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Rabid Response

Rabid Response

ICU/CCU
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Rabid Response has 5 years experience and specializes in ICU/CCU.

Rabid Response's Latest Activity

  1. Rabid Response

    LPN working towards ICU

    Go for the tech job at the trauma hospital. The experience itself is probably not going to count for too much on a resume for RN positions, but you will have a foot in the door at an acute care facility. Never underestimate the power of networking. Also, you can work on basic nursing skills and become comfortable in a fast paced environment. In my opinion (I will get reamed for this) long term care is kind of a dead end/career killer. Good luck and congrats on having two job offers.
  2. Rabid Response

    Is attending a patient's funeral overstepping "the" boundary?

    I've only attended one funeral for a patient, and I'm not sorry that I went. He was in our ICU for a long time, and I got to know his wife very well. I came to work the morning after he passed and did not realize he was gone. His wife was there to sign some paperwork, and I gave her a big cheery wave hello as I breezed past her on the way to my assignment. By the time I learned that he had died the night before, she had already left the unit. I felt terrible. I don't think I could have lived with myself unless I attended the funeral and was able to express my condolences to his wife. The amazing thing about that patient's funeral was that it gave me the opportunity to learn about the man he was before he became ill.
  3. Ugh. This post brings back bad memories of my own student clinicals. So few of the nurses wanted anything to do with us, and the ones who were forced to work with us either ignored us or hid from us. Some of the blame must fall to your clinical instructor. Our clinicals improved (slightly) when we got a clinical instructor who worked at the hospital where our clinicals were held. Apparently it's a little harder to be rude and condescending to someone who you will have to work around in the future. Because of my own past experiences, I have gone out of my way to welcome students into our ICU and always offer to work with them when I can. I have rarely regretted agreeing to work with a student and only then because I had a really busy/crazy day and know that they didn't get to do much besides follow me around. Some nurses are going to be less than welcoming no matter what you do, but there may be a few things students can do to make themselves more welcome on the floor. One student automatically started changing my patient's bed linen right after we had gotten him out of the bed after extubation. I remembered that thoughtful gesture and asked specifically to work with that student again. Also, while I like answering questions, there is a time and place. If I look super busy and distracted (probably more often than I wish I did) maybe that's not the time to ask a very detailed question. Write down questions to ask later during lulls in the workload. One student did that, and it worked really well for both of us. While I understand that students are not placed in our unit to do scut work, my ICU has no nurses aids and so doing any of that sort of work for me (serving meals, helping to turn patients, toileting patients, emptying foleys) frees up time for me that I can spend helping them to learn some of the more interesting and challenging stuff. This too shall pass! I once got YELLED at by a CNA when I was a student and just trying to help. I left clinicals that day on the verge of tears. I now work in the same hospital where that happened and I see that CNA often during my rapid response rounding on the med-surg floors. Now that I've had a chance to get to know her, I realize that she yelled at me because she is incompetent and stupid, and I was the only person lower than her that she could take out her frustrations on. She is lucky that I'm not a vindictive person. Hang in there, students, and try to remember how crappy it felt not to be welcome so that you can change things when you are the nurses.
  4. Rabid Response

    Not a waitress or barista

    A few days ago, a patient's wife was irate with me because I hadn't brought HER any breakfast. "You didn't even bring me a coffee!" she shouted. I explained to her that I am not allowed to provide food or beverages to anyone who is not my patient. I told her that there was a cafeteria downstairs. "But then I will have to PAY for it!" was her response.
  5. Rabid Response

    Rant: I will SHOW you where it is

    I work with one of those too. When I first started on the unit, I helped her a lot. It seemed that she didn't know how to set up/use the majority of our equipment and never had any idea where things were stocked. Also I was constantly running to answer her call lights and alarms. One day I asked one of the veteran nurses how long Wingnut, RN had worked on the unit, assuming that she had started a few days before I had. 15 YEARS!!! She has worked IN THAT UNIT for 15 years. It seems she gets by because her friends (and idiots like me) pick up just enough of her slack that she hasn't killed anyone. Needless to say, I no longer help her unless it is a matter of patient safety. I won't even double check meds with her because I don't trust her not to make a huge mistake later and have it traced back to me. In short--I feel your pain. Working near someone like that always increases the labor load and the stress.
  6. Rabid Response

    do you wear those clogs?

