johnwaynehair

Yup. It was a "make your own corn bar" thing, with spices and mayo. I'm on a low carb diet, so didn't partake. I work night/weekends, so I miss out on all the other events during the week like breakfasts, lunches, etc.

We got a cup of corn!

1) Eat when you can, pee when you can, sleep when you can. 2) Keep your eyes and ears open, and take whatever lessons you can where you find them. 3) Don't let a senior nurse bully you into doing something you are unqualified to do (I cardioverted a patient with a doctor on the phone, but not in the hospital once in my first year because an older nurse said "we do this all the time"; luckily it turned out OK). 4) Forgive yourself for the mistakes you will make, and resolve never to make them again. 5) Check and re-check. 6) Realize that patients will die on you no matter if you do everything right. Good Luck in your practice, and Welcome to Critical Care.

Relating tech experience to nursing is like relating unarmed security guard experience to police work--some similar duties, but not the same field of practice or expertise. I had no previous health-care experience (other than basic first-aid), was a bakery manager before school, and ended up hired directly into an ICU setting/Versant-style training program-- your confidence level and knowledge will help you if they're there. If you can get a job as a tech, and the job doesn't interfere with school (as others have said), and YOU feel it will give you confidence, then go for it. But there is no iron-clad rule that says being a former tech will get you a job faster. Good luck!

It's mostly new grads, but there are occasionally some RN's with no hospital experience allowed in. Can't say what the next class size is...just give them a shout and see if you can get in--nothing ventured.....Good luck! John

My hospital system, Christus Santa Rosa, has a Versant intern program for GNs/new RNs; http://heavenlycareers.com/nursing/graduate/default.asp We have a couple of new RNs on my ICU, and they seem to enjoy the program...I'm signed up to be a mentor for the program for the new class starting in Jan '10. Give us a look...Good luck!!

Concurr c Mianders; usually the MD writes an order "RN to pronounce" for the DNR pts. 2 RNs will palpate/auscultate for pulses; auscultate for respirations, confirm EKG asystole, call time of death, and document. If pt is vented then the MD must order for the pt to be placed on a T-piece-- we can't extubate. If no T-piece order is in place, then the ER doc has to come up to the Unit.

We work hard, so you don't have to! My favorite tongue in cheek: Keep 'em alive 'till seven-oh-five (I'm on nights)

Welcome to the ICU...Hemodynamics is a good first place to start. When I went through my Critical Care rotation, our instructor had us look at all the meds our patient was receiving and break down the route, reason for administration, side effects, etc...Really helped. Do a little reading on the vasopressor, inotropic, and insulin gtts. Review oxygenation and the various methods (Vents, venti masks, NRBs, etc), and when appropriate. There are a few mock code sites on the Internet--take a look at them to get a feel for what really happens in a code (TV does not prepare you). Finally, I would review units on death and dying for your own well being-- the first deaths I witnessed during my nursing education were in ICU, and it helps if you realize it's a part of what goes on in the unit. A little long, but hope it helps.

For a 500# pt: Arrange for transport to SeaWorld for MRI...SeaWorld declined, stating they would not examine a human. For a pt that tried to disempact her bowel with the fork from her dinner tray (perfed herself, too): Only plastic spoons on meal trays from now on.

Talk to Canadian nurses working here about how their healthcare system is not what it's cracked up to be...things like having to wait for months for imaging (there are more MRI's and CT's in my hometown of San Antonio than are in the entire nation of Canada). When I visited Great Britain two years ago, there were ads in the paper for "medical vacations" to India for people wanting CABGs done promply, and not having to wait 3-4 months with the NHS. Our healthcare system is broken, but it still is better than socialized medicine. Moore is just out there to self promote...do you think if he had an MI, he would hop a flight to Cuba, or go to Hopkins, or the Cleveland Clinic, or the Mayo, or even his local Level-1?

