Gigglesforall

This also bothers me when I see people completely uncovering their patients. I always leave at least half of the patient covered when I'm not washing that half. I'd say the majority of nurses that I've seen totally uncovering their patients had gone to nursing school in other countries, which might have not emphasized the importance of privacy in their programs. I can't say it's ever been brought up in a staff education day or staff meeting or anything.

EXACTLY! Especially in regard to the head. Gets me every time.

The one thing I can't get over is that heavy "thunk" as the body goes into the cadaver transporter. EXACTLY! Mostly in regard to the head. Gets me every time.

I talk to the dying, not the dead. After they've died, I say a a little prayer (inside my head) wishing their spirit well and free from suffering. During post-mortem care though, I move them just as gently as I would had they still been alive. And I always keep a gown on them once they are zipped up, just for dignity purposes. I have been told by a few RNs not to, as we won't get the gowns back from the funeral home, but I still think it's appropriate.

Thanks for all the replies so far. I have 3 years ICU experience, so I have a pretty firm grasp on my assessment skills. I wish I was more confident in my IV skills...but most of my patients either have a central line or are grossly edematous and/or a hard stick. I try not to stick more than twice (per policy) and if I know it will be virtually impossible, I defer to our long-time pro who used to be an IV nurse years ago. I'm good with starting/maintaining drips, intubations, assisting w/ art. line/central line insertions, basically all things "critical care". Are there any things "strictly ER" related, or more-often seen in the ER that I would need to know that I probably wouldn't do regularly in an ICU setting?

I currently work in ICU but am interviewing for an ED position in a level I trauma center. Just wondering what skills you use the most on a daily basis and what I should start practicing! (I hope I get the job!) Thanks!

Thanks for everyone's replies. I know the problems have been addressed at various hospital trainings that eventually turned into an ICU pt. visiting rant in iteself. That was not the appropriate venue to discuss it though. Our unit doesn't have a "coordinator" per se. We just got a new unit manager recently, our previous one wasn't too much of an enforcer. As it is mostly a night shift issue with the visiting and sleeping, the manager is not there to see or intervene. As I said in original post, they just started announcing when visiting hours are over (but that does no good). It's possible that other plans are in the works to control this, but I don't know any yet. Security has been contacted on a few occasions, as well as is the POLICY that they are to call up to the unit of a family member comes after hours, to check if it is ok. I can recall 2 occasions for me, where security has called. Otherwise, they are just allowed up. We have families from other units wandering around too sometimes and need to be "redirected" back to their unit. It is very hard to be enforcing of the policies, when all I hear is "But I've been staying for the last three nights " or "I've stayed overnight every single time he's been in the hospital and didn't have a problem" etc... No one seems to be on the same page with this, even the charge nurses, don't take charge of the situation most of the time. No one wants to make anyone upset and so it's the nurses that bend over backwards to make everyone happy. Ok, enough said for now.

I work pm/nights in ICU and am getting so fed up with pt.'s families. (Not all, of course.) I am talking about those who have 20-30 family members lurking around or lying on the floors and more just keep coming from every corner. I am also talking about those who wander into other patients rooms just because "they speak the same language"!!! It's those who have "never spent a night apart" from the pt. and request cots and recliners to sleep in, despite the lack of space. The ones who have tons of stuff taking up all my valuable counter space and want to keep food in the pt. fridge! The ones who will ask for you to take their blood pressure or get them a Tylenol! (That's what the ER is for...or your own house...sorry!) Our hospital visiting policy is 9a-8p, but no one ever enforces it. Just recently a hospital announcement goes over the loud speaker at 8pm stating that visiting hours are over but no one listens. "Of course they don't mean for ICU, right?" We have had to call security a few times for those with 20+ people at 1 in the morning. Security is supposed to not let people come up in the middle of the night, but somehow they always get in! We do have a Care Partner program, which they get info on at admission which states that ONE family member can stay around the clock, if they assist in some patient needs that are in their scope of abilities, such as helping with turns or a bath or ice chips or something. Most of the families I am describing don't lift a finger though or aren't physically able to help. I can only imagine what it would be like to have a loved one in ICU. I get that and make sure I am supportive to family needs and explain what I am doing and procedures and answer questions about the monitors, etc... I try not to be heartless, but it takes so much of my energy dealing with the families...not the patients! I am tired of working in the dark with my intubated/sedated patient and tip-toeing around the sleeping family member. I would love to know how you all deal with this and any tactful/non-offending statements I can use to get my point across that I need to treat my patient all night long and can't just create a space condusive to your sleep/personal needs!!! Please help! Thanks!

