HelloM1M1

Hi, I'm a Med Surg/ Tele RN. I really want to land a job in the ICU, but I just don't know how to start, or how to stand out with my resume. So far, my experiences have been very mediocre. But I'm dying to learn more. I think ICU is the environment for me to thrive. With critical cases you have to really think into the physiology of every little thing, and I would love that very much. Now, the question is, should I take the course offered by allnurses.com? I don't have any ICU experience. This class is a review series to obtain those certifications. Do you think it's worth spending $199 for something unattainable (the certification requires that you must have some kind of critical care experience) ? & do you think I'm fit for this class? Or would I be clueless from the beginning til the end with just a med surg background? Also, any tips for this poor Med Surg nurse to gain a position in the ICU??? Thank you very much allnurses members!

I think you guys misunderstood me. We flushed cold saline for the purpose of vasoconstriction, not to flush out clots. This pt was on lovenox before too... So he bled excessively anytime there's a small trauma... Well the result wasn't so well. We couldn't stop the bleeding even with all the cold flushes and he had a change of condition, so we had to send him out of our facility to an acute care hospital. This was the first time I saw this practice so I was wondering if this is common... If this is a nursing intervention or do we have to get md order for this kind if intervention.

So I had 2 cases of bleeding noted in the Foley Cath. We also noted bleeding around the penile area. However, after penile care was done, no bleeding was noted around the penile area after. So the problem must be inside the urethra. With the first case, after flushing it with NS twice per shift as ordered, the urine became clear yellow again. No bleeding noted in F/C after. The second case, frequent flushing didn't stop the bleeding. The D.O.N then told us to flush with cold saline. So they put the saline in the refrigerator for 30 min - 1 hr, took it out and irrigated the F/C with it. I have never heard of this practice before: flushing with cold saline to stop the bleeding. I thought we should never flush F/C with cold saline since it might cause bladder spasm? I've never been in an acute setting hospital and these nurses that agreed to flushing it with cold saline got this method from their experience in an acute care hospital.

Got my rejection letter today. Ouch it hurts! I guess the Guy Upstairs has better plan for me =,[

So just spoke to nurse recruiter. For anyone who got an interview but didn't get a call back yet, be patient and wait until Monday to receive an offer call. If after that and you still don't receive anything, then you're not selected.

If they take u on a tour around the unit after the interview, is that a good sign? Or is it just part of the formal interview process? I was interviewed at iicu

Thanks for all the wonderful advice! I put in my 2 weeks noticed after the long talk with management and no probable solution was brought up. They told me all the other nurses could do the tasks in the assigned time (in plain words: you're a lazy liar), & that I have time management issue. In reality, the other nurses wouldn't want to speak up for themselves, and was afraid to lose their job (b/c they're not US citizens, it's hard for them in this job market). After they told me that if I'm not capable of doing all these tasks, then maybe skilled nursing is not right for me, that was the last draw. The original comment was "Maybe nursing is not right for you" but I'll take it that he meant this type of nursing is not right for me. So yes, I'll write to the California Board of Nursing to actually investigate all the SNFs. Maybe my letter would not make a difference, but at least it is a first step to end this kind of crazy world. I encourage of y'all who are going through the same thing as me to write to your board of nursing and also the labor law department. I resigned because I refuse to participate in illegal acts.

I don't understand this SNF world... I'm usually forced to clock out on time unless i got a fall or an admission that day. I usually cant finish 2 medpasses & treatments in an 8-hr time frame. I would have to stay 4-5 hrs back everyday to do paperwork: Medicare charting, skin assessments, care plans etc. Or finish the treatments I didn't get to do. This is so illegal, yet nobody at my workplace is saying a thing since they're all immigrant nurses and need their job! I'm an American citizen! I know my rights and this is so unfair!!!! I don't know what to do. I feel like I'm the only one speaking up to management and all I've gotten back are: 'other facilities r like this & actually worse.', 'ur learning... Sooner or later you'll get out on time.' This totally violates the labor law! Sometimes I have to work through my lunch to get things done! That's 8 hrs running around w no water or food!! The other day i clocked out already and still had to do PICC line dressing change. Not to mention one port was clogged up bc no other nurses flush the port except me! What is this? 3rd world nursing? Is this even America !? This is injustice! I wanna Boycott this place but id be the only one! So is this reality of LTCs/SNFs??? Is there a union for this type of nursing????

Thanks! My supervisor was next to me when the PT described the event but she didn't tell me to initiate a fall incident report. I just want to ask for future references... but I guess I will have to check with my DON. The thing is the DON is new, this place just got renovated, and I'm just so overwhelmed with all the work (26:1 nurse, & we still have 5 beds open. Short-term rehab so all the patients are at higher acuity level than normal LTC), that I got no time to think or ask or check out policies. When I got home and woke up today I ran over the event yesterday and just freaked out, left a voicemail for my supervisor. What if it was a fall??? I didn't see the procedure manual that's why I'm so worried. I know it's not right to ask some strangers on some forum but I just needed some insights and no one is available at the moment. Thanks.

