tutu123

They are progressisve care nurses, in other words stepdown nurses. This is the transition between ICU and the floor. YOu can have hearts that are extubated but cannot go to floor, failure to weans with trachs, thoracotomies, cardiac caths, MI's, ect. I can tell you from experince that you will work and have about a 4 to 1 ratio. They are usually hardwired for monitors, have central and a-lines. Just no titrating of pressors and no et tubes.

I had an rt hook the vent up to the yellow air outlet, becuase there was a green gauge on it. I noticed that the pt sats were dropping like a rock. The rt was grateful that it was caught quickly. As we said before mistakes do happen. Always check everything if the sats are down and they are vetned. Something could be disconnected.

:DI have been a MICU nurse for 4years and I can tell you that your pt will extubate themselves even if they have restraints on. Dont be hard on yourself. You have only been a nurse for 2 years, it is a learning curve everyday. Many pts can bite the tube, tounge it out or my favorite is to slump down in bed an mange to pull it out. And dont forget that sometimes it is not secured very well. I have worked in both teaching and non teaching hospitals. Drs make mistakes, nurses make mistakes, respitory make mistakes. The point is you are human, remember to relax, take one order at time. And if you are in code do not panic, the pt is already dead, so anything that you do will not make them more dead. The point is just remember to treat the pt not the monitior and one order at time. And you will be just fine. Hang in there it does get better.

I refuse to wrtie verbal orders for a dr that is standing right there and telling me what they want. In a code or emergency this is ok but, I always have the dr write to orders. Some facilites that I have worked at have nursing orders that you can write. But the lazy dr that say write what ever you want need to do their job. We as nurses have enough to do and we should not enable their bad behaviour. The dr's are just as busy as we are. If the physican takes too long I will write a note in the chart to explain the delay of service.

I am currently on a travel assignement where any dr can admit into the icu, and all of the consultants write orders. The result is having a pt with 6 different drs writing orders on one pt. And they are always conflict with their orders. I have a hard time in following the orders. The worse part is the mds at the facility do not even like to ask for input. I have to search them out and ask what changes have been made. One of my pts the other day had the ivf changes 4 times in 30 min. The only reason that I found out was I went looking for the chart and that took 45min. I this the same all over or just an isolated incident.

Go to a bookstore and get books that are designed to give you an over view about critical care. also ask if you can shadow a icu nurse for a few days to get first hand knowledge. And what type of unit do you work on now? It is best to work cardiac tele or just a surgical floor. The managers look for nurses with experience on those type of floors. If a new grad I strongly suggest this. I helps you become organized and teaches you how to treat the pt not just the monitor. good luck

yes, I am. Good Lord the nuero part is killing me. I would like to bounce questions off other people.

:nurse:Well to answer your question, it does not happen all the time. Some areas have a higher incident than others. You will learn over time and with training how to avoid situtations that are dangerous. Remember you are dealing with humans. And people are at their worse when they or a family member becomes ill. Just because you are petite does not mean anything. If you are anxious over this relax, nurses come in all sizes and you are selling yourself short. You will fine.