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cpkRN

cpkRN

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  1. cpkRN

    New Grad in OR struggling

    You sound just like I did when I started out and I'm now an OR educator and in leadership with our national organization. I was passionate about my job and knew I didn't want to be anywhere else. I had a CRNA tell me I would never make it, that I was just too quiet for the OR. Once I was confident enough to find my voice, she regretted saying that (and we're friends to this day)! It takes time. It will take months beyond your orientation to feel confident and, even then, there will be days where you feel like you've been knocked down. I can't tell you how many times I cried all the way home from work in orientation. I was "kicked out" of orientation and taking call after 4.5 months (was supposed to be 6) due to short staffing at my first hospital. I took every challenge possible and fought to learn everything I could, even if that meant looking things up at home. I kept a notebook of surgeons, preferences, and procedures and kept a "work journal" of sorts to look back on. It's so funny to read it now but I remember how healing it was. I went 6 months by 6 months. I told myself I had to make it through orientation, then a year. At the year point, I felt much better. Still "green," but better. I tell my students that there's a reason we can't sit for CNOR certification for 2 years - it takes that long to feel comfortable!
  2. cpkRN

    Saying I'm Sorry

    Even if you take out the religious part, it's still moving. I felt the power of this story and I hold no religious beliefs. Bravo!
  3. cpkRN

    What do OR nurses do anyway?

    Your patient may be asleep for an hour or even much longer, but you are ultimately responsible for that patient on the table. You may not start IVs or directly give medications (other than drawing them up and delivering them to the sterile field) but everything that happens in surgery is something you have to have knowledge of. The surgeon focuses on surgery, anesthesia does their thing, the scrub tech or nurse has their area. As the circulator, you have to have an awareness of the entire room. It's completely different from floor nursing and you'll often hear other nurses say that all we do is count, but it really is so much more. When I was a student, it was difficult to see beyond the circulator counting, charting, or running to get things for the surgeon, but there's so much going on. I know I'm almost constantly silently assessing and reassessing my patient. I'm just coming up on 6 months and, while I'm just off of orientation, it's still a challenge.
  4. cpkRN

    Forced to stay and work under mandatory evacuation?

    We are part of an assigned team at my facility also. I don't expect it to be family utopia, in fact, I know that staying through a hurricane will probably be worse than the 9th layer of you know where. It is, however, part of my employment agreement and I signed off on those terms. I'd check and see what you signed when you started. If it's what you agreed to, then it is very much legal for them to tell you that you're fired if you don't stay. Even if it's in the "fine print" of something you signed quickly upon taking the employment offer.
  5. cpkRN

    Operating room procedures/meds?

    I work in a smaller community hospital and do mostly general, GYN, and ortho cases. The drugs I see most are: Marcaine (0.25% or 0.5%), Marcaine with epi, Ropivicaine, Lidocaine (1% or 2%), Lidocaine with epi, Bacitracin, Depomedrol, Thrombin, Vancomycin. Some of the local anesthetics are often mixed. For example, a podiatrist I often work with regularly uses a 1:1 mix of 1% lidocaine with 0.5% ropivicaine. Today, an otho surgeon used 1 ml depomedrol mixed in 0.25% marcaine for injection at the end of the procedure. Some surgeons put bacitracin into their irrigation fluids, it's a matter of surgeon preference where I work. While anesthesia always administers the pre-incision antibiotic, I make sure I'm familiar with them. Ancef is the most widely used in my hospital; however, it can't be used in patients with a penicillin allergy. Clindamycin is often used in these cases. You'll also become familiar with other items given by anesthesia like propofol, versed, succinylcholine, and pain medications like toradol and morphine. I know some places qualify their OR nurses to do moderate sedation, so you might need to know about the drugs involved there. I don't do that, but thought I'd mention it.
  6. cpkRN

    New Grad Pay in Louisiana...

