kurlykay

It is really important to make sure the foley is anchored to the leg with a stat lock, tape, or whatever else you can come up with. The less the foley more around and puts pressure on the spincter, the better and more comfortable it is for the patient. I have found numerous foleys not anchored with the patient's really complaining they have to pee, once I anchored the foley, the sensations was greatly decreased and the patient felt better. No matter where I have worked, for some reason foleys are never anchored to the leg.

At least at the school I teach at, CPR requirements are per hospital clinical placement requirements. For each student we must submit proof that they have their current CPR card that meets the clinical sites requirement. So, if most hospitals in your area require AHA, then your school most likely will as well because they must meet the hosptial's standards in order to place you there for clinical. Pro CPR online course is not accepted at my school for this reason. Karen

After leaving this job, please report this manager. It is illegal to change documentation and she should not be allowed to continue to do this. Hope your new job is fantastic!

I work in the ICU. I took care of a patient that was a RRT and transferred down to our unit because the floor could no longer get a blood pressure via cuff. The patient was alert and talking but had nausea and vomiting. When I got on shift she had been on the unit for about 2 hours and Levophed and Dopamine were both maxed. The nightshift was getting only mean pressures and they were all over the place. I called the doc and asked for an aline and he agreed. To make a long story short, multiple attempts for an aline were made by 2 different anesthesiologists (with doppler and sonosite) and 2 different cardiologists attempted groin lines and all line ended up being venous. Finally after 5 hours an interventional radiologist got the aline in the groin using ultrasound. (By this time the patient was intubated and on levophed, dopamine, and vasopressin maxed.) The patient's SBP was 179! What would prevent the docs from getting the aline? I know it can be difficult to get an aline on people with very low BPs, but I've never seen so much difficulty. Especially when she did have a very good BP in the end. Has anyone else had this happen and what was the cause determined to be?

Where are you located? There is a college near me that offers a combined online program, all classes are online but all clinicals are in the local hospitals. There is also a "nights and weekends" program near me for working adults. Maybe you could find a program like this that would fit your life.

I also work 12 hours shifts in California and we get one unpaid 30 min lunch break and two paid 15 minute breaks. As someone said before we waive one of our breaks so that we work from 0700-1930 and get paid for 12 hours. We are not allowed to take all our breaks at once to make it an hour. California also has a law that states that your first break has to be taken within the first 5 hours of you shift and if you work more than 8 hours, your second break must be taken in the last 5 hours of you shift. Since we waive one break, we either have to take a break from 0700-1200 or from 1400-1900. So basically we cannot take a break from 12-2pm (which of course is prime lunch time!). This law cannot be waived. It doesn't make sense to me how we can waive a whole lunch but cannot waive this dumb law. The nurses have gone to the labor board to testify how this law affects us and that we would like to be able to waive it. We have also signed a petition that went to the state capital. We are currently waiting for a decision. Some hospitals in California do not follow this law. Since we clock in and out for lunch it is very easy to track and we are paid a break penelty if we clock out at the wrong times. You can sue if the break laws are not followed and the hospital would have to pay alot of back penelties. My hospital always makes sure you get a lunch break, even if they have to bring in an extra nurse to cover people. -Karen

I agree with CardiacRN, If the patient is in a coma and on a vent we usually will trach them within a couple of weeks. As soon as they are trached (providing that we have "fixed" their other injuries) we send them out of the hospital to another type of facitlity depending on the level of care they need. If a patient who can been in a coma wakes up and they are on the vent, they will usually try to fight the vent. This would make the ventilator alarm and the RN would go into the room to check on the patient. Sometimes we will also see changes in vital signs (such as an increased heart rate) because the pateint is usually scared. I also agree with the other posts that they patient would be confused and have no memory of what has been going on so pushing the call light would not be believable. If I was the nurse, I would explain to the patient that they are in the hospital and have them nod their head to some simple questions (like are you in pain) so I can get an idea of what their mental status is like.

