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You can also take the ACCN course called Essentials of Critical Care Nursing (ECCO).

At the facility I work at, we are floated from ICU to the floor frequently. What is the most frustrating is when there is a 2:1 ratio in the ICU with high acuity then you float to the floor its a 3:1 or 4:1 ratio. I personally think when this happens ICU nurse are just being miss used, especially when the ICU could use the extra help. I personally do not mind being on the floors, but I prefer to be in the ICU. The one benefit of floating to the floors is creating relationships with the other nurses, which will improve communication when a code or RRT is called.

I work 12 hour shifts. I eat when I get up at 5p. lunch is about 11p and dinner is about 3a. I usually drink at least 96oz of water during work. I may eat a small snack on way to home (I drive an hour), but nothing big before bed.

There are plenty of CEU courses for ekg rhythm interpretation that you could take. ACCN offers an online EKG interpretation course too. I personally have learned the most by asking my fellow coworkers about various rhythms when I was a new graduate. I would also pull up various cardiac related videos online on a regular basis. Learn your basics first. normal sinus rhythm. sinus tachycardia. bradycardia. atrial fib. atrial flutter. SVT. v.tach. v.fib. what do PVCs look like? what do PACs look like? learn various heart blocks (1st degree AV block, 2nd degree heart blocks, 3rd degree heart block). when you learn each one review on interventions. if you have your pathology book from nursing school, review the cardiac chapters. I also use to carry a cheat sheet for Basic Cardiac Rhythms. here is the information that is on it: SR R-R regular; one P wave for every QRS, HR 60-100 SB R-R regular; one P wave for every QRS, HR ST R-R regular; one P wave for every QRS, HR >100 SA R-R irregular; P, QRS, T present 1st degree AVB R-R regular, one P wave for every QRS, PR >0.20 2nd degree AVB, type I ( Winkebach) R-R irregular, progressive longer PR, then a P with a dropped QRS 2nd degree AVB, type II (mobitz) R-R irregular, PRI remains the same, then P with dropped QRS 3rd degree AVB P-P regular, R-R regular but no communication with P & QRS BBB QRS >0.12 A.fib R-R irregular, P waves not seen, controlled rate if 100 a.flutter sometimes R-R irregular, sawtooth P waves PJC premature early beat with no P, upside down P, short PRI PAC early QRS, P & T wave sometimes on top of each other PVC QRS complex wide >0.12 and premature V-fib no organized electrical activity. NO PULSE V-tach regular wide tall QRS complex, can be pulseless Junctional R-R regular but no P wave, PR Junctional Tachycardia HR >100, no P wave, P wave inverted, or P wave is behind QRS, PRI hope this helps some.

For certifications such as ccrn va will only give bonus. It does not do anything for u if u looking for a step increase but does let them know u are will to keep up with extra continuing education which is part of annual proficiency

They hire new grads all the time. You should look into the VALOR residency program and go to the usajob.gov website to look for openings

That it is as you discussed but truly the best part is having the HONOR of taking care of the men and women who have fought for our freedom. The best job ever is taking care of veterans!

There is not true difference when you get to the basic caring of a veteran vs civilian. The difference is to understand that these veterans often have various chronic illnesses and various psychological problems. Veterans are often labeled non compliant and withdrawn. They also can get aggressive quickly and frequently. Combat veterans are definitely different than veterans who have not been to war and have the most issues per se. Many times veterans have control issues because when they feel like they do not have control over the situation they are in danger. You must remember some have faced death on various occasions. They also need their psych meds if they have been on them long term. Taking care of a veteran who is going through a blind PTSD exacerbation can be the fight of their life at the moment and people have a hard time understanding. They can be very harsh in tone and sometimes you have to give the harshness back in order to be considered someone who is trying to help. It's not easy to brake their shell but it is essential in order to find out what is going on and many times things are occurring because they do not want to be consider WEAK. Military and veterans are taught from the first day of boot camp that they are weak if they are sick or injuries and they are WEAK if they need to go to a doctor. So many wait until they are so sick they cannot do anything. Taking care of a veteran it is important to give them options so they can have some control, explain things to their understanding so they can trust you and this will often decrease their noncompliantness and anxiety. I work with various veterans in a VA hospital, married to a combat veteran and lived the military lifestyle, and have many family and friends who are combat veterans. Life is different and it is often not understood what they have experienced and seen in their lives. They do have very unique issues that are often overlooked by some Heath care providers. So it's not really that you care for military/veterans differently you just need to take a more holistic approach to care and treatments.

Fyi. They will require you to give current employee information and they will contact them before an offer. I tried to get around this with no luck. I ended up going into my manager at the time and telling them flat out what was going on. She was not necessarily happy but understood. They contacted them and I had my job offer by the end of the next day.

Ruby Vee- I am glad to hear your hospital has a good orientation. I started in the operating room and my orientation was horrible and then I went to the icu. I got a much better orientation but things are still lacking. I do think some high turn over has to do with orientation and the support new nurses receive during the bringing months of their career. I have also heard of many other hospitals that have poor orientations. I do agree that many new nurses take the first job they are offered and leave when the Job they want opens up, but that is not always the case. Some really leave because of the lack of support on the unit, poor orientation, and others staff treating the newbie poorly. My opinion

I personally think there is high turn overs because of older nurses eating their young, poor orientation and follow up from the educational departments of the facilities, and lack of communication of who to discuss problems when they arise or actually action to these problems. If small problems are not fixed, bigger problems will come in the future. This also relates to less experienced nurses (aka. new graduates) because many are trying to figure it out and ask questions, but no one is wanting to mentor or answer those questions. How can nurses learn what they need to with this and why would the "newer" nurses stay if they are not getting the support they need to be successful? This topic can continue for hours...especially with the increased interest in the area of improving healthcare systems, improved patient safety, and actually identifying the reasons for the high turn overs in the are of nursing.

I love working in the VA I am employed with. There are problems everywhere, but it's the patients that makes this job the best. Maybe I am bias because I have a military wife myself, but I don't want to work anywhere else ever again.

"When am I going to die" is a very tough question. Any more I honestly say " I dont have an answer because an expiration date was never placed on your rear" . Yes it is probably not the best response but every patient will look at me like I am crazy and say " I guess you are right" . My coworkers get a kick out of it all the time because of how bluntly honest I am with the patients. I am sure some of the acceptance has to do with working with veterans too.

I don't have children myself but I work plenty of mothers with numerous children and small children at home that work nights. Some sleep after spouse gets home some take naps during the day some sleep a few hours a day. Depends on what works for you. We work 12hr shifts. Definitely make sure to take nap before work. It will help get you through and eat well balance meals.

Remember danskos are all made individually so need to physically try each pair on before buying. One size 39 May fit differently than another pair of size 39. I have the professional xp and the regular ones and the xp version is a lot different fit. I wear danskos at work and home. I love them and don't have so much back pain like I had with tennis shoes