I was a desperate RN new grad, so I accepted this job offer after months of searching for a job. Anyways it has been a month and a half at this facility now, and I'm still unfamiliar with all the protocols here. The other day a resident was participating a physical therapy session and her knees gave out. Luckily the PT was next by to assist, so she didn't fall on the floor. PT got her up to rest on a chair, then used the walker to assist her back to her room. Ok so is that a fall or not? If one of her knees touched the ground, would that be a fall? If not, it's just weakness during PT session right ? Anyways if it's just a minor fall (as the hypothetical case that one of her knees touched the ground), the PT was supposed to get the nurse over to assess for any injury or fracture (this resident has a neck collar) get Vs, neuro check either way right? He's not supposed to get her up on his own and walk her back to her room right ? HELP!!!!

So my resident is totally confused, A&O x 1. She smiles all the time, so it's hard to detect any s&s of pain or discomfort. It's as if she could not register pain. She was admitted due to dx of T-12 fx. She's at risk for fall, and fell on my shift. Well I've only been on my own for a week, and I'm a fresh new grad. I was the only charge nurse there at the moment, and it was an un-witnessed fall. So I found her on the floor, in a sitting position, smiling at me. I asked if she's in pain, but she couldn't understand me due to her mental status and language barrier. She had a TLSO on. I looked at her head, her elbows, arms, feet, legs and didn't see any new skin conditions. The only thing that I didn't assess was her fracture because she had a TLSO on. What I did was with the help of a CNA, I got her back up to bed. There was no complications noted. She was still smiling throughout the whole shift Now that I'm looking back at this incident, I think I should've done the following: lower her down flat on the floor, log roll her to the side, take off TLSO to assess for fractures? Any suggestions for this new nurse?

Thanks yall! Today was my day off & I went in to try to memorize all the meds for each resident (since I can't write it down). Honestly I got confused even more... esp w/ the OTC meds...so I decided to leave and pray to the Lord that as time goes on I'll have it down. Memorization is not the way to go =[ Thanks for the encouragement mombabyRN96 & BrandonLPN (also thank you for your medpass tip Brandon. I have the same method as well. Yea I hate flagging things too. OK I'm going to try to focus and minimize interruptions to as little as possible. & I'm thinking of buying an electronic BP cuff so I can measure their BP while preparing their meds =] ) Thank you all!

Hey guys, So I'm a new grad, recently landed a job at an LTC/short-term rehab. They gave me about 7 days of orientation (one where I walked off midshift crying ... I know it's very unprofessional of me, but I just couldn't breathe & was about to pass out if I continue). The whole 7 days, all I did was passing meds and hoping to memorize them all. The unit capacity is 31, with the census at the moment being at 22. So I've been on my own for 2 weeks now (6 days) and it still takes me from 7:45-12:30 to pass all meds. Is this normal for a new grad? To take 5 hours to pass meds? Of course there are interruptions in between... discharge, appointments, residents calling out for narcotics... but it shouldn't take that long right? I only got 1 FSBG at the moment. Then when 12:30 comes around, 1PM meds are around the corner. Good thing 1PM meds are light... I only got to pass out to about 10 residents, so the leftover time: from 2-3P I can do tx and charting (but that's only if I work through my lunch). So of course I gotta take my 30 min lunch otherwise I can't get back on my feet. Seriously, I only got to use the bathroom once the whole shift and now am planning to wear a diaper to prevent going to the bathroom. So sometimes I don't get out til 7PM. Since I stayed back for that long... I got to see an experienced nurse passed meds (3-11 shift) and she only took 3:45-5:30 ... not even 1 1/2 hrs o_0. I don't know what I'm doing wrong. Does she not take BP before giving blood pressure medications? & they did not train me properly on admission & discharge, hospice patients, how to document correctly, T.O order etc=[ . One day I was on my own and one of the residents was getting discharged. Good thing I found the medical records lady walking down the hall... so I grabbed her to show me where the discharge paperwork is at b/c I had no clue what to do. The other day a resident's IV got infiltrated so I had to remove it... & the supervisor helped me put another IV in the other hand. Well, she was unsuccessful, so she grabbed the other nurse from the other unit in to help. Anyways, stupid me documented that I did it. I also didn't say that MD was notified, and responsible party was notified... well because I thought it was a standing order to put a new IV in whenever it gets dislodged or infiltrated. I don't know how deep of a trouble I'm in with that now. It took me about 3 hrs to chart as well. Help me out on time management! Please, someone here!

LOL... that book now is $99

i'm a new grad & my first RN job right now is at a short-term rehab unit. I only got 2 accuchecks, medpass to 22 residents, treatments to about 10 residents and I already feel overwhelmed. So yes, 9 accuchecks to me is momumental!