mouseynurse

I would be leery of an entirely online program simply because nearly all of the tasks a CNA would preform are very hands on. You can't learn how to take an accurate manual blood pressure or accucheck simply by watching a video. If it was online lectures combined with clinical hours, then I would say go for it. But strictly online, I'm afraid you would feel lost and overwhelmed trying to learn these hands on tasks on the job.

Days typically had 4, 5 was pushing it.... Ours were typically either trach/peg or complex wound care. On nights it was usually 5-6. Charge took 1-3 depending on acuity. This was at a major for-profit LTACH.

Apparently when I sneeze it sounds like a mouse squeaking, so I've been known as Mouse since I was a kid. My brother is considering getting a tattoo for me, a mouse in a lab coat with a stethoscope. :)

If that is where your heart is leading you, to the ER, I would say take the position! Do what you love to do, don't tough it out because you feel obligated to the unit. Eventually you will end up burnt out and resentful. Besides, who knows when the next time an opportunity like this will arise! Congrats on the offer btw!

I was "fired" from a FF who refused his lasix and demanded 3 20oz beverages. I did some teaching re: the need for lasix and his fluid restriction when I said "if you're not going to take the lasix, the extra fluid will make your CHF worse and make it harder to breathe." He kicked me out and demanded a new nurse. I wasn't too upset about it at all!

My favorite was when a patient called and in a very panicked voice begged for the nurse to "come quick!" She wanted a pillow...

$4 more an hour, plus half an assignment. Typically I would have 1-2 patients, usually the easy ones. Plus I was responsible for rounding with physicians, handling the pages out, 4-5 quality control checklists, and admission paperwork and wound documentation (unless the wound care nurse was still there) Personally I took the position because I wanted to beef up my resume, if it was just for the money I would have told them to shove it! :)

Hello all! I have an interview with a research hospital associated with a major university for a position in the CVICU this week! I'm trying to keep my nerves down, but I'm beginning to get a little anxious. We scheduled the interview two weeks ago, but they wanted to bring the entire cardiac team together to interview me (which I took as a good sign) and this was the soonest they could all come together. I have my resume polished and my cover letters written, waiting until Monday to print everything so they are still nice and crisp. This is my "dream job" and I've been trying to get on here for years. Any advice you have will be greatly appreciated! I'm keeping my fingers crossed and would appreciate your thoughts and prayers! Thank you! :)

I was fired recently when I called in after being in a car accident on my way to work. It was considered a late call in and put me over my "points" limit. While it's not fair, if that's the way the policy is written it is legal. My condolences to your co-worker. I cannot imagine losing a child like that.

Hello everyone! Just thought I'd pick your brains for a minute... (my apologies if this is posted in the wrong section) I was at my family dr. recently for a follow-up and the MA who took my vitals instructed me to uncross my legs before she took my BP. So here's my question, does crossing your legs actually have a measurable effect on BP? I could understand uncrossing my legs if we were doing dopplers to evaluate blood flow to lower extremities, but this was just your typical run-of-the-mill follow-up appointment which had nothing to do with my BP anyway! Also, just because I thought it was funny; my BP was 90's/40's. The MA was incredibly concerned about my 'low BP' and nearly ran for the dr. until I told her I typically run this 'low'. :)

Hey guys! I'm a new ICU nurse, I've been on this unit for about 4 months. Last night I received an admission which kinda confused me. Here's the info: (adjusted to protect his privacy) 28 y/o male, type 1 diabetic diagnosed as a child. N/V for about a week. When he arrived in the ER his blood sugar was 170-ish. Na 142, CO2 Diagnosis was dehydration from the n/v and he was given 4L NS over about 3-4 hours. Checked another accucheck and his sugar was 350's. Orders were received for admission to the ICU and DKA protocol. He was started on an insulin gtt @ 9 units per hour, based on the weight based calculation built in to the protocol. 2 hours later, still in the ER, his sugar was 64. Anion gap was still 20. ER nurse turned off the insulin gtt and called the doc who didn't give any additional orders. She called me report and I paged the doc who told me to check an accucheck once he gets to the ICU and call him with the results. Upon admission to my unit, his sugar was 120. I received orders for D5 1/2NS @ 200, 1 amp D50, restart the insulin gtt @ 1 unit/ hr, check an accucheck in 1 hour, call with results. Needless to say, 1 hour later his blood sugar was nearly 400. The doc proceeded to ignore the titration formula on the protocol for the next 5 hours (during which time I charted my ass off, cya) until his accuchecks were back down to about 175. (once his sugars were down I managed to convince the doc to use the protocol for future titration) By the time I left his gap had decreased to 17 and pH on VBG was 7.24, acetone level was still positive. My question is this: should we have been using the DKA protocol to correct this acidosis or is there another way to fix this? Obviously it was working, but it seemed as though we were putting him into DKA in order to correct the A portion of DKA... Help! I'm confused! :)

