Leecy

You will become an expert in the many colors of poo, able to identify infection, GI bleed by smell before you even see the poo. It will not bother you at all. You will eat lunch discussing poo. You will talk about poo, while eating to non-medical people who are also eating on slow days to amuse yourself. TIP #1 Keep a complete change of clothes in your locker. Uniform, bra, panties, socks and shoe. Poo attacks those who are unprepared. Tip #2 Keep and eye on your badge, glasses, pens. I recently did a bed bath on a paralyzed gentleman who had a large, violent accident. It took many rolls to clean him, get dirty linens, replace with clean linens, etc. On the last roll, I looked down, and wondered why he had a pair of blue glasses in his butt crack. I looked over at the new grad who was assisting me, shushed her, retrieved my glasses, and deposited them in the trash. Tip #3 If you wear glasses, keep an extra pair with the change of clothes.

First, take a deep breath. If every nurse who made a med error were fired, there would be no nurses. Personally, I think there are two kinds of nurses. Nurses who will tell you they made a med error, and nurses who are unaware that they have ever made a med error. It next to impossible to have worked for a few years and not have made an error. In you case, the system failed the patient. The physician made the initial error, pharmacy didn't catch it and neither did you. It's not all on you alone. In the unlikely event of a lawsuit, your institution should not only have lawyers, but a risk management team and administration would be on your side. It is in the hospitals best interest to be able to say, "We are very sorry this happened. We are taking a look at how orders are written and checked so this doesn't happen to anyone else." In large hospitals there is computerized order entry which would have alerted the physician to his error. A pharmacist would have checked the order and entered it electronically creating more double checks. The RN is alway the last check. Even though you are rushed for time, try to look up you meds, and always ask the patient, "have you taken this med and this dose before?" That last question has save my butt more times than I can count. Even with computer orders, pharmacy, PYXIS alerts, etc. We are still far from perfect, we have all been in your shoes, and we still have our jobs where we can tell new nurses what we did one shift and how we survived it.

We also use Alaris pumps. Instead of Buretrols we use syring pumps which are part of the Alaris system. The syring pumps give you exacting controls. We also have a problem with overfill with chemotherapy. We ask pharmacy to send chemo in a syring if the volume is less than 60mls. If the chemo volume is greater than that it still comes in a bag with the tubing primed with saline from pharmacy. We infuse the first 20mls quickly as it is not chemo, the stop and program the pump for the proper volume. Still, sometimes it's clearly overfilled. What I have found is some nurse will stop the infusion at the ordered volume and flush even if there is 20ml still in the bag. When the chemo dose was mixed in the total amount of fluid, to get the whole dose of chemo, you have to infuse the whole bag regardless of volume. Personally I think the prefilled bags of NS or D5 pharmacy uses are overfilled my the manufacter. I've pulled 62mls from a supposed 50ml bag with a syring almost daily. I've brought this to pharmacy's attention, but no one thinks it is crucial enough to change anything. So bottom line, when I hang chemo I program the stated volume, and eyeball the bag during infusion to adjust the rate if needed if it's a chemo that will expire in 100 minutes or so.

You need one year minimum as an RN and at least 1000 hours caring for peds/onc before you take the test. The test is NCLEX-like, but not that hard once you have been caring for these kids for a while.

No way. They share a bathroom and chemo is excreted in the urine and feces. They should have just switched patients around. We don't let pregnant mom's so much as change a chemo diaper on their own child. Why take the risk.

A new nurse after her first code needs to be told she did well unless something was truly catastrophic. They usually curl up in a linen closet and cry once the adrenaline go's away. If the manager had stopped her or said something at that point, she may have been thrown off and been unable to continue. If a new nurse gets through a code and manages to stay in the room, I usually praise them. Maybe a few weeks later I'd work something into a conversation in the guise of a story about another code on an other unit. New grads are so fragile.

Lucky duck! At my facility that is a coveted job. The co-ordinator would be responsible for arranging pre-transplant testing, co-ordinating marrow matches through the national registry, setting up housing and transportation. Once the child is here and in the program, the co-ordinator follows them throughout the hospitalization and then arranges housing and meds on discharge, makes sure the get to clinic for follow-up, etc. The co-ordinator is the one person besides the doctor that gets to follow the patient all the way through and gets the pleasure of seeing the success. Us floor nurses just get the rough days and hope for an update once in a while. As far as BMT go's, I think it's the most joyous job.

CPS anyone?

What does your gut say? If you are reassured by many people, will you be OK with it or will you still lose sleep? I have worked with many pregnant chemo nurses. I work with a nurse who, in her first trimester had a massive chemo spill all over her and was advised to abort. She didn't and years later her child is fine. I, on the other hand, am the kind of person who, when my 18 year old gets a cold, wonders if it's because I snuck on the Matterhorn at Disneyland when I was 8 months pregnant with him. Figure out your comfort level first.

I would ask the floor you hope to work for if the course will help. I work for a teaching hospital and we have our own classes. We have had travel nurses come to our facility with their national provider card and get upset because they must still take our class and pass our test before they can give chemo. Facilities without their own program sometimes use the national courses but you really have to check. When I started in oncology I went through our classes, then later decided to take the ONS chemo and biotherapy course on my own to give me a better understanding. It was expensive and nothing was covered that I already didn't learn at my hospital. I am now certified CPON ( pediatric oncology nurse) after caring for kids for the required amount of hours and passing that test, but that is different. Again, check the facility you want to work for. If you aren't employed with them they will still sometimes let you take their classes. Join APHON if you haven't already. http://www.aphon.org/. They are a great resource. Good luck and be persistent.

It's neither good nor bad to get interviewed right after shadowing. It depends on the interviewer's schedule. Don't read too much into it. Practice verbalizing why you want this job so much, what being a NICU nurse means to you, steps you have taken to get there. Remember physician reference only go's so far. This is a nursing world, run by nurses. The Doc got you in the door, now it's up to you. It sound like you'll do great. We always love new nurses enthusiasm and you have plenty of that. Try to relax and enjoy the shadowing experience.

Make sure to have some questions prepared to ask the nurse you shadow in case you blank out a bit. Interact with patients, families and staff a little. When someone shadows with me, I am always asked by my nurse manager later how I felt about the potential hire. If a new grad seems to understand something about the unit, and seems genuinely interested in the patients and interacts well I feel comfortable giving good feedback. I've had shadows who didn't know what kind of unit we were and when asked why they chose oncology, state they didn't, we just had openings. If I don't feel the care about the patient population it usually doesn't work out well. Good luck.

I was stressed out for at least the first year and a half. Everybody adjusts at a different speed. We all have days where we wish we had chosen another profession, especially if we don't have a good support network at work. If you are in the job you really want to be in,stick it out. Seek out a mentor at your facility, join a committee, participate. It can be had to give more than you already do at work, but then people will see you as invested in your job and be more willing to help you on those rough days. If this isn't where you want to be anyway, transfer if you can to another floor. Many new nurses take the job available to them, and if it's not what you wanted it's even harder to become a proficient nurse.

OK Wildcat Fan (AZ?). I also was an LPN before I got my RN. I got a job on a mixed (peds and adult) floor and began working with peds that way. There are many school nurse jobs unfilled and unposted now. Call your local schools if you are interested. The pay is lower than hospital nursing but it could be a starting point. Volunteer with Camp not a Wheeze or something like it. Danville corp does private duty peds nursing and vent trains.I haven't worked for them so I can't tell you if they are any good. Good luck.

What class are you taking? Is it with your institution or a national course?