Lari45

Had a very nervous patient the other day getting ready to be taken the following morning to another hospital for a cardiac cath. His nurse approached me and started talking about how he didn't seem to understand why he had to have the cath done, so I offered to go give him some education because she looked so busy. She told me that he was VERY nervous and unable to settle down for the evening, so she'd given him a dose of xanax. I printed some handouts and went in the room, all set to give him the rather standard education for the cath. I started out by handing him the handouts and then I started to say that the procedure involved "inserting a catheter into your groin area". He didn't let me get very far before he blurted out his fears. He said "I don't want them to put a tube or anything in my member or anything down there. I'd really like to leave with my family jewels intact, you see..." I had to keep my face neutral because he was totally serious. Apparently, everyone had been telling him that we were going to insert a catheter into his groin. He didn't understand that what we meant by catheter WASN'T a foley and what we meant by groin WASN'T via his family jewels. The poor guy thought we were going to cut into his member or testicles and insert a catheter to his heart... After I provided all the required education, he appeared much calmer and thanked me for telling him that he'd get to leave the cath lab with his "boys" intact, apparently his misperception had been the source of all his anxiety. It sure shows that a little knowledge can be dangerous... and adequate education can save the day!

I was wondering if anyone had any feedback regarding patient vigil programs, the most notible of these was first started in oregon at Sacred Heart hospital. Commonly referred to as "no one dies alone" or NODA programs, these are intended to provide volunteer companionship for patients who have no family at the end of their lives (last 72 hours of life, typically). I think it sounds like a wonderful program and I'm going to be persuing starting a program at my facility. Thoughts? Opinions? Experiences? RN Magazine had a very well written article on the subject if there is anyone interested: http://rn.modernmedicine.com/rnweb/Modern+Medicine+Now/Will-you-stay-with-me-The-No-One-Dies-Alone-progra/ArticleStandard/Article/detail/602013 Anyone know of any other articles regarding the topic? Evidenced based articles? Thanks so much! Lari

The best thing I can say is you had better get into an ICU with a GOOD support network. when I started, there were 5 other nurses starting and they were ALL new grads. I had some floor experience behind me and that helped with organization, internal system knowledge, and 'where things are', but it was a whole new world. The scariest part was not feeling supported with a good nurse educator, a senior nurse on each shift, or a resource person to go to with questions. Preceptor programs are great, especially if they combine with some classroom time, nurse educators are invaluable. You don't HAVE to have floor experience to work in an ICU but you must have a lot of support for safe learning. ICU nursing is VERY VERY hard. It's tough mental work. Be prepared. Be safe.

Depends on where you work, I think... ratios effect the exhaustion too. I just feel like working five eight hour days on a busy floor with a 6:1 ratio would be too much. I find that four days off are great, but we have time off because we need what I call "emotional recovery time". ICU nursing can be really great and really emotionally/physically challenging. When i was on a floor, the job was so physically tough. You never stopped running it seemed. Answering phones, calling docs, helping patients move, turn, eat, take medications. And of course medications could be ordered at 9a, 1p, and 5p on one patient, but 9a, 12p, 3p, 5p, and 7p on another... you just spend your day moving and thinking and "handling it"... this isn't true of all areas of nursing, I don't think, but hospital nursing... sometimes, you have to be a marathon runner.

I have to say, I had moments where I didn't know what I wanted to do or if nursing was the right thing, but having been in it this long... I feel like it's a good thing. Nursing, for me, was a good decision. I have a job that I love; there are hard days, and there are easy days, and there are average days, but my job moves me. It moves me to be a better, more educated person, a more caring person, a more confident person. My job has developed my character. When my job stops moving me, when I stop loving what I do, then i have the option of doing something else. There are so many options. When Telemetry stopped moving me, when I stopped liking it, I moved on to ICU nursing and now I'm quite happy. Shortage or no shortage, I wouldn't have changed my decision in the beginning to start the journey.

Great point MBARN. There is some real value to being professional. I work in a small ICU/CCU with 14 beds totally full. It's so hard to pull off this kind of professionalism without any personal involvement day to day. It's a long twelve hours if it's just you and another nurse sitting next to each other at a desk. You have to break up the day with some conversation. Still, being kind, always kind, is the one thing that has saved me. Even with difficult techs/other RNs I (usually) am able to hammer out a relationship.