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JanetCCURN has 3 years experience and specializes in ICU.

JanetCCURN's Latest Activity

  1. JanetCCURN

    NOW how does it feel???

    Sorry, its been a while. Funny you ask about his profession prior. He was in the Postal service, since retired. He makes plenty of inferences from his previous profession in terms of the politics and what not. I do think he is immuned to most BS. However, this really made him mad. Just for those curious about the outcome. Few days later, SAME patient in-fact, he was avoiding me, went strait into the room, only to find full brand new bags of meds, fresh labeled tubing, no trash anywhere. Pt comfortable, sedated, ventilated, crisp linens and turned with pillows. Comes to me 15 mins later and says "any updates". Uncomfortable aura, said what I had to say. Almost left the unit, only to turn back and discuss his perceptions and clear the air. He recognized his issue, I apologized for giving him additional (kinda unnecessary extra work), but asked how he felt. Tried to hug it out, but he said it would take awhile. 1 week later I saw him in a hospital wide forum, he approached me and said "no hard feelings", hugged it out and that was that. Havent followed him since. A few days later, Same scenario, but totally different person. I was slightly livid. I took a picture of it, blew it up in size, no HIPPA info shown--hard to tell which patient this was, and typed a "your mother doesn't work here" type letter, but everyone I worked with was praising and probing. Kept that info to myself and said, "hey, we have multiple offenders, just dont be one". But people know. So that was xeroxed and placed into the bosses inbox. Haven't seen this issue since.
  2. JanetCCURN

    New hospital~~>not a new grad.

    Sorry soooo long, mini vents included Today I started my unit orientation to CCU in a New hospital, in a New state. I've been in CCU and ICU for roughly 3.5 years, have my CCRN. I was very concerned last night about how I should display a "humble, please teach me the ropes, in's and outs" attitude during orientation. But I still don't understand how to convey the "teach me please, but oh I understand this already, but you can still tell me what you gotta say, because I might learn something new and don't want to miss a learning opportunity, and DO NOT want to come across as rude, or even act like I think that I know everything". I have the utmost respect for the experienced nurse and love learning from them as well as recycling the teaching to others because learning is fun. This nurse I was paired with was an extremely knowledgeable nurse, 30 plus years in nursing. Personality wise, she was firm with patients, kinda militant, and dry humored. Im a little softer and very sensitive to the emotions in the air, still firm when I have to be but definitely not a stickler, I like my patients to be in control of what they can be when they can be for themselves. Hippocrates said, "Cure sometimes, treat often, comfort always". I was proactive (just jumped right into pt care, charting, paperwork etc), asked questions as they came along, discussed aspects of patient care, shared knowledge and experiences so she could add teaching moments. Eventually, I felt there were lots of differences in what I thought I knew to what she was teaching me. It was frustrating because she wasn't receptive to the differences and would just shut me down by saying "No" to this and "I've never" to that followed by correction. I wanted to learn from her perspective and her experiences in accordance with how this hospital does things, so I found myself nodding along with understanding, only spoke for clarification, and continued listening. It gets worse. She converted my orientation to the unit, to orientation to basic nursing. I asked where we got rid of medical wastes for tubings and bottles/bags etc, no blue bins, "oh, just put it in the trash, BTW tear off the HIPPA info and place in the shredder bin." I said a big "OK" in my mind. Another instance, I asked her to run through the Crash cart monitor and organization of supplies meds etc. At one point, I suggested perhaps I should recert for ACLS since it was an entirely new machine, tons of fancy buttons, and its up for renewal in 2 months anyway. She said, no, and said this is all ACLS, kept honing in on placing the patient on the pads and leads first. Basically, going through ACLS protocol. Talking about PEA, AFIB vs Aflutter, sync cardioversion etc. I kept listening, she kept insisting it would come along with experience, stating it will get better as I see more codes. I almost lost it. At that point, I thought. Maybe since I was more of a listener and had less of a discussion and asking questions, I think I may have made myself out to be clueless. Yet I don't know what else I could have done. I wish I had just sat in front of the computer and just informed myself of policy and procedure. Every hospital, different formats of orientation, never felt like this before. Not even given the opportunity to actually validate skills. She had trouble starting an IV, needed to start Bicarb and DDVAP, she didn't even give me the opportunity. I asked, she said no, pt is already stressed out. The pt was calm but she exceeded her attempts, Hmmm, okay. It was her show. Suggestions please.
  3. JanetCCURN

    NOW how does it feel???

