Zelda, RN

At my hospital it varies by unit. On my unit, we are required to sign up for four weekend days in a 6 week period. We self schedule, so this can be four Saturday's, four Sunday's, two Saturday-Sunday's, etc (night shift weekends are Friday night and Saturday night, but same concept). We have a high number of weekend-option staff, so there is always a chance you'll get moved off your weekend day (and if that happens, you don't have to pick another one). Other units do mandatory every other or every third weekend, but the way our unit does it works for us, and we are always pretty well staffed.

Unisom? That works really well for me. Also, Ambien isn't the only sleep med available. I took trazodone for a while and that worked well for me, without the drowsiness or burn-your-house-down risk.

A one hour commute after a 12 hour night shift is dangerous. I did it for 5 months. I would not recommend it. The number of times I nearly caused an accident falling asleep... Also, working nights your first day off is not a true "day off". You will likely spend most of it in a zombie state, getting no work done.

My rule of thumb is to take every position at face value. That means that even if they SAY they will be cross training you, they may not follow through. Assume you would be in the LTC building forever if you took that position. There is a chance they'd do exactly as they said, but there is also a chance they wouldn't.

What about floating to medsurg units? I work in a children's hospital, and we get up to 23 year olds on my unit. Do you not see 18-20some year olds in your picu?

I am not a night shift fan. I miss my husband terribly and feel like I never see him. I'm waiting patiently(ish) for a day position to open. Now, if only they would quit hiring people into the day spots...

I do stairs at work - usually one swift jog down 6 flights & and I jog/walk back up. Wakes me up and I don't feel QUITE so bad if I don't get a workout in. We get hour long lunches on nights (one 15 min break & 45 min lunch on days), so half my lunch is eating and half is stairs/recovering from stairs. I like to do yoga on my days off, or lift weights if I'm feeling really ambitious. I also walk my dogs. I eat nuts, string cheese, Quest bars, oatmeal, Greek yogurt, fruit, PB, chicken, hamburgers without buns, etc. I like to eat light because I get really nauseous working nights. I eat a protein granola bar on my way home, then usually go straight to bed.

Some baby docs I love, some baby docs I don't. If you answer my page, come see your patient without me having to ask 10 times, and if your answer to my reasonable request at 0200 ISN'T "well let's wait for the day team to get here" - then we will get along fine. I don't mind if baby docs are lost, or put in the wrong order. Just please don't get sassy when I bring it to your attention. We're all just here to take care of patients, after all.

It varies by state. I recently obtained a MO license along with my KS one (the hospital I work at requires both, as it has two campuses - the main one in MO, and a smaller one in KS). I received my temporary MO license within 3 weeks of applying, and my permanent one a few weeks after that. I had to submit fingerprints for my MO license - but it should say on the BON site if they require fingerprints.

It's not that people function fine on certain medications. It's that people function NORMALLY. Off these medications, they are much more of a liability than on them! I have a prescription for Xanax for anxiety. It's a tiny dose, I never take it within 8 hours of work, certainly never at work, but occasionally I need it to prevent myself from falling into a full-blown panic attack. In these situations, I'm far more impaired by the panic attack (during which I hyperventilate, can't move, and can't talk) than by Xanax. Again, I've never needed it at work, but there's a chance it could show up on a drug screen if I took it the day before. I'd be very upset if I lost a job because of it. OP, I'm so sorry this happened to you. I have no words of wisdom for you - just know that you're not alone. People who don't have a mental health disorder, or don't have to take controlled substances to manage their health, often struggle to understand how these medications only impair a "typical" brain, and that they are, in fact, beneficial if they are truly needed. I hope everything works out for you.

I love peds. I work in a children's hospital, and our med/surg units are more specialized... My unit gets kidney (CKD, kidney transplants, etc), liver (disease and transplants), and rehab (much different from adult rehab, as our kids are usually brain or spinal injuries and are getting to the "optimal" level of functioning, whatever that might be). We also get your "typical" med/surg kiddos - RSV, occasionally seizures, cellulitis, etc. My favorite patients are babies and toddlers, but I work with plenty of nurses who prefer the older kids. The oldest we take is around 22 - though those are usually kids who have been followed by one of our docs since they were little. Our docs don't like to let go - and rightly so, as we "spoil" our kids a bit (call to remind them of appointments, find them transportation, etc). We DO get a lot of noncompliance, though that's more the parents fault than the kids'. You do see a lot of abuse, or parents who aren't available. I can think of one baby particularly whose mom no one has ever seen, and whose dad is only there to admit, do family meeting, and discharge (but my goodness, baby is fun to snuggle). If the parents are there, they can be a godsend, cuddling and playing with their kid. Kids need stimulation and entertainment often, they don't really entertain themselves like adults. And they don't always understand not to pull their NG, IV, port, etc out - so sticking them in a caged crib so you can do your other duties is not always an option.

I assume you mean high-flow nasal cannula. It is still very new at my hospital, at least on medsurg. We just started using it this past March, and I have yet to see it used in practice. Nurses aren't supposed to mess with it - only RT at this point. RT disagreed with me about how hard baby was working to breathe. This was last night. Today, she was still working hard and began wheezing, so they started breathing treatments and switched her to hypertonic fluids. She looks much better tonight.

Hey all, So I work on a med/surg floor of a Children's Hospital. We get a fair amount of RSV/bronchiolitis/rhino/entero babies. Sometimes I struggle with knowing when to put oxygen on them. Obviously if baby is desatting and having trouble holding a good sat, you do O2. But what if baby is satting ok - 93-95% - but working hard to breathe? The other night I had such a kid. 2 months old, satting 93-96%, respirations 50-60s while sleeping, but moderate subcostal retractions and some mild head bobbing, even after suctioning. I spent the whole night debating whether I needed to start her on oxygen. I know once you do start, it sometimes takes a while to wean them off it (our babies like to hang out on 0.06L forever). She just made me so nervous. What's your take?

I tested on a Friday, and my results were in by 1700 that day. Score.

I did child psych. 90% of what you need to know is learned on the job, more-so than most other specialties (in my opinion). Psych so much communication, and that can't be taught by a book. It takes a while (took me 3-4 months to feel comfortable). You learn by watching the people who are good communicators. Listen to how they talk to their patients. Some people are excellent de-escalators. Some aren't. I had a charge nurse who wasn't. I often found myself trying to "beat" her to an escalating patient because I knew she was more likely to push the situation further downhill. She was great in a situation in which a firm hand was needed, but not when a pt needed a gentler approach. I don't know how your unit is, but I ended up leaving my unit after 6 months. I loved the work, but more value was placed on social work than nursing, patient AND staff safety was in danger, and it was just a mess.