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Stratiotes

Stratiotes

Critical Care
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Stratiotes has 4 years experience and specializes in Critical Care.

Stratiotes's Latest Activity

  1. Stratiotes

    How do people feel about male nurses?

    I don't believe gender has any part in getting hired or how you're treated by employers. However, as much as stereotype deniers try to say otherwise, there are situations in which male and female nurses are treated differently. The truth is, while we as professionals may put stereotypes aside--many patients and even physicians have not. There are elderly women who can't fathom a man providing their nursing care. There are certain cultures where it is against their values for a man to see them naked, even in a professional role. It isn't uncommon for female patients to request a female nurse bathe them, place their foley, etc. Yet, I don't think I've once witnessed a patient, male or female, who didn't feel comfortable with a female nurse. And then there are times when patients who are confused or combative respond better to a masculine presence. This said, I've never once felt that being a male nurse is any more or less challenging. You simply work with your coworkers to accommodate the situations in which a certain gender would be more appropriate. I don't know how many times I've asked a female nurse to put in my female patient's foley while I offered to pass their meds or something in exchange.
  2. Stratiotes

    Disturbing Conversation on Overweight Healthcare Workers

    I think that it depends on the context. If I were a patient, I wouldn't judge a nurse's worth by his or her bodyweight. That said, I would have trouble listening to any teaching they might have to offer on nutrition and/or weight control. This would be like a nurse teaching smoking cessation while he or she smells like cigarette smoke after each break. It has nothing to do with their ability to care for someone. That said, educating people on good health habits is part of our responsibility, so I think everyone should make a good effort to practice what they preach.
  3. Stratiotes

    Health care administration - non nurses

    From what I've experienced, even those who have worked as nurses seem to lose touch once they get into admin. I'm not sure it really makes a difference.
  4. Stratiotes

    Why do you wear a white coat? (if you indeed do)

    I can't answer why normal staff nurses would want to wear a lab coat. They are hot and I would imagine easy to get soiled during patient care. I have never worn one while working as a bedside nurse. I do wear one when I am working as a clinical instructor so that I am identified as an educator (as the last poster said). I think white coats should be worn by advanced practice roles or educators. That said, I don't think it should be some status symbol, but just a means of identifying certain roles. I also don't think there should be some special rule or anything--just an understanding. I hate when people try to alter their appearance in some attempt to appear more important. It actually kind of disgusts me how much more respect I get from people when I'm wearing a lab coat as an instructor. Kind of sad that a simple piece of clothing can make people treat you differently.
  5. Stratiotes

    New grad starting out in ICU?

    I would say a lot of it depends on your personality. I think for the majority of people, it is a better idea to spend a year on a tele or stepdown floor. That said, I've precepted and worked with several new grads who have done great. I have also worked with nurses with a year + experience that didn't do well at all. There are always exceptions, but only you know you. Without any other hospital experience, I would hope your hospital offers a really good orientation.
  6. Stratiotes

    Transition from step down to ccu

    I think whether or not people are successful in ICU (or any new setting) largely depends on personality. We mostly get nurses who transfer after a year on tele, but we've also hired on med/surg transfers, and even new grads. Some do well, some don't. I think if you are one who seeks out learning opportunity and experience, remains humble, asks lots of questions, and learn who you can go to for help, you will do fine. Having a good orientation with a knowledgeable preceptor is also important.
  7. Stratiotes

    CABG recovery ratios?

    We have the same policy, but as a charge nurse, I generally would try to let the nurse with the CABG take over someone else's patient and have the other nurse take the admit. This depending on the acuity of the new admit. We get a lot of not-so-critical stuff so sometimes it is no big deal to get a new admit.
  8. Stratiotes