    I work with a newer male nurse who's been nursing about a year as a second career. He's older than me, he could be my dad. We have a policy at work, all the piggybacks and drips must have a hide-a-sticker label over hippa type info and they carried out and disguarded in the medical waste bin in the dirty utility room. This nurse has built the reputation for leaving his old bags piled up in the rooms he works in and hardly ever throws them away, in addition to leaving his room and patient discombobulated in the bed. One day after noticing a pattern I addressed it stating how it's unprofessional and rude not to throw your trash and let the next shift pick up after you. He's response was "oh, did I leave my tubings and bags in the sink again??? Hahaha..." uh, yeah you did! So I had to follow him on a different day same patient with multiple bags changed through out the shift. Guess what I did!???? Every bag was due to be changed by the next morning, I'd tossed all the old tubbings with all the piggybacks out as they were completed. (so he'd have to start fresh) I even gave him a nice heads up that the patient was gonna need new tubings for everything he says "oh whatever, that's fine" ok. Pumps alarm after change of shift... I hung around to see. It's an isolation room too! Lots of gowning and ungowning, ESP if you forget to bring stuff in the room. He says omg! I didn't think you left it all empty! I said have a good day :-) and left. Come to find out from a another nurse "ohhhh, you are on his hit list" I said why, because he gets away with leaving his trash behind. Well all I did was cleaned up (literally) she too has had same issues. Today I get to see him. Was this too far? I personally don't know what else to do to get him to change his chronic bad behavior. What's worse is that he thinks it's funny and ok to do this. I'm trying to avoid going to the big boss, but how unprofessional is this???!!!!
  4. JanetCCURN

    Just started new job - not impressed.

    This happened to me when I moved from my first hospital CCU to a MICU. It was so bizzare I felt like I went from high standards to a place keeping afloat and trying to meet minimum standards. So much so that my preceptor and others would share stories about what they got "dinged" on during Survey. It was jaw dropping the things I was told. Yes tons of gossip. As far as families, I just here people vent but if it's abusive or from a lazy and unempatheic stand point, it would drive me to say something. Extremely funny coincidence was that the preceptor I had at this hospital 20 plus years ago was oriented by my very first preceptor from the hospital I left. So in essence I felt a bit of kindship. When I spoke with my first precepter she said "did going to that ICU make you wanna turn around and run as fast as u can?" I've been there ever since only because I control the kind of nurse i wanna be and contacting a doctor and I will page them a million times until they call me back. Im obvious not gonna harrass them for things that can obviously wait but I'm gonna call down my list of consults if I had to and keep documenting. Using what you know and what you've learned and share it in this new hospital might help you feel like a contributor as opposed to feeling like you have to conform. If you have a better way of doing something or feel like there should be a policy in place for a particular situation construct and formulate a plan with your management. Hopefully they are receptive and openned. But yes give it time if you don't like it or no one invites new ideas then move on....
  5. I don't feel like I regret being an RN, but I certainly don't want to ever reach that level. Im responding because of how you describe your feelings and what you are going through. Im a new grad, started off in CCU still in my original place of employment going on a little over a year now. I can't say that waiting a year helped so far but the stress, I feel, is coming from the heavy demands of nursing. No two days are a like and no two people are in the same mood always. The culture of one's environment weighs about 70-80% of how you feel. You can have 1 night of pure chaos, but it's the people who you work with both days and nights that get you through. Personal conflicts, tension, demanding mgmt, etc can really throw your "A" game off. Im noticing a pattern with me over that last year; factors including bully nurses, bully management, lack of professionalism, poor role models, stressed out senior nurses, short staff, no charge nurse, overcoming the learning curve, meeting everyone's expectation (including your own), lack of feedback, no support system, having family life stress, depression, guilt, lack of confidence, proving yourself, poor sleep/ diet, union's vs. mgmt, etc...-- There are sooooooooo many moments when I've felt like Yes! Im getting there then being stomped on by senior staff or managment. It's such an evil roller coaster of ups and downs. Right now, Im experiencing a down by a combination of those factors above and some. Now Im using EAP services to get through this... Im learning that there are more things that just nursing that I need to learn and that is the world of professional working politics. That takes a whole new level of maturity and a whole new way of learning how to control your sensitivity level. Another word new to me is "Coping"...maybe we are not coping with our stressors very effectively. There's another level of learning that I thought I was good at and that is communication. I don't know where this will get me or where you are at right now, but...don't loose sight of why you became a nurse. You have control of YOU. Everyone's time will come, but also keep in mind only you know your limits and when you've reached them. I know I will have to find somewhere else to go, but I don't think that will change what the demands of nursing are or the type of patient's I will care for. Just gotta find the right fit. I don't plan on being where I am at any more than 6 months longer. But I now have the stress of thinking where Im going to go, taking what I've learned and becoming the new person again somewhere else, different mgmt demands and expectations...but all in all, Im hopeful and will keep searching for that right fit. I love my patients and we have the privilege of caring for them like no one else can. RE-connect with your family, yourself, and your passion for what you do. Let me know what you decide to do. It would be nice to follow up.
  6. JanetCCURN

