mh356

Just wanted to introduce myself, I was accepted into the Fall 2014 Adult-gero ACNP program. Very excited to finally get started on my master's!

Thanks everyone for the replies. Always helpful to get different POVs. I'm sure administration has thought of everything.

So I want to get out of bedside nursing bad. But I also like the steady paycheck. I work in an understaffed ICU. We use travelers but they leave as soon as their contract ends. I keep getting phone calls from recruiters about certain ICU positions paying nearly double what I make now. So would it be that bad to quit working for the hospital and just take the agency job and work on the same unit? (assuming it is the same hospital/unit)

University of Md Medical Center in Baltimore has a lot of nursing positions open. I know they have a med-surg/tele position open that is a great first job for new grad RNs (I know because that was my first job there!). And the commute at 6.30am takes about 20minutes on 95.

If you have worked ER/Trauma and been an EMT then you should be fine on a neuro floor (just my 2 cents). I also worked as a tech in an ER as an EMT-loved that adrenalin rush, and I really enjoy the variety neuro provides me. The best advice I could give you is to just keep checking on your patients. Sometimes when they are quiet its not a good thing-I had a pt once that used her hemerrhoid cream as chapstick and another that loved to be naked (in front of her visiting son-in-law!) When I first started on my unit I bought a used Hickey book (Neurological and Neurosurgical Nursing) on Amazon and would look up diseases of my patients every night after work. That way I could apply what I was seeing to what I was reading and made such a difference.

Share time is when you go to visit a unit and follow a nurse around and see what its really like to work there. Try to notice the non-verbal communication-does the nurse look annoyed that she has to show you around? How well do the doctors and nurses communicate? Ask about lunch and potty breaks. How do they handle lunch breaks? Are they assigned coverage or is it a free for all (which means you most likely won't get one)? Most of all listen to your gut reaction. Do you get a good vibe from the staff and you enjoy being there? The units I visited (and worked on) I enjoyed visiting and could have stayed all day. They made me feel at ease right away.

I would try Craig's List as there are many neighborhoods nearby the University such as Federal Hill, Fell's Point and Canton that have rowhouses for rent with multiple bedrooms. You can find a room in a house with other young professionals (grad students, teachers, etc) or find other people looking for housing. Good luck!

If you can buy Joanne Hickey's Guide to Neuroscience and Neurosurgical Nursing, you can buy an older version on Amazon for less. It has everything you ever wanted to know about neuro and will give you a good foundation. Good Luck!

No extra pay, Almost always have an assignment (we try to give them the least number of patients/less acute, but that leaves them open to taking the first admission so some would rather have a full assignment of 3 pts.) During day shift Charge is expected to go to rounds with the teams, bed meetings and help other staff-a third of our staff has less than a year of experience. Plus assign beds, check the equipment/crash cart, make phone calls to ensure adequate staffing for next shift, etc. We are a neuro step down unit with an epilepsy monitoring unit, 1:3 ratio 14beds Mid-Atlantic

You'd be surprised how many patients are fine all day, no pain, no nausea, never need anything every time you check on them and then the family comes and they become a hysterical crying mess. Suddenly the family is out there following you around the unit, asking the nurse for pain meds for this patient and all other kinds of things. I wonder if the friend put some idea in her head...

UMD no longer offers the dependent tuition benefit I believe. Howard County (part of the Hopkins system) does offer some type of tuition benefit to dependents but I don't know how much.

We recently had a patient that had a reaction to ketamine after surgery. She was transferred to us for care. I thought it was odd too since I never hear of it being used but I guess some hospitals still do use it. The patient was young-18 y.o.; don't know if that makes a difference in choosing which drug to go with.

We use PTT on all our Heparin gtt patients. Do you use a nomogram-something that tells you how to run the gtt depending on how high or low the PTT is? Our facility says PTT; we don't even check the anti-xa.

We have this problem too. We were told to fill out an incident report every time it occurs so that it gets the attention of upper management. Do you guys clean the equipment yourselves with any wipes? We were wiping them with Cavicide and it seemed to be messing up the channels.

Thanks for all the responses. I went back to work today and my manager seemed to be laying low today-hung out mostly in her office. Just to answer a few questions...the feedback I got from the first tracer I did a few months ago in the beginning of the summer was that I should relax, try to answer just the question asked and not using phrases like "I think" which is my version of like. I say it without even realizing it. I have to say this-I am reserved when I first meet people. But during this tracer I was accused of making a sarcastic remark. I asked the other nurse if she heard me say anything like that. She said no. But I don't think my manager really cares and it would just be a he said/she said sort of thing so I didn't protest. I understand the message she was trying to deliver but the way she delivered it was uncalled for. Yes she was yelling and the last people that yelled at me like that were my parents.

