Seemoni

In the ED I work in 18g is standard. We deal with a lot of IV drug users that blow out veins and skin pop and in them we get whatever we can in. I'll be nice sometimes and do 20g if they're not really needing much, but I typically default and grab an 18g. 16g if they're a GI bleed or trauma. For those that keep saying that you could end up missing the vein and wasting time you could have used to start a smaller line I think its just a matter of getting comfortable with larger caths. I used to only do 20g's at the last ED I worked with and at first had an awful time getting 18g's into people. But after a week or two of pushing myself to try the 18's I'm pretty competent and just as fast. If there's a vein that I can put a 20 in I can 90% of the time get an 18 in as well. And now 16 are easier for me too so that when that massively bleeding patient comes in its no sweat to get a line in them. Practice makes perfect.

Wow, I wouldn't say that attempting an 18g is a waste of time at all. I have been in the ER for almost 6 months now and 18's are my mainstay. They're pretty much all I start. I feel a bit defeated if all I can get is a 20g. I know that for most part a 20g is perfectly fine for things short of fluid resuscitation. However, being able to stick an 18g in just about anyone is really helpful, cause usually when you actually need one the pressure is on and it becomes that much more difficult. If it's a habit, there's no big deal about it. Just keep practicing with it and use the larger one if you can. After a few weeks of 18's only you'll have no problem at all, then try 16's when you can because those actually do feel pretty different, you have to get a certain "popping" sensation with them and advance with the needle a lot further cause the bevel is so large you can start advancing into the vein wall if you're not careful. Actually make sure you're doing that with your 18s. After you get a flash, don't thread immediately. Your bevel tip may be beneath the vessel wall but the entire needle may not have gone into it and you don't want to advance without being all the way in or you're just tearing/blowing the vein then. Get the flash, slowly advance a bit more, than thread. Voila.

I'm glad that you've found your niche in Adolescent psych. I had been training in ER, my first love, but after graduation they didn't have PT positions only full time and as I was continuing for my BSN and still in school FT I couldn't keep it up for long. The only place with 8 hour shifts in the area was Adolescent Psych and I really loved it there. However, now I'm ready to go back to a clinical setting and, by golly. It's like I'm worse than a new grad. I'm sure I can pick up those skills again. I mean I learned IVs in a couple hours the first time, couldn't take much longer the second time around could it. But to most recruiters and managers I've just been out of touch for too long. If you're sure you want to stay in Psych indefinitely, you really have no need to worry. But if you plan on ever doing something else, or having the option to, you may want to consider pulling some med-surg time.

Ahhh Homesickness. It truly can strike anyone but I see it more in the younger kids. And I don't just mean the 6 and 7 year olds. Whoever is the youngest tends to be the most homesick. If we have 10-12 year olds in session then 10 year olds tend to be more homesick. If we have 7-10 year olds the 10 year olds are fine but those 7 year olds feel it. Either way, I feel that calling parents is the worst thing you can ever do. I also feel that the nurse isn't the best person to deal with this. As much as its in our nature to wanna help, you really don't want that kid bonding with you so much. You'll find that just leads to them wanting to hang out in the clinic all day and take even less interest in their peers and camp activities. The counselors are typically a great point guard for home sickness, and when kids bond to them they tend to bond more with the cabinmates as well. I just like to be a resource to the counselors, and if they're at their wits end and can't deal with mopiness anymore, I'll come into the picture. If you become mom at camp they won't want to leave you and hanging out at the Clinic isn't what camp's all about.

I think that maybe a few of you who demand that foreigners learn English if they live here in the US are overlooking quite a simple fact: Learning a second language, especially in adulthood, is very difficult. It's not just a matter of taking a couple classes before you come here, or enrolling in ESOL once you get here. You're lucky if your English classes in another country teach you anything more than just how to say "the book is on the table". It takes time, and I don't mean a few months, I mean a few years, to learn a new language. Not to mention that when you're sick, and feeling ill, and scared, you tend to revert to the comfort you know in your own language. I mean imagine being in another country, whether as a new immigrant, or even just a visitor and falling ill. How on earth do you communicate to someone your medical history. Medical terms are ridiculously difficult for the common American, I mean "Smile oh Mighty Jesus" (a.k.a. Spinal Meningitis)? I don't believe that we as nurses HAVE to learn a second language to accommodate our patients. But we really should try and understand the difficulty some of our patients might find themselves in. I mean do you seriously think they like living in a small bubble that doesn't allow them to communicate with the world around them. They're scared, and with people huffing and rolling their eyes at them at their feeble attempts I can't blame them for not wanting to look stupid by trying. Anyhow, that's all I have to say about that.

New Grads at Erlanger, Memorial and Parkridge started at $17 last year. I worked per diem at a mental health facility for $23. I don't know what an ICU nurse makes, I believe that there isn't actually a higher pay specifically for ICU nurses, just higher pay depending on total experience but I could be wrong about that. Hope that helps

Wow Tampa to Orlando for a year! You may want to do a test trip or two. Traffic in Orlando can be horrendous. It's easily an hour and half drive each way and you've got to remember that sometimes clinicals start at 0630. FHCHS is a great school, especially because they're part of the Florida Hospital system and are well integrated with them but only there BSN program is online so you're going to be putting quite a bit of campus time in. Make sure that your commute is doable before starting in. If you do go for it though, I wish you the best of luck and endurance.

Hello all. I will be heading to Minnesota this summer to work as a staff nurse at what sounds like an amazing language camp. I worked at camps for a few years during college and have always loved them but not in this capacity and last year I volunteered for a week as a camp nurse to help a friend (the director) out. I'm very nervous and excited. I got my RN license over a year ago and I worked for 6 months in mental health but I decided to take time off and volunteer in Brazil, not as a nurse. I'm finishing up 8 months away from nursing and am a bit anxious about returning. I hope my time at camp will bring back my confidence and give me time to brush up on my skills. After camp I'm going to be tying to get into an ER internship program, I worked as an ER tech and loved it and really want to get back there. I'll be back here looking for some help no doubt, as the summer progresses. Happy tick-less summers!

I'm making the opposite move going from Chattanooga to San Francisco in the fall. The greatest difference of course is the pay scale/cost of living factor. You will most likely be getting between 50-70% of what you're making now unless perhaps you do travel. But housing costs are quite a bit cheaper. I don't mind having to pay higher rent in San Francisco because I'll pay off my student loans about 5x faster this way. I recommend working your tail off to horde up money while in CA , your money will stretch a long way in good ole Chat-town. PS If you're not familiar with "Southern livin'" you may be in for a culture shock.