akvarmit

Hi OP and GaJen! I just returned to the ED after a hiatus of 8 years on a PCU unit. I am copying down all the wonderful comments here and from other threads to read when I have my OMG moments. I keep saying "I know enough to be dangerous" but I need to stop that. I ask a ton of questions, even as an experienced nurse, and I'm learning who the go-to-gurus are in the unit. Hang in there, it does get better, the brain needs time to digest and store everything we're encountering.

[quote=MillennialNurse;9114160} Thanks everyone! It helps to know that I'm not alone. I'm trying to just ignore the comments, accept that I'm there to gain experience and not to make friends. It's hard when you don't know anyone in the area, so you literally have no social life or support network. All I do is work and go home. That kind of stinks. You've gotten some great "work" advice, I just wanted to toss in a hug because I've been there, done that. Pat yourself on the back for uprooting your life and changing everything! I did the same thing at 39 yo, moved 4600 miles away and it took me at least 8 months to find my groove again in life. On my days off I shut the door on the job in my mind and explored everything I could about my new home. One night I did have a big tear-fest and hubby told me to get a puppy. I hiked my girl far and wide and made this place "my home" and that helped. I also used Meet-up.com to find book clubs and hiking clubs. Own your skills and your new place :-)

Everywhere I've worked two nurses ALWAYS check blood/identifiers/unit number together before each infusion.

Hi Lovely - I personally think there is a big difference in cardiac or neuro nursing. I love cardiac - it's very measurable and you get instant gratification from giving IV drug therapy. (when it works ) For me neuro is very un-measurable and in acute care you don't often see the results of your interventions at all. I hope that makes some sense and maybe helps you pin down what type of nursing activity you like.

I've heard of the facility, it's just up the road...but have no real info for ya, sorry! Dawn

Umm from what I'm aware of, no, UAA is it. I think there's a LPN school, too, but I see little hiring of them in the hospitals. I have also heard there is a big wait list due to UAA being the only nursing program..... Hope this helps!

Hi all ! I haven't posted here in a while.......but I relocated to Anchorage last year and the hospital employing me paid the relocation expenses. (Otherwise, we'd never have been able to afford the move ourselves.) Don't forget the Anchorage hospitals - there are 3 here. We used to use a ton of travel nurses, but we've eliminated almost all of them and hired on permanent staff. It's beautiful, wonderful area, wonderful people! Dawn

I have found that casual/registry positions sometimes come with less oritentation than a regular position, and might leave you feeling even more overwhelmed. Check in your area for which hospitals seem to need staff the most....maybe be willing to take any position you can get.....and if you can get an interview honestly share your career goals and desires. Basically "if you give me the chance and training, I'll make it worth your while ......" 10 years is a bit of time to be away from the bedside. You might be amazed at the changes in meds and treatments! I also left acute care for a year and was amazed and how fast my brain cells forgot stuff!!! I had done ER before, and I got an ER position in a small, small facility with a great staff, and got my skills back up where they needed to be. But it still took time to regain that level of comfort. Dawn

aknotted - Thanks for your reply - all good info! The cruise is one part I'm definitely looking forward to Heck, I'm looking forward to the whole process! I'm so excited I could bust, then I get butterflies and want to puke! Just a healthy respect for the adventure we'll be on. I'm really looking forward to working up there, too, and the new experiences that will bring. Leaving PA officially Oct 11 - arrive Anchorage Oct 30th. Will keep in touch.......

Thanks AKnotted! We have a few days in Seattle & Bellingham waiting for the ferry, so I may check out the shopping there to kill some time. Dawn

Thanks for the messages here from the AK nurses! Our plans have finally come together, our house sold, I have a temporary license for AK and a job offer. We'll be hitting AK in 2 months, looking forward to it! Can anyone tell me if there are uniform stores in Anchorage, or am I better to get a few more scrubs here before I go? Dawn

Dang........I even subscribed to this thread so I can keep an eye out for the answer..... or rather, what the OP's prospective employer THINKS the answer is. ShEEsh. Since Florence N's day, nurses and administrators just don't get each other Dawn

There is a fine line between complementary and quackery! When I did health lectures at an in-pt drug and alcohol detox unit, one of the patients asked me about doing colon cleanses...... he saw the ads all the time on tv at 3am, because, of course, he was up at that time dealing and using his drug of choice. I used that as a teaching opportunity - that in the presence of ALL the other life changes he needed to make - he got sucked into the "fear of the unknown" colon cleanse ploy! I have always used the example that "all natural" doesn't mean safe. Poison ivy is natural, but has it's obvious bad effects. Kava Kava is another example that bought some people liver transplants when it was mixed with RX anxiety meds. I just don't trust that the people bottling the unregulated "natural" stuff really have MY best interests at heart Dawn

Magnolia- #1 - Definitely call your Board of Nursing and find out if your practice act allows you to give those meds. Here in PA, LPN's are NOT allowed to push any IV meds, they can only start IV's and do IV piggybacks, such as antibiotics. #2 - I also believe needless systems are mandated now........I'm thinking you can no longer use needle access into IV tubing ports.....someone jump in here if I'm wrong. #3 - MA's, etc can perform certain functions under the "auspices" of the MD. What that means is his office is his kingdom and he can train the janitor to draw blood if he wants - under his direction. I had a run in (long story) with this and a private MD I worked with once and him taking it to extremes. Dawn

Hi Pip - I'm an Excelsior Grad from 5 years ago. Have had no problems with jobs. I was an LPN working at a hospital and getting tuition paid for when I did the program, then I just moved into an RN position with that same hospital. Why don't you call and ask the hospitals where you plan to work if they hire Excelsior grads?

