Dinith88

If you are competent, you would do better than any new nurse. Period. You'll have experience with critically-sick patients and what goes along with all of that...so you should be comfortable when dealing when caring for these patients. You should have ACLS (perhaps even PALS) by now... Cardiac/tele/rhythm stuff should be old-hat for you. You already can run a code. You already deal with critically sick patients regularly and more often than ER nurses do. A new grad has to learn all of that...there's no way around that and a new ER nurse simply doesnt have the time to devote to soley caring for critically sick patients...as it's only a fraction of what ER does. BUT that doesnt, by itself, translate into a successful transition to ER. The ER has it's own pace and speed that you're likely not used to. You'll have to do well with large volumes of patients, (Dr's office-type patients, drug-seeking ER abusers, kids, etc,). And you'll have to get used to doing more moving/running than you're used to. You may not like that. But...if you are already a good and/or competent ICU nurse, you'll be light-years beyond a new grad. It's simple common sense. The idea that the ICU has spoiled your nursing-mind-set is garbage. BUT....you will have to learn to change your style for sure. Treat-and-street can have it's merits...and you may well learn to love it. If not, you have a incorrect impression of the ER and maybe shouldn't go.

Dude..you are totally freaking out for no reason...

And...most women (and all men) who have this attitude are at least mildly homophobic, typically lower-class/income, resentful (for a number of reasons), have poor self esteem, and a very limited life experience/world view. Without fail. Easy to pick these folks out

Hey man. Bros before Hos! YOu'll do fine.

Dont be afraid of it. I say go for it. People come to the ICU all the time who die...and will die regardless of what you do or what machine/machines we use...and...when they die it doesnt mean it's your fault or your responsibility or... Or..a better idea... lets just give up all the techno-critical-care-type important machiney-stuff...and just wipe butts and pass meds. This will then let us feel less responsible..and less afraid.

International project? Have you been talking with Xigris reps/Eli Lily? :)

That's it sissies..I'm gonna kick your butts! (cracks knuckles)

Yes Takotsubo reverses... usually within a few weeks to a few months. Cardiac function usually returns to baseline in that time. In my experience with it, an initial improvement occurs over a few-to-several days but residual HF symptoms can take longer to resolve. It's troubling because of the low EF and bump in enzymes and usually results in a trip to the cath-lab... At any rate, my limited experience involves a smattering of patients and picking the brains of a few cardiologists about it. The sickest of these patients was ventilated and on IABP...but improved...dramatically...after a few days. Hope your father's doing better...

Spoken like a new grad. I'm glad you get confused for a seasoned nurse. Kudos.

New grads can be ok going into ICU (or any other department). There's just a bigger (much bigger) learning curve than with experienced nurses who migrate to ICU. And regardless...even when a new -grad becomes a 1 year, 2 year, or even a 3 year nurse....the experienced ICU nurses can pick them out fairly quickly (not saying they suck...just that their relative inexperience can be obvious). There is NOTHING more valuable than experience. ICU 'culture' is only a fraction of what nursing is...and this core nursing-knowledge developes wherever you work....not just in critical-care...(the ICU stuff is the same as any other specialty) Throw good grades, test-scores, ambition, and everything else out. EXperience trumps them all. (well...as long as you're not a complete moron)... This is why any ICU that is run well (i repeat 'that is run well') will ALWAYS prefer experience over ambition...but...obviously, circumstances can and do dictate otherwise.

Holy crap that is the funniest thing i've read here in a long time. If i'd have posted that i would've been reprimanded by the allnurses post-police. Watch it...cuz they've got their eye on you now.

