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Pediatric PIV starts
I have not had much success with them. I have been in the PICU a year now and I realize that sometimes, there are complicating factors, dehydrated or fluid overloaded, but I have a hard time just FINDING the veins sometimes. I have started a scalp PIV before, but just learned about finding a vein between bicep and tricep and someone told me that you can kind of blind stick between the knuckles. I know peds patients aren't the only hard sticks out there. What did you do to improve your skills? Any tips? I have tried to observe as many other nurses as I can and somehow they just see/ hit veins that I can't.
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Am I wrong to think this is NOT okay?
I think it's wrong. It's ordered that way for a reason and one of the "Rights" of medication administration I learned was "right route." I don't think that that's ok and I would not do it. As far as the difference between IM and IV administration, I don't know about specifics about IM administration contraindications, but IV antibiotics can be vesicant. Also, IM meds are absorbed over a longer time than IV and so it could be to control the blood level of medication, which could have it's clearance from the body affected by another medication that the patient is on. There are many reasons, but the bottom line is, that it's ordered that way for a reason more than likely. (Of course, it could always come down to cost as well.) Sorry I don't have the answers to some of your other questions, that's just my as your comrade new nurse. Hang in there!
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I almost made a stupid nursing mistake and now I can't stop thinking about it. Help!
I'm a new nurse as well in my first year and I've been through these same feelings. I want to seem like the "smart new guy", but honestly I don't think they want me to be. I think it's okay to still be the one learning and getting better and the last thing I wanna do is look like I know everything, because then it's harder to get help/advice. In the end, it doesn't matter so much what your coworkers think, but what your patients think and the quality of care that they recieve. I may not be the best nurse on my unit, but I care about my patients and bust my butt for them.
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Feeling guilty for not going in to work, when called for extra
Thanks for the feedback, everyone! I am a new nurse btw. Only off orientation now for a month. I do agree with several of you about it not being my house and my responsibility being to take care of myself and my house first over "their house." I do suppose it will be something that I'll just get over eventually.
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What do you guys use for art lines??
I'm really not sure who makes our art line setup (we have a 26 bed PICU), but we use a closed system made up of a two 48 inch pressor tubing and a transducer with two syringe ports, one that we cap during setup and priming and never remove and the other that gets a 10 ml syringe attached during priming and is never removed except to zero. (let me know if I'm wrong in calling this a closed system. Because we use the 48 inch pressor tubing, we can draw the waste back into the tubing up to the transducer and clamp it, then draw the sample from the hub closest to the patient on the tubing, then flush and return all the waste blood.
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Why I don't tell my family...
As a new PICU RN (still in my sixth month), I have totally experienced this already. I started out feeling overwhelmed like everyone does and venting occasionally to friends and family, but they don't have any point of reference and anytime I mentioned anything sad, they were looking for the happy ending. ("but he got better right?") Like the poster said above, it quickly turned to awkward conversations and now when my friends and family ask me about work I don't tell them it was fine if it wasn't. I just tell them it was "long" or "difficult" and don't go into detail. It's good to hear that others experience the same thing.
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New job...daily essentials?
If you work on a respiratory floor, I recommend a good stethoscope! I work in a mainly respiratory ICU and that is my most treasured piece of equipment!... that and Sharpie Pens Fine point! A good pen makes a big difference. Also, eat a good breakfast. You gotta bring your A-game!
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New nurse in ICU and I hate it...please help!
I too am a new grad in an ICU. I go to work anxious everyday over what assignment I might have, but everyday is a new learning opportunity about a new disease process or situation that I might face. It's very mentally and emotionally taxing to start here, but I feel that it will be beneficial in the experience gained in the end. It might help to think of it as an opportunity to gain experience and perspective for future patients. If you are going into hospice, those people might have had stays in the ICU and you can use your experience to know just the kind of things that they DON'T want that they were getting there. I have always known since I started working in my unit as a tech in school that it's where I wanted to be. It scares me all the time, because I know that there will be situations where I'm unprepared and will have to act and think quickly, but it will be one more situation that I'll be prepared for the next time. I also lean heavily on my fellow experienced RNs at work. They are like TREASURES to me and I hope that with enough practice I can reach their level! I hope this has been some encouragement. HANG IN THERE! From a fellow new grad ICU nurse!
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Feeling guilty for not going in to work, when called for extra
I work in a mainly respiratory ICU and can't help but to feel guilty lately when my personal circumstances or preferences prevent me from going in to work extra nights when called. I already worked 36 hours this week and got called this evening because the unit is shorthanded. I had stayed up most of the day after working all last night to do christmas shopping so it was 8 pm and I had only had 4 hours of sleep in the past 24, so I didn't feel safe going in for an 8 hour shift. I knew it was the right thing to do, but I still feel guilty like I'm letting down patients or my coworkers. Anyone else ever have these feelings?
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Anxiety Attacks on my days off......
I know the feeling. I'm a new grad in a Pediatric ICU and I occasionally have feelings like this. I know that I feel fine at work and once I get going. I feel like I just never know what's coming. It helps me to remind myself that I have made it through it in the past and I'm not expected to be an expert right now, just to do my best. Just do your best.. that's all you can do. I'm sorry that the people that should be your resource are being so rude. My coworkers are a source of confidence and comfort to me.
- UAMS Summer 2009 Acceptances!
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UAMS Summer 2009 Acceptances!
I haven't got anything back.. However, some useful information I do have! 1. Booklist is required by law to be posted on the website by noon April 1st. (check either through the new summer 09 BSN admits page that has a link to a booklist page or check the bookstore webpage.) 2. The Scholarship committee meets one of the last weeks in April and they hope to be sending out award letters on May 1st.
- New Arkansas Laws (bad news for nurses) ???
- UAMS Summer 2009 Acceptances!
- Timing and acceptances