    1 month new ICU job. I want to run

    I'd say the ICU takes around 3-6 months (depending on the acuity level when you start which I've noticed can be vastly different at times) to even feel halfway comfortable. I didn't start feeling competent until year two! Now I have my CCRN and charge most of the time, but I still feel inadequate fairly often. That is part of being in the ICU. If you don't feel that way, you don't belong (with some exceptions). Having a good preceptor is vital. No orientee deserves having eyes rolled at them and such. I'd politely tell your director that you feel that you would benefit from a new preceptor. To avoid drama and conflict, talk to your preceptor first and let them know that you are going to ask for a different preceptor because you want to see if another teaching style fits you better (nice way of saying you suck). But sometimes it truly is just a clash in teaching/learning styles. Do not be afraid to ask for more orientation time. Some of the best ICU nurses I've worked with had a rough orientation and asked for an extension. Some of the worst I've worked with were seemingly having no issues with their orientation but once off showed that they were not ready. I'd much prefer honesty. It protects you, the patients, and your coworkers. Seek out good learning experiences. Preceptors should look for opportunities for you. Don't let them take the easy patients day after day. Take the scary ones so that when you get them off orientation you won't be a deer in the headlights.
  9. I struggled with this for several months after moving to ICU nursing. While I have encountered the rare individual who simply does not seem to learn from experience, most people do. At first, everything in the ICU is so overwhelming, task based nursing is pretty much the only way one can cope! But once the tasks themselves are easier to handle, you can start flying on autopilot and focusing more on the big picture. Furthermore, as you experience more and more situations, you will begin to develop a greater awareness of your patients. Let me give you an example. Not too far into ICU nursing, I had a post surgical patient who was breathing pretty fast. He was hurting, so it didn't concern me initially. I asked if he felt short of breath or if he was just hurting. He assured me he was just hurting. The pain medicine ordered was not relieving his pain, so I finally called for new orders. I mentioned to the physician the patient's respirations had been around 30 for a while, but like me, he chalked it up to pain. After giving the new meds, the patient reported his pain was better. Now I was starting to get concerned because he was still breathing really fast. I asked again if he felt okay. He assured me he felt much better. His other vitals were great, heart rate and rhythm perfect--absolutely no signs/symptoms aside from tachypnea. My gut was telling me something was wrong, but my lack of experience was leaving me without answers. I decided to draw my AM labs just after midnight and this guy had a potassium around 7.0. I immediately called and got orders to fix him, but in the few seconds it took me to draw up insulin, this patient went into vfib and coded. Of course, then it hit me that the patient had been acidotic and he'd been breathing fast to compensate, but having never seen such a case without any accompanying symptoms, that hadn't even crossed my mind. Another night later on, I walked into a fellow new ICU nurse's room to help her turn her patient. The patient had been fine, but I noticed she was breathing really fast. The nurse said she'd denied pain and everything else was fine. Given the experience above, bells and whistles were going off in my head. I knew this patient was acidotic and we were able to get a blood gas and determine the cause long before it became a serious problem. An experienced ICU nurse might say "Well, duh!" But, for the noob, you have to have some bad situations before you learn to recognize when patients are heading in that direction. You'll get there!
  10. Stratiotes

    Should ICU get more pay than floor nursing?!?

    Sorry to bump an old thread, but I thought I'd throw my $0.02 in. I've done both med-surg and ICU. Everywhere I've worked has a "Critical care" differential. In my opinion, this is absolutely fair. I never claim to work harder than a med-surg nurse, but critical care requires more education and skills. ICU nurses where I work have to maintain PALS and ACLS. We must train annually on balloon pumps, impellas, and other technologies. We must know several protocols like hypothermia, DKA, etc. I can't believe anyone wouldn't support at least a buck or two more an hour for specialized nursing roles.
  11. Stratiotes

    RN pay in NW Arkansas

    Actually, most registry positions around NWA are around $35 an hour. There are also a couple of PRN agencies that pay this. But, these jobs do not come with benefits.
  12. Stratiotes

    Beginner's Blues?

    I thought I'd made a big mistake by going into critical care my first few months. The fact that you feel the way you do is actually a great thing. It shows that you care about your level of knowledge and want to learn. Soak it up. I posted this one another thread... something I do is take notes of things I find confusing or want to better understand and study it later.
  13. Stratiotes

    New ICU Nurse: Wanting helpful tips

    Keep a notepad with you at work. Anytime you question something or feel that you don't fully understand a concept, write it down and study it later. Unfortunately, in my case, I run into these questions at the worst times. For example, when I was new in the ICU, we had a patient whose temporary pacemaker wasn't working correctly. It so happened that I was the most experienced nurse working that night and I was clueless as to how to change the settings. The doctor on the phone angrily walked us through it, but I vowed to learn everything I could about pacemakers after that night. Read the stuff over at index -- very helpful!
  14. Stratiotes

    Critcal care as new grad

    Many new grads have been accepted into our ICU, though it is a smallish hospital. However, we do take open hearts and stuff--so it isn't an "easy" ICU. I started after a year of med surg right along with some new grads, and I can tell you that I didn't feel that my med-surg experience gave me any advantage over them except perhaps a little edge in my time management skills and familiarity with charting. I'd say that the most important thing is making sure that you get a good orientation or residency and learn who are the best resources on your unit to seek help from.
  15. Has anyone encountered this? According to my director and verified by HR, it is hospital policy to not write letters of reference due to liability. It is nice to find this out after 18 months of employment.
  16. Stratiotes

    Discrimination against males in the nursing profession.

    I had one nursing school instructor who I felt discriminated a little against men. But, in practice, I've never felt that way.