tsgarman

Actually I have thought of Joplin the only problem is I would be driving the same amount of time that I am now. Do you happen to knowthe name of the agencies that are around there and what pay they are offering?

I am thinking about making a switch from fulltime to PRN at my hospital. Reason is I live 1 1/2 hours away and that is one way and the drive is starting to get to me. I love what I do and don't want to completely give it up either. Anyway to supplement what I would be losing income and hour wise I have been tossing around the idea of going through an agency. I know nothing about them and don't even know where to start about looking for one. I live in a rural community in Southeast Kansas and have no clue if hospitals around here use agency nurses. Please let me know if any if you can guide me in the right direction.

Well I am in the minority here. I drive 1 1/2 one way to work three times a week. I know you probably think I am crazy , but I live in a area where there is no major hospital only a small rural hospital. For the experience in critical care i am wanting a small rural hospital will not give me that. The closest major hospital is an 1 1/2 away the rest are 2 - 3 hours away. I do agree with the burnout on commute. I am starting to feel that after doing this for almost 2 years. To be honest I will probably find something else to do in 3-4 years or move closer. That is if I can convince my husband to move. Most of the people I work with drive an hour away.

I have been involved with several end of life issues and I have to say that I have never witnessed what you went through. I think as a nurse I would have been concerned seeing that same reaction from your grandfather. I do know that each pt reacts differently to their situation. I am truly sorry for your loss and sorry that you had to witness that reaction.

I work in ICU and we had sirens go off 2 days in a row at our facility. The only thing we could do was move our pt's the best we could close to the doors and cover them with blankets and pull down the blinds and put pillows up against the windows. When your dealing with pt's on vents and tons of gtts. and plugged into monitors you are not going to be able to move them very far. You just do the best you can and hope that the tornado does not hit you. Luckily it did not hit, but you could look out the window and see the wall cloud and the rotation.

It was my 3rd day on orientation, if that is what you want to call it. I was pretty much just thrown out there to fend for myself. You are all right I should have called the doc, it is my license on the line here. When I think about it I did not even know how to page the doc. My preceptor had not even showed me how to do that. I know it is still my license and I should have pressed the issue. I am smarter than that. I chalk this up to a lesson learned and one that will never be repeated. You will be glad to know that I have decided to quit this postion, because I am just not comfortable with how things are done there. I worked to hard to get this license I am not going to screw it up by listening to incompetent RN's.

I am putting this out there for anyone to answer. I had started a new PRN job in small ICU and it was my 3rd day of orientation when things in my opinion had gone wrong. On this particular night I had one very stable pt. who q now and then would take of his 100% NRB mask and desat, as long as you put it back on he was fine. Later in the night we were going to be getting an acute MI from ER. Well since I was new I did not figure I would be getting this pt. since I am still learning the ropes. The Rn in charge decided this would be a good time to learn how to do an admit. I thought about it and thought she was right. So I take him, besides my other pt. was fine. As I am getting report over the phone on this pt.my new admit my guy c the NRB has taken it off and is yelling for help and the pt. I am getting report on over the phone is rolling through the door at the same time. I am beside myself because the other 2 RN's are busy c mixing a gtt and there is no one to help my guy or take this other pt. I ask the other Rn on the phone why this pt is here when I am still getting report on him? Her reply "I did not think he would get there that quick." Yeah right! ER is just next door! Finally one of other RN's go into help my other pt. while I get off the phone to admit this MI. I don't even have the chart on this new pt because the Er Rn was still charting in it. So I had no idea what his orders were. Well this new pt. is fairly stable on amio, and integrilin gtts. VSS. As the night goes on my new pt. starts to c/o sweats and being hot. I ask if he is having any pain and he says no. I take his temp it was fine I check his SBP. It reads 60's. I decide to lay him down and retake it. Now it reads 50's. I then decide to switch arms and retake it again. Still 50's. I talk to one of the Rn's to see what we could do. She says sit on it awhile he did have 25mg lopressor in the ER, and he was A & O. So I thought OK. So I sit on it and watch q 15 minutes. It never increases. By this time I am thinking about calling the doc and getting some dopamine because his HR has dropped into the 50's. The RN says give him a fluid bolus I do and it still does not go up. I am ready to hang the dopamine now and call doc later. Well after about an hour of his pressure being in the 50's and his HR dropping the Rn decides we need to hang the dopamine. Low and behold his SBP is now in the 120's after a few minutes and his HR increases. So should I have listened to this RN or should I have done what my gut told me and call the doc and hang the dopamine a lot sooner then we did. Just a side note. I also work in a 32 bed ICU and we would of hung the dopamine and called the doc. I really hope this pt. doesn't end up having renal problems because of this.

