DroogieRN

My unit allows visitors from 10-2 and 4-8, with enforcement up to the discretion of the patient's nurse. Sometimes I am very strict with the hours; others, I allow family to come and go, generally, at will. We are a locked unit and the visitors have to pick up a phone to be admitted into the unit. If I am in the middle of my assessment, or I am cleaning a patient, or doing a complicated dressing change, the family has to wait. Generally, I allow them back. I absolutely do not allow them to stay the night unless the patient is actively dying. Our visitors' lounge has fold out couches and we provide blankets, etc. The size of the room does not allow for tons of people and me having complete access to the patient. I also find that I am often bombarded with questions while I am trying to assess, listen, pass meds, check neurological status, etc. I do understand that people have concerned about their loved ones -- I have been that family member wthoutna medical background -- but I appreciate the uninterrupted time that limited visiting hours affords the nurses. It is not selfishness. It is about being able to provide exemplary care without interruption. I had an intubated patient recently that the pulmonologist was trying to wean (albeit agonizingly slowly). Her family would get six inches from her face and shout, "Mom! Are you thirsty?!". Her resps would be in the high 30s and her heart rate would be well over 120. I would beg, insist, plead, that they get out of her face and just be a presence in the room and let her rest, to no avail. Fnally I made then leave from 2-4 pm, explaining that it was a rest period for patients and that they should go get lunch. They wholeheartedly agreed. Her VS were perfect while they were gone. They arrived promptly back at 4 pm, got right in her face and screamed, "Mom! We tried to come in but SHE wouldn't let us.". Patient's heart rate shot up promptly to 140 with resps At 36. Patient never was able to extubate.

I'm talking about visitors.

This is what I don't understand: no one asks the countless members of the unwashed public who traipse in and out of the hospital every day if they got their flu shots. I haven't had the flu in 25 years and I've never had a flu shot. Right now my employer doesn't require it, but we do have to sign a declination. Until they require it, I'm not getting it.

We do CRRT on my ICU. We set up and run it in it's entirety, based upon a set of preprinted orders. It's always 2:1, but they try to gmake your second patient fairly stable, although one that will remain on the unit so you won't have to have an admission. We have to take a class in it first, and be "checked off" before we can take a CRRT patient. I personally love doing it.

I am incredibly proud to be a nurse! I was you just a few short years ago, and I remember the feeling well. I've been a nurse three years now, in an ICU the last 15 months, and I couldn't be happier with my choice of profession. I think being an RN is the best job in the world and as difficult as many aspects can be a great deal of the time, if I am going to exchange hours of my life for cash, there is not another thing I would rather do than this. Best of luck to you as you start your nursing journey.

This happened to me yesterday. Still so fresh and troublesome and I'm so glad to have three days off now. Patient stable all night and threw a PE right as I came on shift. There were literally 25 family members at the bedside all a.m. In an ICU but I let them stay. Sent them out at 1400 to eat and get some rest and so I could do some basic cares. Patient crashed and died quickly afterward. I firmly believe she waited until they left.

I've been a nurse three years, but I am 48, so I have life experience to add to many situations. I don't have trouble dropping a difficult NG that may cause discomfort immediately but ultimately is for the patient's benefit. Doesn't even make me blink. I do struggle sometimes with intervention after intervention on a septic 90-year-old full code patient, because I genuinely believe they are suffering and I feel like I am only adding to it, when I think treatment should be withdrawn and they should be allowed to pass peacefully. And I have to squelch down my disdain about the 45-year-old 4-day post-op belly who won't even reach for his water glass and moans for Dilaudid Q1H when I have a World War II vet in the next bed who is eager to walk and get up after his thoracotomy and has taken only Tylenol because, after all, "well, I figured it would hurt, but lying around isn't going to get me better." As nurses, we can feel, or not feel, whatever we want about patients. No one can say any feelings are "right" or "wrong.". What matters is how we care for them.

I'm in ICU. I didn't start there, however,; I started on telemetry. You'll get lots of opinions, but I don't personally recommend ICU for a new grad -- you'll get lots of varied experiences, and develop good time-management skills, if you start on med/surg or tele right out of school. In ICU, I love that you can be incredibly focused on your two patients, know everything about them, know the docs well, and have a great deal more autonomy than is possible on a medical floor. I love the critical thinking that you can develop caring for patients with multiple concurrent disease processes. It is never boring, and things can change in an instant. I don't love that a great many of our patients die, or else are shipped off to LTAC and die there. Very seldom do I actually discharge a patient to home (usually it's a patient who has had a carotid endarterectomy -- lots of those go home from ICU, at least at my hospital). It can wear on you to lose patients week after week and watch families grieve and/or make decisions to withdraw treatment. It might be the eighth patient that week you've had with these issues, but often, for the families, it's their first time dealing with something of such magnitude.

Littmann Master Classic II for nursing school is a good scope and will serve you well. I upgraded to a Littmann Cardiology III once I hit the floor just because I was afraid I wasn't hearing everything -- at 47, maybe my hearing is going. The Cardiology is superb but it's heavy, so I am not as comfortable wearing it around my neck. I have it tricked out with a little bracelet with my name on it and follow the docs around when they borrow it. I also have an Ultrascope, which is great, but I've broken the diaphragm off twice -- not very durable if you are a little rough with your stuff, which I am.

