ChipNurse

I started in the SICU as a "baby" nurse and have managed just fine. I did work as a tech in the hospital system, so I was familiar with the charting system and did a practicum in the SICU within the same hospital system, so that may have helped as well. I also studied every day after work and looked (and still look) up things that I am not familiar with. I do not think that everyone is cut out for the specialities straight out of nursing school, but if you're motivated and willing to study, then I think that a new grad can be successful. As far as being an NP with with only 1 years experience? I do not understand it at all. I thought that NPs were valuable since they had so much nursing experience, so that replaced all the med school. It seems to me if you skip the whole bedside nursing experience thing, then what do you have to offer as an NP?

You need to advocate for your patient. Like others have said about the Heparin, ask your pharmacist to clarify. In terms of the aid, just tell her that you use a new washcloth for each body section. She may not know.

It is very possible for new grads to be successful in a specialty fresh out of nursing school. However, I do not think this is recommended for ALL new grads. I think the new grads that do fine are those who went to a good nursing school (adequate amount of clinicals, good clinical sites, ability to practice and learn skills), participated in a senior practicum in their specialty, worked as an aide preferable in the same hospital system, self-motivated and willing to study outside of work. I think med-surg is a specialty all on it's own, but is a great place to hone their time management, manage different disease processes and overall have less stress in a less acute area.

I have only seen one nurse write in the 3rd person and it weirded me out big time? I was never taught to do that in school. It seems strange and unnecessary.

I only want basic info from ER... why are they being admitted, pertinent PMHx, Baseline mental status, current vitals, Fluids, what you did for them (lasix, fluid bolus, blood, etc), did they get any scans, what labs were sent already, what was replaced based on the labs, are there meds that were not given that I need to give (ie: antibiotics). Report should take 5 minutes tops.

As a new grad it is normal to feel overwhelmed by the "tasky" things like starting IVs, inserting NGTs, foleys, etc. You will get help in orientation. Do not be afraid to tell your preceptor what you need help with. She will find you the experience. The most important skill in nursing is your assessment skills...trust me.

We use mcg/min without weight. Order is usually 2-40 mcg/min and titrate to MAP > 65 mmHg. If the MAP was 40, then I would crank it up as the flow rate would be higher and the pressor would reach the pt faster, once my MAP was about 55, I would start backing off by about 5 mcg every minute or so. Actually if my patient was deteriorating that fast, I would bolus the patient with a 1.5cc of Levo from the bag, but that probably isn't best practice but it beats cracking ribs :)

I work ICU and I don't get as many people who are complaining about trivial matters. However, it does happen more often than you would think. If you do go into ICU, be prepared for family members who can become quite difficult.

I would be living paycheck to paycheck if I spent $3000 per month

I prefer a man just because the men who perform my PAP is usually more gently whereas the women who have done my exam were a little more rough...

Yeah... where I work, the docs do not even listen to the patient as we listen to them frequently and are expected to report changes...

I started in the ICU as a new grad, but I did do a 200 hour practicum one on one in an ICU within the same hospital system, so I was already used to the patient population, policies, and charting system. I think there are many new grads that can handle starting in the ICU, but they need to be "self starters" and be very organized. It will require studying at home on your own time. The hospital needs a good orientation, that is an appropriate length of time, for new grads. The unit must also have supportive nurses that are willing to help the newbies along. If you are motivated, the hospital has a good orientation for new grad ICU nurses and if you know that the unit that you will be working in is conducive to learning, then I would go for it! Good luck!

Couldn't agree more with staying ahead on your charting. I always tell newbies that you have to stay on top of your meds and charting because it's when you slack that your patient starts to crump and then you're in real trouble...

So should female nurses not cath male patients?? Inserting a catheter is not sexual and most women do not feel uncomfortable with a man putting one in if they are professional and have good bedside manner. There are special circumstances ie: Muslim women who will not allow a man to see any part of her (except her husband) for cultural/religious reasons, which then would be totally appropriate to have a female perform the procedure, but don't just assume- they will let you know (and will usually request a female nurse right off the bat). Please do not stereotype women just because YOU are uncomfortable.

We get liver transplant, multi visceral transplant, bowel transplant, occassionally kidney transplant. We have had 2 face transplants as well. We get anything surgical (other than cardiovascular) that gets sick. We see a lot of pneumonia, sepsis, afib with rvr, post op codes, PE, etc. We also float to neuro icu and medical icu, so there is plenty of opportunity to learn a ton!