    I really wanted to love clogs. I never felt quiet right in Danskos or Sanitas. Although I don't ever really run while at work, I don't like the feeling that I couldn't if I wanted to. I wore Crocs for a while but I would bump the toe of my foot on the floor every once in a while and pitch forward--ugh. Then one day, while transporting a critical patient by gurney, I did the toe bump thing, my croc flew off and got run over by the gurney while I hopped on one foot after my co-workers trying to retrieve my shoe and catch up in time to get the elevator. So awkward! After that I started wearing shoes that would stay on my feet, that let me feel the floor, that I could run up stairs in if I had to--Adidas Sambas and Converse Chucks. My shoes have no arch support and no padding. Other nurses think I am crazy, but my feet feel better than ever, and I never trip anymore. I save my squishy, comfy shoes for when I get home.
  7. Rabid Response

    If I see one more post titled....

    I have a 2.0 GPA, a criminal record, and I'm pregnant. What are my chances of getting into nursing school? Should I wait to apply until after the baby is born? Should I wait until I'm paroled? Also--do these pants make me look fat?
  8. Rabid Response

    I sleep my life away

    The same thing happened to me when I worked nights. Because I have a family and other obligations I could not keep to a regular schedule of being awake nights and sleeping days; I was always short a few hours of sleep. When I did finally get to sleep for an uninterrupted period, it was not unusual for me to sleep 18 hours at a stretch. After I switched to day shift I was amazed to find that I only needed 6-7 hours of sleep each night to feel rested. Multiple doctor visits and tests showed nothing wrong. I cured myself by switching to days. I feel so good that I don't miss the pay differential. It's worth it to feel human again. Maybe you should cut out the daytime OT?
  9. Rabid Response

    Fictional vital sign charting

    That was the gist of my argument with the intern. He was claiming that the patient's code status disallowed us from using a non-rebreather. On admission, during their code status discussion, the patient and his wife had expressed a wish that he not be intubated nor (supposedly) be placed on bipap. At the bedside, however, the wife was requesting that we give him more oxygen, as he was barely rousable (not his baseline). The wife (who spoke little English) did not seem to understand what exactly she and her husband had agreed to when they worked out his code status with the ED doctor the day before. She didn't understand what bipap was, so how could she have known that her husband wouldn't have wanted it? In any case, I could not see that his status should preclude us from placing at least a NRB on him, and I was having a ridiculous argument about it with the intern. We placed the NRB, his O2 sats went from low 80's to high 90's, and he perked up considerably. Time for a meeting with the palliative care team WITH AN INTERPRETER. I also always get my own vitals on my patients. I did not realize that the problem of CNAs fudging vitals was so prevalent. I'm slightly horrified. On my next RRT shift, I am going to talk to the manager of the m/s floor on which this incident occurred and relay my concerns to her. I like to give people the benefit of the doubt because, lord knows, I have made my share of charting errors, but something about the situation just doesn't feel right. I really appreciate everybody's input on this situation. Your stories are unsettling. The scales have fallen from mine eyes!
  10. Rabid Response

    PICC dressing changes tips & tricks

    Are you not changing the biopatch along with the tegaderm? It is my understanding that the biopatch is supposed to pull off along with the tegaderm when the old dressing is removed. This is why we are taught not to tuck the biopatch under the line.
  11. Rabid Response

