MaroonTX

CVA symptoms can also be subtle.. I had a patient recently who came up to us after getting tpa for an ischemic stroke. When they brought him up he was intubated and sedated so in order to do neuro checks they just had me cut off his sedation every 1-2 hrs as tolerated. Since his blood pressure would sky rocket soon after the drips were turned off I had very limited time (basically just long enough to see some movement and eye opening, but not following commands) Then during one of my checks I noticed a slight decrease in the amount of activity. Since I had only been working in the ICU for ~1 month, I wasn't sure if the change was significant or not, especially since I wasn't able to perform any sort of objective assessment. It just seemed to me that he was moving a little less, so I decided to let the docs know anyway, just to be safe. A stat MRI was ordered and he had indeed had a hemorrhagic stroke as a complication of the tpa. It was definitely a learning experience!

The hospital I work at has an ICU fellowship program for RNs with experience outside of the ICU. I am in the internship and the folks in the fellowship go through the same type of education/orientation period as we do, except their length of time in the preceptorship is 12 weeks instead of 16 weeks. The program includes class at least once a week, rotations through the STICU, MICU, CTICU, and CCU with various preceptors and of course ACLS and other certifications our hospital requires for their ICU RNs (dysrhythmia, epidural, stroke etc.) You should definitely look into hospitals offering similar programs :-)

I am new nurse in the ICU also (~3 months) and what many of us have started to do (since there's quite a few newer/inexperienced nurses on our unit at the moment), is print off a list of Y-site info for our pt's and pass them off during shift change. These lists usually include what drips/meds the pt. is currently on + common emergency/procedural drugs we use. When there's a change made people will update the lists, or if time did not permit during that particular shift they will just mention that there was a change and I will usually try and update the print out at start of shift. It really helps save time (not to mention paper) to hand these off rather than printing out new ones every shift. We don't expect the experienced folks to update them of course, but they have been great about keeping them to pass along and will just mention during report that these meds have been started so you may want to add them to the list. Another thing I started to do is make a master list of all the IV drugs I've encountered (starts off a little tedious, but eventually you won't have to add drugs that often) and just play around with them on the Y-site program on your days off. Definitely not close to being an expert yet, but the repetition is helping things to start and sink in. If I've learned anything in these past couple of months its that being a new nurse is like being in school. Your job is definitely not over when your shift ends, you gotta study and do your homework on your days off, b/c as you mentioned free time is a rare occurrence during your shift (esp. us newbies, who are much slower at getting things done lol)

I did my nursing school capstone in the SICU and LOVED it, but like you I had reservations about being a new grad nurse working in the ICU. Especially when so many say "new nurses should start on the floor". However after speaking with those I had worked closely with (preceptors, other SICU nurses and a couple of my professors) they all said that there is no reason ALL new grads HAVE to have floor experience first. I have been working in the ICU now for about 3 months as a new nurse and I'm LOVING it. I think what area of nursing you start your career in should depend more on your personality and what you find satisfying in a job. ANY new grad is going to have to work their butt off regardless of the unit. I won't speak for others b/c I don't want to upset anyone, but I feel that straight out of school I was pretty useless. 3 months of experience + extra education/guidance, I'm not quite as useless, but I'm still far away from knowing it all, heck I've barely scratched the surface. What's important is that my work environment (the ICU) keeps me driven. Everyone thrives in different environments, you just need to figure out what you're most interested in learning about and the type of environment that keeps you motivated to persevere. As a new grad nurse you're going to have to overcome a whole lot of obstacles. I can't even begin to describe the highs and lows I've experienced in just 3 short months, but when I reflect on my career thus far the positive experiences outweigh the negative ones by a long shot. That being said, I would strongly encourage you to start out in a program designed for new grad nurses (whatever area you decide to work in). On a side note: What is the reason behind "the new graduate needs to put in their time on the floor" theory?? Please know I'm not being rude or sarcastic, I'm just genuinely curious b/c where I went to school this was never encouraged. I just remember some of the veteran nurses (20 + yrs experience folks) saying this all the time while I was in clinicals, but never really got the chance to discuss with them their reasoning??

Has anyone ever had trouble with near fainting while working?? I remember this happening to me a couple of times in the past, but today it happened again and it really freaked me out!! It seems to happen in the early morning during day shifts (I've been on nights for so long since the first couple of occurrences that I had totally forgot about it happening to me in the past), but before it happens I'll just be going about my business and I suddenly feel overwhelmingly hot, then sweaty, light headed, then my vision and hearing becomes distorted and at this point I usually have to leave the room and sit down or run cold water over my face. I know it has nothing to do with bad smells or any of the "grosser" aspects of patient care, so I can't really seem to figure out what is causing it. Any help would be appreciated because it's pretty embarrassing when I have to suddenly leave a patients room (especially right now since I am in orientation at a new job, working with another nurse). Not to mention I won't feel quite right for a long time after. THANKS!

