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wannabecnl

wannabecnl

PACU, presurgical testing
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wannabecnl has 4 years experience and specializes in PACU, presurgical testing.

wannabecnl's Latest Activity

  1. wannabecnl

    Ridiculous medical mistakes on TV

    Not a mistake as much as just a silly choice for the writers: two weeks in a row on Code Black this season, the patient went into Torsades de Pointes (already a rarity) AND the resident failed to recognize it. Really? I learned that before I finished nursing school!
  2. wannabecnl

    Ridiculous medical mistakes on TV

    Since we started this thread, I've been more aware of stupid TV medical errors than ever, and this season of Chicago Med hasn't disappointed. My ongoing favorite on CM is how the BP can be reading fine one second, the patient goes into some crisis, and maybe 5 seconds later the nurse/MD/family member says, "Their BP is crashing!" No A-line in sight, btw. Fastest cuff in the west, I suppose...
  3. wannabecnl

    Tell me why you regret about becoming a Nurse

    I came to nursing as a 2nd career and have realized in 3 years that it is very, very different from the IT/tech writing background I had before. Then I had projects, near and long term goals, and actual advancement with more responsibility and new things to learn all the time. Don't get me wrong; I'm in a VERY nice position: per diem in pacu and preop, so I pick my hours, and the pay gets a little better each year. BUT, I do feel like a cog in a giant wheel, a cog that could be replaced in 2 seconds by another nurse cog, and it really wouldn't matter that much. Also, the realization that the 20- and 30-year veterans are doing the SAME WORK I AM DOING is starting to bother me; in 20 years I should be doing more than I'm doing now, right? I do hope to move into a research role eventually, and I know some nurses get more advanced degrees and go into management or NP/PA work, so I'm probably not the only one.
  4. wannabecnl

    Ridiculous medical mistakes on TV

    Every episode of Chicago Med seems to involve a chest tube. Every single one. They use etomidate and succs for EVERYTHING, too--I've been in PACU for 5 years and I've had exactly one patient that got etomidate for induction. And how is it that Colin Donnell's character can so seamlessly move between ER/OR/and now transplant? He must have trained at General Hospital. The monitor inaccuracies make me nuts, as someone posted above. Pulse checks while pt is getting compressions. On Chicago Med and Code Black, their compression rate must be 140 at a minimum, and yes, those wonderful bent elbows look so nice and would NOT WORK. But I guess they'd break all of the patient actor's ribs if they did it more authentically! A few episodes ago on Code Black, a rich donor's wife was lying ALONE in a dark room, having not yet awakened from surgery, when he came to see her. Uhh, PACU? Stay with the patient until the are CONSCIOUS, maybe? Just a thought if you want that money to keep rolling in. One real question for our ED people: how long do codes really go on in the ED before they call it? For a witnessed arrest or close to it (usually the case on TV), they seem to give up very quickly. Of course, no one is doing the 2 minutes of compressions between shocks/epi/etc., either. I know how long 2 minutes feels in ACLS class, and I don't think the TV producers would allow that...
  5. wannabecnl

    Your Uniform....

    When I did my public health nursing clinical in an elementary school, the school nurse (my preceptor) wore scrubs every day, but I was required by my nursing program to wear street clothes. Some of the kids thought I was a teacher! The nurses at my kids' schools seem to wear whatever they like. If I worked as a school nurse, I would TOTALLY wear scrubs. They are the most comfortable work clothes I've ever had (of course, I work in PACU, so my scrubs are just miraculously there, clean and folded, for me every single shift, which is suhhh-WEET).
  6. wannabecnl

    A question for the COBs

    No idea about the use of Notes on Nursing in earlier years, but I have to say that I LOVE that book. My mom bought it for me before I even went to nursing school, and I have read and referred to it many times. A comment was made on another thread about how people incorrectly think we're like Florence Nightingale, and all I could think was that the poster must have never read Notes on Nursing or would not have such a low opinion of that assessment! I personally would love to be as observant and proactive as Flo was; she was really one of the first epidemiologists and was the catalyst for making nursing into a science, while not losing sight of the art.
  7. wannabecnl

    Are we better than the hosts of The View?

    Wow, we can't be trusted to use a stethoscope, but we can prescribe ourselves a Valium? Who knew?!
  8. You can probably get into a float pool at your hospital, but that isn't likely to expose you to the specialized areas like ICU, PACU, ED, maternity, etc. My recommendation is to shadow. I knew the first time I shadowed a nurse on a med-surg unit that it was not for me. I also knew the first time I shadowed in PACU that I was hooked, and to this day it is my favorite place in the whole hospital! What do you like about the places you've worked? What did you dislike? Think about your preferences/strength in nurse-patient ratio, acuity/critical care needs, telemetry/technology (I LOVE monitors, but a lot of nurses hate them), continuity of care/LOS (i.e., do you have the same patient for an hour like me, or for a year like LTC), age of patients, type of health issue (if you don't like cardiac, don't work telemetry), amount of patient education, etc. Don't forget to look at your hours/days; urgent care usually requires every other weekend, but there is no call; OR/PACU require call but may not schedule nights depending on the facility, etc. Office nursing typically has no nights/weekends/holidays/call, but the pay may be lower, and you may miss the hospital. Also, what do you want to learn? I'd like to learn wound care, but it doesn't come up in PACU and would require me to take a course or moonlight in the wound center! I didn't take the self-test, and from people's responses I'm not sure you should, either! :) You have valuable experience coming from med-surg and LTC, and there is no reason you can't find a real niche in nursing! The sky really is the limit!
  9. wannabecnl

    Do all nurses need 20/20 vision?

