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Larry3373

Larry3373

Critical Care; Recovery
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Larry3373 has 2 years experience and specializes in Critical Care; Recovery.

Larry3373's Latest Activity

  1. Larry3373

    ACNP OR FNP

    If an ED will allow them to only see adults, I don't see why not. My understanding is that for the fast track they prefer an FNP due to the fact that they can see all ages.
  2. Larry3373

    ACNP OR FNP

    Acute care is designed for setting like icu, specialty practices such as cardiology/surgery, or other inpatient roles like hospitalists. FNP is designed for primary care in the outpatient clinic, or urgent care, or emergency dept fast track. You will see some fnp rounding on inpatients, but this is supposed to be the exception, not the rule. At my hospital, fnp are not able to round on ICU patients at all.
  3. Larry3373

    Three attempts and no success

    Some free resources include all of Mike Linares YouTube videos and David Woodruff's videos. The latter is the editor of critical care made incredibly easy. Mike Linares has a website too and it is Simple Nursing, but you have to pay for a membership as I recall.
  4. Larry3373

    When to increase patient load during ICU orientation?

    I say start the second week. The sooner the better. That way they will get the most out of their orientation. Also you won't have to be separated from them while you're taking care of the other patient.
  5. Larry3373

    Forgot to carry out an order? Reportable to the BON?

    My experience with this has been "I just wasn't able to get to that today". This could pertain to bed baths, dressing changes, etc. I usually reply with "that's fine, I'll take care of it. This is a 24 hour facility." I understand some things are time sensitive, but we must use common sense when prioritizing what will get done on our shift.
  6. Larry3373

    New grads are expensive...really?

    My services are billed for. Every time I give any IV push for example, say Dilaudid, the patient is billed 300 dollars. It's silly to say that nurses are a drain of resources, because we are valuable. We help prevent lawsuits, for example. Let us walk our of that hospital for a day and then we'll see what happens with revenue.
  7. Well if job hopping hurts ones chances of getting the next position, why are we job hoppers able to continue to find new positions to hop to? Lol
  8. Larry3373

    New grads are expensive...really?

    I work SICU with 3 years experience, 1 of which in the ICU. I still received 8 weeks orientation, not counting 1 week classroom orientation. I also get paid more than a new grad doing the same job.
  9. Larry3373

    New grad school nurse

    I've never worked as a school nurse, so I can't speak to that, but I would recommend you go for it if it works better for you and yours. I imagine that the pay is not quite so good as working in the hospital. Money isn't everything though. I can relate to the stress of hospital work. I work in a high acuity surgical ICU, and I sometimes dread going to work a little bit, not knowing what to expect. Not sure if you mentioned how long in your current position, but I'm sure many people would advise you to stick it out for a year for the experience, and also so that you don't burn any bridges with potential future employers (since nurse managers talk to each other), but I would do what is best for my peace of mind, and my family.
  10. Larry3373

    Help Me Get Excited About My Shift to Night Shift!

    I've worked mainly nightshift for the past three years. A few suggestions: purchase some blackout blinds for your bedroom; get at least a 2 hour nap on your first night of nightshift; don't eat anything too heavy that might make you sleepy while at work; be prepared for dayshift to never be satisfied with what you were able to accomplish (hopefully not, but it helps if you have low expectations); if working consecutive days, take full advantage of your sleep time between shifts; don't call physicians in the middle of the night for something that can wait till morning.
  11. Larry3373

    Experienced nurse - new to MSICU

    I'm in a similar situation right now. I've started working in a 24 bed SICU that takes fresh hearts. My experience was in a smaller hospital in the ICU that doesn't take hearts (1 year), and two years of telemetry and med surg prior to that. I also worked PRN in PCU for a while so I am familiar with hearts and cath lab patients. My advice is to ask questions and to show humility. That is what has worked for me. I try to avoid saying "this is how we do it at my other job" because I know I wouldn't want to hear that if I was precepting someone. As far as resources, check out the following youtube.com: medcramvideos, Eric's medical lectures, hemodynamicmonitor1, Dr Gallagher's neighborhood. IUcritical care, and gotresuscitation. I have found numerous helpful videos on those channels including ventilator management, pressors, shock, ACLS, DKA, hemodynamics, etc. A book that came highly recommended to me is A Manual of Perioperative in Adult Cardiac Surgery by Robert M Bojar. So far it has been very helpful in understanding the management of heart surgery patients.
  12. Larry3373

    I PASSED NCLEX with 265 Questions!!

    Congratulations.
  13. Larry3373

    How do you deal with difficult patients?

    In my experience, patients that are problematic to other nurses are not difficult for me. I always try to treat them respectfully, and as I would want to be treated. When they have prn meds like pain medication, I give it. Some nurses hold medications because they do not feel the patient is truly in pain or they don't want to give too much. My philosophy is that I am not going to cure their addiction to narcotics in this short hospital stay, nor is it my job to try. Many patients, unless they are opioid naive, can handle a lot more pain medications than you would think, and if you are not sure, you can simply check on them more often. I emphasize drug seekers because these are typically the patients who I see with snotty attitudes most often. Many of them self medicate at home, and it may truly be difficult to achieve adequate pain relief, because they have developed such a tolerance for opioids. I would also add to always introduce yourself, set realistic expectations at the beginning (give yourself some wiggle room), and explain what is going on to the patient and family.
  14. Larry3373

    CSICU nurse to pt ratio??

    I would look up on YouTube interview tips for a nursing job. I found tons of helpful info on YouTube. As far as preparation goes, you could read a few CCRN review books, and when they ask you to tell them about yourself, you can mention how you have prepared for an ICU position by reading several CCRN review books. This will at least give you plenty of theory that you can use for an ICU position. To the OP we take 2 patients in the 24 bed SICU that I work in, or 1 if they are a fresh heart.
  15. Larry3373

    how long is enough orientation for icu

    My nurse manager offered me 10 week orientation at a 24 bed SICU that takes hearts.
  16. Larry3373

    Respiratory therapist to RN

    If you want to do it, then do it. You will likely be paid less than a floor nurse to teach, however. Your RT experience should help you land your first ER or ICU job. It may also help with school as well. It you can make if work financially then I say go for it.