Critical_Care_RN

I'd be a SAHM.

Restraint charting Mandatory meeting Pharmacy's gone(we don't have a 24 hr pharmacy at our facility. I suppose the patient can only be sick between the hrs of 7am and 8pm. Otherwise, they'll have to wait until morning) New admit Drug overdose Educational opportunity(to enhance my job performance cuz I didn't do your stupid paperwork right the first time cuz I was more concerned with taking care of the patient?) Bowel obstruction(can't stand the projectile emesis/fecal matter coming from places where fecal matter should never be) psych patient(Sorry, I would NOT make a good psych nurse) telemetry overflow Crazy family(like I have time to deal with that?)

I get that a lot too. I don't even bother with trying to argue with it for 2 reasons, 1) it IS nice to ONLY work 3 days a week and 2) those who say that wouldn't understand even if I did explain it. They are the type who think nurses sit at the nurse's station talking, playing games, and snacking all day/night. They don't realize that our 12 hr shifts generally end up being 14 hr shifts by the time all is said and done. They don't understand that our job is stressful and that we make lots of split second decisions every shift that ultimately effect whether our patients live or die and what their quality of life may or may not be. They are the type that think all nurses do is to pass pills and that the doctors are the only ones who actually make a difference for the patients. No point in arguing with that sort of ignorance.....You're not gonna win and they're not going to "get it". .... But back to the ONLY working 3 days a week...I used to work on a tele floor that had lots of mandatory OT and call days. I hated it. I moved to ICU. I work 3 days a week. Any OT is volunteer. We are generally pretty well-staffed so call days are rare. I love it. I have thought of what it would be like to work different hrs and I honestly don't think I'd like it. I don't want to work 5 days a week even if it were only 8 hr shifts. I'm spoiled to having 4 days off and I like it even if it does mean that sometimes I'm working when my friends who are school teachers are enjoying the weekend with their families. :)

Our facility only requires documentation of full head to toe assessment on ICU patients twice each shift(at the beginning of shift and halfway through the shift). However, we are required to document on every patient every 2 hrs and when any changes in condition occur. I have to say though that for most of us, it depends on the condition of the patient. If the patient is really critical, we document a lot more. If the patient is pretty stable, you can cover everything with documenting the 2 full assessments, q2h focused, with changes/interventions documented when they occur.

I was taught: oxygen, nitro, aspirin, morphine This is also how I've seen it done in practice where I work. As far as NCLEX, oxygen would definitely be first because you always want to protect your airway and promote oxygenation. The nitro and aspirin would come after that as you want to decrease the workload on the left ventricle as well as decreasing myocardial oxygen consumption with the nitro and promote reperfusion and decrease platelet aggregation with aspirin. Morphine isn't always given-depends on whether the patient is still experiencing chest pain after the nitro.

Ours are COWs too but I rarely hear people refer to them as such in the presence of patients. We usually just say "computer" if we're in a patient's room. The only time we really use the term "COW" is when we're talking to each other or if we have to call IT with a problem regarding one of the COWs. In that case, it gets even more comical as each of our COWs has a name of it's own. Some are named after cartoon or movie characters and some creative individual even named one of them "Lula Belle" :stone

Like someone else already said, start studying up and have a good understanding of preload and afterload and what medications effect those and how. Fluid & electrolytes are a basic concern on any floor but they're an even bigger concern in ICU so review those too. Ask lots of questions. Take every opportunity you get to learn everything you can. And every time you see something you've never seen before whether it be a medication, procedure, or a certain condition or disease process, learn as much as you can from your preceptor, the docs, etc. and then, when you get home look it up and read up on it as much as you can so that you solidify what you've learned and the next time you see it, you'll remember it. Also, like another of the posters mentioned, remember to follow whatever routine your preceptor has. It's probably going to be a bit different than what you're used to but most ICU nurses are OCD and they have a way of getting things done. It is hard to let go of your old routine and just go with whatever your preceptor does because you WILL see things that he/she does that you have been more efficient at in your old routine. However, if you focus on that, it will become a hinderance to your learning. If you take the time to see what your preceptor does and let thm explain to you what they do and why, you'll find that you will learn a lot of new tips and tricks and you'll end up being able to take things from your old tried & true routine and put them with the new tips and tricks you've learned from your preceptor to modify your routine so that it will work well for you in the ICU.