If I hadn't gotten the okay to transfer to ICU when I did, my next phone call would've been to our RART team. Out of everything she did yesterday, that's what made me most upset. You want to screw with my day, go right ahead, I'm a big girl I can take it. But don't put my patients at risk...

Thank you both for your comments. I don't want to sound like I'm 'defending' my position or tooting my own horn, but on the days when I work with any other charge nurse I am almost never behind. I just get suspicious when every time I work with her the luck of the draw is against me and only me.

Hello All! I first want to say that the majority of the nurses I work with are very kind caring nurses who have done EVERYTHING possible to be helpful and supportive. We are on a VERY busy stepdown unit but we have amazing nurses and I am blessed to have started my career with such a wonderful team. However, there is one woman, a charge nurse, who has seemed to make it her life's mission to ruin my day. For example: Yesterday we were called 2 new patients, a transfer and an admit. She took the admission and gave me the transfer. Typically on our floor, transfers are ALOT easier to deal with than an admission, so I was kinda surprised that she gave me the transfer. This time the transfer was a train wreck and ended up being transferred to ICU within a few hours of being on my floor. The pt was started on a cardiac drip I'm not allowed to hang. (I can monitor them, but I'm not allowed to start them yet as I haven't finished all of my classes with the hospital, 2 more weeks! :) ) I asked her how we would handle it and she said she would start it and have me monitor, just like we've done several times. The issue? It took her 45 minutes to come start the drip. Normally I wouldn't be too upset about this, we're a busy unit. But I literally had to follow her around while she chit-chatted with dr's (not about anything to do with the patients) and played on her phone. Anytime I asked another nurse to start the drug she jumped up and said she was on her way back, took the drug from me, and sat back down. After 6-8 phone calls I finally got the dr to agree to an ICU transfer and we got her to the unit. I wouldn't think anything about it, except that later in the day I overheard her telling one of the aides that the patient she was supposed to get from the ER signed out AMA, but that she had expected that, the patient is in the ER frequently and ALWAYS signs out AMA. (her words exactly) I brushed it off and worked my butt off to get caught back up. With the transfer I had fallen behind on ALL of my other patients. Later in the day we had 2 more patients called, a transfer and an admit. At that time we had an LPN and an RN who were up for patients. In my state, LPN's cannot do the admission assessments. Who does she give the admission to? The LPN. One of my patients rooms was right in front of the nurses station. There were 3 other nurses sitting at the nurses station charting, I was standing outside my patients room getting ready to give meds. She proceeds to ask me to do the admission for the LPN. (To give an example of the wonderful team we have, 2 of the 3 nurses who were charting jumped up and grabbed the paperwork, they had the admission done by the time I had finished passing my meds) Up until yesterday I had always just brushed it off as me being taking things too personally and told myself that I just need to toughen up and get the job done. But yesterday 3 different people mentioned that the charge nurse was being especially hard on me. I guess I'm just not sure how to take this. I work my @ss off while I'm there, and yet all I ever get from her is snide remarks. My boyfriend says it's because I'm a super-nurse who is making a name for myself and she's threatened by that. It sounds nice (and made me feel better) but I'm not convinced... Any thoughts/advice?

For the most part, infection control in the home is VERY different than infection control in a facility. In the home, patients are accustomed to the germs. They live with them every day and have built up an immunity. This immunity is then passed on to the infant. Now I'm not saying that major infections will never happen, as you illustrated above. But with a little bit of common sense and some soap and water, the risks are very very low.