    Fictional vital sign charting

    Today, as part of my rapid response rounding, I spent an hour at the bedside of a patient who was having respiratory issues secondary to TB and exacerbated by CHF. The whole time I was there, the patient's O2 sat never exceeded 89% despite his being on Hi Flo NC at 100% FIO2 and 30L/min. I had a lovely argument via telephone with the brand new intern who claimed that putting patient on NRB would violate the patient's wife's wishes that he be a partial code and basically disallowed everything except for pressors in the event of a code. (The patient and his wife had no idea that they had apparently signed away their rights to an O2 mask!). In any case, the doc at one point said, "I just checked his chart, and he looks like he's doing okay.". HUH??? I walked to the nearest computer cart and opened the patient's chart. Sure enough someone had charted the patient's vital signs as O2 sat of 94% on 50% FIO2--ten minutes ago! Up and down the halls I roamed searching for the person who had charted these vitals. The hour I spent in that room, not one other person had come in to take vitals or assess the patient. Apparently it was the CNA. CNAs are responsible for getting vitals on the patients on our med-surg floors. Unfortunately this is not the first time I have found the charted vitals to be completely divorced from reality. Every med-surg patient has a respiratory rate of 18 or 20 for some reason, and nobody's O2 sat is ever below 90 unless the patient is busy for some other reason (diarrhea for instance) and the floor nurses want her/him transferred to a higher level of care. I have noticed that assessments and vitals are especially fictional if the patient, like this one, is on isolation precautions. I could not find the CNA, but the RN for the patient assured me that the charting must have been a mistake. She thought that the CNA must have charted another patient's vital signs in this patient's chart. I decided not to make a stink about it so as to maintain good relations with the staff on that med-surg floor, but the more I think about it the more I feel that the CNA made up those vital signs just so he wouldn't have to enter the room; the values were much too similar to what the vitals had been 4 hours previously. What do you think? What would you do? Find the CNA and question him (he pretty much disappeared after that!)? Fill out an incident report. Contact the manager for that floor? I did put a note in the chart stating that I had been at bedside during the time the vitals signs were alleged to have been taken and charted the actual O2 sats and FIO2 on top of the erroneous values.
  12. Rabid Response

    Just a reminder to watch what you say!

    A couple of nurses at my hospital were fired based on a personal exchange they posted on a social networking site. I have been extremely cautious since then.
  13. Rabid Response

    Who really belongs in the bed...

    I never know what day it is and have been forgetting what year it was since I was just a kid. I told my daughter that if I'm ever hospitalized, she needs to tell the nurses that this is my baseline so I don't get diagnosed with delirium and get written for Haldol by the intern covering night shift.
  14. Rabid Response

    Moving back to the Bay

    Since you have experience and want to work med/surg, it's not entirely hopeless. If you are willing to work night or evening shift, you will have a better chance of landing a job. Most Bay Area RN positions are part time, but you can make over 100K/yr working a .8, and most hospital systems offer full benefits for RNs working at least a .6. You will probably have no success dealing with any HR departments. I can't think of a single nurse who was hired at my hospital in the last 3 years by going through the "proper channels.". Contact everyone you know in the Bay Area who might have some connection with a hospital. The idea is to get your resume into the hands of someone who can CREATE a position for you (not advertised to the public), which you can then apply for (praying that no qualified internal applicant wants it). Another good option is to sign on with a travel nursing agency and take assignments in the Bay Area. Nearly all of my unit's newer hires have been travelers who stayed on as permanent hires after their contracts ended. Again, management liked a few of them enough to create the positions for which those nurses could apply. If you went to nursing school here, your old classmates will be your best networking option. Whatever you do, don't move back here unless you already have a job lined up; you have no idea how long your employment search will take, and you already know how expensive it is to live here. Good luck.
  15. Rabid Response

    Moving to San Fran in May 2012

    Ah. Much better scenario. Who knows what the job market will be like in a year, but right now it takes longer than one month to find a job. A BSN will not be much advantage if any since there are a ton of locally graduated BSNs already looking for work here. I know of one excellent new grad who found a job in Sacramento, worked for a year there, and then transferred to a Bay Area hospital in the same hospital chain. Sac to is not too too far from SF by train (not a good commute, but manageable for frequent visits). Maybe you could try applying to hospitals in that area . Best of luck to you in school and with the job search!
  16. Rabid Response

    Moving to San Fran in May 2012

    I am insanely curious as to why you absolutely must move to this area when you don't know a soul here and face probable financial ruin by doing so. At least save up a little money to live on before you move. Without employment you will find it difficult to find a place to live, and roommates will not be able to charge your portion of the rent to a credit card if you choose to save money by moving in with a few other people. I'm scared for you, and I don't even know you. Please be cautious or you will end up sleeping in your car and, eventually, on the street. I love SF, but I wouldn't ruin myself to live here.