Just keep trying. Like mrod said, if you can't get a job right away in the ICU, try going to a tele floor and then transferring into the ICU. I worked tele for awhile before transferring to critical care and have been told that the ICU managers prefer to hire nurses from the tele floor because they are easier to train as they already have experience with many of the drips as well as having a good understanding of cardiac monitoring.

Unfortunately, that is how people are. I made straight A's through my entire nursing program but I busted my butt for those A's and yet, people had a tendency to have a negative attitude toward me if I shared my grades. I quickly learned that the best answer I could give when asked how I did on an exam or other assignment was to say " I did ok" or "I passed" and let it go. My classmates always knew that I pretty much always had the highest grade in the class but they respected that I never bragged about it. I think that's part of the problem is that, even if they ask, they don't want to hear that you made a 98 on an exam that they barely passed. They tend to feel like you're bragging if you share your grade even if you weren't bragging at all and were just giving them the answer to the question they asked. And I suppose, to some extent, I can understand.......Think how it would feel if you were the one who didn't do so well and then you found out someone else aced the exam. They didn't do anything wrong. In fact, they did everything right. That wouldn't make YOU feel any better though, now would it? Still, we should all try to be happy for those who do well. And if we're lucky enough to be amongst those who are doing well, we should do our best to be supportive of those who are struggling.

i wear nothing but nike shox for work. i've had nursemates, crocs, and quarks. all of them were ok and i didn't have a lot of "pain" even after 12 hrs but my legs and feet were really tired at the end of a shift. someone recommended the shox to me so i tried them and love love love them! i can work an entire 12 hr shift and my feet and legs are still happy at the end of the shift!

The correct answer is B. Anytime you are administering a known vesicant, you need to have the antidote on hand in case of extravasation as it needs to be given in a timely manner so as to prevent or at least leasson harm to the patient. You should always use gloves as well as always knowing the mechanism of action of any drug but again, the BEST answer is B.

I actually like working nightshift. I find that there aren't as many people in my way and I actually get to spend more time caring for my patients with fewer interruptions. The only thing I don't like is that we have fewer resources on nights.

:yeahthat:

Nursing is definitely a difficult field. However, if you feel that nursing is truly a calling for you, I say go for it. You won't regret it if it truly is a calling. There'll be good days and there will be bad days. There are lots of docs out there with "god complexes" who think they can do no wrong and will find something wrong in everything you do regardless of whether you do exactly as they tell you. There are other docs who are very respectful of nurses and will never have a rude comment. There are patients and families who will assume that they, or their family member, are the only patient you have and will be quite angry to find out that isn't the case. There are those who think "H" stands for "Hilton" rather than hospital and I even had a patient tell me once that the only difference between a hotel and a hospital was that the menu at the hotel didn't include all those good pain meds he could get at the hospital On the other hand, there are patients and families who feel they can't thank you enough for every little thing you do. And there's NOTHING more rewarding than having a patient who is very sick and seeing them recover and get better and go home to lead a normal life when the odds were all against them and knowing that you played a part in helping them to recover. There really is something special about being able to help people during their most vulnerable times. It isn't just about the patients either because while our job is to provide care for the patient, that often includes providing information and support for the families which can be just as rewarding. As for the environment and coworkers, I have worked in places where it was short-staffed and it seemed that the senior nurses always tried to eat their young but I have found that it is NOT like that everywhere. The unit I currently work on has the most amazing teamwork I have ever seen. Follow your heart. If this is, as you say, something you feel a calling for, go for it. You will do well and you will find the good far outweighs the bad and the rewards of being a nurse are endless.

It is absolutely within our scope of practice. Having said that, I will tell you that, in the facility where I work, most nurses wouldn't be comfortable doing so. There are only 3 units in our hospital that require ACLS training(ER, CCU, Telemetry). The docs run the codes in ER and do all the defibrillating there. If a patient codes on any other floor INCLUDING the tele floor, the nurse begins cpr and calls the code. They get the crash cart to the room, hook the pt up on the crash cart monitor, and by that time, the code team is usually there and will take over. The CCU nurse(s) is/are responsible for pushing meds and, if the patient is in a shockable rhythm, providing said shock unless the doc wants to do it, which he usually doesn't. The ER nurse may share the responsibility of meds and defibrillation, depending on the situation.