I disagree with those who are posting "...well...thats just life in the ICU....". I understand where they're coming from, in that we're constantly...daily...exposed to all this suffering and death and tragedy...and... BUT...from your post you mention that these hopeless cases are kept going/suffering for the sake of learning? And despite patient and/or family wishes the doctors (and 'baby-doctors') boldy lie to families and disregard their wishes??? Really? If you are indeed suffering from such an authentic moral dilemma, you will be complicit in this immoral activity and completely ignoring your moral 'duty' to these patients IF you don't attempt to change it. Maybe it's because you're a new nurse and not yet entirely comfortable in dealing with doctors...but if you call them out on this...repeatedly...and in front of others...the activity will likely change...you dont need to yell or be angry...(this is just one simple 'way' of changing bad doctor behavior) And never forget you're the patient's/family's agent in these cases. It's a shame you work with such cold-hearted jack-A$$es....and it's a shame that you feel powerless to attempt to change this behavior because of the "doctor-god" culture of healthcare... I hope, in your nursing practice, you reach a point where you have the moral 'fortitude' to act rather than simply wax-poetic about this suffering and injustice. Until then, your moral angst will be firmly strapped to your back...and it should be.

Nah thats wrong. The reason for this is because (forgive me if this has been stated already), In the vast majority of ICU's there are no doctors there 24/7. Yes, certainly there are many hospitals that have intensivists, and hospitalists, and etc... But in even these cases many times the MD isnt 24/7. MOST ICU's in the USA dont have this luxury. Now...keeping that in mind...the ICU is where the sickest of the sick patients are...period. Couple this with a nurse who hasnt an MD on her hip, the 'autonomy' we're talking about is born of necessity(sp?). Of course, ALL NURSES are bound and dependant on physicians orders....otherwise we'd be practicing medicine...but...the ICU nurses often-times dont have time to wait around trying track down a doctor while working with critically ill patients. If they were to wait for physician direction (which can waste considerable time) these same patients may die. As far as 'evidence' of autonomy is concerned, i'm sure ICU protocols, ACLS algorythms, etc. have been mentioned. But a better (i think) example of how an ICU nurse can be considered more 'independant' is that in many ICU's (the one i currently work in for example), the 'routine' ICU orders include various labs and tests (cbc, cxray, abg, etc.) that an icu nurse can order "In an urgent situation". This is important precisely because there is no protocol or algorythm attached to it....but rather based on clinical judgment(sp?). And yes the MD will eventually be informed and may even disagree... but it's the nature of the ICU beast. And as far as being more autonomous than ER nurses...it's simple. ER doc is always there...within earshot. And...any critically sick patient that comes through and is NOT being closely followed by the ER MD is one where patients dont want to be...!! Also, ICU nurses (ideally) only handle critically sick patients...the vast majority of ER patients are not critically sick. So...the ICU nurse becomes a specialist in this regard...because it's the only kind of patient she handles. Lastly, i think it's important to add that although there is the 'appearance' of having more autonomy, it's simply because of the work ICU does. If the ICU nurse is thought of as a 'specialist', then this pseudo-autonomy can be thought of as one aspect of this specialty. 'critical care nurse' can be applied to many nurses...including ER nurses and ACLS-trained tele nurses, etc... but the critical-care nurses who work in the ICU setting are the 'specialists' i'm speaking of.

True that! (cyber knuckle-bump...bros before hos)

Females like being laterally violent (what is that?)... or females like doing research???

Wow...i felt like i was reading excerpts from Burrough's, 'Naked Lunch'... Your story is both frightening...and (more than a little) funny (for a quasi-burnt-out-nurse...please accept my apology if that insults you). Break-out the Haldol and four-points... I'm goin on break! *wine

You make fair points. And i agree.

