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

also...Ive seen many Orthodox Jewish women and Christian women who are RNs who wear scrub skirts but they usually wear a mid-calf or just below the knee style with thick tights...I think for them and those skirts can be safe to wear as they dont drag in body fluids or hamper a run or perch on an edge of a bed getting a pt back...its the whole full length ankle length skirt which I think is unsafe. just to clarify

Hi all...we'll I'm a Muslim, I cover and I'm an RN on a step-down. I also previously worked as an Advanced PCT (fancy term for an aide who can do blood draws, insert IVs and read monitors)...anyway. Let me give you my own personal thoughts about this...and if you have any *specific* questions feel free to IM me via AllNurses as it can be difficult at times for those who dont cover or arent Muslim to understand where we are coming from. anyway. My main concern with how I dress at work is *SAFETY* and *CLEANLINESS*...Now, Nursing is a DIRTY profession...certain floors are dirtier than others...if your on a post op floor expect a LOT of bodily fluids...if your on a pulmonary floor or a abd, organ transplant floor...the body fluids are never ending...you get used to it BUT you need to be extra careful with cleanliness and this goes for ALL Nurses...as nothing is worse than "burping" an Ostomy bag and it splashing on you...eww...or from a SAFETY standpoint...like on a Cardiology floor...patients are OK 1 minute...next minute they are in pusless VFIB and you are RUNNING down the unit grabbing stuff as you go to their room and jumping on TOP of them doing chest compressions OR pulling the off whatever they fell onto OR running to grab a crash cart.... so...personally I do NOT wear a scrub skirt. Now...Ive seen online scrub skirts which are "modest"...like ankle length and cut to be good for a decent stride...but I can tell you...when your perched on the edge of a patients bed doing chest compressions you are NOT thinking about if your calf is showing...which in a skirt unless you wear pants under it...your going to have that problem...plus...what about body fluids? So No...I do NOT wear scrub skirts...and unless I moved to an office environment I would not wear them anywhere in an acute care setting...not only would you potentially be MORE exposed but I feel like it would be unsafe...you could trip easier OR get the hem in something nasty or whatever. What I do wear is a very baggy pair of petite length (cuz im short) scrub pants...and a baggy scrub top usually with a scrub jacket on op which hips around hip length/upper thigh or said scrub top over a long sleeved top. Wheh purchased baggy enough it really doesnt show anything. There are some scrub brands which make fitted scrub outfits like Greys or whatever but I usually buy basic Cherokees or Urbane Scrubs a size big and they are baggy enuf to hide my butt but not too baggy to be unclean or unsafe. This is a HUGE concern... Now for a scarf...I only wear regular sized stretchy jersey shaylahs...I buy mine from Hijab-Ista...I prefer these are they stay for 12-16 hours without being readjusted, generally dont even need a pin and when I use one I have a big weighted one which doesnt budge an inch and its stretchy so I can easily fit my steth UNDER it at the sides of my face to get to my ears...im on a Cardiac unit so we use our steths a LOT. That nonsense of using a steth OVER your scarf which you see in staged pictures is unsafe...you cant hear faint crackles or murmurs or whatever doing tha...you hear just crunching...also you cant be readjusting your scarf every 2 seconds or have pins falling out OR have it danging...I tuck my ends INTO my scrub top...this way no sundowning elderly patient can grab on and choke me OR someone with a bad attitude grab it. FYI on PSYCH units this is a MAJOR CONCERN! So on those when I had clinicals I wore an al-amira so if it was yanked it would harmlessly pop off...it never happened as I couold pick up on aggressive body language fast but since I dont work psych...I found that jersey shaylahs are the best fit for me. Also again when your on top of a pulseless patient doing chest compressions you can NOT have your scarf falling in your face or falling onto the patient... Safety is FIRST.... I feel I cover to the best of my abilities to do my job. Some may disagree but they arent Nurses or even Doctors so have no clue as to what my job entails.and patient safety and then my safety is priority....as long as im not buying scrubs which purposely show off my butt and i try to be as modest as I can I feel like im fine. Outside of work I dress much the same as you...abayaat, jalabeeb...etc. I hope this helps...

