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Critical care, neuroscience, telemetry,
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cloister has 25 years experience and specializes in Critical care, neuroscience, telemetry,.

Mother of 3 boys, Boy Ccout leader

cloister's Latest Activity

  1. cloister

    Should an RN accept CNA/PCT job for now

    I would think that working as a CNA, even after passing your NCLEX, would be a great way to keep your foot in the future-empoyment-as-an-RN-door, so to speak. We have a young man working with us now as a nursing student. He failed last semester's term and is having to more or less start over. Regardless, I still want him to come work with us when he's through with nursing school. Why? Because he has a great personality and work ethic, and he's eager to take on any task. Nothing in patient care is beneath him. That's the person I want as a colleague. It is certainly disheartening to have to defer your dreams of being an RN for the present due to this lousy economy, and I wish you luck with your job search. In the meantime, however, I'd take the CNA/PCT position and run like hell with it. You never know who you're going to impress with your professionalism and patient care, and it might just open some doors for you. At the outside, you're making some money and learning new skills. I say go for it.
  2. cloister

    A changing paradigm in nursing/healthcare?

    An emerging trend we're discussing in our ICU right now is family centered care. Other topics with lots in the litereature include nurse mentoring, family presence during resuscitation and open visitation. You might also look at the new nursing drama TV shows for their effects on the general public's perception of nursing. Hope this helps. Good luck! :typing
  3. cloister

    Being a preceptor blows

    amen, and amen. precepting, good or bad, will only take you so far. i've done a lot of precepting in our icu, and i've been told that i do a good job. i like having new staff come aboard, and i remember my own days as a new grad. kindness is always warranted in any of our interactions. that being said, some folks do not make it through our icu orientation. sometimes, i'm the one who has gone running to the nurse educator to demand that the person in question not be turned loose on the night shift. ususally, i've sat through report with them and realized, to my horror, that they don't know enough to safely take care of a patient. we had one poor soul who kept reminding us that she "was a slow learner", and that she needed more time. i feel for you, darlin', but you don't need to be taking care of people with multi organ failure if you can't distiguish levophed from nipride. not on my watch. it's a steep learning curve, and getting steeper all the time. i've been pushing for extended orientation time for our new staff, because i don't think they can reasonably be expected to perform at the level we expect in the time frame we are currently allotting for orientation. the flipside to this is that we need to expect basic competency as a nurse of anyone off orientation without having to watch them like a hawk. not everyone can do the job. those that can't should be reassigned out of the icu.
  4. Had three guys in trench coats sneak three very large pythons into the cardiac ward at the regional Naval Hospita to visit their herpetologically inclined sailor buddy. Needless to say, we asked them to leave.
  5. cloister

    Preceptor becomes villain

    I agree with this poster. The insecurity among some nurses is HUGE, and sometimes intimidation of the newbie is their only defense. I also agree that what goes 'round, comes round. My philosophy on new staff? Be nice to them. I never know who might be my future boss. Follow policy and don't take shortcuts. Everyone else may be doing it, but that won't help you one iota if you get singled out. Find a mentor - someone whose nursing style you'd like to emulate, who has the respect of other staff, and who will help guide you as you're beginning your career. It might even be someone from a different area of the hospital. It helps to have someone who will act as a sounding board and advisor at work. Good luck to you. Hope things get better.
  6. cloister

    If you applied for a job that isn't your "dream" job...

    I wanted oncology too, fresh out of school. I drove up to Nashville to interview on winter break my senior year, hoping that's where they'd place me. It wasn't. "We'd like to hire you for 11 South, the neurology and neurosurgery floor", said the nice recruiter. I don't remember what I said, but I wasn't doing cartwheels at the prospect. He then pointed out that it was medical AND surgical - a selling point, I guess. To which I, naive 21 year old that I was, said, "OK". Fast forward 6 months, and I am off orientation, in charge, and hating the stupid floor, because I don't have a clue about how to determine a neuro change from say, a stubborn old man who is feigning sleep. The residents are already tired of me, and it's only July. As time went on, though, it got better, I got better, and you know what? Neuro is everywhere in nursing. That first assignment has stood me in good stead over the years. I finally did oncology, about 5 years later. Really liked it, but no full time positions available and left after 3 months for telemetry, and eventually SICU, where I think I'll stay. I imagine that ortho will be the same for you. There's a lot of basic med surg there, and frankly, most of those folks are going to get better and leave the hospital fairly soon. In the meantime, you're learning all about mobilizing patients, how NOT to screw up a hip or knee replacement, and oh boy, will you know a thing or two about pain control. Probably never going to be your dream job, but hey! Fake it till you make it. At least for the interview. Good luck! I hope you get where you want to be. Keep us posted.
  7. cloister

    Am I supernurse or superdud? Or somewhere in between?

    Sats in the 40s? Hell, I'd be calling a code too, and I'm an ICU nurse. You don't screw around with that, and the misinformed folks who told you that it "looks bad for the floor" might want to consider that it looks much worse when no help is called and folks subsequently get hauled to the morgue. I've never berated a floor nurse for calling a code in the middle of the night, and I've reeducated a few of my super nurse colleagues who had the temerity to sneer over what they considered "inappropriate codes". It's never inappropriate to call for help, and frankly, the rapid response guys would have done the same thing. Been there, done that. The day charge needs a reality check. Hell, at least you stayed over to do the charting. Did the night charge take some of the load off you? Does your floor have a resource nurse? No? Well, then, short of cloning yourself or ignoring your other patients, sounds like you did all that was humanly possible. Two unstable patients? Some nights, I'm overwhelmed with ONE unstable patient. All of your patients still had pulses at the end of your shift, and baby, some nights, that's the only goal in mind. Quit flogging yourself. Sounds like you did a great job!
  8. cloister

    We Lost A Good One

    I'm so sorry to read about your friend. The death of a friend is never easy to bear, but her young age and near completion of one her goals makes it all the more difficult to contemplate. My thoughts and prayers go out to you at this time. Please take care of yourself, and keep us posted on how you're doing.
  9. cloister

    OMG...not again

    Unfortunately, the English language ain't what it used to be. My favorite misspelling? Seeing "Acheive Excellence" in a poster at my kid's school. THAT seemed to send a mixed message!
  10. cloister

    Issues with a nurse who eat their young!