Lovely- I tried to send you a PM, but I'm not sure if it went through or not (don't think Ive made enough posts or something??) Anyway let me know if you didn't get it!!

I can say that after orientation I'm more excited than ever to start my nursing career at S&W!! Yes, it was a long week, but wow what an amazing opportunity they give all of us new graduates to fulfill our potential as nurses!

Lovely, I had my interview on a Friday and received the call from HR with the official offer on a Tuesday and they e-mailed me the new hire packet later that day. Apparently the offer I was given the day of my interview was "unofficial" (oops lol).... Anyway I'm sure HR is just swamped right now, but it couldn't hurt to call just to see what's going on. And again CONGRATS

Congrats lovely!! Sorry, I haven't been on here for a while, but that's really exciting and I will see you in June. As far as places go, I didn't look at apartments because of my dogs so I don't really have any advice on those unfortunately...However, it only took me a day to find a place, so hopefully the rest of you won't have too much trouble!! Anyway congrats to everyone and I am sooooooo excited to start and meet all of you :-)

I went to Temple today and found a duplex that I signed a lease on. I didn't check out the apartments because I have dogs and wanted a backyard, but from what I can tell prices are pretty reasonable (I'm paying $779/mo for a 3 bed, 2 full bath duplex with a yard). There are definitely some areas of town that are kind of sketchy, but also really nice areas (i'm lucky bc my boyfriend is from the area so he could tell me immediately what places to avoid based on address). If anyone has any specific questions regarding an area they are interested in, let me know and I would be glad to try my best to help. Another tip one of the realty companies gave me is that right now the selection is a little slim, but starting soon many rental properties will open up bc the interns/residents @ S&W leases will be up and they will be moving on.

What unit?? I got the call for the ICU, and I'm super excited :-)

I believe for the ICU it is room 286 on the second floor. I was told it was in the South Tower, but technically you have to go around some strange way to get there. There is a patient services type desk if you take a left after entering the South Tower and just tell them where you are trying to go and they will give you a map with some directions (as you can tell I got lost and had to do this lol). Again, best of luck :-)

Yes I'm from Texas. Definitely let me know how it goes, we may be coworkers in June :-)

I interviewed for the ICU. Lovely, what they did was initially talk to all of us in a group and basically gave us a brief overview of how the program and the interview will be conducted. Then everyone is separated and given one on one time with each interviewer (director, manager, educator etc). Then after about 10-15 minutes they will swap you off to the next person (just like you are rotating through stations). Try not be nervous and instead show them your enthusiasm for the program. Good luck :-)

I agree boooo to the negativity. Of course I appreciate when people share their experiences and give input, but it is definitely understandable that in a competitive atmosphere people do not want to be too revealing. I will go ahead and share that my experience interviewing at S&W was amazing. I felt very comfortable and connected to all those I interviewed with, and can honestly say it was the best interview experience I have had so far. The interviews seemed more like a conversation than a nerve wracking test, and I feel that I really got to know about the hospital and they really got to know me. My advice may sound a little generic, but it really made the difference between this interview and previous one I had about a month ago, so here it goes..... 1) Prepare. Google or read the forums on this site about common interview questions. I printed these out and quickly jotted down my thoughts on each. The first time I interviewed at a different hospital I did not do this for fear of sounding too reheorificed. However, I quickly learned that nerves may leave you feeling tongue tied or as if your mind has suddenly gone blank. By collecting your thoughts on these questions ahead of time you can avoid those long awkward pauses after the interviewer asks you a question. Take out the pauses and you seem more prepared + you have more time to let the employers know just how wonderful you are :-) 2) Research the hospital and unit ahead of time. This is pretty self explanatory, but I think it allows you to really get a feel for what the hospital and those who work there are all about. 3) Be prepared to ask questions. What do you need to know about them in order to assess whether this place is the best fit for you. I actually wrote these down ahead of time and brought them with me to the interview. 4) Be yourself!! Yes, I know this sounds a little lame, but I think a major part of an interview is letting the employer get a feel for your personality. Most people probably have the same basic types of answers to the questions you will be asked on an interview (ie. Q: Why do you want to be a nurse A: I enjoy helping people). Think of ways you can incorporate aspects of your personality and past experiences into answering these questions so that your answers are truly personal rather than generic sounding. 5) Get there early!! The hospital is a little confusing and I wandered around for about 15 minutes before someone kindly directed me to where I was supposed to go. Plus getting there early will allow you to sit down, relax and talk to others who are there to interview -- This really helped relieve some of my pre-interview stress. So like I said, not the most original advice, however I made the mistake before of not taking these simple steps and the result was less than desirable. This time around I really prepared, and things went much more smoothly :-) .... Best of luck to everyone who has interviewed or will be interviewing soon -- and don't be discouraged if you (like me) have had any previous bad experiences interviewing -- learn from those experiences, stay confident in your abilities and have faith!!