Do-over

Any adult ICU nurse is expected to float to other adult ICUs. The specialty ICUs are expected to use common sense when making assignments for floats. Side note - pet peeve - the automatic bad attitude about floating. I generally have a good experience when I float, but I also try to go into it with a good attitude.

Recently had a family member of a patient comment on how young the night staff looked... His mother reprimanded him for not including me in the "young-looking" group... At any rate, it was a great opportunity to manage up the many bright, intelligent and hard-working young new nurses I work with - they receive an intense orientation and one that is specifically tailored to critical care.

We don't have set days, but it seems so rare to have a dressing last 7 days anyway - especially IJs in intubated patients... Like unicorns, subclavian lines are rare and beautiful things.

I generally pack a lunch and its pretty healthy. Either way, it doesn't take me any longer to eat healthy food versus junk food.

Perfect - ER, ICU, tele here. ICU is definitely the most lifting, etc. in my experience. Especially with CNAs being almost non-existent - you not only do your own baths, turns, mobility you help your teammates with others.

I really like that I have actually laid eyes on the patient, and don't feel the need to run in the rooms immediately after report. Especially if I have one going sideways - I've already seen the other, even if I haven't done a complete head-to-toe - that can probably wait. It really helped me once I accepted that the patients have a RIGHT to hear report, and to participate in it. I don't think it is going away, and it started slowly at my last hospital - but they kept after it and it has become the norm.

Learning how to be comfortable being very uncomfortable.

As for me, I think bedside report is essential - especially in critical care. If you find yourself getting bogus info - open that computer up at the bedside. We are supposed to, although it doesn't always happen. Believe me, though, if I know I am dealing with someone that habitually leaves orders or meds undone - open that chart and look at it. Allowing the patient (and/or his or her family/advocate) to participate may feel inconvenient... But, that is the point and it is about them, correct? Besides, after a decent bedside report - I've got half my assessment done.

PS - God bless Kaci Hickox, and all the others willing to go and to serve. That are willing to touch the untouchable.

I will be willing to volunteer to care for Ebola patients when/if that time comes. I am far more afraid of false imprisonment by Chicken Little, though, for doing so. How long have international HCW been traveling from Ebola stricken regions back to the west? Maybe since the 1970s? Further, there are probably 1000 things MUCH MORE likely to kill me in the next week than Ebola.

I see both sides (I am ICU and have worked the floor and ER). The argument for more pay, to me, is that so much more is expected out of us (at least where I am). Knowledge, leadership, expertise, floating all over, etc. So I don't really see it as an issue of who "works harder" - clearly the floor nurses usually get that honor. To me, its the constant vigilance, etc, that make the ICU so exhausting. I don't really expect any more pay though, simply wouldn't fly. I am CERTAINLY not saying that floor nurses don't have knowledge, etc. But there is a drastic difference in the two work areas, in my experience. On the other hand, critical care experience can be worth its weight in gold and its own reward. I believe a critical nurse is much more marketable, and one that can work in several areas even more so. Get CC experience, and learn to float joyfully (or at least with a decent attitude) and you'll be welcome a lot of places.

The most inconvenient spots - like radiology. Only partly joking.

What is with the poop that smells like mothballs? Wicked GI bleed = slaughterhouse

In all seriousness, I was terrible at first. Now, with oodles of practice I rarely have a problem. When I do, it is with females. Can't really explain my technique. Kind of like IV starts, I think there is a "feel" to it.

I prefer to go through it.

I use gravity on G tubes, but plunger on naso/orogastric tubes.

Which is a great reason to never come in extra when asked...

Sometimes, I think they go way too deep for nursing school. Yes to central line and ICU level monitoring for 3%.

as far as someone "not liking needles". I say, "Neither do I, and it is truly better to give than receive!"

I rarely sit down at parties / family gatherings for fear of falling asleep... Knowing that my family will let me sleep and probably throw an afghan over me "cause she is so tired". I'd miss the whole thing!

My worst is driving past my own driveway in the mornings. Happens at least once a month.

I have no problem saying no. Especially because they will force you off later because you are OT.

I found both 1302 and 1308 to be extremely tough - I took them both online at UTA and barely passed, although I am impressed that I did as well as I did without any help (legitimate or otherwise). I took them before the proctor requirement. I wonder if they found a lot of cheating? I would advise anyone not super strong in math to take these classes locally and not online - not because of the proctoring, but because the material is tough and there is a lot of work to be done in both classes.

Love House of God. Read it again a couple years ago - it renews my sympathy for new docs. I especially love the patients whose charts are buffed are the ones that did the best =)

5 or 6 months sounds like a lot of orientation, but depending on the hospital you might not get to see many patients that critical even on the unit during that time. And then, ER will likely either hustle those patients to the unit (and rightly so) or to another facility. Also consider that vented patients, or patients on multiple drips would be 2:1 on the unit (or 1:1). I would think that should be the case in ER, and even though you would still likely be too busy to do a lot of research at least you can focus on that one situation.