CarpeDiem2004

"Seize the Day" and the year I joined the board - because that's how I try to live my life. :balloons:

I'm a native cheesehead. I moved to Maine about 10 years ago and have been very happy here. I think the weather is very similar and Maine has the added bonus of the ocean and mountains. I live in central Maine (near Lewiston/Auburn). Close enough to Portland to take the easy drive down for shopping or events, and far enough away to avoid big city issues. Some of the largest hospitals in Maine are Maine Medical Center in Portland, Central Maine Medical Center in Lewiston, and Eastern Maine Medical Center in Bangor. There are a number of smaller hospitals scattered throughout the state. Each of the larger hospitals I mentioned has a pretty good reputation. They have cath labs and open heart programs. I guess I'm partial to the smaller hospitals though. I guess in my experience, I've felt more like an individual and less like one of the masses at the smaller hospitals where I've worked. I worked at St. Luke's Hospital in Milwaukee (1990-1993) and while I learned a lot and worked with some wonderful people, I've come to prefer the more personal feeling I get working at a smaller hospital. Good luck with your search.

I'm an ICU nurse of many years and, for a variety of reasons, have recently been looking for a new job. I saw an ad in the local paper for an RN Case Manager at a local Hospice agency and decided to investigate. The more I learned about what a Hospice nurse does, the more I realized that is what I would like to do. I interviewed for the job and was getting very excited about the position. Today the Hospice agency called and told me that, while I was a strong candidate, the job went to someone who is a Nurse Practitioner. My question is, is there anything particular that employers look for when hiring a Hospice nurse? Is there something I should be doing now to make me a better candidate when another position opens up? Are there many advanced practice nurses working in hospice? I believe that I have what it takes to be a good hospice nurse. Now that I've "discovered" the specialty, I plan to hang in there until I find a position. After working in the ICU, it feels like the right direction for me to go. :)

I'm an ICU nurse of many years and, for a variety of reasons, have recently been looking for a new job. I saw an ad in the local paper for an RN Case Manager at a local Hospice agency and decided to investigate. The more I learned about what a Hospice nurse does, the more I realized that is what I would like to do. I interviewed for the job and was getting very excited about the position. Today the Hospice agency called and told me that, while I was a strong candidate, the job went to someone who is a Nurse Practitioner. My question is, is there anything particular that employers look for when hiring a Hospice nurse? Is there something I should be doing now to make me a better candidate when another position opens up? Are there many advanced practice nurses working in hospice? I believe that I have what it takes to be a good hospice nurse. Now that I've "discovered" the specialty, I plan to hang in there until I find a position. After working in the ICU, it feels like the right direction for me to go. :)

From your description of the patient's movements and the scenario, it sounds to me like it was posturing you were seeing. To avoid this sort of problem, I frequently go to see my patient with the nurse I am reporting to or am receiving report from during our report time, to make sure we "are on the same page" about what we are seeing.

I don't see how you can adequately take care of ICU patients without knowing about the IV drips that we so frequently use. Are they planning on not assigning you to these patients until after the year is up? This is an integral part of an ICU nurse's knowledge base. We have what we call an Intern program where I work. We take either new grads or experienced nurses who work in other disciplines who want to work in our ICU and give them a pretty extensive orientation (both classroom and at the bedside with a preceptor). From day 1 we incorporate the drip teaching. It's particularly effective when we have a patient on a particular drip and the intern is actually able to titrate, watch its effects, and learn more about the drug with my guidance.

In my ICU, we have 2 RN's for 1-4 patients. We never have just one RN in the unit.

I agree with jwk. In my institution, we use propofol on vented patients all the time. If it's going to be used for conscious sedation, it must be given by anesthesia or by an intensivist. It is a wonderful drug, but I've seen plenty of patients that need their respirations assisted after it's administration, and one that needed to be intubated. I, for one, am thankful that our nurses can't give it on non-vented patients.