I looked into moving to Fresno a year or so back. I also was looking into ICU and acually toured the Clovis community ICU and heart hospital ICU. I spoke with HR, and although they could not tell me the exact pay rate, it was somewhere in the 30's. I seem to recall her saying around $34/hour. They give alot of differentials for various things so it is probably very specific. I had also heard good things about Clovis community so I wanted to see for myself. I don't know what kind of hospital you are coming from, but the ICU was very small. I think it had something like 7 beds. They do not have a cath lab or do anything that requires bypass. It's a very small community type hospital. After touring it I decided it is not someplace I would want to work, but to each his own. The Fresno heart hospital was beautiful and the people seemed friendly. They do alot of CABG, thoracotomys, stents, but they also do bariatric. I know all the big stuff goes to the large downtown hospital. Although it is not in a great neighborhood, its a very short commute to some nicer places to live. Let me know if I can help you with anything else.

A few of my coworkers and I were complaining to one of our docs that we always have allergy symptoms at work and not at home. He said it could be the hand sanatizer as he has seen this reaction many times because of the harsh chemicals. We started only using soap and water washes and the allergy problem went away.

For anyone looking for a night RN program there is one through El Camino College sponsored by Little Company of Mary hospital in Torrance. The program is nights and weekends so people can work during the day or take care of their children. It is a two year ADN program and meets at the hospital for all classes. Hope this is helpful :)

Little Company of Mary in Torrance has a 4 month ICU training program with classroom and clinical hours. I think it starts in August. They are hiring.

We get $2.50 more per hour. This is in ICU where the charge nurse must respond to all rapid responses and code blues in house plus we have a 28 bed unit. They do not take an assignment except in a rare occasion that we are really understaffed. We also get he $2.50 more per hour when we precept :)

I am an ICU nurse in so cal but in LA county not in Orange or San diego counties. I can tell you though that many hospitals in this area do take travelers in the ICU. It is a good idea to check out the hospitals first. The problem is though that you need to be trained in ICU before you can be an ICU traveler. There are many hospitals in the area that offer excellent ICU training programs with classroom and clinical hours. But I would come check out the hospital and talk with the staff before choosing. Many of the ICU programs want you to agree to stay for a few years to "repay" your long training program and you don't want to get stuck somehwere you don't like. Also be careful with only looking at the pay and relocation packages. Some of the higher paying hospitals are the worst ones for RN satisfaction and support of their staff. Touring and talking to staff will let you see what the hospital is really like.

I did some student rotatioins at St Mary's in Long Beach and it was a nightmare. Bad staffing, almost all registry nurses because they could not get regular staff since conditions were poor. I saw some of the scariest things there like running out of insulin for an entire floor and not being able to get anymore and reusing iv connectors on different patients! The layout of the floors are horrible, it was certainly not designed by someone who was atually going to have to work on the floor. It's a huge rectangle and you get patients on different sides. It's also in a rough area of Long Beach. This was in 2002, but from what I've heard things have not really improved. You might want to tour the hospital before agreeing to work for them. Karen

The hospital soap and water handwash does kill the C-Diff. It's the purel hand sanitizer dispensors that do not kill the C-Diff. So just make sure your washing your hands everytime you come out of a C-Diff precaution room.

I did many student hours at Long Beach Memorial 3-4 years ago, we were mostly in the ICU and pediatric units. I hated the peds unit but loved the ICU. Most of the nurses were friendly and seemed to enjoy their jobs. My grandfather also had heart surgery at Long Beach. He had been transferred from another facility (from which he got horrible care) for the surgery. I was very impressed with the care he received at Long Beach. I do know Long Beach also has some really great new grad training programs that can really make a difference to your start as a nurse.

A new policy started at my hospital about 4-5 months ago. Anyone with active diarrhea gets put on contact precautions for C-Diff until it is ruled out. I work in an ICU that was getting alot of C-Diff. This seemed to really cut down in the number of pts with C-Diff. We also use the Purel hand santitizer which doesn't kill C-Diff., so you must wash with soap and water. Many staff didn't know this so now all of our dispensers are labeled "not for C-Diff". The rooms also have to be cleaned with bleach because the standard cleaner doesn't kill C-Diff either. So each C-Diff room get a "clean room with bleach" sign to informe housekeeping.