    Sounds like you know how to deal with this mensch. You're right on both counts, the silence, and the age factor. It's GOOD to be 40+........ Nursingpower, I gather from your previous post that I have offended you, and if that is so, I apologize. My main point, which I obviously fumbled, was that the OP shouldn't have met with that kind of behavior from the night nurse, regardless of how she mixed the drip or handled the situation. I have unfortunately seen a lot of this kind of behavior in the ICU, and I feel strongly that professional nurses shouldn't behave this way toward their colleagues. It would appear that I didn't communicate this well, however, and again, I apologize. Freedom42, I agree with your tactics and only wish that more of our newer staff had your wisdom and maturity. It's hard to be new and young when one of the "old guard" gets you in their sights. We've had folks leave the unit over this kind of stuff. It's a real problem.
  11. cloister

    Nursing market cools, new grads have a tough time finding jobs

    I think Southern California is still hiring. We're getting new grads into the ICU where I work, and it seems like they always need nurses on PCU. They hired 18 new staff for ER last summer. Many of them were new grads.
  12. cloister

    Issues with a nurse who eat their young!

    Ummm......I think perhaps you're missing the point of what the OP was trying to convey. Mixing the drip one way or another is not the issue here. In any event, she checked with her charge nurse, so that she made sure that she was doing it correctly. As far as the cost goes, hey, if she was worried, she could have called the pharmacy and cancelled the drip. It's not rocket science. The night nurse had no reason to be rude to her for what she did. Hey, she stayed over to try to make it right. Had it been me, receiving attitude from this individual, I'd have been sorely tempted to remind her that there are 24 hours in a nursing day, and my hours were now officially over. (I said tempted. I didn't say that I would actually do that.....) I agree with the poster who told you to be empathetic, but firm. "Hey, I know this is a busy assignment, but I did my best, and I'd ask you to please not speak to me like this. Now, is there anything I can do to make it easier for you to get started?" Look them in the eye when you do it. A lot of times, that's all it takes. We all get frustrated with each other from time to time. It's tempting to roll the eyes and sigh when starting with a cluster in the evening. I have to remind myself, however, that I'm not God's gift to critical care and sometimes I really leave a mess for the next person. I appreciate it when they extend me some grace and don't berate me. I do the same for them after a bad day. We have to support each other.
  13. I hear you. We have a lot of new staff, and I think they're by and large a smart bunch of folks. I enjoy precepting, and I've been told that I'm very approachable for questions, advice, etc. My problem isn't with the newer staff as much as some of the folks who have been there for years. I assume care on a patient with a swan ganz catheter, and the nurse giving me report hasn't bothered to check a cardiac index or even connect the swan to the transducer. "Huh? There was no MD order for that." Have you heard of the guidelines of care? Weren't you just the teensiest bit curious about why this patient may have needed a swan to begin with? We were introduced to a potentially new order set for post intubation at our practice council this week. Many of the MD orders listed are nursing care orders. The person spearheading this effort (an RN for awhile) made the comment that people would be more likely to do these things if they were listed as MD orders.....things like keeping the HOB elevated 30 degrees and performing oral care q4. The argument that these actions were a part of professional nursing practice was lost on many of them. I had the same discussion with one of our hospital educators this AM. It seems that the word tripping a lot of folks up is "professional". Professional means that you are accountable for your practice and take the time to make sure you are doing things right. It means reading and educating yourself and knowing what your resources are. It means doing the right thing even when no one will probably ever know whether you did it right or not. I don't think we currently have an environment in our ICU that demands nursing excellence, and until we do, we're not going to get it. Presently, we're working on the healthy workplace thing and trying to make the units a better place to work. I think a lot of it goes back to giving excellent nursing care, and knowing that your colleagues are doing the same. I don't think that many of them will agree with me, however.
  14. cloister

    Will you work during a Pandemic?

    I'd work.
  15. The mere fact that you realize how hard it is to offer comfort in these situations puts you ahead of a lot of folks, in my opinion. Some situations are just unbearably sad. I always cringe when I hear people talk about "getting closure" after the death of a loved one. Some things are never closed, and I would imagine the death of an infant to be one of them. You mention being in your late 20s. Sounds like you've experienced more death and loss than many others in your peer group. Kudos to you for facing all of these events and not running from them. I cry when I see babies born, also. I also tear up when we have young people in our ICU or watch families struggle with the deaths of their loved ones. I don't see that as a detriment in this line of work. I have probably become a little more sensitive to these things as I've gotten older, but I'm also much more at ease approaching families and offering comfort. Nursing provides one with a lot of practice comforting people in the face of death. My advice? Pursue L&D nursing. Put yourself on the front lines. Don't deny yourself the opportunity to pursue a career choice simply because it stirs some deep emotions for you. I have found ICU to be deeply rewarding, but it still gets to me from time to time, and I imagine it always will. I also think it has made me more compassionate, more joyful and more aware of what matters and what doesn't. Sounds like L&D might be the same way for you.