I'm kicking myself because i keep looking at this thread! But because i was personally insulted my curiosity gets the best of me...but wow...your post is a perfect example of what i was talking about. I cut it to highlight my point... So...my response to your post is this... You state that you're angry and your a$$ is chapped because the ICU nurse wont take report immediately. I suspect you find this with every other hospital unit...and it's not unique to the ICU...right? (if it's unique to the ICU @ your hospital then yours is unusual)....ummm.. At any rate, because this is the thing that chaps your rear...you go on to bash ICU nurses, their work, and paint them as lazy and have luxuries and calm/quiet and etc. that you cant possibly have because you're in the ER. (Do you see how this post makes it seem that your anger is an over-reaction or mis-guided or coming from someplace deeper? perhaps because of some strange 'complex'? I say 'inferiority complex' because of the tone of the arguments i keep hearing....like some broken record...And I'm NOT pegging this on all ER nurses...the confident/competent ones know they're good and dont need to insult other units/people to make themselves feel like it.) Oh...and the only thing your posts needed at the end was that while your four patients were coding and you were running with the sick kid looking to throw him at a doctor during your ER dance...was theme music...to reinforce the 'importance'' of your job. Unfortunately for all of us, drama isn't unique to the ER. And by the way...having the option to throw a sick patient at a doctor...is a luxury the majority of ICU nurses dont have. But i will bite my tongue...lest i seem to have a 'complex' :)

Ouch! You wound me with your cyber-barbs!! ignorant of me to point out generalizations? Forgive me if you mistakenly assumed i meant ER nurses are inferior. That wasn't the point. Seriously. I am a firm believer you cant judge a nurse by the unit she works in. (re-read the previous sentence) And although you call me ignorant (i would argue against that), it's funny that you want me to bring "evidenced based logic" into a post about my opinion....what?!? What?!? Would it make you feel better if i said ER nurses are superior to ICU nurses?...because "you have seen it the other way around." (your words)? Really? Did you really say that? I was kinda laughing when i read your post. You sound angry. And suspiciously like you have an inferiority complex...driving your anger...and comically like my generalizations...

This post...and the bazillion other posts like it share common threads...and can kind-of shed light into the roots of this 'cross-unit animosity'....just read them.... First off, it's a generalization...specific to YOUR hospital...and the people YOU deal with....different levels of this garbage probably exists most everywhere...but to different and widely varying degrees. When it comes down to it the 'classic' struggle between ER-ICU most often involves two (fairly common and sadly juvenile) personality-types. 1) The super-busy ER-nurse who sees a gazillion patients a day...half of them are sick...the other half are system abusers...she tries her hardest to keep things moving and doesnt have time to hold patients in the ED. During report/transport she catches flack from the condesending(sp?), anal-retentive ICU-nurse who is often-times rude and insulting. The 'hatred' she developes for the ICU nurses is based on her INFERIORITY COMPLEX....like it or not. 2) The super-busy (in a different but no less real way) ICU-nurse thinks she's being abused by the ED nurse who cant give her a few extra minutes to prepare the room and wrap-up some loose ends. She thinks the ER nurse is stupid because she hasnt all the answers the ICU nurse wants...and has a flippant attitude about what the ICU nurse feels is important. Her 'hatred' for ER nurses is based on her SUPERIORITY COMPLEX...like it or not. Now THESE GENERALIZATIONS are just that...generalizations....but are none-the-less the steryotypical personality-types who rant about this stuff and have strong feelings (hatreds) for the other units' nurses.

really depends on where you are geographically. Around here, there is a 'glut' of people wanting to become nurses...so schools are very selective. Meaning they typically take those with the best GPA's/records...it's unfortunately fairly common for students to get stuck on a waiting list and in a 'pre-nursing' limbo....where you work on pre-req's and electives forever...and ever (years)...and it discourages lots of people to the point of quitting. But...as someone said...if you're serious and determined...you can become a nurse...even if your path to reaching that point isnt how you envision or want it to unfold...

Yes! ...but you should qualify that by stating that it only helps if the patient is calcium deficient (as is fairly common s/p CABG). It wont 'do the opposite' and raise BP otherwise...

YOu're male. Middle-aged women nurse-managers seem to prefer male-nurses over female-nurses if they have a choice...even if the women are 'better' qualified. This is,of course, an opinion based on personal observations... but... i'm, right.