    ECCO Program

    Its okay. I really prefer face to face learning because you can be challenged in a class room. Its a lot of info. I printed off all the notebooks it comes with. Good info, just a lot to digest. Im a new grad in CCU, its relating the info once its learned that really helps.
  7. 6 weeks is not enough to even gather yourself and transition smoothly. Im a new grad, started working in CCU mid sept. Just started taking a full load after three months. At about six weeks I took 1 pt. So far I have worked with about 6 different seasoned nurses who all work very different. I have to keep in mind that I am still new and will not know everything. Lately I have had feelings of whether or not CCU is right for me or if Nursing is right for me. Although I keep hearing that I am doing just fine, I really feel like I am setting myself up for failure. Maybe starting at a tele floor may have been the best thing to do so that I can get used to basic nursing practices. All though I feel like I am able to communicate with docs and I help out everyone and try to keep a good rapport with all the nurses because I never know when I may need something, I still feel like I am being setup to fail. The only thing that keeps my head above water is really gaging my time and time management. We still have paper charting, dinosaur if you ask me. Eventually I am supposed to go to nights but I will not have the level of confidence it seems like we new nurses are yurning for. You know if you really want to be there at this point I would have a serious regroup session with myself and organize my thoughts, figure out the routines, spend that extra time outside of work and really try hard to grasp what you feel you need. Do it for your self confidence. I chose ICU because I knew selfishly that I would not be nearly as interested in nursing on the floor as opposed to icu. However, I will say that if I could have this realistic picture I have now, I may have been less selfish and start in a Tele floor prior to icu. I didn't realize how much organization and prioritization outside of critical care learning it would be. you hear the argument saying not to let anyone tell you that you cannot start in the ICU as a new grad...aggghhh we all have to find our own cup of tea even if it is disappointing at first. So this is either a blessing or a call to rise up to the challenge. We can always be better and no one is perfect. I really wish you the best!!!!!!!!!!!
  8. JanetCCURN

    New Grad entering CCU/ICU..opinions?

    Couldn't help to notice but...I have been on orientation for about 3 months, new grad RN on CCU 12 bed small but interesting. Its not a teaching facility nor a trauma hospital but we do have open hearts. Anywho, I just wanted to say that you have a great challenge in front of you that you will love at times and maybe like instead of love at times. I cannot say that I hate it because all through out nursing school I was told to make the most out of my experiences, in other words I drive the boat on making anything my own best experience. But it is hard because you cannot control other people. Advice, find a fabulous preceptor who you will follow almost 100% of the time, go to codes and help with new high skill level pts as much as you can. I realize half way through my 6 months of orientation that I really need to step up on my pt difficulty. So far I feel like sometimes I take the back seat and sometimes im in front with everyone else. Time management is sooooo key because things change and they change fast. Hemodynamics is a headache, ive just ordered the little binder that the last post suggested, kathy white? I try to remember that we cannot remember everything but we always have drug books on the unit. I always check and double check because things change fast. Also noting the dr's orders if I see them come in I make it a point to see what their opinion is on the plan of care, what are OUR goals, they seem responsive to that so far. The more they see who I am, the more relaxed they are when you need something. I guess saying hello/acknowledging them and asking how they are doing really helps so when you need them they know you are a person too. Its building good rapport. They may seem scary at first but we use SBAR when we communicate. Always having your chart at hand, VS, Labs...etc preparation before calling and having your info at hand. A nurse told me never to feel bad about disturbing the dr at 2 am (for instance) thats why they get paid the big bucks. lol. So I always keep that in mind when I see them. They are people too. I cannot say I am comfortable as a new ccu nurse yet, but i know it won't be for a while. I always feel like I have forgotten about something or that I was not thorough enough. Its just weird to see all the seasoned nurses calm cool and collected. Im over here worrying about little minute things. Im still jumpy though always looking at the monitor for changes. There are a ton of suggestions, but really remain flexible keep your cool, trust your instinct, follow through, be patient with yourself (I am not gonna master this for a while myself), efficiency takes time, know your units P&P things in nursing school sometimes don't carry on to the unit. Let me know how you do, this site is a good outlet for frustrations and candid feelings w/o repercussions. I wish you the best!!!
  9. JanetCCURN

    When will I feel comfortable in my nursing role?

