21strawberry

Hi All, I work on a locked inpatient unit in a community hospital and have been in psych nursing for about a year. I switched disciplines and now feel I can look around and notice some places our unit can improve. Are all psych units blah and drab or just mine? Are there general restrictions prohibiting decorating for adults in a locked psych unit? If anyone has ideas or links I would appreciate it. I am just picturing old school thin cardboard decorations that my mom used to hang in our house in the '80s ? thanks in advance!

Thanks very much, KelRN! Very helpful info í ½í±

Hello All, I was hoping to get some input on the peds hospitals in and outside of Boston. I have PICU experience and ICU float team experience and CHOP and CHLA, possibly relocating to Boston area for husband's job. Would be living outside of the city (northwest most likely) so commuting would be a concern! Any experience with any of the facilities that have PICUs? Mass General, Floating Hospital, these facilities are new to me. I'm sure Boston Children's is great. Thanks in advance! 21s

My previous therapist was a tongue depressor and I just couldn't express myself clearly to him.

The PICU I'm from had sleep surfaces in every room. There are certainly pros and cons, but I don't think the family members should be kept away. Were there some who did more harm than good while at the bedside? Sure. But there were also patients who, if well enough, would melt down without a parent there. If I were a PICU parent, I'm sure I would want to spend the night if I had the option.

When I give report, I start with the patient's history and what brought them in for this admission. Sometimes I go into "overnight events" before I start my system by system report, just to give a little snapshot of what the issues may have been most recently. Then we break it down as follows: Neuro (pain), Cardiovascular (PIVs, central lines, drains), Respiratory, GI/GU (I&Os), Skin, Psychosocial. Ruby Vee's advice about imitating the reports you receive is also sensible. Good luck, don't over-think it...it comes with time. I remember skipping around a little when I was a new nurse too.

ASHRN828, maybe it's because I was interviewing for my first travel position, or maybe because one was Kaiser, I'm not sure. It seems most of the others who responded had much less structured interviews.

Where I work, they are very grateful for their experienced travelers and I do get most of my schedule requests. This is my first experience as a traveler so I cannot speak for the majority.

My interview with Kaiser out here in CA lasted about 30 minutes. It was very structured, she was reading the questions from her computer screen. First she asked me about my work experience. Next I had to identify 10 drugs that she gave me, their therapeutic category and whether I had administered it in the last few years. Then I believe there were about 6 clinical scenarios that I was given and had to answer how I would provide care for that particular patient. One of these included a child pulled from a pool of warm water. Another involved blood gas results and how I would expect the ventilator settings to be changed to correct it. And I believe there was a review of EKG strips where she described the wave and I had to identify it. That would've been easier had there been visuals but it worked out. My interview with a hiring manager at another hospital was less structured but he did have a list of clinical questions as well as open-ended "tell me about the sickest patient you cared for" and questions regarding conflicts with patients/families/co-workers, etc, and the importance of teamwork. I hope that helps, good luck!

Like Esme posted, if you are in one of the states that requires you as a mandatory reporter to report the abuse of an unborn child then you can't very well mind your own business. Personally I would educate her about the harm she is doing.

You are over-thinking the reaction, it seems. The pupil is reactive or non-reactive based on the response to the light initially being shone on it. The pupil will not continue to react as the light shines, unless I suppose the light source was getting dimmer or brighter. I hope that helps.

hope it went better!

I wouldn't rush to cancel your contract just yet. Take a deep breath. Do you feel any more confident after completing the shift that was out of your comfort zone? Do you feel it was unsafe for you to care for that patient? In general, I have not heard of many travelers being given the sickest kids on the unit. On my first travel assignment, in a CTICU, I was given some patients with equipment, therapies and diagnoses that I did not have much experience with as I am a PICU nurse. However, I did not feel it was unsafe. I asked questions as needed, made sure in report I asked pointed questions about that which I was unfamiliar. I made sure I knew who and where my resources were, just as if I were on my home unit taking care of a child who I felt was a little above my head. It should get better. Perhaps staffing was a challenge on your first day and they didn't have a less critical patient for your preceptor to have while she helped show you the ropes. That's my two cents, perhaps others may feel differently.

NedRN, does the hospital have to pay that hefty commission to bring you on as staff once you are there long enough to be maxed out? I believe the hospital where I am currently only accepts travelers for 1 year. I know you had mentioned before about going away and coming back as a way to reset the clock. However, my hope was to go to their ICU float pool when they tell me my time's up. I know that this facility, or at least this unit, does offer staff positions to their travelers at the end of their contract. Sorry to hijack the thread somewhat! But I kind of had the same plan as the OP when we moved out here to CA. Thought it was an easy way in and that I'd be able to check out the area hospitals about which I knew nothing. Turns out I ended up at my goal hospital from the get-go anyhow.

Well, the first thing that I would think of is that I would never again be able to work a contract for that company. Secondly, if the company who offered you more is aware of your breaking contract with the initial one, they may not be too thrilled to be working with you for the long term. I believe there should be some wording in your contract's fine print, or on their website, that will give you specifics regarding what you would owe in this situation. I would imagine the costs of any pre-employment physicals and drug-screens would have to be repaid. The more experienced travel nurses on here may have better knowledge though, I'm new to it myself.