Thanks for the input! iPink...looks like you came from the same situation as I am in...its pretty intense....oooh 'Happiness"...!!! *smile*

I have to condense my question as Im off to work...but in a Nutshell I work on a very very hectic Cardiac step-down, we have up to 6 patients and half of them are fresh from the ICU, multiple drips, procedures...monitoring...lots of VT and CPR and all that fun stuff. Our floor is a Cardiology "hub" so we are busy, busy, busy. Now, I had planned to stay in Cardiology but what got me into Nursing originally was wanting to be a Midwife or L&D Nurse....I always found maternity Nursing incredibly interesting and I wanted to help women and families during such an important time in their life! But...thought Nursing School I found I had a knack for Cardiology and fresh from School L&D was impossible to get into...so a plum job in Cardiology landed at my feet and I grabbed it. Anyway...recently we have had a LOT of changes...a LOT of staff leaving and we are so short staffed its heart breaking and not safe....work is now just so stressful. A few nights ago there were just us 3 Nurses with no PCT or HUC and half of our patients required pretty frequent attention, one was bleeding internally and externally from a Cath insertion site gone awray and bedside surgery was required...so anyway Ive decided I may look and see if anything is available in L&D or M&B. Do you think moving to such a different speciality will be too difficulty? whats the turn over rate like? whats the staffing ratios like? whats the typical shift like? I had considered C-ICU but dont know if I want to stay in Cardiac per se anymore. Thank you

Well...I'm a Amercian whose Muslim who covers AND I'm a RN to boot! LOL. Personally I generally dont get problems from patients because of my professional attitude. I work Cardiac in a Hospital. yes now and again I get patients who are uneducated or whatever and think all Muslims are foreigners or I cant speak English or some nonsense but frankly...I dont shy away and I dont get scared of them...if anything it makes me want to show that patient that we are normal people just like they are! My last such pt said some nonsense to me right at shift change which the other Nurses with me found embarrassing...I just was like whatever...by end of shift he'll adore me...and as I predicted...said indiviual by end of shift adored me and told me I was cooler than he thought...because I made a point to relate to him and his family. Neway, all I'm saying is...I view it as an opp to educate them about a part of society they may not have interacted with..dept on where they live. I do find it tedious that some individuals assume all covering Muslims are foreign, that we arent American, or some thing like this. yes I know plenty of foreign born Muslim Nurses and Doctors but there are just as many who are straight up regular Americans! Also...I dont see how there is necessarily an "Islam conflict" in the states...as far bac as I can recall there have been issues with the mainstream media and how it reports Islam and Muslims...but nothing new...right? at every point in history some group or other has been targeted. But...I dont really feel like it impacts me too much. Again...I'm American by birth and culture and everything else...just my religion is Islam...so perhaps it doesnt bother me as much...I also ignore stupidity and ignorance in general. LOL

Nice tip...I know many covering nurses do the al ameerah too...I personally dislike them but I disliked them even before I was a nurse. I just do reular jersey shaylahs, ends tucked into my scrub top and it is just as good.