Fredericksburg in the Hill Country has a community hospital that is always looking for nurses... http://www.hillcountrymemorial.com/

From Wikipedia: Maurice Rappaport and Howard Sprague designed a new stethoscope in the 1940's which became the standard by which other stethoscopes are measured. The Rappaport-Sprague was later made byHewlett-Packard, later Philips, and today there are still cardiologists who consider it to be the finest acoustic stethoscope. Acoustic stethoscopes are familiar to most people, and operate on the transmission of sound from the chestpiece, via air-filled hollow tubes, to the listener's ears. The chestpiece usually consists of two sides that can be placed against the patient for sensing sound — a diaphragm (plastic disc) or bell (hollow cup). If the diaphragm is placed on the patient, body sounds vibrate the diaphragm, creating acoustic pressure waves which travel up the tubing to the listener's ears. If the bell is placed on the patient, the vibrations of the skin directly produce acoustic pressure waves traveling up to the listener's ears. The bell transmits low frequency sounds, while the diaphragm transmits higher frequency sounds. This 2-sided stethoscope was invented by Rappaport and Sprague in the early part of the 20th century. One problem with acoustic stethoscopes is that the sound level is extremely low. They are the most commonly used. Try this site...this is the type of Sprague our nursing school required with "accessories", i.e., the extra bells and diaphrams. http://shop.advanceweb.com/ProductInfo.aspx?productid=551

I use "salt and pepper; lettuce and tomato, with a burger in the middle"

These are new TJC (the new & improved JCAHO) requirements: we got audited this spring and after the visit we were told the same thing; the only time we can take a verbal is if there's a code running.

When I graduated I bought an ADC 602 Cardiac, compares to the Littmann 3128 Cardiac III; it was about $80 cheaper at the UTHSCSA bookstore. I love it, and have had several doc try and bogart it after using it on the unit (ICU).

Make sure the MD ordering extended release meds is aware they can't be crushed and put down an NG tube. Good luck.

Shared experiences and challenges ahead...Welcome to the profession; good luck with the NCLEX

Of all things, I bought a concealed handgun fanny pack, and took out the holster...lots of pockets and really roomy!

I work for Christus Santa Rosa Medical Center, and we need experienced cardiac tele nurses; go to heavenlycareers.com for more info...can't tell you what they'll pay; as far as housing, costs are starting to climb, and property taxes are high, but there are no state/local income taxes (only sales).The Northside of town (including NE and NW) tend to be a little safer than the East, West, and South sides. There are also several "bedroom communities" around if you don't mind the drive (public transit SUX compared to Chicago). Lots to see and do, winters are mild, summers can be brutal. Hope this helps, and welcome to SA.

Sorry, don't know anything about the Hem/onc units...Maybe you should try and take a Southwest flight down mid-week and tour the hospitals...contact HR and see if they'll give you a tour. Good Luck!

Welcome to SA! I work for Santa Rosa at their Medical Center facility, and my daughter was treated at Santa Rosa Children's when she was a neonate with severe idiopathic jaundice (thought it might be Gilbert's syndrome, but thank God it resolved on its own). The Staff at Children's was top-notch, and I've been told that it's the best children's hospital in the region. Most of the attendings are on the faculty of the Medical School at the Health Science Center. Having said that, I was told by one of the RN's taking care of my kid that yes, it was the best children's hospital in the city, but (in her words) the main problem was it was "in the ghetto". Children's is downtown, non-profit, in the heart of the West side of San Antonio, a very economically depressed area. The clients are mostly indigent, on Medicare/Medicaid, predominantly Latino (like most of SA and myself as well) and mainly Spanish-speakers. There are a lot of health issues associated with that populace (high rates of type-I diabetes, juvenile obesity, lots of CP, child abuse, mother-to-child STDs, Down's, etc). Methodist Children's in on the North side of SA, in the Medical Center complex. It is high-dollar, for-profit, very modern. The care there (I've taken my kid there as well) is good. I also did my Peds rotation there when I was in nursing school. As to which is better to work for, I'd first consider which is offering the better pay/benefits package. Then I would go with my heart...I joined Santa Rosa because it is a Christian (Catholic) hospital system that is still non-profit (Methodist and Baptist systems here are both for-profit; the churches are minority share-holders). I feel I am doing God's work here. Still, if you feel you can't deal with the types of patients you would predominantly see Downtown, then you've got to go with Methodist. A little long-winded, but I hope it helps. Feel free to ask any other questions...Good luck. John Transplant ICU RN

UTHSCSA is a lot cheaper that UIW; When you make too much to qualify for financial aid, you go with the cheaper one. My entire cost for 2 years at the HSC would pay for about a semester and a half at UIW. We must have done some things right with our clinicals, as I was hired into the ICU I had clinicals on in my last semester...

On of the RNs in my ICU worked there--did not like it. PT/RN ratios are too high on Med/Surg, she said. That was about 5 years ago; maybe things have changed...

We rotate the duty, and get a whopping $1.00 an hour diff. We also have to take our normal patient load.