Jenny P

After 34 years in critical care; I never went to work without my own favorite med book, my stethescope, scissors, 2 hemostats, a penlight, my own 2 pens, and a critical care pocket reference book that I added my own paper to so I could add my own little "perls" to: I would add certain MD's odd little quirks (ie: if one surgeon liked some different lab test done that others didn't); hosp. and MD telephone numbers for emergencies; and if there were certain tests that were difficult to remember how to do them. In other words, my extra pages of perls were the things I didn't use often but if I needed to use them I could find those things STAT.

Zee, when is the test? I'm too lazy today to read back. I think you will do okay if you remember to use your head. Sunnybrook had some excellent advise.

Congratulations HealingtouchRN; I have never heard of this exam before. How does it compare to the CCRN exam?

My hospital no longer calls them "incident reports;" they are now titled "safety forms" and are referred to as "Sentinel Events." These forms do not go in the chart either; nor are they referred to in the chart. We have supposedly switched to "blameless reporting," where all facts are stated clearly and concisely and anything that may have led to the incident is recorded there, including any department that may have added to the problem. These forms are then studyed by the Safety Committee who then try to correct what failures in the system caused the specific incidents. The person filling out the form is not considered the "guilty" party either; which really helps to make sure the forms are filled out and all incidents are reported so problems can be corrected in a timely manner.

Cyberkat; I've had an idea for a nursing show for a long time but don't know where to go with it. In my mind I'd call it "City Nurse, Country Nurse" and have it about 2 sisters who are nurses, following the Mom and Grandmother's footsteps in nursing. One sister would work in a rural setting in a small howpital; one as a float nurse in a city in either based in a large hospital or else as an outside agency nurse. In my mind, I'd have them have occasional flashbacks comparing their Mom's and G-Ma's work also and how it differs from their work. I've never thought of going anywhere with this idea; never thought it would be "saleable" to anyone. But if anyone has any idea of what to do and where to take this idea, please let me know; or if anyone thinks it is a good idea and would like to work it into something, please contact me! I think that in my years nursing I probably could provide hundreds of stories!!! :) JennyP

What type of facility are you talking about? Bellehill gave a good answer for a pt. in an acute care facility; but I think the approach would be different for a LTC facility.

jfpruitt, a couple of lovely smelling roses or a thoughtful hand-written card for the preceptor and a bouquet for the whole staff (or a 1 lb. box of chololates for each shift) would be enough of a Thank You gift for this new floor for you. If you go overboard; that may raise some suspicions or hostilities later if you have a problem with someone on the staff. My PERSONAL opinion is that a handwritten note to the preceptor and a bouquet of daisies for the staff would be the perfect touch myself. A hand-written note takes more effort than most people want to take these days; it requires a personal effort that ready-made thank you cards don't have. Most hand-wriiten cards I have recceived over the years are saved because of the effort involved. And a small bouquet of daisies always seems so cheery to me.

Zee, I believe you have to have at least a 76% in order to pass-- anyway, that was what it used to be the last time I took it back in 1996. I have re-certified with CE's since then; but had tested out at least 4-5 times for it between 1978 and 1996. I did let it lapse a few times also during this period; but I used to test out of it to prove to myself that I knew what I was doing; since '96 I've decided that things change too much for me to rely on my memory!

You know, I have seen elderly patients (and a few not so old ones too!) grab any and all available body parts when they are confused and agitated. I just don't feel like I want to give them one more thing to grab. I once had this tiny ancient lady grab my nipple and twist it for all she was worth- thank goodness I wasn't pierced or she would have ripped any jewelry out without trying. I also think that multiple piercings and tattoos should not be on any professionals, nurses in particular. The majority of our patients are the elderly, we are trying to help them heal and should not be presenting them with any mental or emotional discomfort at a time when they are already often stressed from their illness and from their needing to be dependant on others. Anything that we do that marks us as "our just being individuals" may be something that can alienate them from the very help they need. I think back to my DH's dear Aunt Hazel being 83 and in a rehab unit (after she broke her hip last year) where about 90% of the employees were black and she had never been exposed to any different races before. Her confusion was worsened by the fact that there were so few whites around (sorry, but her small town in Minnesota did not have blacks; I am not being racist here; just stating the fact). After her confusion cleared, she told me she thought that everyone "dressed funny" in that rehab unit-- I do remember her telling several of the CNA's that they had "nice outfits" but only later figured out what she meant. BTW, she was also legally blind, so don't judge her as racist either. As a nurse, I reallly feel my duty is to my patients: and sometimes the best thing I can do is try to blend in with what they recognize as familiar faces. Tattoos and multiple piercings just aren't that common here in the Midwest.