I agree with the above posters - and if it really fired - YOU probably would have known it too! See the web page below under the topic "what should I do if I get a shock" - it talks about warning family members that if a shock is delivered while someone is touching them, that person may also feel a mild shock and should be fore-warned. http://www.rochestermedicalcenter.com/implantable_defibrillators.htm

klcrn- I am in an ER exactly like you have described. Nothing gets in my craw worse than a poor, poor orientation program that leaves us good nurses doubting ourselves instead of being trained! The only thing that kept me going when I started here was that I had 2 years prior in a BIG ER a few years ago. Our physicians are also not "board certified", they are more like glorified PCP's - and some of them need watching! I think working in this smaller environment is harder than the level I trauma center I was at before. No matter where you work, you will never feel 100%. I think my own lack of confidence at times is what drives me to look for something new to learn that day, so that way it serves a good purpose. I've had those days that I thought "I can't do this", but that's just my "monkey mind" taking over :imbar Hang in there - I'm glad you posted what really I think many of us experience!

Saline shooting for distance with a Level 1 rewarmer............... not that I EVER did that on a slow night shift. No, I usually got hit with it.....

I love it! So true! We've had a run of 3 day old bug bites with about 1-2 cm of erythema, no itching, no pain........and "I thought I better get it checked out." Also, the kids 2-3 years old with fever - no tylenol or motrin given. These are the ones that typically ask for the tylenol RX on discharge.

My belly, below the belly button. Except for the time I had a physician as a med-surg patient and he had HIS physician give us a written order to give his Heparin in his arms. Have never done it that way since.

I hear ya! I just came back to ER nursing in a tiny ER.... I did a BIG hospital ER in the past. It's very interesting to see the difference in small versus big ER. I keep telling myself the benefits of this............I get to review how to do things when the technology isn't available. I take time to look things up to make sure we're not missing anything when we get something more acute in........but I must say - I DO miss the Pyxis. I am amazed that there's not some other system in place with the liability that comes with poor med storage. We have these crazy little ziplock bags labeled with the unit dose med name, but more than once I've found the wrong med in the bag. It just allows another persons hands in the pot to make a mistake. Our ER staffs an RN and an LPN at night, so I don't have anything to add on that. I'd probably call on the house supervisor also if one's available.

Just curious for your thoughts on this..... I'm working in a VERY small ER (after doing level I trauma a few years back) and I've encountered a doc that just makes me crazy! He and I have clashed on a number of issues.....it's pretty unanimous across all the staff that he's not the best physician we have:banghead: Anyway - he was admitting a patient with test results that showed a pericardial effusion and the woman was stable and not having pain at that point. He starts running around the bed wanting us to manually check the B/P on inspiration and expiration for the pulsus paradoxus. This is AFTER he went to the desk and looked up "pericardial effusion" in a text book. One of my coworkers with gads of experience told me about just checking the pulse for a change in strength with breathing..........but has anyone really, really done a slow B/p check to try to measure this manually? I really thought it was just something one might monitor through a line readings? (This is from a doc who ordered a CTabd on a patient - then gave her lasagna to eat from the staff fridge himself.) I am really trying to appreciate all the lessons I can learn from being in a smaller environment, but I think this one makes me nervous! Dawn

I can "ditto" what the other posters here have said...... Excelsior is do-able, with the right background and personality. There was a huge wait to schedule for the clinical part. You need to study for the clinical, not just blow in and expect to pass. It's a process in itself not to be taken lightly. I had zero college credit and completed my ADN with them in exactly 2 years. I averaged a test per month. I had 1 manager hesitant about my Excelsior background when I transferred from med-surg into the ER. But my present Med-Surg manager at the time told her not to worry about it. (Found out later the ER manager had wierd hang ups about other stuff, anyway) It all depends where you live and where you want to go for your first job. Research your area. You can call the college and ask for the names of graduates in your area that are willing to share their experience. (The college has a list of these folks) That might help you see how your local community has received Excelsior grads.

This is a great thread! Thanks for reminding us that in the midst of the negativity - there's a reason we keep coming back and clocking in! I love it because no matter how long you've worked there, some nut can always trump whatever craziness you saw the day before. There's no end to man's ingenuity.

Wow - they paid a consultant to come up with the "internal waiting room" concept? Heck, I've seen it done for free in numerous ERs.........it's called the HALLWAY! Seems to be the favorite location for crazed charge nurses to start throwing patients. My favorite, though, is "send them to the waiting room on a transport monitor so we can still watch them." Sure, let's err on the side of proving that's a bad idea when they do have a dysrhythmia in the waiting room after 2 to 3 hours. Besides the obvious safety concerns, etc.........the scheduled number of doctors and nurses remain the same regardless of what ER orifice you start shoving patients into.