KellyMPH

I also applied for the PMHNP part-time program! I was already admitted to another school but UF is my top choice! Fingers crossed ?

How would you handle this situation? I got report from night shift (a fellow traveler) and she said "I was really confused about the PPN and how they do it here so at first I just started the lipids but then I stopped and I didn't finish it, maybe you can look into it and start it." I asked her who she asked for help- she said another nurse who said to just start the lipids only. Extreme annoyance was coming through in my voice at this point and I asked her to put in a note why it was not started and the policy reasoning behind this (if any). She didn't put any note in. Open up patients chart and see no blood sugar was done since 9pm the night before and her 6am insulin was not given or charted against. At this point I'm pissed and go searching for night shift and of course she took off so fast after giving me updates on the patient and I couldn't find her. Going into the patients room I find that neither the PPN nor the lipids were given at all, there's no filter on the PPN yet both are charted as given in the MAR. Patient also is covered in poop up to her shoulders. Spent first 1.5 hours of my shift doing her work. We don't do bedside report because this is a COVID ICU and PPE is not given out immediately so as to not hold up night shift and limit time in COVID rooms. I was so mad that I brought all of these issues up to daytime charge. Anything else you would suggest?

So yesterday I was shaving my patient since he looked like no one had given him a bath in a long time and his facial hair was crusted with disgusting secretions. I was very careful to move the tube that you use to inflate the et tube cuff out of the way. At the very end the tube fell back on his face right as I was removing the razor and finished and unfortunately it knicked the tube and cut it partially. What a freak accident! I immediately heard the leak and notified respiratory. Respiratory arrived and asked me to go grab a clamp, went to ask another nurse for some kelly clamps and this nurse kept asking me what for (she is the unit nosy busy body masquerading as a kind concerned nurse). I briefly told her while she was grabbing the the clamps and she said you have to replace the tube in some accusatory fashion like I was just going to clamp it and walk away. I gave the clamps to respiratory and the patient was not in distress. MD was notified and he laughed and called me the "shaving master" and said it was OK and the patient's et tube was changed out for a new one. During this time the patients spo2 remained in the high 90's, resp rate did not increase and he looked comfortable. The Charge RN filled out an incident report. I overheard the night/day charges giving report and heard the night relay what happened and state "she just decided to clamp it" and several other gossipy statements. After I finished taking my report I immediately went to the charge RN and in front of the night charge stated I'd just like to clear up the facts so there's no confusion going around that I did not just decide to clamp it and that's it, respiratory clamped it while waiting for anesthesia to come change out the tube. 1) Does your facility require an incident report for something like this? 2) Would you have done anything differently in the immediate moment after? 3) would you have addressed the "unit gossip" differently? 4) anything else I can learn from this experience?

What I used to do when canceled from my unit was to call the nurse supervisor and tell him/her that I wanted to work and if they had ANY other needs that day. This worked because I'm an ICU nurse and I could float to any other ICU and I would also go to Step-down, Tele floors. Is this an option for you? Can you speak with the supervisor when they cancel you and ask if there are other needs in the hospital that you would feel comfortable floating to?

Vomit. The moment the pt mentions nausea I am on it so fast with the Zofran. I also offer it when pt asks for pain meds like oxy, dilaudid, fentanyl etc. The day I get a patient with intractable vomiting I really dread! I can handle poop, trach stuff, colostomy bags etc. Doesn't phase me.

Yes, I dealt with this issue a lot in my previous job. What helped was that the they switched the tech reporting time so that they arrive 30 mins prior to RN's and are finished with getting report when RN's start so they are now available for pt care. This really helped the flow of the unit and shift change, although they did all groan when their reporting time changed to 6:30am instead of 7am.

Yes, I work agency as an RN from time to time. I also have a consulting business and do public health consulting- a former career of mine prior to becoming a nurse. Mostly technical writing for clients although I have done some monitoring and evaluation type work for a past client. Business is good (15-30k/yr), but not steady. I work full time as a nurse and prefer to know when and how much my paychecks will be, so I only do the consulting work part time.

Yeah I moved from VA to FL and my employer allowed me to work with my compact license but required that I show a Florida compact license within 90 days. I had to get a FL drivers license etc and show my proof of residency to get my FL compact license. See what timeline your employer gives, but get started on the new compact license asap when you move.

I would check with the travel company you are interested in. Mine says CPI required for the job but my travel company provides this training free of charge to their travelers.

I got started in a step down unit right after graduation, so I think starting right away in CC is not the problem. I would not take that job primarily for the commute! How awful will 3 hrs of commuting be on top of a long shift. My shift ends at 1930 but sometimes (most nights during my first 6 months on the job) I didn't get out of there until 2030 or even 2100 if it was a terrible shift and I didn't get to chart as much during the day. Now as my time management has improved, I'm getting out consistently at 1930 or 1945 but I'm so dog tired I couldn't imagine having to drive 1.5 hours home after that and then if I have a shift the next day- no way! I would also listen to your gut feeling during the interview. I didn't listen to my gut feeling during an interview with a manager and it turned out to be the worst job I've ever had and he was the worst manager I've ever had! Never again to I ignore my gut. 1 year in med-surg is not the end of the world and there will be other CC jobs closer. Good luck in your decision.

Hi, Plan to relocate to Jacksonville area in the next 6 months and wondering what the pay rate is? I will have 1.5 years of experience and will be certified in a specialty area, but only have my ASN (working on BSN now though).

I chose based on price, ease of applying to the program, number of courses I'd need to complete coming with a previous Bachelor's degree and accreditation. But the primary choice was price based!

It's some formula that depends on hours worked per pay period and time in joband increases at 3 years in I believe. Right now as a newbie it amounts to 18 days per year or 6 weeks of combined sick/annual leave.

I'm testing 6/28! Think I'm going to get Uworld qbank and I have Saunders and Lacharity books also.

I would shadow a few nurses in different areas or volunteer at a hospital to see what nurses really do. There are so many option for nurses, which is really great and many options beyond bedside. CRNA is a great career, but it will be a long road (3 years school when you cannot work at all--so likely means A LOT more student loans for you + 1-2 years ICU experience). The good thing is that you're young and have a long working career to earn money and pay back student loans so the opportunity cost is lower given your age IMO. If you are really averse to taking out student loans now, can you go to a community college nursing program while working? That's what I did and while it was exhausting I was able to make it work. I went to a hybrid program where the lectures were online and the clinicals were on Saturdays (NVCC).