Why did I choose ICU? I choose it at first because I wanted to pursue a career in flight nursing, which I am still thinking about doing. But I also choose it because I did not wnat to do floor nursing. I can't handle having 10-15 pt's at one time. I need the 1-2 pt's where I can focus more time and energy on them and actually feel like I am doing something worth value. Not to say that floor nurses don't. I just need more of an adreneline rush. The bad side of ICU is the families, not all but some. You get some crazy ones! I have also come to find out that ICU nursing is a lot of pysch nursing too. Not one area I really wanted to be in. I started out right out of school as an ICU nurse and would not do anything else at the moment. If you are a person who loves the adreline rush and can handle stress really well, and make quick decisions then I would say go for it! Good Luck! Tami

I agree with everybody study study study and yes do take a review course. I have to admit that I did do all of those things and still failed my first time through. I beleive my problem was I became to nervous while taking the test and frustrated that it did not stop at 75 questions and I gave up at some point during the test. I did pass my second time. The one thing I do recommend that everybody else has said is the day before the test do not study don't even think about it. Relax have some fun, (but not to much). It will be over before you know it and you will have the wonderful title of RN behind your name. Congrats!!! Tami

THANKS EVERYONE!!!! I now have some reading to do. Just skimming through those sites they look like they will be very helpful.

OK all of you experienced RN's out there. I need help I have been in ICU for about 18 months and I still have a tough time trying to figure out ABG's. I know how to tell when it is acidosis and when it is alkalosis. The trouble I am having is knowing what to do with that info when calling the doc. Most ICU RN's I work with could tell you immediatly what needs to be done before they call the doc. I look at them and have not a clue. I want to be at the point where I can look at gases and say this is what we need to do. Any suggestions would be greatly welcomed.

We are also an unlocked unit. I absolutley hate it!!! I have only been a RN for about a year and wanted to work in critical care for the one on one pt care and experience. I find it very hard to do that when I have to take care of the family more than my pt's. It seems that it does not matter how many times you tell the families the rules they still do what they want. And yes I hate it when they hang around other pt's rooms while you are busy with pt's. Or threaten to sue you because you are busy and don't have time to do something for their loved one. God forbid the code you are in the middle of is not important!!! I do understand that this is their loved ones but they also need to understand that we are trying to take care of their loved ones and with them bothering us q few minutes makes it impossible. I could go on and on about this but I won't. I think we could go on and on about this.

I am also a recent grad and started working in an ICU in May. I love it! The staff has been very accepting of new grads. They hired 5 of us and we are all still there. I have to agree with what the others are saying. If this unit is not accepting of new grads, then you will have a hard time learning and taking care of your patients safely. There is a lot to learn in an ICU and I am still nervous at times when I get a new admit and not sure what to expect, but I have a wonderful team to work with who is willing to help with whatever I need. That is the main thing to remember when working in this type of environment. Good luck with your new job!

At the ICU I work in we do not have CNA's, but nurse techs. They help do the usual give baths, fingersticks, turning ect. But they also help with procedures examples ( setting up for CVC's, swans, chest tubes, and other procedures you do in an ICU). The techs also go to codes and are the ones who do the compressions durign a code. There has been talk about getting rid of our techs and I sure hope that doesn't happen. They our an assest to our unit. For one a lot of us nurses do not know how to set up for procedures and having a tech do it for you helps keep things running smoothly.

Thanks everyone! That is what I figured it all depends on what the hospital decides to call it. I will pass this information along to him.