    Area hospitals offered me as a new grad RN (BSN) 19-25. I make in the middle of that range. The higher paying hospitals here in New Orleans actually have pretty bad reps, so if you come here, do your research and forget about the dollar signs.
  7. cpkRN

    Louisiana Nursing School Rankings

    Well, that is open to opinions, but to start with, what area of the state are you interested in? Are you looking to get your LPN, ASN, or BSN? Maybe this will give you a start:http://www.lsbn.state.la.us/documents/AnnualReport/AnnualReport2011.pdf Scroll down to page 67 and look at the NCLEX pass rates for each school. The more people who pass on the first try is normally indicative of how well a school prepares you. Don't necessarily concentrate on the best, concentrate on what you want out of nursing school and your ultimate future goals. I'm a graduate of LSU and I have no issues with the education I received. The majority of my colleagues in the workforce attended Charity. The only reason I chose LSU over Charity is because I wanted to go straight through my BSN instead of getting an ASN and having to bridge later.
  8. cpkRN

    New OR nurse needs some advice

    Orientation is technically 6 months. I was hired for a smaller facility but trained at the big "parent" hospital for the first 2.5 months. I've been at the small hospital full time for 2 weeks now and it's almost like starting over. I'm also someone who needs feedback whether positive or negative. While I was getting that feedback from the educator my first few months, there's no feedback where I am now. Do you at least have the support of your techs and fellow circulators? That's where I'm finding feedback if I ask for it. Some aren't good at giving it, but others are and I take it and run with it. I guess you could think of it as allowing the tiniest positive feedback to inflate my sense of pride in myself until something knocks me back down again. That's another BIG piece of advice I was given upon starting: you'll feel on top of the world one day and the next you'll feel like you're back to square one - that is totally normal and it will be the norm for quite some time! I'm used to excelling at any job I do within a few months' time, so this is all very strange to not feel like I have a clue. I tend to think that everyone around me is thinking about how dumb the new girl is. Even if that happens sometimes, I know that once I "get it," I'm going to be darn good at my job. That's what keeps me from getting too depressed. I'm sitting at home feeling a bit down because a group of surgeons decided to not let something silly I said slide and continued to rip on me about it all day. Oh well, they probably forgot about it the minute they left the hospital and I should too! I hate to be fodder for anyone's jokes but, ultimately it was just something that I was unaware of that was common knowledge to them. Now it's part of my knowledge too. All part of the process. I've never been one to use positive affirmations to make myself feel better, but just reaffirming how far I've come (even though they're very small accomplishments in the big picture) keeps me going. Take a look at all of your lists you've made, I'm sure you'll see just how far you've come. It's the smallest of things, but just a few short months ago, I was freaked out by helping people put on space suits for ortho cases. I was afraid to budge around the sterile field. I stood in a corner totally freaking out at the beginning of an emergency case. I still find myself in the corner every so often, but it's baby steps. Fall down and get back up. Ahhh... online therapy :-)
  9. cpkRN

    New OR nurse needs some advice

    I have also been in the OR for 3 months and was hired as a new graduate. I still feel stupid and inadequate on a daily basis, but we (myself and the other new hires) have been told that it's normal to feel that way for a long time. Many say even 2 years! I'm normally very hard on myself but the OR is what I wanted, so I'm learning to give myself a pass on things. I keep a small notebook in my pocket and an constantly jotting down notes. I compile my notes on a bi-weekly basis into a more "formal" book that's organized by surgeon. It's been very helpful in remembering surgeon preferences and "quirks." I started with 5 other new hires and we're given time during the week to sit and talk about our experiences... We're all in the same boat! I'm certain that if you were joining us for these discussions, you'd fit right in. Our OR educator "forced" us to keep journals. While it was a pain in the backside at first, I love looking back in it and seeing how far I've come since the beginning of March! The best advice I was given is that every case is "BS" times 2: All you need to start is BOVIE, SUCTION, (kick) BUCKET, SALINE! I still run around like a chicken with my head cut off and freak out at least 3 times a week, but it will come in time. Take the time to reflect on what you're learning everyday, no matter how trivial it may seem. My biggest deal is that I get so focused on what's needed for the procedure that little things like grabbing warm blankets go out of the window! At this point, I'm very comfortable in any laparoscopic procedure, some smaller general procedures, and some GYN. I still freak big time in ortho. If the OR is where you want to be, make it work! That's the advice I give myself. I'm soaking up whatever I can, taking bits and pieces from how others do their job, and really working on not being hard on myself. Don't let frustrated surgeons get you down, show them you're strong and never take anything personal!
  10. cpkRN