Bad rep in California. They are a Long Tern Acute Care facility so they can get around our mandated ratios, which means each nurse gets lots of patients....

My mom is on Rebif but has never taken and other MS medications. She doesn't typically get flu-like symptons, only about once in a three month period. She does take the injection before going to bed at between 9-11pm and takes a tylenol before injecting. That way if she were to have flu-like symptoms she sleeps through it. She hardly ever wakes up with them during the night except very rarely. The side effects she gets are red skin reactions around the injection. These are not as bad if you let the injection warm to room temperature before injecting. She also puts a cold pack on the site for 30 minutes after injecting (it just an ice pack kept in the fridge instead of the freezer). The reddness fades with time and are not super noticable. She also wakes up with headaches the morning after injecting, but my mother is prone to headaches anyway and has fought them her whole life. She hasn't had an MRI since starting the Rebif, but has had improvement of her symptoms. Hope this is helpful to you.

At the hospital I used to work at a nurse on my floor worked part time at Disneyland. She didn't have any public health type experience, just tele for three years. Her only complaint was she had to work crazy hours that were sometimes inconsistant. She really enjoyed it and said it was pretty easy so that's why she choose it as her second job (after three twelves, if I'm going to work overtime it has got to be something easy or I'm too pooped!) Most of the things she saw were kids with scrapes, bumps, headaches, etc. The occasional chest pain or dehydration case. I guess there are EMTs that do basic stuff out in the park or CPR if needed. She did say that you are absolutely not allowed to really treat. If someone needs a brace or ace wrap you cannot put it on, but can only give it to them to apply. The only thing she could do in a seroius case was apply oxygen until the parametics arrived. It kinda makes you wonder why they need an RN....but she could get her and her family/friends into Disneyland for free whenever she wanted :)

If you go to the second website I mentioned earlier it has a compatibility page for love relationships. Just click on your personality type and then the heart at the top of the page. My boyfriend and I took the test when we first started dating. It said we matched as most compatible (I'm an ENFJ and he's a ISFP). I guess it was right because now we're married!

My father in law is really into this stuff. I took the test a while ago and it's pretty accurate. I'm an ENFJ. I found this website where you can take a shortened test and see your results for free. If your interested... http://www.kisa.ca/personality After you take the test, this website has good descriptions of each type and what it means, etc. http://www.personalitypage.com/portraits.html It will be interesting to se if nurses tend to be certain types or if it is very mixed.

I learned to swallow pills by tilting my head back, gargling with water, then dropping the pill in and swallowing. That's also how I taught my sister. The first few times were difficult, but I finally got it!

I graduated from CSULB's traditional program. I had a very good experience. I took me a total of 5 years to get my BSN from the time I entered college to when I graduated with my BSN, which I think was very fast. You might want to consider going the traditional route for a few reasons. First, I have heard very bad things about the accelerated program. The traditional program was well established with faculty that have been there for years. They have alot of nursing and teaching experience. From what I understand, since the accelerated program just started, many of the teachers are inexperienced or have never taught before. The program is also very unorganized because it is not well established and therefore they have not found what works best for the program. Second, I have heard alot of bad things from other nurses (particularly from nurses at Long Beach Memorial where the clinicals are) that the students are not well prepared. The clinical skills of the students are way behind other students that come through the hospital from many different programs. I'm not sure if it is because the faculty are new or they are trying to cram alot of material into a short amount of time. I do not have personal experience with any students or graduates from the program...these are just things I have heard from other nurses, so do your own research. Like I said before, I graduated from CSULB so I like the school. I think it is great that they are trying to ease the nursing shortage in California by expanding there programs and admittance into the program. I just would be cautious of entering a brand new program that is not well established. Hope this helps...let me know if you have more questions.

I worked on a tele/renal floor for a while and Viagra was sometimes given to renal patients. It was supposed to increase blood flow to the kidneys by vasodialating or something like that. Did you patient have CRF also?