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RN, ER-Trauma/Critical Care

Content by NickiLaughs

  1. Hi all! I've been in GI for a year now. Previous to this I was ICU and ER for 10 years. We have staggered shifts from 4 PM to 530 PM and when it's time for the early shifts to go home we frequently are expected to take over mid case. My problem is that they seem to think its ok to hand off labeled syringes to us in case we need to give additional doses. I KNOW this isnt typically acceptable and I have tried to push with other staff to make it become standard to waste what's left and pull my own meds as needed. The issue is also its mod case and doc may still be collecting specimens and to take away the nurse who is monitoring and to waste seems also inappropiate. Just curious how other GI departments are handling this? I looked at the policy for procedural sedation for the hospital and it doesnt really give me the specifics I'm looking for. I personally believe if you are starting the case you should be finishing it barring any extenuating circumstances.
  2. NickiLaughs

    How does your department handle handoff mid procedure?

    Thanks brown book. I have a couple coworkers who don’t label them right so that’s another problem.
  3. Thank you! This was me 6 1/2 years ago with my first. The lactation consultant was borderline cruel in her encouragement, I felt like a failure. The exhaustion took over ND had it not been for my step mom telling my husband to "give the baby some damn formula and your wife is going to sleep right now as n long as she needs." I'm not really sure what would have happened. I admire the women who rock it,but I couldnt. Good for you for telling her to back off. I wish I had done it sooner with the first one.
  4. NickiLaughs

    Emergency Nurses Week 2016

    Love ER, I wish I'd started directly in it although ICU gave me a lot of useful knowledge. To many more! We also don't jinx by saying the type of patient we've never had if we are terrified of it.
  5. NickiLaughs

    The Obesity Problem in Rural America

    I don't trust anything where BMI is the source of obesity. I expect dry muscular farmers to beaver the BMI. The one time I was under the BMI of people kept asking me if I was sick. I started lifting weights and got a very lean body mass and fit in a size 8 at 5' 11" but my BMI was still 25.5 BMI can suck it.
  6. NickiLaughs

    The Patient I Failed

    That right there is why I left ICU.....and I'm so glad I was able to talk my grandma into honoring my grndpas wishes.....it took 3 days and she still holds a grudge against me....but he died peacefully. Beautifully written.
  7. NickiLaughs

    Confessions of a Hospital Administrator: I Feel Your Pain...Pill

    I worked at an ER where we frequently did that. If pt had multiple scripts in the California registry. The nurse and doc sat in the room together, explained we were not allowed to prescribe because of this and they needed to see their primary doc and we were happy to ensure a follow up with a pain specialist. Usually works better with both of us there in force. If we were not together they'd keep trying to manipulate one or the other. Where I'm at now I notice it's very physician dependent. I wish the rules were consistent across the board, it makes things easier for all.
  8. NickiLaughs

    CRNA Week 2016

    It is a great article. I remember when I was in an LVN program at 19 and swore Id be a CRNA but then after following one in my RN program for a day I learned that any job with absolute sheer terror and intermingling boredom wasnt likely for me. It looks like a great job for those that can do that.
  9. NickiLaughs

    Do Nurses Earn Big Money? You Decide.

    Definitely depends on location. I'm at 130k working 64 hours in 2 weeks (4 8s on swing shift). I can pay the bills, little savings and have enough to save for a small vacay yearly. Not rolling in the dough, but we do have the luxury of my husband staying at home. So huge advantage.
  10. NickiLaughs

    Magnet Designation: What's the Attraction?

    I've worked in magnet and non magnet and while there was a strong sense of community among some nurses who were involved, the non magnet, strong nurse Union facilities I've worked at have far better environments. We still have committees and are constantly improving things. But we have staff to help enforce these changes because it takes man power. Shocking...
  11. Wow classy. I was an LVN before I was an RN. I assure you the brunt of my education occurred in my LVN program. I frequently had to make tough decisions in the variety of settings I worked in. Assessment skills are very much still an important part of the job. I believe this option was intended for military health workers who had the experience but not the "degree." I've worked with several in the past who challenged after their many years in Air Force/ army and I'd trust them with my life over many others.
  12. NickiLaughs

    Do Nurses Earn Big Money? You Decide.

    Location has a huge influence. I'm probably pulling close to 140k this year, with a some OT. But I live in CA. Yes, it's hard to get a job here, because of the money. But even then, because of cost of living, I'm still middle class. I'm grateful though, i love my career, and can afford a mortgage, a nice car and things my kid wants/needs. Not everyone can say that. All medical staff should though, I had three coworkers punched a work today. Our job isn't exactly "cushy."
  13. NickiLaughs

    Nursing Salary Survey 2014

    Geographic location: nor calPay rate. 49.37/Hr In which area / specialty do you work? ERWhat type of license do you have (RN or LPN)? RN 2009, LVN 2005What type of degree and/or certification do you have? Associates initially, completed BSN 2011How many years of experience do you have? 4 years RN, 5 years LVNAre you full-time, part-time, or casual / per diem / PRN status? FTWhat shift do you work? NightsDo you receive any shift differential: 6$/Hr i made 115k with working a bit of OT last yearAre you a manager or supervisor? No thank you!
  14. NickiLaughs

    The Elephant in the Room

    Great post! Our docs are getting brave, if they see that the pt has already had recent work ups at our place, we do tell them, "you are not getting DIlaudid." Amazing the cures we are giving as they walk right out the door pulling their own IV out. I had 2 last shift...
  15. NickiLaughs

    Everyone Won't Succeed. And That's Okay!