I make about $23 per hr in OH. Less than $1 shift differential or charge pay. No pull or preceptor differential. No difference in pay between ADN and BSN.

I dunno. Maybe it's because 100 years ago people lived near/with extended families or at least knew their neighbors and could rely on these people to care for their children. Not so much anymore. My husband travels for his job and I have no one to look out for my kids nearby. My daughter is at college, but my son is at home -- am I going to leave him for possibly days alone at home while I work a disaster? Unlikely.

I don't love working holidays, but I don't necessarily mind, either. I've only ever gotten time and a half, which is better than straight time, to be sure. I'd always rather be with my family, but I tell myself that at least I get to go home to them after my shift... My patients aren't so fortunate.

I'm voting early, since I'm scheduled for Nov. 6. It takes a little pre-planning, but most states let you vote early 13 days before the election. Shouldn't be a problem.

Are you pulled to other floors to work? At my facility, we are, once we are three months off of orientation. The only nurses in the hospital who are not pulled are ER nurses. I think ICU is at least just as specialized as ER, and I don't think we should be pulled. I am newer to ICU and have spent the last six months trying to think like a critical care nurse. Totally messed with my chi the other night to be pulled to a telemetry floor and have eight patients (for the first time in my career). I am feeling a bit dejected because I feel like I didn't give great nursing care to any one of them. Just hoping for some encouragement or advice. I love my job but a steady diet of this would make me look for a different one...

I would hate to work five 8s. I realize most of the work world does this, but nursing is different. I NEED those three days away from the hospital per week to decompress and think about life outside of nursing. Maybe a nursing office job would be OK with those hours, but in a hospital? No way.

I didn't read all the replies, so feel free to ignore. Most don't stick around to waste and don't expect you to, either -- and often there just isn't the time. Don't ever witness for someone you don't trust implicitly. Probably you can count those who qualify on one hand, if not one finger...

Please don't say anything about health or personal issues. They can't ask you about them, but they'll have questions and will no doubt look for any reason not to hire you. Say it wasn't a good fit and the hospital didn't have anything open for you with your Level of experience so you opted to leave before either of you had invested any more time. Be pleasant but offer minimum details. And good luck!

None of the stuff you mention is ultimately a big deal. I'm sorry you don't have a lot of support to know this. Maybe you can find a mentor you trust and can vent with? So important! As others have said, try to stick it out at least a year. Not only will it look good on a resume, you'll likely feel better about your skill set by then as well.

>Overdoses, attempted suicides -- not for me. I have compassion but not patience for that. Other psych issues, not so bad. >"I don't take that at home." "I take that at night." "I take a different dose." "I take x, y and z. Why am I not getting x, y and z?" -- Gee! Maybe what you were doing at home wasn't working out so well, seeing as how you're in the hospital now and all. >Don't mind trachs but not a fan of any other situation ending in -ostomy. >Families. Especially when 13 people call about one patient and want the same info over and over. "Can you designate a spokesperson?" "Well, except for Tillie and Raymond and Geraldine and Homer, because no one is speaking to them.">Super morbidly obese patients. Please don't flame me. I am kind and provide the best care I can. But it is so hard to keep them clean and dry and positioned properly when they weigh 600+ pounds. Pretty infuriating when I hurt my back providing care and they want to yell at me because they have to have skim milk instead of whole for breakfast. I am human. It ticks me off.>Collecting stool samples for tests. I'd just about rather rip off my baby toenail with little pliers.>I's and O's. Hate gathering them. Hate. Oh, and insulin gtts -- right up there.

I hate night shift for what it does to my life and my body but the shifts themselves? Love them. There is something great about the night shift vibe. No less busy most of the time, but different. And no families, procedures, meals -- heaven. At least insofar as heaven exists at the hospital. :-)

I stood out in school. Did my clinicals at the hospital and on the unit for which I was eventually hired. Had been selected for a student externship the summer prior to graduation. I knew where I wanted to work and did my preceptorship on that unit -- and blatantly told the manager I hoped to work there. Started applying two months before graduation. Sent a note to the manager one month before. Two weeks later, I was interviewed and offered a job. It did help that I went to a small school, in a small town, and it was a small hospital.

An IMC is a great place to begin your nursing career! I did, and I am a firm believer than it is a great foundation for whatever type of nursing you want to pursue in the future. You will learn time management and prioritization like you would not believe, not to mention recognizing acute patient status changes and dealing with high patient turnover. Not to scare you -- your orientation should be a great intro and you will no doubt have lots of people you can go to for questions once you are on your own. It's intense, but in a good way. Good luck!

What's that?

My old facility called Code Blue overhead followed by a scrambled four-digit number, which everyone knew how to decipher as unit and room. I thought it worked pretty well. New facility calls Code Blue overhead with unit only, and select personnel have pagers that give more detail. That seems pretty efficient too.

Hoe exactly does the BON define "moral turpitude"? I'm honestly curious. I'm careful with social media and don't think I'm committing "moral turpitude," but I'd still like to know what it is or have examples.