Anyone using heparin anti-Xa labs now instead of PTT? Our heparin protocol still uses PTT, but some orders say "pharmacy to manage" and whatever their protocol goes by uses the anti-Xa result.

I moved to Chicago 3 days after I took the NCLEX in my hometown in MN. That was 2 1/2 years ago. It was the best thing I've EVER done! It's been amazing to pick up and move to a city where I didn't know anyone and start a new life with a new career. I've never been happier than here. If some place is calling your name and you feel that excitement just thinking about moving to that city, JUST DO IT! Sure, it may not work out, but it might be the best thing you've ever done and you won't have the regret you'd have your whole life by not doing it. Especially if you're young and unattached! I've met the love of my life here in Chicago and can't imagine what my life would be if I hadn't made this move. Good luck and have fun!!!

Hi~ St. Joseph is part of the Resurrection Health Care system, one of about 10? hospitals now. It's the largest Catholic hospital system in Chicago. My first job two years ago was with another Res hospital. I left after a year, it wasn't for me. They're not among the top hospitals in Chicago. St. Joseph though is probably one of the better ones, I'd say, along with Resurrection Medical Center, which is pretty far north. Last I heard, St. Joe's still does paper charting. Some people like that though. That's really all I know. Good luck with your decision!

Hi everyone~ Just looking for some input from experienced SANEs. I've been an ICU RN for two years and will hopefully be transferring to the ER by the end of this year. I worked for law enforcement part time in college and have volunteered as a rape crisis hotline counselor. I've posted here before regarding my goal to get my MSN in Forensic Nursing either through Duquesne or Quinnipiac. I am interesting in taking SANE training in February, despite my lack of experience in the ER (other than a semester-long internship my senior year in nursing school). Is this a realistic option or should I gain more experience with ER and encountering assault victims in general? Ideally, I'd like to expedite this career path, because I'm confident it's the right specialty for me. I was hopefully going to start my masters classes within the next two years. I want to get the "theory" out of the way now while I'm young (I'm 24) so that I can have a long career in this specialty and get married/have kids(?) after school. I feel like I have all my goals in line and can achieve them, but are they realistic? Am I going to be out of place because of my lack of experience or be set back because I haven't seen enough? I feel like by reading the posts that most of you experienced ones are so much "wiser" and have had more extensive backgrounds. I have all the confidence in the world that I can learn the theory and will gain the experience eventually, but what do you all think? Thanks in advance!

How often do you change the filter for say, mannitol or dilantin?

Our ED does not fax report, gladly. At another hospital I was working at I got a chicken scratch of a "report" that I could not discern anything and could not even fine out what the patient's diagnosis was, lab values, IVs, etc. I like getting report first so I can be prepared to get an NG suction set up, or have the IV pumps on the right side, large adule BP cuff instead of standard, etc. Being prepared with the specific equipment the patient will need before he gets there and is possibly too unstable and I can't leave the room really helps!

A few people on nights in ICU would wear them when it was slow and they were just charting or during a.m. care with a sedated/vented patient, but they were "outlawed" when someone told the manager. It's not the most professional thing to do, but sure did pass the time and I don't think the sedated patients minded!