Morguein

Charge nurses frequently take patients, especially when the unit is short staffed. You would need to be able to pick up a team. Charge nurses are also considered resource nurses which means you are an expert on the unit you're in charge of. If you don't have any critical care experience, then you're not going to be an expert, and will not be able to help or educate anyone on critical care issues. Charge nurses make assignments for the next shift. How will you be able to do that if you don't know which patients are requiring more or less care? Only an experienced nurse will be able to determine which patient is going to need to be a 1:1 or can be paired. Some critical care charge nurses are also required to be on the rapid response team. Bottom line is that you are going to have to be a critical care nurse first before you can lead a critical care team. I would not want a med surge nurse making decisions for critical care nurses. It just won't work. It would be best for you to work in critical care for a few years, and then apply for the next charge nurse position. You would probably love working on the unit.

What do you all think of having mostly new grads in your ICU than experienced ICU nurses? Do you see that as a recipe for disaster, or bringing in new creative fresh ideas, etc? Has anyone ever worked in an ICU where there were more New grads than experienced nurses; or maybe even equal amounts? How would you feel being precepted by someone with less than or equal to one year of experience? Just trying to get a consensus here.

I feel like you should do what you can in the hour that you have left. I'd assess the patient, do any STAT labs, and any emergent STAT orders like hanging blood and starting drips. Then, I'd get the admission paperwork done. As far as the paperwork, I feel like you should just do the part where only you can do that part like the initial assessment part. Make sense? As far as any history info or patient family info, etc..the next nurse can get all of that. It's ridiculous to have to stay for hours to complete the admission process. As they say, nursing is 24 hours. The next shift can pickup from where you left off. Just because the patient happens to come on your shift, does not mean that you must do EVERYTHING including ALL THE ORDERS, and ALL THE RIDICULOUS AMOUNTS OF PAPERWORK, etc... Sorry, I'm not screaming. haha! I'm just emphasizing key words. I think it's terrible that anyone would get upset with you for not doing 12 hours of work in 1 hour. That's ridiculous. They need to tell you "thank you, and I've got it from here" and let you go home.

I get what both sides are saying here. I work critical care too; and sometimes, my patients are too sick to leave them in order to document all this real time information that's required. I'd say that pretty much, every day I work, I'm standing at one of my patient's bedside for 90% of my shift. I am lucky if I get to just sit and document for a few minutes. Because, if I'm not in one of my patient's rooms, I'm in another nurse's patient's room. A lot of my documentation is done after my shift is done. I try real hard to get my vital signs, I&O's, CRRT info, IABP info done every hour. Everything else is usually documented much later. As long as I'm looking at my patient and I'm aware of their changes and act on them, I feel like I'm doing the right thing. We don't have the luxury of copying and pasting anything. My director didn't want us to have that option. In fact she asked that we not be allowed to generate our assessment from one shift to the next even if nothing has changed. They felt that we would just keep generating and regenerating information without actually assessing our patients. It's the most ridiculous thing ever! We have to input every single data manually which is very time consuming. So, I'd rather actually touch my patients and do things for them before documenting. We all thought that going to computerized documentation would make things easier and faster; but it seems like it takes longer and they've added soooo much more to document on. If we forget to document on something, we get called at home and are expected to come back to work or come on our day off to document. Some nurses didn't document, because they didn't do it. But, they are expected to document anyway. So, then it starts to look like management only cares about what our patient care looks like on paper/computer. We can complain that we don't have enough staff or time to do everything they want to no avail....BUT we better have "everything" documented. Anyway, I'll bet that Nightdove is a good nurse. I know many nurses who just have all the time in the world to document; and their "paperwork" looks flawless and perfect, but they don't even have a stethoscope or barely touch their patients.

Thanks Trauma! :)

I've noticed that we can't delete any of our own blogs. Does anyone know why? I went through all of my posts to make sure they were "okay" and didn't need to delete any of them; but If I had wanted to, I would not have been able to anyway.

Yeah, that's me; naive. Not anymore though. At least, with this subject. I'm thankful that I have never had any crazy pictures on my page; but I did take some of them down just in case someone else might think they are.

I definitely need to be more on the cautious side. I am used to speaking my mind on my page and expressing my frustrations, etc... But I guess that's pretty dumb huh? I've learned a lot in just the past couple days here. Wow, even discussing a TV show can get you in trouble. I can see how that situation turned into the monster it did. It sounds like a total misunderstanding gone wrong. I feel bad that you had to go through that Ruby. It seems like every conversation and written word is potentially up for public scrutiny, interpretation, and the perception of others.