I believe that being a good nurse begins with being a strong patient advocate. Sometimes we are the only ones that a patient has speaking up for their best interest. Good luck on your assignment.

The ICU I work in has a 12 bed capacity but we average 5-7 patients so we staff for this number. We frequently have patients that come into our ICU who are inappropriate admissions, and many who stay longer than they should and take up an ICU bed just because the MD wants them "watched closely for just one more night". This is a strain on our resources - staffing, supplies, available beds. We have a medical director who should be acting as the "gate keeper", but he doesn't want to make any of the physicians mad at him by not allowing their patients into the ICU. The nurses have no support when we question an admission to the ICU. We even have patients who spend at least overnight in the ICU on a ventilator post-op just because anesthesia wants to go home and doesn't want to hang around until the patient is extubated and recovered in PACU.:angryfire What a waste of resources! Now our hospital is experiencing the usual yearly budget crunch and nurse managers are expected to find places in their budgets where they can cut supplies and people. We suffer because the Docs aren't held accountable for their waste of resources. Some days it makes me want to scream. (Or quit.)Unfortunately, I'm pretty idealistic and believe that if we keep speaking up making noise about the problem, there must be someone who will listen to us and stop letting the Docs trample over the nurses-even though I know that the Docs are the ones that bring the customers into the hospital and Administration bends over backwards for them.

At my institution, we check vital signs pre transfusion, every 5 minutes for the first 15 minutes, then every 30 minutes for the duration of the transfusion. A complete set of vital signs includes temp, BP, pulse and resp. rate. A rise of 1 degree in temp during the transfusion qualifies as a reaction and we then have to initiate our transfusion reaction protocol.

I've been working in the ICU for 11 years and I love it! In my experience it takes a mix of personalities to make an ICU unit strong and an enjoyable place to work. On the other hand, the "strong" personalities I've encountered over the years can make it a difficult place. I most enjoy working in ICU because I am able to and expected to know my patient inside and out, from history to labs to family issues to x-rays, ekgs etc. This is in contrast to floor nursing where I would have miltiple patients and would not be able to be as in-depth as I would want to be. I believe an ICU nurse needs to be a strong patient advocate and needs to be able to communicate well with physicians. Often, there are lots of tubes and machines to keep track of, so a good sense of organization doesn't hurt. I work in a mixed ICU - cardiac, respiratory, neuro, a little bit of trauma, and what ever else comes our way. I really like the variety. :roll

I've been working in the ICU for 11 years and I love it! In my experience it takes a mix of personalities to make an ICU unit strong and an enjoyable place to work. On the other hand, the "strong" personalities I've encountered over the years can make it a difficult place. I most enjoy working in ICU because I am able to and expected to know my patient inside and out, from history to labs to family issues to x-rays, ekgs etc. This is in contrast to floor nursing where I would have miltiple patients and would not be able to be as in-depth as I would want to be. I believe an ICU nurse needs to be a strong patient advocate and needs to be able to communicate well with physicians. Often, there are lots of tubes and machines to keep track of, so a good sense of organization doesn't hurt. I work in a mixed ICU - cardiac, respiratory, neuro, a little bit of trauma, and what ever else comes our way. I really like the variety. :roll

I'm planning on going back for my masters in nursing with an education emphasis - not because I expect to make a huge amount of money when I'm done, but because I would really like the opportunity to pass on my knowledge and experience - possibly in staff development. I hope I'm not being too idealistic, but I think that's where I'd be happiest.

Hello to all you great nurses in my adopted state of Maine! I've lived here for 9 years and right now can't imagine living anywhere else. I'm an RN and am hoping to start working on my MSN (emphasis in education) soon. Has anyone out there had any experience with St. Joseph's College and their Distance Learning program? I love my job in the ICU, but am starting to wonder if I'll still be able to do the physical (lifting, standing on my feet all day) part of the job 10 years from now. Education seems like the perfect way for me to keep contributing to good patient care by passing my knowledge and experience along to others.