Rscarlatti, NURSES advocate for nurses; BUT only after they advocate for their patients first. Join your professional nursing organization (I noted that your profile does not say what type of nurse you are, whether RN or LPN) and get involved in your professional organizations. The nurse who substituted the KCl for the Kayexelate could have KILLED that patient! Would YOU have let it go if that patient was killed? How does one account for the missing dose of KCl; how does the nurse chart what she did; there are so many questions that are "what ifs" here. What if it was YOUR family member?? How would you feel if it was, and some nurse covered up for the other nurse? I do not condone any nurse eating their young; but I put my patients' lives above my co-workers' back any day. I have also found that it is necessary to expect 110% of myself when I am at work. I expect my co-workers to do at least 75% of their peak performance. When I have someone who doesn't give that much towards their patients, I will talk to them on a one to one basis, then if their is no improvement, I will talk to our manager. I do happen to work with a bunch of nurses who are willing to go the extra mile for our patients. We also are there for each other, and also help each other out as needed. The one thing that is so important though, is that we also have to learn to ASK for help when we are overwhelmed. Maybe if we would all do this, we would be more supportive of each other.

I worked nights for something like 12-14 years and started working evening Baylor shifts back in January. I still have nights when I can't sleep til 3AM or later. What worked for me was I always slept at the same time everyday. And for me my schedule was to come home and eat something light, use the room darkening shades, put on an Enya CD, take some tylenol (if needed, but not the PM or Benadryl) and then I'd get up somewhere between 3 and 4:30 PM. That way I'd be up when the kids got home from school, I'd be sociable in the eves for my family, and my schedule would not affect others. If I had nights off, I'd stay up until I felt tired (and it might not be til 4 or 5AM), then go to sleep til noon. I never got up before noon unless on vacation! That was MY SLEEP TIME, and my family and friends all knew it! For those who repeatedly would call or wake me before noon, I found that a telephone call at 1 or 2 AM a few times (just to "chat") would finally get my message across! If my DH would have insisted on my being up before that, I would have probably killed him. If there was a real reason for me to be up before noon; he always would bring me a strong cup of coffee and set it on the bedside table and then leave the room-- I'd hear him enter, and the smell of freshly-ground GOOD coffee would gently wake me! :)

Zee, you can do it! Like I said before, you are doing it for yourself and that is the best reason there is to take the test. If you want, we can be your cheering section here to help you stay motivated.

Zee, you can do it! I first became a CCRN in 1978 and have been a CCRN for the better part of that 25 years. You have the best motivation for taking the test -- doing it for yourself! That is the only reason I took the exam for so many different times; I have only recertified using CEUs for the past 2 times. My hospital has only recognized and paid extra for any certification for about 5 or 6 years now and that has increased the number of people interested in going for it. I don't know what book you have, but since you spent the $$$ on buying it; take a chapter a day and just read that chapter. Don't try to memorize it or anything; just read through it, then close the book each day and visualize what you read. A book is just a written bunch of information; it is up to you to use it in a way that you will benefit from it. After you have read the book or a series of chapters, then it is time to go back and study what you read. When I first took the test, I read Guyton's 2 volume Physiology book and also Harrison's Medical Diagnoses book. I don't even know if there was any CCRN study guides back then, although I would think there was at least one. Other posters have mentioned study guides in their posts, so I'd suggest that you follow their advice. Good luck! I know you can do it! We will expect ap thread saying you passed in about 3-4 months; okay?

I'm certified as a CCRN through the American Association of Critical Care Nurses. Back when I was first certified, I believe the requirements were 2 years in critical care experience but it is now less than that. It is a very hard exam and one needs to keep up with CEUs or retake the test every 3 years to remain certified. My current workplace pays $350/yr. for each certification a nurse has. And you are held to a higher standard when you are certified.

Agnus, you were 50 when you became a nurse? I thought you were one of us old-time nurses and not just one of us old-timers! You give such GOOD old NURSING advice!! Love you! Keep on giving that good advice!