sabRN2b05

Are you a single parent or are you married? How many kids and how old? Not trying to be nosey, just trying to get more detail about your family. Are your kids younger (toddler, preschool) and more dependent on you or older (upper elementary/middle/high school) and more independent? Your home life is going to be a major factor. My husband is a cop and he works 12 hr shifts (days) and I work nights (12's also). I try to schedule my shifts to work the nights that my husband is off the next day (hope that made sense). That may not always work out....have to get to the "plan sheet" at work when it first comes out. 1st come, 1st serve. Everyone has their own thing, but here's what I do. My first day on, I have usually slept the night before (generally don't stay up on my nights off), get up the next a.m. and take my son to school (unless hubby if off and takes him). That's only a 20 minute round trip, so once I get home, I get housework/laundry done PRN, errands, etc, then get a nap the latter part of the morning around 10 or 11 a.m. for a few hours or until time to get my son from school. We are fortunate enough to belong to a car pool in our neighborhood, so sometimes I just make arrangements for my son to ride home in the afternoon. Same goes for if I have worked the night before, and my husband has to work that day, then I make arrangements for carpool in the a.m. The mornings that I have worked the night before, I make no plans when I get home (errands, housework, whatever)...I just get a shower and crash. I am usually asleep by 0830 and wake up around 2-3pm. I try to make supper before I go to work so I will have something to take with me. Sometimes my husband will cook something quick and easy (like tacos, sloppy joes, casserole, etc) if he's off. Crock pot recipes are wonderful!! If my son has something at school during the day (field trip, class party, etc), I try to request off the night before or swap with someone. Again, gotta get to the plan sheet 1st and hope I know about these events when it comes out!! Adjusting to nights is difficult for some. You either love it or you don't. I transferred to ICU this past July. My orientation was also on days and I switched to nights about 6 wks ago. I had to take a night position to get my foot in the door. I did nights before on med/tele as a PCA while in nursing school, and I hated it then. I have done days since being out of nursing school (5/05). I think the night shift is more laid back, and I am adjusting well. Pts in the unit tend to keep you very busy, so the shift flies by, but it is also (sometimes!) a slower paced environment (i.e., no docs rounding, no procedures unless emergent, what others have said about PT, ST, OT, etc), so it is easier for me to learn. Also, you'd be amazed how you can stay up when there are other people around you doing the same.

Did you say "type A?" ....gee, I've never been called that!

I am glad someone else asked...I was wondering myself

Don't ever change either...had another nurse that I worked with on med/tele who was such a b**** one day about all the stuff that I had in my pockets. She told me that once I was a nurse about a year, that I would quit carrying all that. Well...I've been an RN for 17 months and my pockets are still full!

I have a "Critical Care Made Incredibly Easy" book, a "Hemodynamic Monitoring" book, drug guide, my journal, makeup bag, personal hygiene items (toothbrush/toothpaste, hair spray, makeup, deodorant - hey 12 hrs is a long time - feels good to freshen up midway through the shift if time permits). In my pockets, I have alcohol preps, pens, hemostats, scissors, hi-liter, black marker. On my stethoscope I have another miniature light that is velcroed around it (in case pen light goes dead), and a roll of tape. One of the more seasoned ICU nurses that I work with was picking on me the other night because no one had a black marker except me (she was needing one). Always find the newest nurse around and she/he will have everything in their pockets!

I started in ICU about 3 months ago (1st night off orientation is tomorrow night - scared to death!!). Shortly after I started, we had a code and my preceptor made me get up front and center (another RN had the pt that day). I pushed the atropine and epi that brought her back. She was the cutest little old lady in her late 60's - lots of medical issues including a rare genetic disorder and multi-system organ failure - don't want to give much detail due to HIPAA. She was a med code only. I was so excited to get to push the meds that I did not even pay attention to the pt's name or anything. I was even more excited when she went from asystole to sinus rhythm. A few days later (or maybe a week), my preceptor and I were assigned this same pt. After I got report, I realized that it was the same pt that I had "pulled back from the light" and I felt so GUILTY. There were lots of family issues....pt was going to die. It was just a matter of time. Family looking to the oldest daughter to make the decisions (make a DNR, turn off ventilator?). I was working 3 in a row and I knew it was going to be a very emotional 3 days. I just kept thinking I wish it hadn't been me that had kept her from dying the previous week. I had a really difficult time with that. I felt guilty for being so excited about that code (it was my first one in the ICU). Luckily, I had a wonderful preceptor who gave me a lot of support to get through those feelings. Suffice it to say that the family took baby steps from med code to DNR to stopping dialysis (after recommendation from nephrologist) and finally to pulling the ventilator over those 3 days. No one wanted to make the decision individually and they finally came to a decision together as a family on what to do. The pt remained intubated but placed on a t-piece my last day with her. I watched the MD turn off the ventilator (happened toward the end of my shift) and I cried with the family. I made sure all day that the pt had Morphine to keep her comfortable. I am one of those nurses that will keep pushing it (i.e., q hr, q 2 hrs, etc) in an end of life case as long as I have an order. At the end of my shift, I gave all the family members a hug, wished them all the inner peace and strength, and told them they would be in my prayers. The pt died peacefully the next morning surrounded by her family. They came by the hospital on Monday, brought a beautiful cake for the staff, thank-you cards for me and my preceptor with gift certificates inside to a nearby restaurant. They looked so at peace. They were smiling and gave us all hugs. It was a proud moment for me to be a nurse! I stopped feeling guilty for "pulling her back" that previous week, and told myself that her family needed that extra time to process what was going on and be at peace with one another. BlueEyed RN, I wish you all the inner strength and peace in your job. Someone else mentioned keeping a journal. I was doing that when I first started in ICU and it helped me A LOT! I also called other nursing friends when I'd had a bad day (believe me, there have been several along my 3 month orientation!) And, this web site is great to come to when you need to vent, need support, and just need to read that someone has "been there". Best wishes!!

