, but my orientation will be one week. I'm a relatively new RN, and have no hospital work experience. Any advice for making the most of it? Thanks! Lisa

I'm so glad someone else commented on this! I was worried I was the only one dealing with these shortages. My clinic uses fentanyl and versed for conscious sedation and we're now out of both! We're doing our best to replace them with combinations of demerol, vicodin, xanax, and valium, but it hasn't been easy to adjust. Hopefully it won't be long before this "shortage" is over!

Hi all, I graduated in April 2010 and got my RN license in June 2010. I looked desperately for a new grad hospital job, because I really wanted to have a solid foundation in medical/surgical nursing. Unfortunately, after a year of applying, I still had not found this job of my dreams. I finally accepted a position as a recovery room RN in an ambulatory surgery clinic. The clinic only performs an extremely limited scope of procedures, and our patients are all relatively young and healthy. I'm happy to have a job, but don't feel like I'm learning much. Basically, I'm still dreaming about ending up in a med/surg unit in a hospital, but I don't know how to get there. At this point I no longer qualify for new grad programs, but don't have the hospital experience to apply to med/surg units. A nurse friend suggested I apply to PACUs, since that's most aligned to what I'm doing now. The PACU of a hospital seems so much more intense than what I see in my clinic, though. Do you think that's the best course of action? I really don't want to be stuck in the clinic forever, I feel like any knowledge I gained in nursing school is just draining away month by month. Thanks, Lisa

I got an email March 23rd that said: "Congratulations! Your application for Registered Nurse I indicates that you meet the minimum qualifications for the examination. Your name has been placed on the eligible list with a total score of 80. At this time your rank on the eligible list is 4." I'm not holding my breath...