    This isn't the level of vision problems you're talking about, but vision is starting to become an issue for me. I have been very nearsighted for many, many years, and when I entered nursing 3 years ago, I always wore my contacts to work (figured that if a postop took at swing at me and knocked off my Coke-bottle glasses, I'd be useless). Lately, at the ripe old age of 45, I'm noticing that my close vision isn't what it used to be; it is really bad if I'm wearing my contacts, though it is fine with glasses (I find I peek out below the glasses to see up close, though, and I need more light than I used to). I tried some "grannies" with my contacts to pop on when I need to read a tiny med bottle or see lines on a syringe, but it was annoying to put them on and off all day. I know it's a normal part of aging, but it was definitely hindering my practice. So I've switched to wearing glasses at work, with a spare pair in my bag. This is working for the moment. I had trouble with the microscope in my prereqs, and the day is probably coming when I can't avoid the "grannies" or bifocals. I figure I'm blessed beyond measure that my terrible eyesight is 100% correctable, but if that changes, I'll make a faster switch to research or teaching than I planned. I hope your article encourages all nurses to ask for the accommodation they need and to not despair if their vision (or any other issue) starts to affect their practice! There is so much we can do for our patients regardless of where/how we do it!
  10. wannabecnl

    Peds patients in PACU?

    Take PALS, PEARS, and any other pedi courses you can, especially if you don't have a lot of pedi cases over the course of a week. Find out what pts come to your PACU and which ones go to NICU/PICU. I've taken care of babies as young as 4 weeks; younger than that tend to go to our NICU to recover. Also, if you're going to be on call, you need to establish where you will recover peds and find out what your backup support will be. We've started the discussion of recovering kids after hours in the PICU, and I think it's 100% necessary; I adore my ICU backup RNs for adults, but they and I would be more comfortable with peds nurses at the ready if the situation went south.
  11. wannabecnl

    Ambulatory to hospital PACU?

    You'd be a shoo-in at a hospital that is willing to train new grads into OR, PACU, and other periop specialties--with your experience you'd be ahead of the curve; you'd benefit from the acute care training and would bring a new perspective to the group! Focus on the work flow and take some time to learn the more critical aspects of your position (I assume your postops are on 3-leads? Do you need ACLS?), and you'll be an asset. I went right into PACU from school and have managed to make a go of it, so you shouldn't be worried!
  12. wannabecnl

    Certification in pacu

    Start with ABPANC's website (Home | American Board of Perianesthesia Nursing Certification | ABPANC), take a certification review (even at the early stages, it helps you get your head going in the right direction--ASPAN does a bunch of these every year, and independent instructors do, too), and read the Core Curriculum. I want to do the same this coming spring--good luck to us!!
  13. wannabecnl

    Some Days I Can't Stop Crying

    God bless ER staff, first responders, and the like. Most of us (even in acute care hospitals) will never see what you see.
  14. I was a candy striper some 30 years ago, and to this day I balk at rolling an empty wheelchair forward into an elevator. I think we were the only nursing school that learned, "Oh, our old, trusty truck acts funny; very good vehicle anyhow." I do use that one sometimes. And then there's OLDCART to assess pain: onset, location, duration, character, aggravating factors, relieving factors, and treatment. Like we have time for all that in PACU! Gimme a number, preferably one that matches your face and what we did to you... (I'm kidding; please take it as the joke it is!!) Loving this thread! Interestingly, a lot of the items people remembered are actually very useful, everyday info for me, but maybe I'm just a geek working in a strange field...
  15. wannabecnl

    How to tell the experienced nurse to slow down

    It is beneficial to the PATIENT as well as the orientee that this be corrected. Be tactful, be professional, and be specific and task-oriented, but don't let an error go. There is a difference between "you need to slow down" and "See, the cannula is kinked in that spot; if the catheter gets pulled out (or whatever; I actually have no idea how to do what you're talking about), it won't lay right." Or whatever.
  16. wannabecnl

    So...What Kind of Nursing Task Do You LIKE?

    In reading this, I realize that while PACU lets me give 1:1 care, which I do love, and we do all our own vitals and frequent assessments, etc., we don't get nearly as physically involved with our patients as other nurses do! I wish I had these skills people have mentioned! But I do have some favorites: 1. I LOVE assisting with pre-op procedures (blocks, spinals, etc.). 2. I love seeing a patient go from sound asleep/disoriented/howling in pain to sitting up, drinking juice, and asking for lunch (and I love my part in getting them to that point). Great to get to know them a little bit and be there for them. 3. I actually love getting into the nitty-gritty of surgical wounds, which really doesn't happen that often. I wish I could do more with wound care; I'd like to understand it better, and most of my dressings fall off because I never have to put them on! As a former poster said (best quote of the thread, I think): sometimes wound care is almost like a craft. Love it. 4. Giving my post-ops Ativan if they really need it. It is truly a beautiful product. Phenergan is a close second. And Valium for spine pts whose nerves are waking up for the first time in months (and those nerves are P****D!). Heck, labetalol and neo drips are pretty cool, too. Basically, I like the relatively instant gratification of the meds we give in PACU; in our time frame, meds need to work fast, and I feel like I'm really doing something useful when I give a med that works. Favorite direct-care task example thus far, though, had to be straight-cathing a post-spine surgery guy retaining 1200 cc of urine and sporting a ridiculous BP as a result. So gratifying to help him feel comfortable, see that lovely pee coming down the tube, and watch the numbers all come back down to earth, too.
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