    It's not impossible. My dad was dyslexic and a drug addict during my childhood. He couldn't even read his mail. Even though i loved with him, i had super supportive grandparents and liked doing homework. (Distracted me from my dad). I got straight As, and when I finished my RN I slept on a couch for 9 months and graduated top of my class. Ernie, if he's bright, could stay late at school to study. Supportive teachers, his friends parents and others can make a huge difference It's not easy, but personal drive, intelligence and support from someone can make a huge difference.
  16. NickiLaughs

    Nursing: The Financial Side

    One thing to add to the eating in. You HAVE to meal plan or else you will still way overspend on food and throw away a lot of food. Pinterest and other sites out there will definitely help you waste less. My grocery bills were always insane and I threw so much away until I figured this out. Plus many of us tend to overbuy food today.
  17. NickiLaughs

    "When Was the Last Time I Wow'ed a Patient?"

    Hit the nail on the head! In my ER, whenever we get someone "important" the charge will rush him back and say "be nice,". I'm instantly offended, because if you are my homeless patient or Bill Gates you get the best of me.
  18. NickiLaughs

    Fayetteville, how is it?

    Hi All! Hubby and I are looking into several states to move to possibly in the next year and a half. I am just about one year in ICU and currently finishing my bachelors. We have been living in California, and really don't like it here. I am pregnant with my 1st baby and want to raise them somewhere else, safer and with less of a focus on materialism that runs rampant here. We are looking for friendly areas where hubby could keep up his fishing possible hunting habits, decent schools and friendly family oriented communities. Does Fayetteville seem like one of those places? Thank you in advance!
  19. NickiLaughs

    "What I Really Do" meme

    I couldn't figure out how to enlarge the all nurses one. I saved it from a website, and uploaded it. If anyone knows how I'd appreciate it!
  20. NickiLaughs

    "What I Really Do" meme

    Did you guys see the one that encompasses all nurses yet?
  21. NickiLaughs

    Patton State Hospital?

    So I'm now 6 months into ICU...and I get a letter for an interview next week at Patton State Hospital. Normally, I would just trash it, but I actually really liked my clinical experience here, I thought it was interesting. (somewhat of a fascination with psych/mentally ill. Plus I know even with the budget cuts, the salaries are on the higher end and the benefits are fantastic. I was a state employee before. Can anyone give me any info? How bad are the furloughs cutting in? Is it usually 8 or 12 hour shifts for RNs? From what I remember it seemed like 8s back when I did clinicals there. Thanks
  22. NickiLaughs

    Quit stealing my stethoscopes!

    Tired of having people take them. Half the time, I'm sure it's an honest mistake, but I've now lost a total of 3 this way. An 80 dollar ultrascope, a 180 dollar littman (which I eventually got returned to me, but then my wonderful dog ate it the next week...first time she'd ever managed to climb up on the counter) and then a 40 dollar littman. All of these had my name engraved. One was very unique. I am just tired of spending money so I can take care of my patients to have them disappear. I know everyone says keep them on you. But if you have an iso patient, and you dont want to take it in the room and things get busy, it's easy to forget and set it down on the counter (which seems to be my main issue for them to take a permanent vacation). Sorry for the vent. I just need a "trick" I guess so I can not keep wasting money.
  23. NickiLaughs

    Whats your specialty?What are the Pros and Cons

    I work in Critical Care. I would say the Pro's are that we typically only have 2 patients, sometimes 1 if they are very sick. (I've seen patients be 2:1 as well and have heard of ratios of 4:1 for VERY sick patients). So because of that, our assessment skills need to be very good and we have a lot of specialized skills for our unit, including care and removal of arterial lines/swan ganz/CVP and arrhythmia knowledge. Not saying these are unique to only ICU, but these are some of the things we deal with. So because of this you have to really be ready to continually update your knowledge because different hospitals have different equipment and are always looking for ways to improve. You have to be comfortable taking care of sick patients, and I think with most floors, think quickly and be quick on your feet. I enjoy the fast-paced environment. What I like is when we have that very rare very sick patient with a small chance of survival who gets better and ends up doing to a rehab facility, talk about feeling good inside! Cons: Well because our patients are sicker, we also have more deaths on average than most other floors, I believe the average for hospitals hear in California is 13%, and that can range. You tend to have the patients longer because most of them don't recover in a day, so there is definitely some family issues that commonly occur. Good people skills are a need! I hope that helps a bit! People will have different perspectives to add I'm sure.
  24. NickiLaughs

    VA Long Beach Vs. White Memorial New Grad Programs

    I would take the VA, the salary would end up being more with weekend and night differentials, no other hospital system gives you a 25% weekend differential. I've also heard they are a great place to work and you learn a lot. And as you said, the benefits/retirement system cannot be beat.
  25. NickiLaughs

    Why doesn't the military accept online BSNs?

    I am fairly certain it just has to be a CCNE or NLNAC accredited school?