UmmIbrahim

Id agree...2 years looks betterand gives you a chance to move beyond the new novice RN role into a more natural, somewhat seasoned Nurse. ICUs invest quite a bit in new Nurses as do specialized step downs and floors like Cardiology or Neurology. Its very unprofessional looking to leave after a year or less. I understand its different if its a unique specialization with few openings and you luck out but overall its better and reflects better to wait a bit longer. We've had Nurses whove been on our floor 2-3 years who always said they wanted to try ICU or ED and who after 2-3-4 years made the change and its sad for us but u expect it... its part of ones career development unless one is hired into their dream job and love it...but its kinda annoying and looks a bit unprofessional for a new hire at 6m to 1yr to up and move...they aren't generally really competent yet as Nurses being so new anyway. I dunno...id wait 2 years, esp if ur departmentis fairly tolerable n coworkers, management are decent!

Good morning all! Random question.. I am taking 8 weeks off my RN to BSN program for financial reasons and am working more but i need something intensive to do in my spare time...lol. taking the PCCN for personal fullfillment has been a desire for 2 years now and im considering studying in my free time and taking in March. I did a practice test last summer and did well (it was a PCCN prep class my employer offered) so i know if i hunker down i can do it. I work on a cardiac stepdown. Anyway i have a few PCCN study guides a cousin gVe me last yr which r in storage...can i use them for practice questions? I know CCRN is critical care whereas PCCN is more my cardiac floors focus but do the tests overlap? Would a CCRN test book prepare me well? Or should i buy a proper PCCN practice book? Thanks!

For a Cards floor....I'd follow the Cards CP protocol...nitro...Labs...ekg...obviously get the MD involved...if cp not going away anticipate nitro gtt...if pin continues or pt deteriorates or EKGs changes prep for stat Cath. The CP is the biggie. That needs to be controlled. Bigemeny...I'd watch and be sure lytes ok so pt won't go into a lethal rhythm. I could go on but that's the history.

Class helps but being in Cards as seeing the monitors helps the most...and asking questions of experienced cards nurses.I'm now learning reading EKGs...like LBBB vs RBBB, ischemic changes... you get it eventually. But definitely in Cards the focus is on rhythms so a lot of time is invested in preparing new Cards nurses for reading telemetry correctly as it can mean life or death for our patients!

Hey all...where I work. Big huge teaching hospital + level 1 trauma center on a Cards floor...generally for TR bands we the floor RNs deflate 60-90 min post procedure once in room. If a pt does well at procedure they come right to the room. Obviously if they have issues or an intervention is tricky or no beds to they begin to bleed immediately post cath then to the cathlab holding they go! In which case they come back deflated.

I ditto the paying your dues thing...you can easily tell new Nurses who worked as PCTs from those who didnt...and Unit Directors do indeed look for that too! It takes less work to "break you in" to the unit routines...

It was a LOT easier for me to get an RN position as I already worked in the same hospital system as a PCT and was a PCT for 2 years WHILE in school...and I was casual though worked more part time or full time hours depending on my course work. My classmates who also were PCTs got jobs a LOT faster than classmates who did NOT work as a PCT or NA or even a helper during school. Seriously...keep it...do a few shifts a month... you'll be glad you did!

!!!! Oh my goodness...I think any Nurse will agree that when you are at work your concern is your patients...NOT your hair or looks or even scrubs. Scrubs are meant to be plain and simple and easy to wash and comfortable. Id rather have baggy comfy scrubs and be plain and simple and focus on my WORK! This isnt a salon or a office or a fancy restrautant...also what ICU Nurse would ever work with their hair down *flowing*...?? Heck, any Nurse PERIOD! When sh*t gets real...your hair SHOULD be your last concern....Ditto for shoes...wear whats supportive for your 12 hours + standing!!! Im just quite surprised by the original post.

So random question...in a nutshell we had a guy come in who has baseline unsymptomatic AFlutter...was on coumadin at home went to get his INR checked at his MDs office and was found to be....10!!!! The MD sent him packing to our cardiac stepdown and while there he had an ICD/pacer placed. Anyway...all anticoagulation was stopped...like not even a Heparin shot. Plan was to get the INR down to a suitable level then cardiovert him to attempt to restore SR. So some of us were unsure why they would need to wait for the INR to come down...cardioversion isnt invasive...and you want them to be anticoagulated and yet he had a pacer/icd placed with an inr of around 4...last I had him with am labs his inr was 2.4 with cardioversion planned for a few days. We couldnt quite figure out why the wait for INR to come down for cardioversion...yes he had a small healing incision and a new icd/pacer...so...is that why or must the inr be lower for a cardioversion? Trying to figure this out...im sure when I go back he'll still be there this time on a heparin gtt on a coumadin bridge... hmmmm

Id trouble shoot the monitor and when in doubt then ask someone with more experience with the monitors but usually a bit of trouble shooting on the monitors works...now if everything is done and pacer spikes arent showing then maybe something is fishy with a pacer lead or the pacer itself...call the MD they can get someone up there to check the pacer.

