traumalover

everytime I've received an order for a gtt it states start levo gtt and titrate for sbp>90 or map>60. They've also said occasionally start at a certain rate but never titrate by so much, only titrate for desired effect. Could you possibly shadow in ICU for a few shifts and spend some time titrating vasoactive gtts with an experienced ICU nurse?

As a new grad with LPN experience I was hired into ICU and given 3 months orientation. have never looked back. Great reviews, prn'd in the ER after six months, did open hearts, balloon pumps and CRRT in my first year. Three months is a long time. And they if you work in a team orented unit, you'll never be "on your own."

Had a patient's daughter complain to director nurse "ignored her mother's cries of pain all night while she sat on the Internet all night and only checked on her twice." Thankfully we wear Big Brother tags that you can run a report on....SHOCKINGLY I was in her room evey hour for at least fifteen minutes, had placed four pages to the anesthesia on call managing her epidural, two calls to the surgeon, had multiple coworkes who had assisted turning her every hour and who had observed said pt sleeping while daughter cried about how much pain she was in.

everyone is entitled to their opinion. I have seen a lot and been around the block a few times. Perception is reality. What's real to you as a person in one room in pain and afraid may not be the same perception of the people involved. I have witnessed two people involved in the exact same incident describe it two totally different ways. So, yeah, you want to know point blank? I think much was exaggerated. An outright lie? No, again, a different perception from someone who was undergoing pain and anxiety. And you can believe what you want. Either way, good luck to you in your future endeavors. Same to the OP.

Your circulating blood volume consists of components. Hemoglobin and hematocrit are only indicative of the part of the rbc count that binds to oxygen, and not reflective of total blood volume. After a traumatic injury or blood loss, you produce new immature RBC's that weigh less and are smaller, so while your hgb and hct counts may be low, as long as you are producing them many docs esp trauma prefer not to transfuse, as your RBCs mature your hgb and hct will go up on their own. There are risks with transfusion. Not trying to make anyone mad, just stating facts.

Mmmmm....something about this is just not adding up. don't want to fight or debate but as a ER/ICU vet in three major hospitals, remember, perception is not always reality.

had four interviews before I got hired, two panel. never knew there would be another until they called to set up the next one. First with a recruiter, second with a panel, third with the hiring manager, follow up/fourth with her again.

To the frequent flier OD drugseeker repeatedly pushing their call light while we are emergently intubating and putting lines in/starting pressors on my two day post partum septic patient (very sick) to tell me over and over again she can't sleep and needs me to call MD for benzos. "I am busy trying to save someone's life. I am not coming back in here until i am done next door and you're are not getting any more pain meds or downers, so stop bothering us while we do our real work." Two minutes later hear code blue paged overhead. Patient had gotten out of bed and pushed her own code blue button in room because she knew a doctor would show up. And then she asked him for meds. And then the charge nurse spent five minutes in there and we didn't hear a peep out of her until shift change. Don't know what she said but it worked. Said but not by me, to a frequent flier who had extubated himself and was leaving AMA while telling us all what a bunch of jerks we were "You're lucky nurse can't carry guns."

Click if you're lucky. If he's still on the phone after that you better hold that baby away from your ear about a foot.

Can you ask to shadow a day to see exactly how the patients are assigned? Acuity in our hospital depends a lot on whether drips are titrated or not...stable amio/cardizem gtts and low dose Dopmaine/Dobutamine are on our stepdown units. All our open hearts are extubated, lines pulled, and have been up to the chair prior to transferring from our ICU. I think the stepdown's patient ratio is 4:1. They take all post cath lab patients as well unless they are really sick.

Don't agree. It's the same everywhere. I started as a new grad in a competitve ICU and had a great experience there before I moved and started a new ICU job. I don't even remember seeing instances of bullying and "eating the young" and if they happened it was rarely. I find a lot of the times I hear people say that they are the ones creating drama in the unit. In my experience if you work hard and care about your patients and are a team player, people accept you with open arms. Especially with the fact we are short staffed all the time. Prinicples before personalities my boss says, you ain't got to like them just work with them. My best friend is a teacher and she has drama at her workplace, as do all my friends with their respective jobs.

no flipping idea which patients have insurance or not. Doesn't affect my care one whit. From a ICU nurse viewpoint. Not saying it doesn't affect others.

if you plan on having them insert an appendage in you or vice versa. Or show up when ur hubby's had a massive MI is on a IABP and scream "where are the god!@# drugs?"

As a new grad, you need to learn many skills. You shouldn't worrying about being competitive. Learn from experienced nurses. Ask questions. Read up on things you don't know. Never do something without knowing why. Watch procedures. If you simply focus on being the best nurse you can be for your patients rather than the best nurse compared to everyone else you will be the best nurse. Nursing, especially where I work, is a team effort. Somedays you get the really sick septic shock pt on CRRT, and have schloads of fun, and sometimes you get the detoxing alcoholic in 4 points and spend the night giving Haldol and Ativan and being verbally (and sometimes physically) abused. That's nursing. Take care of both those patients like you would your family and you'll be all right.

Got my GED in 1998. Got into the first nursing program I applied to after taking comuterized test and have been an ICU RN for seven years. Good luck.