This is a long vent but hear me out... So we are doing mock surveys to prepare for Joint Commission. We were warned ahead of time like 8:30 am) that they would be doing tracers and start reviewing charts. Well of course I have my orientee with me-a new grad who is very chatty and has a million questions and we are down a tech so we are doing our own vital signs, care, etc. Plus PT/OT see pts at this time so its very busy. At 9.30am 3 ladies arrive on the unit to do the survey and pull a chart. My patient. Okay. So I go in there and try to answer the questions as best I can. Of course things are not done and paperwork is missing but I am used to that. I can't control these things. They ask me all sorts of questions-about cleaning equipment, about the fridge, etc. I thought I was just being straight forward and to the point with them. After the tracer is over my manager pulls me into her office. She says that she got feedback today that I was rude, acted like I was disinterested, and made snide comments during the survey. I was so embarrassed. I know I can come off as distant and cold when I first meet people because I am very serious but I wasn't trying to give any attitude. She also mentioned that in a previous survey that feedback was given about me-how come no one ever told me? Now I am beginning to second guess myself. Does everyone think I am being rude if I am not touchy feely and chatty with them? I have never been that type of person. My manager went on about how I seem to have trouble when I am trying to multitask or work under pressure and that things wont always be perfect and go my way, etc. Huh? I had my yearly evaluation last week and none of this was mentioned. She literally yelled for 15 minutes. I am not a crier but I did shed some tears in her office. And on the drive home. I don't know what to think about her comments. I just want to hide under a rock and never go back to work.

Anybody take the CNRN exam recently and have any study tips they want to share? I have signed up for a review course but 4 days does not seem to be enough. I want to start reviewing now but don't know where to begin. I have my Hickey book ready. What types of questions do they ask-critical thinking or straight recall? I am an anxious test taker so any insight would be really helpful!!!

You might want to be specific about what things interested you during those clinicals instead of "I saw a lot of different things." Some med-surg units serve different specialties so it can give her an idea of what units you might do well in (We have a ENT/Neuro/Vasc/General unit, an Infectious Disease unit, a mult Gen Med units, mult Cardiac units, etc. So pick your poison, lol!!). Since it seems that most new grads are the opposite these days and want to go straight into ICU, I don't think you will have a problem getting a med-surg position. But make sure the unit you choose is a good fit-you should get a good feeling about your coworkers when you do an observation day.

I am looking to do something like that--yoga with neurosurgery and neurology patients but have not found much information.

The hospital I work at states that English should be used. However some of the foreign-born nurses (Filipinos) tend to give report and talk in their native language. Not a big deal until you start taking report over the phone and have to deal with thick accents and people mispronouncing words. Sometimes I could barely understand what people are saying. Now its a patient safety issue with things getting lost in report or misinformation being passed along. It does not help anyone of any background to encourage them to use another language when the standard language is English. We must all be proficient in this language to communicate effectively for our patients. (And I also come from a multicultural household and speak 2 languages.) Excluding others is rude. We don't whisper so why would we use another language?

Its called relational aggression, all the gossip, cliques, etc doesn't end in high school. It's found its way into nursing. Cheryl Dellasega offers a workshop on RA and nursing, google her website if you are interested in learning more. Just keep focusing on the positives and how many days left you have in class!!

Expect a lot of physical and emotional work. Feeders, bedpans, turning every 2 hours and getting them in the chair each day. Families that can drive you crazy. Patients that have pegs, trachs, NGTs, drains, IVs and will try to pull them out no matter how many times you explain to them it is very important and not to touch it. Lots of patience!!

I work on a neurology/neurosurgery stepdown unit. I love the variety. You definitely will get experience with cardiac; we have a lot of stroke patients on heart meds. They usually have some kind of prior history of HTN or stroke, etc. Sometimes you will get a pt with a hx of afib that throws a clot during some routine surgery and has had a massive stroke. Its always interesting on a neuro floor!

Can you try telemetry or a step down unit? It would be good to get some critical care experience before starting NP school. Sounds like you are comfortable in your unit but might need some new challenges to keep things fresh. Or think about certification in a specialty or getting your ACLS. There are alternatives to the ICU setting if you want something different.

I did 2 years on a med surg/tele unit before switching to a neuro IMC. I found that med-surg was much more stressful because of all the admits/discharges, patients that went off the floor (to smoke, etc.) and going off to tests. Hard to keep track of 5 patients. 3 IMC pts are no walk in the park either, but I am a lot happier in neuro.