Hmmm...Ive never seen an order like that and dont know if Id agree because well, what if its a new run of VT even IF unsymptomatic its still NEW! What if the pt has occasional runs but suddenly starts having small runs frequently while remaining unsymptomatic. To write such an order sounds off to me. Personally if the runs are NEW or the pt is symptomatic but occasionally has them I call, even if its like 4 beats but unsymptomatic and new I call OR lets say the pt is new to ME and they had maybe 1-2 shifts ago a few runs and now suddenly having a run even if its say 5 or 6 but unsymptomatic I call and give the MD a heads up then I ask...hey, when should I call? Usually they say...call if the pt is symptomatic OR the runs are becoming frequent OR they have like 10beats or more. I always ask...I ask, ask, ask, ask...even if the MD is generally rude or mean I still ask as id rather be safe! So id say...use your discretion and just ask what they would prefer and if this is a safety concern let your director know...

Trust me when I say with time and practice and experience it gets easier...speaking from experience here...

Well...im on a Cardiac step-down in a large urban hospital and its quite frequent for staffing to be 6:1....our ideal is 4:1...but due to extreme short staffing we frequently are stuck 6:1. Our unit doesnt tend to get any random patient though...unless literally every other floor in the entire hospital is full then we may get an odd trauma or neuro pt but they are moved asap...a 6:1 ratio leaves much to be desired and some weeks our acuity is very very high, other weeks its not...like you may have a few post cath/ablation/starting tikosyn/prep for OHS or hanging out indefinetly for a heart tx...so we dont get post surgical or pt with a whole ton of lines...we do get a lot of Cardiac drips which require a great deal of monitoring and labs (heparin gtt anyone?!?) and those darn post caths can be incredibly time consuming... esp if you have a pt with a cough or who insists on getting up every 5 minutes... Personally I prefer to do day shift as there is more support...which leads me too...whats most worrisome about what the OP writes is lack of suport...TEAM WORK is absolutely essential in the hospital. Everyones patient is everyones patient. If im charting at the front desk and hear a red alarm behind me and see a co-workers PT tele showing VT I will immediately run in and chekc on them and if need me get care started....WE ALL MUST TAKE CARE OF EACH OTHER AND OUR PATIENTS.... I did work previously as an APCT on a diff floor and dont wonder if your experiencing a bit of hazing...the floor I worked on first as an APCT while in school for Nursing was VERY cliquish and anyone new was basically hazed...mentally, verbally, physically...from being treated rudely to be gossiped about to even being undermined...once you passed this apparently "trial by fire" you were "IN" with evveryone and suddently there was team work and help. It was an aweful environment though which is why I didnt want to work there as an RN. The floor im on now...there is a LOT more teamwork and less of the "hazing/new person" mentality...and our unit director makes a point of not allowing it. id say keep the job but START APPLYING EVERY PLACE YOU CAN! You will get burnt out there... Unfortunately as others h

Im not in the ICU but am trying to move to a MICU from a CRAZY BUSY Cardiac stepdown where we have up to 6 patients...ideally we should have max 4 but due to short staffing we max have 6...anyway, Ive been there for 8 months and ive gotten very very very good at time managament...I am a NOTE person and find if I have a good brain sheet and jot everything down and then immiediate tasks I put on a postit and put on my cart its front and center...which is wonderful when you have 6 patients and on day shift are discharging sometimes your discharging 3/4th of your assignment and getting new patients and you need to chart and do discharges on them all...floors are CRAZY but personally id think your issue is with time managament more than nayhitng else...if your a note person dont feel ashamed putting notes on your cart or have a very detailed brain sheet....it really helps. MOst days im out after report unless something crazy occurs but thats rare. Organization...just figure out what works for you. Skills will come and dont forget its OK to accept help and ASK more experienced coworkers for advice.

Hi all, so a question..can anyone pls direct me to interview questions which directors of ICU's specifically ask? I currently work on a very specialized Cardiac Step-Down and am looking to move to a MICU to give me a broader experience in Nursing and because I like working with the more acute/critical patients also I feel while Cardic is wonderful its very very specific and sometimes I feel like being that I am a relatively new Nurse that its useful to have a broader range of skills and knowledge under my belt...anywho...but since I had only interviewed for specialized units out of school I am at a loss as what an ICU director would ask. I am hoping I get the position though...its much, much closer to my home...wont have to deal wit traffic or parking issues and the unit is smaller with a wider range of patients coming through...so i'm quite excited. Thank you