stressgal

And here I thought I was the only one who had a rough week, lol. Our facility, including critical care has open visitation, anyone and everyone can visit at anytime. We had been told by management that we would "always be backed" if we needed to ask visitors to step out for patient care. That only works until a visitor doesn't want to leave. All demands from "customers" seem to always be granted. Let's face it, people are less respectful and more agressive. Seriously thinking of a career change too.

Love my Tarascon Pharmecopeia pocket giude. Small, fits in my pocket and has all the info I need. I also have the Critical Care pocket guide. I must say these are my FAVES, and I do tend to buy lots of reference guides :)

Yes and absolutely

A few thoughts from an ICU staff nurse, charge nurse, preceptor, and clinical instructor for 4th quarter ADN students in the ICU: As a liscensed RN I am responsible for the patients assigned to me during my shift. As a liscensed RN precepting students I am responsible for patients and the student assigned to me As a liscensed RN precepting new grad RN's I am jointly responsible for the patients and trainee assigned to me As a liscensed RN teaching students in a clinical setting I am responsible for their actions, assessments, charting, medication administration and any care provided. Maybe it is different in your state. As a clinical instructor I will only pass medications with two of my students per clinical. I am responsible if there is a med error. Once again I teach in an ICU setting. My students do nothing invasive without me at their side. With that said, it sounds as if you are developing effective critical thinking skills. The more assessments you complete the more thorough you will become. It will in time become instinctive to assess the patient completlely every time you enter the room. Chalk it up as a learning experience and move on. Good luck in your future studies. Keep up the good work.

I would save my money. Hospitals will pay for the certification once you are hired. In my area it would not make you more "marketable". We actually don't allow our new grad critical care nurses to take ACLS until the have been on the floor for about 6 months. Once they have a few hours on the floor they have a better understanding and retain more information. In this job market we hire new grads based on previous employment within our facility, job performance in that position, or through their final semester preceptorship.

Each department at our hospital wears a different color scrub. The uniforms are provided by the hospital, pretty much. We get an allowance annualy and if we want to spend more than that they payroll deduct. I like knowing who is in my patient's room, be it phlebo, radiology, tech or whatever. I think it also assists with security. I may see someone in scriubs but can easily identify if they are an employee or not. Our dress code is pretty strict when we are not in scrubs, say attending a staff meeting or ed day. No open toe shoes, no capri's, sleeves on shirts, no jeans and so on. I chose to work there, pay is good and location is important to me, so I comply.

I work Intensive Care and here is how our shift change occurs. The off going charge nurse gives a brief report to all nurses coming on shift on all patient's in the unit. These include dx, drips, rhythms, O2, chem sticks, treatments etc, takes about 15 minutes for our 13 bed unit. On coming charge nurse hands out assignments and walking rounds are completed between off going and on coming nurse. There was a lot of resistance from staff about walking rounds initially but I love it. We have a lot of new grads on our night shift and I think it is a good time for all nurses to visualize, ask questions and transfer information. Of course we use common sense and may report sensitive information to each other away from those who don't need to hear, I think the example was given earlier about a patient not being aware yet of a diagnosis. When I have floated to the med surg units they just do walking rounds without the initial group report. They have up to 8 patients per nurse and it works for their situation.

I agree with the above poster. New grads are very task oriented. Nursing often does not allow for a set "routine", some days you are simply stamping out fires as they occur. With that said I attempt to take report from the off going nurse, doing so with walking rounds helps me lay eyes on the patient, address any urgent needs. Then I glance at my labs, grab meds and head in to assess the patients. Usually after that it's about time to check my new orders, and then reassess my patients. Some days go better than others. Some days I have radiology, physicians, pharmacy and whoever else coming at me in all directions. It really does take time to find your groove. But as the above poster stated, try to find ways to streamline your tasks. It's a 24 hour day and everything will get done eventualy.

Our facility invested in the "Vocera" system. Basically it is a cell phone that we wear around our necks on a lanyard. It is a hands free device that works on voice activation. It will announce the caller and ask if you can take the call, you simply answer yes or no to connect. If you want the calls to be private you must wear a earphone. When we got the a couple of years ago we were hesitant. Recently the system was down for a couple of hours and boy did I miss it! It is so beneficial to call for needed assistance when a patient starts circling the drain. We do not transfer "family" calls through the system, I think that would probably send me over the edge.

Congrats!!!!!!!

My understanding is they have the same purpose/action. Calcium Gluconate is perferred as it is less irritating. Still nasty, worst infiltration I have ever seen.

Good Job!

No raise for us this year but the Hospital did cover the rise in insurance premiums. I do participate in the career ladder program and will see a couple dollars/hour increase from that. We too are running a tight unit/hospital with staffing and are taking low census on occasion. I think it has come around every couple of months or so. I'm not complaining my turn happened this past Thursday. Thanksgiving, my holiday to work and I was told to stay home. I refuse to get too involved in what management gets monetarily. I have worked management and they can have it. I cannot think of a business that I have ever worked where management and hourly employees would see equal benefits. Just my experience.

I studied for about 2 1/2 months with the Laura G videos and Pass CCRN questions. I spent a little bit more time as I work in a 13 bed community hospital ICU. We have about two baloon pump patients and a handful of PA lines annually. I passed the first time, but boy was it the hardest test I have ever taken. I am preparing to study for the CMC certification over the winter months. Good luck!

Stay strong and put in the time. I too faced challenges as a new grad in the ICU. That was over 4 years ago, now I have earned the respect of my peers. Believe me, it isn't easily given. A couple of the "seasoned" tough nurses have retired, a couple others now ask me for advice. Pretty cool! Lead by example. If you ever need an attagirl, pm me.