ICU/CCU

I work in AZ too and we have been signed off by doctors to pull PT. I looked at the AZ Board of Nursing site, but cannot find information about what is in the scope of practice. They only have the meetings listed. How do you know nurses are not supposed to pull pleural tubes and can you tell me where to find that information? Thanks. I I do know that doctors have to pull epicardial wires.

Thank you for that link - interesting information. I went to a community college in IL which had a 98% pass rate for NCLEX for several years running. I have mixed feelings about how much to rely on that. It seemed that they were very hard on students in some aspects which only seemed to "weed out" people to keep up their pass rate. I wasn't 100% convinced we were taught more as much as average people were pushed out of the program. I agree with the person who posted to check into what hospitals are in the program for the schools and the hours and days of clinicals. It may seem an inconvenience, but you will be better prepared when you graduate if you had more clinical, hands on time. Practicing in the lab at school helps, but it is NOT the same.

That must be frustrating when the CNA's don't keep you informed! I think nurses who have a little concern about moving to another area is a good thing. The fact that you are so conscientious and a little worried is a sign that you will do well!

" I like the idea of being at the bedside more. Knowing that everything was done." I would say that if your hospital has a transition program and will give you proper orientation, you should go ahead and try ICU. Your post caused a bit of concern with what you said about being at the bedside more and "knowing that everything was done." You are at the bedside more, but you don't always have the time to pamper or get everything done. I orient new grads and experienced nurses to the unit regularly. I had an experienced nurse start last week and she made a comment about how she thought it would be easier to keep up with only two patients because it is hard to juggle five on the tele floor. I agree that it is hard to juggle five, but I said, "You would be suprised how busy two patients can keep you. Actually you would be surprised how busy ONE patient can keep you!" We started with two "easy" patients that I thought were well within her ability and quickly sent one to cath lab because he was extending his MI and sent the other to OR. Well, the cath lab patient ended up being our only patient the rest of the day and we never left the room - two of us! He went into failure, got a balloon pump, intubated, swan and central line, plus the addition of pressors and other drips. Even after12 years doing this, I still go home sometimes feeling like I didn't get everything done.

RN's who have been signed off on a competency pull medistinal and pleural chest tubes at the hospital I work at. I would never do it without proper training or being signed off though!

The responses were regarding transvenous pacers (TVP) and I have not heard of a hospital policy that states no turning r/t contact point of the pacing lead with them. As the other poster stated, it only has to be a small shift but turning is still recommended. Let me just add this....people poop. :wink2:

We also turn q 2 h. I agree with the previous poster, just make sure the line is secure!

It isn't easy to get a day job in CVICU as a new grad, but it can happen. It happened for a lot of new grads at our hospital last year. I think it is partially r/t luck, timing and need of day shift personnel.

I think just the fact that you are nervous, realize you don't know everything, and will have questions is a sign that you will be a great nurse! When I orient new grads I often tell them that they are not being patient with themselves. It takes a lot of time and practice to learn the basics and the learning never stops in this career. Ask your questions, and don't think any question is stupid. Good luck to you!

I was fortunate enough to get a critical care internship as a new graduate nurse and it was thorough as the one you are considering is. I feel that I was very well trained, but I will warn you that when I was initially on my own I realized there was still so much to learn! I agree that the learning will never stop and having some fear shows that you realize what you are getting into, which means you will do great! I have been a nurse 11 years now, still can't imagine working anywhere but critical care.

I agree with joeyzstj that products may be indicated or the patient may need to return to the OR. Our policy doesn't specifically cover turning, but it will help to get the blood out and it is doubtful that would cause the bleeding to increase. Our policy does state to call the CV surgeon if the pt has 100cc/h x 2 hours. If that continues, something has to be done.

I get the same answer!

I agree about buying some NCLEX books to help you learn the type of questions. An instructor I had told us not to change an answer on a test unless God Himself stood on our desk and told us to! When I changed questions, I missed them. Try not to overthink them. Good luck!

Bortaz, Perhaps with all of this discussion my statement about hiring experienced nurses was ill-placed. I am happy to have new nurses, however I work in ICU and too many new nurses at the same time is very difficult. It isn't safe either. My posts come from the place where I am in charge, the unit is full and perhaps I have one other experienced nurse working. I don't mind questions. In fact, if these nurses asked more questions of me and didn't just do everything that a doctor said without thinking, everybody's job would be easier. I do remember those days as a student and I don't want to discount that they are difficult for you, but I am not that nurse.

Wow! We aren't short staffed at all. Our hospital, unlike many, staffs appropriately. We also have people move on to further their careers, travel, CCRN, NP, etc. We hired a bunch of new grads who were at our hospital for school, so they must have thought we were ok to work with...... Clearly, you did not understand my post. I said that there is NO excuse for nurses behaving that way, but you need to understand that we get tired and need a break too. I have said "no" to having a nursing student on TWO occassions in over 11 years. I have been nice and taught quite a lot to nursing students who request to be with me and tell others to request me as well. They even chose me to be their preceptor once they graduated. I hope that you lose some of your attitude. Nurses who realize that they cannot know everything make the best nurses.