ICU_RN2

You gotta do what makes you happy - in the end, that's what you'll do anyway. But, do remember, opportunities will come up again for ya to get into a cardiology setting. And after a couple years in an LTAC, transitioning into an ICU would probably be pretty easy in some aspects. I'd stay at the LTAC, get a good year or two experience, and start applying for ICU positions after that time (if there is where you want to end up anyway).

I've never heard of using narcan for itching either! And I worked on a med surg floor with a tonnn of PCA usage! Great to know! Thanks!

D-dimer can elevate for several other reasons as well...in my experience we never use a d-dimer alone to diagnose... The rest of your questions are hard to follow, but as long as you drew and send the labs before starting the heparin gtt you should be fine.

We hardly ever use propofol in our ICU... We frequently use Fent. gtts, Ativan IVP, and Versed IVP. We do see the Haldol IVP as well. Propofol will drop your pressure pretty much every time, just varies on how much - with a patient on pressors already, we def. avoid it at all costs. No many how many pressors you pour into someone, if they need fluid, you won't get better BP's until your fluids have been replaced. We're a trauma ICU, so nearly everyone seems to needs tons of fluids and products...and until they get them all...your pressures going to be crap and its going to be a pressor vs sedation fight.

I should add, if I had it to do all over again, I would have stayed on the med-surg floor until I was sure we wouldn't be moving. Although, the ICU positions were all filled by that time, and I would have likely be on the med-surg floor for another 6-9 months. However, I am pretty sure my ICU experience greatly helped in getting my dream ICU job now (Trauma ICU, Level I trauma center, big city, awesome coworkers)...would I have gotten my current job without the ICU experience at the old job? Who knows...but I'm happy I'm here right now.

I thought I'd comment because I was in pretty much an identical situation I was on a med-surg floor for about 8 or 9 months when I decided I really wanted to apply for an open ICU position (there were 6 jobs posted, and I knew I would get one). I also was aware that my husbands job could leave us relocating in the next year (But there was also the chance it wouldn't, and we'd be in he same place for two or three years - odds were about 50/50). I applied and took the ICU position. I oriented for about two months, before the hubs applied for a new job about three hours away (his job doesn't offer opportunities to advance every day...he gets the opportunity to apply for a new job/promotion about every two or three years). He got the job and a few weeks later we began our house search. I was set to commute back and fourth from our new home, staying in an apartment in the old city for my three day stretches. I wanted to stay at least 6 months, or at least until the weather got too bad to continue making the drive. I did feel like I should tell my managers, so that I could be let off of orientation a little early and be productive (they had wanted me to do a 4 week open heart orientation as well - making total orientation 4 months). I spoke with my managers, who told me there was no need to stay. I literally worked one day off of orientation, and was asked not to come back. Found a new job that same day in the new city. Always try to do the right thing - but, remember, your employer isn't going to watch out for you like you're trying to watch out for them. I'd say, get the specialty job where you can get it...then, if one pops up closer to where you want to be, apply for it. Be honest with your employer though, as much as possible.

I've heard that is why they put them in their rectum - it doesn't hurt as much? Who knows...the kids that are doing this are not your typical stupid teenager I feel..these are the minority.

I don't work in the ED,but here in NW Pennsylvania, I have heard of kids doing this too.....so bizarre!!

AHA is good for 2 years as opposed to 1 year for American Red Cross.. Also, correct me if I'm wrong anyone, but American Heart also does ACLS cert. and PALS cert, correct? That could be why....Interesting though, I've never had anyone care which one!

I guess I don't expect answers regarding unemployment unless you have a personal experience...but do your facilities mandate cancellations like this? Thanks for your help!

I'm just getting off of orientation at a new facility, and had a couple questions for you guys! Since there are several of us getting off of orientation at the same time, we will be over staffed. Our manager stated that if we are canceled, it will be mandatory. Cancellations go by seniority, so theoretically we could be canceled several times in one week since we are lowest in seniority. It also goes by who was last canceled, but that is secondary to seniority. So, say someone with a years seniority hasn't been canceled in months, I will still get canceled first even if I was canceled yesterday due to seniority. Other factors do get consideration, such as PT/FT status, etc..however there are 3-4 (5-6 some days) extra of us on some days in the coming weeks. Am I wrong to think that this shouldn't be mandatory? At the last job, we had a right to refuse. If I'm canceled for say more than 20 hours a week for a couple weeks, I can put a claim into unemployment correct? Thanks for your help!!

I applied prior to gradation at two large local hospital's in the North Western PA area. They met with us in a class and told us to start applying in Dec-Jan. With everywhere else I applied, I simply called the HR department or Nurse Recruiter and asked when she would like to start receiving applications for new graduate positions. I took a job at a hospital - I applied to it in January, interviewed in Feb. and March (three different interviews), and accepted an interview in April. I started in June.

Thanks everyone!!! I'm sure it won't be thatttt bad...!!

Because no one in my household is particularly interested in hearing about my excitement..I've come here to share! Orientation completed!!! I'll be officially on my own Wednesday :) This isn't my first job, but I'm excited anyway!! A little scared too..but I don't think that will go anywhere anytime soon! Lets hope I survive and get home at a semi-reasonable time the first day! Thanks for the ear

Our area must be better job-wise than yours, as most of us easily found one prior to graduation in May 2010. Where are you located?

Working in LTC facilities can be tough for sure! I worked as an RN at a facility just prn for about a year, however I worked there for 4 years prior as a CNA and was somewhat comfortable with the place. I had a FT acute care job at a hospital, went through orientation, then starting picking up shifts at my LTC job here and there. I will agree with you that it is much more paper work and much less patient care than you'd see in a hospital with only 5 patients. As a new grad, at a new facility, I can't imagine orienting and feeling competent in LTC. I barely felt okay in my situation, and a lot of times only because I had a boat load of experienced LPN's and CNA's that I already trusted and had a rapport with. Good luck in whatever you decide! Make sure you leave on good terms, you never know when you'll want to go back to that $35/hour job in the future!

It would benefit you in the future if say you decide to do Case Management down the line. A lot of our nurses at my old facility transitioned into Case Management positions - still interact with patients, families & physicians, however you get out of the bedside yet still get to have an impact. The working hours are a huge plus too! The previous poster is right, however...it won't necessarily make you stand out among other candidates for your first nursing job. But further jobs down the road it might do just that!

And we needed to sign for it each time it was given (mar/tar)

In my experience, there needed to be an MD order in place.

I had a friend that graduated in May and didn't even start looking for a job until Sept...she took the summer off to travel as well. It can be done.

Our EKG monitors do not always catch PEA. We notice first if the patient has an art line that suddenly loses wave form.

I graduated in May 2010 as well, and in PA (western, at least) new grads aren't having that difficult of a time. Maybe try some of the larger hospitals in PA as well. I can tell you that interviewing and moving could be costly, as they are not offering any sort of incentives.

I am in the middle to trying to transfer sites as well. I simply wrote a letter, stating in detail the reason why, and sent it to the address listed on my contract. It didn't stipulate any other details in my contract. I have not heard back, and I did try to call to check the status with no luck. I left a voice mail and my call was never returned. It's going on three weeks or so now. Good luck!

The new job I started a few weeks ago isn't using any of the above... The old job had us carry cell phones, but that was more so docs could get a hold of us easier....

I received the email in mid August, signed and returned contract, and received final contract which was dated August 29th. I think it arrived to me by Sept 2nd. Good luck!!!