Thank you all so much! I appreciate the time you took in responding to my questions. I've just gone through my FB page and pretty much deleted ANYTHING that might get me in trouble, including some personal pictures, even polls I've taken about gay marriages, spiritual or political issues. I even deleted posts that just said, "not looking forward to going work" in case someone thought it might be too negative. A bit paranoid? Yeah, probably. I guess I need some of that to think twice before posting anything. I do see a lot of nurses on this website talk about their day at work. Many present their "case" so to speak and want to know how they could have done things better or if they did thing right, etc... I mean, it's like everywhere on this website. And it's mostly done innocently; but I'm guess that a lot of people have gotten in trouble for posting such things on here. Anyway, lesson learned. Even though I am excited about some of the things we do on our unit, I will just keep it to myself. Thanks again everyone. :redpinkhe

Hello. I hope someone can help me with this. I am confused about the whole HIPAA thing. Everything I learned at work about HIPAA was about not revealing a patient's name, room number, their address, phone number, or anything specific like that along with their diagnosis, etc... I did a dumb thing and posted something on my Facebook page about the day we had at work with a patient. I did not mention a name or describe the patient or anything like that. I was told by one of my coworkers that some of the other coworkers became upset by it and may go to management. So, I promptly deleted it. I didn't realize that it was wrong. My page is private, but I do have people from work on it. Can someone tell me what the law is regarding this. Everything I have read about HIPAA only talks about the obvious violations; but nothing about situations involving talking about something that happened at work without using personal information like names, etc... I'd appreciate any information regarding this. Thank you.

Eventually, I'd like to move to the same area. I have sister who lives in the Satellite Beach area and I'd like to live near her since we are very close. I also work in ICU. How do you like the hospital you work in now? I also hear there is a trauma hospital nearby. I especially love working with trauma patients. What is the pay like for ICU nurses in that area. I have 7 years of experience.

You are perfect for the ICU. I don't know what's up with your preceptor. The ICU is usually pretty busy; and yes, things do need to get done quickly, but it's sooo easy to forget to do stuff. So being organized and writing things down helps you to keep track of what you have and haven't done. You're on the right track.

What to you think about having the patient wear a face mask?

Thumper HAHA! Right on!

My body was telling me it needed some tender loving care (physically, mentally, and emotionally), so I decided to work weekend alternative to take better care of myself and to have a life beyond nursing. Its the best decision I've ever made. I love having 5 days off a week. I'm even thinking of going back to school. I love nursing, but it'll make you as sick as some of your patients if you don't give yourself the attention you need.

At my facility, if its working properly, we treat the A-Line BPs over the cuff BPs.

You and your family are in my prayers.

Even as an experienced med-surg nurse, you should have more than 5 days of orientation! You should have at least 6 weeks. That's what we do here at my hospital. ICU is a totally different world compared to the med-surg. I would demand more training. You deserve it.

When I was giving report to a night shifter, I told her about how labs were ordered on a patient 15 minutes ago and Dr.X is to be called with the results. I told her the unit clerk sent the order to lab. She asked me what time she sent it for and I didn't know, I told her the unit clerk knew it was to be STAT. She got huffy and asked me to "look it up on the computer". So, I got on the lab page on the computer, but honestly didn't know how to find out the "time" the clerk requested it be drawn. I told her "Here is the lab page, but I don't know if I am on the wrong page. I have never done this." She didn't say a word. Instead, she let out a big sigh, picked up the phone and called lab herself and asked them. Never showed me or told me what page to go to. Instead, she got pissy and made me feel so small. Where is your preceptor during these times? Isn't she supposed to be there during report time to help you fill in the blanks if you forget to mention something? I mean, she should be there with you to make sure you don't forget anything even though the night nurse could do it, but obviously not all nurses are good at doing it, so she should be there to help you look up information that is needed etc... you should not have to be treated this way. It is wrong and if they want to keep new nurses around, they must change the way they treat them. I think you should stand up for yourself. Let your preceptor know what's going on. Maybe she'll have some good advice to give you. I feel awful that you're going through this.

If you work in the ICU setting, not only do you do "RN" work, but you also will do "CNA" work as well. We get down and dirty every day. I don't know of any RN who doesn't do "dirty" work. If you're not doing dirty work, then what are you doing? surely there's more to nursing than just charting and passing out meds. I believe that working as a CNA would do you wonders in helping you to feel comfortable touching patients and working with them. I went right into nursing school without ever working with patients before and let me tell you, I was soooo akward (SP?) during my clinicals when it came to touching and bathing my patients. I remember wishing that I had worked as a nursing assistant first before attempting nursing school. Starting nursing school without being a nursing assistant first is do-able for sure, but I believe its much more easier to start off as a nursing assistant and then going to nursing school.

