aei631

Maybe she found the zombie apocalypse!

I know that studies show open visitation is helpful to the patients but in the ICU I work in I don't find this to be very accurate. Our patients are very sick, and a lot of the times we end up with families anxiously hovering and agitating the patients. We also have a policy of no visitors between six and eight. I politely tell my family members that hover that while their loved one is in the ICU they are on a 2:1 ratio with their nurse and they are receiving a great deal of attention in the ICU. This is a good time for them to rest and make sure they are as healthy as possible because the real time their loved one is going to depend on them for assistance is as the improve and move out to the floor and prepare for discharge. They are usually pretty receptive. Anyway, I guess I got a little off topic there. I'm just polite and straightforward with them. It's explained at admission so we page overhead throughout the unit and let them know that quiet time is starting, to please exit the unit, and that they may re-enter at 8.

It's probably easier to observe another nurse helping with a line than it is to find a video. For any procedure you know you'll need to be the one to touch anything that is not sterile. You need to know if you are responsible for having supplies or if the Dr is bringing what he needs, and by this I mean his or her sterile gloves, procedure kit, ultrasound if needed, etc. For a central line you need to have your line caps ready as you will be the one to put those on, and have a dressing ready. Everything else is usually done by the dr. They should prep their site, drape the pt appropriately, etc. If they choose to use ultrasound guidance then you will need to help them get the probe into its sterile cover. Central lines mostly just require a nurse to babysit the Dr, make sure they aren't excessively sticking the pt, jabbing around, and for goodness sake keep an eye on the guide wire. (I work at a teaching hospital so we have to babysit, not so much for someone working with experienced drs) For an arterial line you need to have your transducer set up and connected to your monitor ready to go. All you should have to do for an arterial line will be to attach the tubing to the catheter once the dr has it in, and dress the site. This is of course dependent on your facilities line kits. Ours include all necessary needles, numbing agents, etc. Hope that helps!

This is is our situation exactly in the level one trauma center I work at

In the icu I work in we have a no visitors policy from 6a-8a and 6p-8p. Outside of those hours the patient is allowed one 'support' person who may come and go as they please. The are asked to wear an armband that identifies then as the support person and we keep a picture of them in the patient's thin paper chart. Any other visitors are held to visiting hours. There are three times for open visitation on day shift and one at night. A lot of the nurses will let family back during non-visitation hours though if the family is not a problem and it doesn't interfere with care of the patient.

Nursing

Brandon, you can change your username once every 180 days if you want to change it.. I am very careful about what I say about my employer(i would never identify the name) even when I have a gripe. It's got less to do with them seeing it because usually my gripes at work are minor and I address it at work (such as scheduling) but more because you always see on the news when there is an article about a nurse, no matter whether what she did is related to nursing or not, you always see them pull their facebook posts and social media sites!! So you won't ever see me 'check in' at work on my facebook, or post 'man i dont want to work today!' or really anything I wouldnt want my employer to see! There are no pictures of me doing anything I wouldnt do in uniform. Thats just good practice to not broadcast your lesser qualities to the internet. My page is "private" but I am well aware that nothing is private online. So I just try to be the person online that I want other people to see me as...

Oops, hit reply too soon! You can expect anywhere from 6-12 hour days in clinicals, mostly likely on a day shift, where you'll be expected to arrive between 6-6:30 so you will need childcare early. Clinicals are usually 2 days a week with the rest of the week being spent in a classroom setting...hope that helps some.

In/around meridian you can expect to see $19-20/hr as a new grad RN. I am not sure for LPN. Are you applying to admit in the fall? Maybe you can speak to your college counselor about finding a math tutor?

When I have a patient who is capable of cleaning themselves but doesn't "want" to..when they ask me I usually just hand them tissue/wipes/whatever and tell them if they aren't clean after THEIR attempt THEN I will assist. But like a previous poster said..if it becomes an issue or if it's something I feel is unrelated to their symptoms (such as pain) I just tell them that they have to "use it or lose it" and As their nurse I won't be the one that helps them grow weaker and more dependent...

Umc has a 95-100 bed NICU. You should know that turnover of staff can be high. A girl I went to nursing school with works in the NICU and said they may take up to 6 babies depending on staffing. I believe new grad pay at umc is still 19.50.

I understand how insurance pays for acute care as I've been working in an LTACH the last two years. I still don't understand what the issue with the nurse is. Sounds like the problem lies with the doctor and case management, if that is really what this was about. I feel like I'm missing part of the story..

I'm confused as to what the issue is and why the supervisor needed to see you?

I'm in Mississippi working night shift in an LTAC and our med/surg max ratio is 6:1 which can be challenging because these are usually total care patients. 5:1 is much more comfortable and when staffing allows that's what we run. ICU (what we call high observation) patients that are vented or require more frequent monitoring for whatever reason has a max ratio of 3:1.

I got 6 weeks as a new grad and I felt comfortable at the end of my orientation..but we have had people here get longer orientations if they need it. I think what is important is making the most of your orientation. ASK QUESTIONS! Your preceptor is a great resource while you have them...use it!! Tell all the nurses on the floor you want to practice your skills...they will usually be happy to let you practice on their patients and it's a good way to get the practice in while you have your preceptor as a safety net.

Regency LTACH was bought out by Select Specialty...pay is good but it would not be my first choice.

I went straight to an LTACH from school and it's been a great learning experience...I am getting experience with vented, critical care patients and experience with med/surg. You see lots of disease processes, lots of wound care....and contrary to popular belief the patients are sick! My biggest gripe is I feel like some of the doctors we admit to think it is basically LTC and we have to push a little more to get orders for labs/tests/meds. But overall I think it's been a good learning environment...

I was taught that if it's not written down it didn't happen. Are they filling out the flowsheet and the narrative for everything? Maybe they are unaware that there is a place on the flowsheet for a lot of the info they are charting in notes..

This. And that question should get tossed!

Foot care, inspecting the feet daily, insulin administration, their hgb A1C and how often they need to have that checked, dietary needs/restrictions...it's late and that's all I can think of right now

It also helps because literally every new piece of information builds onto the basics so you can't really forget the important stuff because you will always be using it!

I'm not a very assertive person either so what I do when I've got a patient with a stand-offish vibe is I don't give them any options. I'll go in their room for whatever reason, and as I am leaving I'll tell them "I'll be back in 30 minutes to reposition you." That way they know what to expect, and it's clear it's not optional. I agree with previous posters that you should also be able to tell them why you are doing what you're doing when they ask you why they have to be bothered.

Where will you be working and at what time? Is the work stressful? How strict will your schedule be? Will you be able to call in to work if something important for school comes up? How tight will your budget be? Who will be responsible for what portion of the bills? Is your boyfriend willing to support you if you find that you can't work at go to school? How well do you function without regular sleep? Just some things to think about, coming from a 4th semester student who is still working 25-30hrs a week at night. It is very very hard to find a balance, I still haven't worked it out.

I was taught that the reason you crush each med separately is so if something should happen to your med cup, like if you spill or knock it over, or if the tube closes off that you know exactly which meds the patient has gotten and which ones they haven't. If they are all mixed together and you accidentally spill half or something then you don't know which meds were actually delivered and they are missing their medications or getting a double dose because it's not like you can just give them the ones they didn't get.