MemorialCCRN-CSC

Our differentials are pretty good then... Night weekdays (Mon-Thurs) 7p-11p is 3.35/hr 11p-7a is 5.00/hr Night weekends (Fri-Sun) 7p-11p is 11.00/hr 11p-7a is 11.35/hr.

You can quote the recent article from the New England Journal of Medicine that states unsafe nurse to patient ratio will lead to increased patient mortality. The staffing ratio's you quote seem very unsafe to me. I would hate to ask what the night time ratios are.

I would recommend studying up on your hemodynamic parameters and treatment related to abnormals values. Also definately don't be affraid to say you don't know something but you are very willing to listen and learn. If you are familiar with something and your preceptor is doing it a different way, try to not jump to conclusions and say they are doing it incorrectly cause many things taught in school are not the way they might be done in actual clinical setting.

Post interventional Retroperitneal bleeds do unfortunately occur and can be exacerbated by the use of low molecular heparins and anti-platlet agents. And with the increasingly over-weight population it can become a more difficult complication to prevent. In patients with unusually high femoral artery access sites it can be very tricky to acheive adequate homostatis regardless of methods used. Classic signs to look for are the flank pain and also the sudden urge to pass gas and have a bowel movement. Most retroperitneal hematomas don't require surgical intervention and will be treated with blood products till space is filled and bleed tampenodes off. Psuedoanurysms on the other hand to tend to be more aggressively treated with thrombin injection or surgical intervention. As far as issues related to just the use of lovenox and not associated with cardiac interventions, I have only come across one case of a spontaneous rectus sheath hematoma that was self limiting but did require the transfusion of some blood products to maintain adequate circulating volume.

I have to agree with the above message. I worked a total of 5 years in a med/surg background with almost 3.5yrs as a travel med/surg nurse before moving to an ICU setting and I cant tell you how much those begining years benefited me down the road. And now after close to 12 years in critical care I still find myself seeking new learning opportunties and additional certifications to broaden my knowledge base. I for one don't feel that new grads should be allowed to work in an ICU setting right out of school. Even with the best orientation and preceptorships you cannot learn critical thinking skills that only come with time on the job. Being able to work in an environment that you will feel comfortable starting out will benefit you way more than being placed in a totally new and stressfull place. You will know the people that will help you and lead you on your way to becoming that great nurse you plan on becoming.

Sounds to me like your going through the anxiety fears that everyone who starts out in nursing go through. Hopefully you have a resource person that you can refer to for things that seem "Not Right" to you. Its never wrong to say you don't know and refer to someone with more experience and hopefully that more experienced person doesn't make you feel even more inadequate. It's a shame that nursing tends to eat their young when it's those young that might be caring for ourselves one day. But all in all it sounds like you have a good head on your shoulders and are progressing to becoming an experienced nurse. I'd be more scared if you posted that you felt like you knew everything right out of school then being honest and having the feelings you do. Best of luck to you in all your future endeavors.

I found the best way to review and pass the CSC exam was to attend the 2 day review offered at NTI and sit and take the paper and pencil exam the next day. Only downfall was waiting 4 weeks for my results.