Hey and salaam...I'm a Muslim RN, work on a cardiac floor and cover. Sis just get yourself some jersey shaylahs...wrap normally, put 1 pin at the top, tucks the ends into your scrub top and you can easily pop the steth in AND out of your ears with zilch issues. I work cardiac so obv I am *always* manually auscultating BPs and listening to heart and lungs...I cant be fiddling and you dont want to keep removing your pin as you may loose it...which you dont want. I buy all my jersey shaylahs from Hijab-Ista.com...i have like maybe 10 and I just wear a diff. color wear day at work. They last for 12-16hur shifts and I dont have to adjust at all...even once...which I good as im *busy* as heck during those 12-16hrs so even running to pee is a huge celebration for me...even eating...so I cant waste time messing with my scarf. DO NOT PUT YOUR STETH OVER YOUR SCARF! I repeat...do not! That is POOR PRACTICE and is NOT safe...because you are oputting your pt at risk. You CAN NOT HEAR through a steth over your scarf!!! I remember trying that to practice a few times at home on family and you can NOT hear low heart sounds or diminished lung sounds or properly auscultate a manual BP! You hear crunching fabric. It also looks unprofessional. Just do yourself a favor...buy a few normal jersey scarves at hijab-ista and dontnsweat it. Your fee to email me if you need more advice. [email protected] OK best of luck. Dont sweat stuff like this...its not a biggie...you have bigger fish to fry...fiddling with your scarf isnt one of them + need I mention its also not safe...lost pins...patients who sundowning or anxious and grabbing at things/people/clothing...infection control...need I go on. Keep the shaylah intact...no stress,

Hey all...in a nutshell. I just need some fresh ideas on how to go about applying for RN positions! I graduated in July but took my boards and passed in the first try in mid-Oct. I had a rough summer and felt it best to wait until things calmed down before attempting the boards. I applied constantly after graduation but before the boards only to find out they wont even contact you due to not passing the boards yet. NE way. Ive worked full time as a PCT + Phlebotomist in a huge urban hospital and on a very famous, world renowned unit. I know our director generally doesnt hire out of school due to the nature of the floor...BUT all the other PCT's I knew who had grad before me managed to get jobs in sister units/floors...most got jobs within a few months of taking their boards. Ive also been in contact with my classmates and those who passed their boards all got jobs withina few months. I live by 3 major hospital systems... the first one which is smaller and about 40min from me...I keep applying constantly...and they keep posting that I have been passed over for the position for whateve reason. The other 2 hospital systems are very very extensive and huge and its renowned how long they take to even look at applications let alone forward them to managers! Ive tried talking to my unit director, the night AOD...anyone I can about what to do...I also had 2 RN's I work with help me with my resume and cover letter. Ive contact directors of whole sections of the hospital and I just get a generic reply...which I can expect...because they, im just a small fish in the sea. Its now been 4 weeks that im applying...and applying and applying...no calls..no nothing and im starting to get annoyed. Everyone told me I would easily find a job given my PCT experience and time in the hiospital and the hospital system I work for does give pref. treatment to employees...so I dont know why its taking so long. Some thoughs ive considered are this: Should I print off a resume and a personalized cover letter and on breaks hoof it around the hospital (or atleast the part closest to me!) and start giving them to unit directors... or would that come off as rather odd? I know on a lunch break recently I heard some RN's mocking this Nursing Student who worked on the floor across from mine who would run over on breaks to talk to our unit director although she wasnt interested in her. Ive tried talking to everyone...and not sure who I should contact next? Ive also been emailing the recreuitment person who first contacted me back in July after grad (they did this for all of our class...contact us to inquire what fields we were interested in...)and shes said just be patient, if something is available that Im a fit for, i'll be contact. I feel like on onehand this is an ok-ish time to be going through this as almost noone is graduating right now...but I would rather not go through winter still a PCT! Lastly...I thought I had a wonderful coverletter and resume...but am unsure...but I dont know who to talk to about that. I wrote up a nice cover letter which I modify a little each time I apply for a job...though my resume stays the same. I am applying for everything and anything...I just want a job and will worry about a specialization once ive been working as an RN for a year or two! Pls any advice... Thanks

Congrats!!!!!!!!!!! Congrats!!!!!! Good things await.... for those who wait! I passed Nclex-RN on the first try Oct...but I waited almost 5 months after grad to take it due to Family drama and moving and all that and you better believe I was a nervous wreck but its such a fantastic high when you find out you passed! Treat yourself...and congrats!!!

Yea its aweful waiting huh...I was a depressed, crying mess for 48hrs until I forced myself off the sofa and checked it...give it time! *best of luck*