    New grad in CCU where we recover everything and anything ICUish. Feel okay but not enough, need lots of structure but I cannot expect that in the unit because anything can happen. Just making room for something messy is hard to do but I try. Taking only 1 stable pt is time consuming because everytime I sit down to chart, I get pulled aside to help some out so I can't fully focus. Which leads me to thinking I am forgetting something and then I feel incomplete with my work. (Only 2 Months in) Everyone keeps telling me, it will come, it just takes time so don't worry. but I do worry cause I am a new grad who cannot see what they see and that takes time. IMPATIENCE aggghhhh. I want it all. :-)
  10. JanetCCURN

    Peds Resp Trach Issues

    Thanks! thats really nice to know. Yup his history shows remarkable for tracheomalacia and laryngomalacia. He's got a ways to go before he completes 1yr. But his growth is actually exponential, of course due to his lil GT. Since D/C at 5mo 6.6lbs to almost a month later nearly 12lbs. We will see. I hope its not uncomfortable for him when he makes those noises, it just sounds like screetching or nails on a chalk board some times. I just wish there was something I can do.
  11. JanetCCURN

    California budget cuts

    Spoke to another recruiter and he said that this cut mostly affects LVN's, he said it was related to most of the home health type cases are medicare and RN's don't usually work those type of cases because their care usually falls under the scope of an LVN.
  12. JanetCCURN

    California budget cuts

    I was talking to a recruiter yesterday and he mentioned this bill. Of course I was concerned because Im on my way over to starting a new job at MMC in santa maria and well that population is very dense with medical/care patients. This recruiter mentioned that this particular case he was needing to fill was suffering for nursing help and he didn't know why. When he said budget cut, I asked what's the pay, he said 25/hr. To start? Or with experience? It didn't matter. That definitely was probably one of the reasons why he couldn't get coverage for his case. That doesn't fit the cost of living expense. However, he did comment and say that he didn't think it was going to pass. Hmmm? I wonder how union negotiated wages are impacted?
  13. JanetCCURN

    Peds Resp Trach Issues

    I have a lil pt who was a 24 weeker, trached, gt with fundoplication. Now he is approx 6mo chronological and 12lbs. His trach size was changed from a 3.0 Neo to 3.5 Peds. He makes these raspy forced sounds. His lungs are clear, pulse ox 95-98 on 1/16L/min O2. If when I suction, nothing comes out. When he settles back down, his sounds are completely clear and easy flowing. He doesn't look distressed, I just cannot pinpoint what is going on. His pulmonologist has heard the sounds during visits according to mom and has not made any note of it or any changes to his care. What could this be????
  14. JanetCCURN

    New Grad in Sacramento, CA

    Im graduating on the 30th and sit for boards in july. I have an ICU position in the central coast that starts in aug. They are not a trauma hospital but they like new grads and are willing to train in almost any specialty area you are interested. April taft is the recruiter, Marian medical center is the hospital. I hope this helps.
  15. JanetCCURN

    Navy Nurse Questions

    Just wondering about how to go about getting CRNA through the navy. Thats my target and it seems like the navy will definately have its greater share of experience for this type of nursing. I really dont mind all the other naval duties, I just dont want to wait for more than a year to get into a masters program. What are your suggestions on getting off to the right track before getting to sign contracts? Could I have the recruiters put a timeline and promise something in writing that within "whatever timing" I will then progress to having full orders to get my masters? I dont plan on going anywhere real soon, I just know what I want to do, with that said, i have no issues giving the amount of time needed to repay the navy. Really it seems like with the experience aspect and school repayment, its rewarding. Dan I have two kids and a husband, what would they do? Could he go to school on the government's tab while I am active? He wants to do nursing as well, I just happen to be finishing in June and he needs to start from ground zero. Last question, is it wiser to go navy after getting a masters in nursing, CRNA program and just having them pay the loans off and whatever sign-on bonus?