I can't stop laughing at this one!!!

:yeahthat:

My test cut off @ 75 questions but 2 of my classmates that I know of took all 265 questions (they were devastated!!) and still passed. Just think positive!! Let everyone know when you get your results!!

Chadash, I firmly believe that you are going to be a great nurse!!

I agree! Marie, you just tell it like it is!!! My kind of girl!!

All our charting is computerized (even med administration)..I love it!!

Got my results in 2 days!!! 6-8 wks....UGH!! My m-i-l is a retired RN. She took the paper and pencil boards.

This is how I am getting ACLS certified too. American Medical Response has a class that I am attending in July. Our hospital had a class scheduled June 8-9 (and I had specifically asked off those days to attend!!) and then that got postponed until next week and I will be on vacation :angryfire (Destin, Florida....woo hoo!! ). A couple of other hospitals near where I live are also having theirs next week too!! And one hospital told me that they issues just getting their own employees certified (not enough classroom space...classes fill up too quickly), much less certifying non-employees! I feel your pain!! Hope it all works out for ya!

HAHAHAHA!!!! I'm there! I was off yesterday, thank goodness!! Can't wait until July 22 to transfer to ICU!!

At our hospital, our docs/nurse practitioners are responsible for checking a box ("C" for continue and "DC" for discontinue) on the MAR and THEN they have to look at the "home meds" sheet and check "C" or "DC" (e.g., some drugs may have been on hold at admission, dosage changed, etc). Of course, some docs had to be "broken in" when this process was first implemented. It was a royal pain in the a** when it first started, but soon they became used to it. We still have to go behind them, make sure everything matches up (e.g., they may check to d/c something on the MAR, but then continue it on the home meds sheet, or they may check continue on a drug that the pt was not on at admission and then the MD forgets to leave a Rx for it when the pt is d/c'd.). Quite tedious, but I understand the rationale behind it. Never heard anything about the rationale thing you are talking about....not really within nursing scope of practice IMHO.

I used a Prestige dual tubed stethoscope in school (bought it in the bookstore on campus)...forget what I paid for it (maybe around $15-$20). I used a Littman lightweight right out of school. Relatively inexpensive (around $40). Like a previous poster said, stay inexpensive for school. You can upgrade when you get out. Within about 6 months of my graduating , I upgraded to a Cardiology III and I am happy with it.

I've had insomnia on and off for MANY years! I've tried OTC stuff (Benadryl, Nytol, Sominex, Melatonin), just ended up hungover or wired (esp with Benadryl). Ambien does not work for me. One of our internists was nice enough to give me a Rx for Lunesta recently (all the advertising on TV got me interested). It seems to be working well. I don't have to take it every night, generally just the days that I work (7a-7p). No hangover effect...and it works fast. I know we're not supposed to give each other medical advice, so I'll just say see your MD about your insomnia. Seems like different things work in different ways for different people. Good luck!!

I understand your point. Our unit is very "educational" and "hands on" with our techs/PCA's as far as helping with procedures (hence, the word "helping"), but I am not saying that they should be able to do all nursing skills, just a few (and I do understand the complications of pulling IV's, PICC's). Of course, if even our hospital were to put in-services in place to train our techs, some of them would fight it (they enjoy just doing v/s, baths, linen changes, peri care, etc.). NOW, of course those techs that work for us that are nursing students (which there are several) would jump at the chance to get more experience.

Valuable advice!! I learned that in nursing school from my experiences with some nurses in clinicals (those nurses/nursing instructors who would take you under their wing, let you jump in on procedures, and those BAD nurses who snubbed you because "you're in your last semester and you don't know how to ________!) I remember(ed) that when I graduated and I strive to treat PCA's and SN's the same as I wanted to be treated when I was in that position. Don't EVER forget where you came from.

I have been a nurse just over a year now and if it's any consolation, I still get nervous when I start IV's but I am gaining confidence daily. Used to be, I would just go get a veteran RN and not even try to start an IV if a pt had bad veins (which most of ours do!), then slowly, but surely, I would make myself at least try once before I gave up One of my co-workers (9 yr veteran RN) has been on a "losing streak" recently with starting IV's and drawing blood and she has been coming to get me to try for her. Pay back for all those times I came to get her when I first graduated nursing school last year!! Another confidence builder for me is that I got 2 out of 3 last weekend for her!

The hospital that I work at has somewhere around 400 beds. We DON'T have a program like yours, but I will certainly bring it up in the next staff meeting as an FYI. Stupid question but what is a midline?