    Scrub stores in New Orleans area

    I shop at either Uniforms by Bayou on Causeway in Metairie or Uniform Advantage on Severn in Metairie. Both places carry brand name scrubs.
  11. You're very lucky! Lots of applicants out there right now and many of my fellow students are upset that it's so difficult to even get called back! When I interviewed a year ago, it was basic questions: What is your biggest weakness? Biggest strength? It's a basic conversation. Just be you and never answer something in the negative - turn it around to a positive. I didn't get the job last year because I needed the entire month of June off (understandable), but the recruiter is very nice. Most people in my class working for Ochsner have the title "patient care tech" and some do have jobs lined up. Others don't because the job market is so slim right now and there aren't positions available on their respective units, but at least they have good contacts because of their job!
  12. cpkRN

    LSU BSN

    That's not true. A large number of people do come in from BR because they want to continue their education at LSU, but everyone is weighted the same when it comes to admission. It's just a rumor propagated by the large number of people who do come in from BR. As long as you took your classes at a legit school and meet the minimum requirements, that's what matters.
  13. cpkRN

    LSU BSN

    LSU will set up times for you to get everything done. You'll get emails and such detailing how to get your background check done, where to buy your malpractice insurance, etc. They'll pretty much walk you through the entire process. It was all done a few weeks into the first semester when I started. Charity has to hurry because they actually have clinicals their first semester. There's more time to get the State Board clearance stuff done at LSU because you have no clinicals until your second semester.
  14. cpkRN

    LSU BSN

    You won't start clinicals until your second semester. That's when you'll need your CPR card.
  15. cpkRN

    LSU BSN

    Class schedules are already up: http://nursing.lsuhsc.edu/AcademicSchedule/ClassSchedules/Fall%202011/Fall%202011%20Class%20schedule%20preregistration.pdf If you have Ab Psych, you'll have the Tuesday phys lab, if you're not taking Ab Psych, you'll have the Thursday lab. Anatomy lab will be decided on the first week - they'll give you a chance to make your preference for lab day known. Intro has been split into an 8-10 and 10-12 section down the middle alphabetically in the past. We didn't know where they split us until the first week of school at level orientation.
  16. cpkRN

    LSUHSC CARE Program Information

    NolaRachel: you might want to run this by someone at the school first. I know they'll take Delgado credits for Abnormal Psych, but I just have no clue what they'll really do for anatomy. I had straight A's across the board in Delgado A&P I and II, lecture and lab. Unfortunately, the semester I started CARE, they wouldn't take our Delgado anatomy credits (August '09). This last year (August '10), they took a ton of Delgado A&P credits for anatomy. You just never know which way the school will turn. A friend of mine had her wedding in October of our first semester and it comsumed her - she didn't move on. Still in school, but 1.5 years behind the original CARE class. She got credit for ab psych and says she thought she had so much free time when she really didn't. If you can take ab psych, it will free up some of your time, but just don't let that free time get away from you. Phys and anatomy exams used to be late Friday afternoons - not sure if they still are because they've changed testing procedures drastically since I took the classes. We had a phys exam the Friday before her wedding which was her downfall. Of course, I don't know you or how you handle things, but I wanted to give a concrete example. I know it can be done with a big life event because I had a very personal one myself that semester, you just cannot allow it to comsume you for more than a day or 2. Anyhow, cadaver work is incredible, but you will have to spend a ton of time in the lab since your practical questions are directly from the cadavers. The entire class is just structured completely different. I think you'll get a ton from it, but if you want that extra time to spend on other classes and can get credit for anatomy, do it. I was used to being a straight A student and sacrificed all of my grades across the board for phys that first semester. They're all passing, but not up to my standard. That's just something you have to get used to through all of nursing school, though.