The 1st problem is a tricky one. I could be wrong but it seems that the density of the Isopropyl may not matter but the mass of the lead along with the displacement of isopropyl matters. So, d= m/v= 343.6g/30.3mL I think you're right on the answer for the 2nd problem but I'm not sure how to set it up. I mean 1.2g Ca/.12 Ca = 10g Ca In the 3rd problem, I believe you can use the density forumla to get the answer. I would first take the dimensions given and convert them to cm and then multiply all three of the values and you should have your volume. So, 444cm x 348cm x 253 cm = 3.91 x 10^7 cubic cm or mL. Ok, now we're going to have to rearrange the density formula to get the mass. d=m/v becomes d x v = m so, 1.29 X 10^-3 g/cubic cm X 3.91 x 10^7 cubic cm =50439 g. Convert the mass into kg=50.4g. Man, I hope that's right. Sorry if I'm way off base! (I forgot to sign on under my own screen name, which is Soleilpie. So please don't get mad at Moonepie, if I totally don't know what I'm talking about! :)~ )

I find it inconceivable that your school doesn't teach med calculations being that it is one of the most important aspect of being a nurse. If passing the dosage calc tests is that important, all nursing schools should be teaching it. Because our patients can be gravely affected by receiving the wrong dosage of medications, it is pertinent that the schools teach our future nurses this subject no matter how "basic" it is.

Roland, Is your wife mentioning during the interview that her goal is to go into CRNA school in 2008? If so, that may be a turn off to them, because they may see it as her not being a possible "permanent" canidate and that's what many ICU's are looking for. It is discriminating if they are not hiring her because she wants to go to CRNA school, but realistically, they are looking at that without saying so. There's nothing wrong with her having goals for advancement, but the ICU is also looking out for themselves too and they prefer nurses who are planning to stay for the long haul. They may see your wife's desire to go to the ICU as a means to an end and not to any benifit to the unit. I hope I have not offended you or anyone; but I'm just telling you this from what I've seen at my own hospital. Also, at my hospital, we have NO problems hiring medsurg nurses or new grads. They all do well depending on many factors (for example, their willingness to study at home, to take the initiative to learn and use the knowledge they've been given, their relationship with thier preceptors, whether or not they're self starters, etc...) I have no doubt that your wife will reach her goals.

Thank you all for your input. Downtime is the time at work when you can sit and relax and take a breather and even talk to your coworkers to get to know them better. As far as the food thing, I can totally relate. I'm trying to eat healthier and better, but find it almost impossible to do. My goal was to eat 6 small healthy meals a day, but in the ICU you're lucky if you get one meal....and when you do, it might be 10 hours into your shift. I actually sneak and eat food on the unit when I can. I'll bring things like cheese, fruit, yogurt etc... and risk getting in trouble to eat 'em. But I figure, I'm just as important as my patients and I must take care of myself if I want to be functional at work. But there are many days when all I can do is stare at my lunch bag and never get a chance to sneak a snack from it. I feel like many of our patients should be one to ones, but they aren't. They seem to be getting sicker and sicker. Thanks again for all the input. I like reading about how others handle the same stresses as we do. If anyone else has any advice or would like to vent as I have, please share your experiences. Thanks!

Does anyone here ever have any down time at work besides their lunch breaks? What I mean is do any of you ever have time to just kick back and talk to your coworkers without feeling like there's a ton of stuff still to be done? I feel like all I do is run run run all day long every day. I know it seems silly to be asking this as I know that nurses are notorious for not taking bathroom breaks or ever getting to sit down. I almost feel like nurses are abused...maybe not intentionally, but as a result of not having enough staff or having two very very sick patients who clearly should be one to ones, but can't because the department can't afford to have that extra nurse there. I often wonder if running around crazy all day everytime I'm at work is somehow going to physically, mentally, emotionally and maybe even spiritually harm me. I guess what I'm feeling these days is burnout. I really love working in the ICU. I love what we do. Its just that there just doesn't seem to be enough time in the day to do it all unless I'm running around the unit like a chicken with its head cut off. Its like, I love ice cream; but it wouldn't be enjoyable if I had to shove it all in my face in two seconds. Can anyone here relate?