vera4130

Arterial line is best. Especially if they are on pressors or cold (hypothermia protocol), or even have very calloused hands. When I have an art line available I never use finger sticks.

A few options in the future: Document when there are safety shortfalls. No chair alarms? Document it. I had to document a "system" problem when the phones were apparently down and my trauma patient decided to de-recruit a lung. Not my fault, not the physician's fault. Tell the doctors you can't follow their orders for up to chair and explain why. Document if you cannot get a patient up due to the above reasons. Tell patients and families when they're frustrated about things like this that they should mention it on their survey. My hospital's been really into arbitrary rules made up on a whim, and this has been my strategy to address it and safeguard myself.

I'm not 100% sure this is what you're looking for, but the book 'When Chicken Soup Isn't Enough' by Suzanne Gordon is fantastic.

I think many people fail to prepare for HESI, they assume that they will be prepared without actually doing much preparation. Did that 25% invest time in studying or doing practice exams? I personally prepped for exit HESI by reading, reviewing, and taking as many practice exams as possible. It paid off, I scored in the 99th percentile. The same strategy worked when I took my CCRN and I will do the same for boards as an NP. I would not have been prepared if I had relied solely on what I was taught in school. I had to personally figure out what my weaknesses were and work on those.

This is not unheard of. They're setting a minimum passing score based on exams. I cannot even think of how this would be a "legal" issue, how schools grade is not regulated. If it's clearly stated it's definitely fair game. There can be all kinds of rules like passing HESI exams with minimum scores. And the BON is definitely not going to get involved, they're worried about people who have a license or are in a position to sit for boards.

That's really a little rude. I think it's totally normal to worry about "being behind." The OP hasn't shared anything about themselves other than they're worried about delaying graduation. OP, don't worry about it at all. You'll work with nurses who are 22 and nurses old enough to be your grandmother. And in 10 years 22 will sound so young.

Had a patient come in with hyperkalemia and was going to need dialysis, wasn't currently on dialysis and so didn't have access. Didn't seem emergent and renal was swamped so they decided to hold off until the following morning. Throughout my nightshift he progressively looked worse. Finally, he goes into a junctional rhythm in the 30s. I literally had him hooked up to the crash cart when the resident called back. She tried to tell me that since his BP was ok they were ok with that. I used some very assertive language and told her that I was not, and her attending wouldn't be either. Someone was placing a quinton 10 minutes later.

Why not just get the experience? Short cuts are not always the best route. What makes you qualified as a manager if you have no experience? My best managers have had clinical experience and an MBA or MSN in admin. I honestly can't imagine working for someone who had no previous experience. Edit: a couple years working (even while in school) can make a big difference.

There are research nurses too, and many do more than just taking patient histories. Public health could be a good option too. I hated nursing school so much I almost dropped out. I also had a previous degree and thought that I wanted to do research, but found that the lab was not for me. The only thing that prevented me dropping out (other than I couldn't figure out what else to do) was watching an open heart patient land in the ICU after a valve replacement. I knew immediately that I wanted to work in the ICU. That's all I've ever done, and although some days are really hard, I love it. Stick with it, you can find something that fits you.

Yes. It is as much me evaluating them as it is the other way around. I care about how units schedule, floating, staffing, education opportunities, etc. Well thought out questions should be seen as a bonus. And I'd get benefits info up front from HR.

I'll second that. Some places may be an outright no, others will want more information. But I'd want to find out before spending the time and money to go to school.

I had one who was a "therapeutic touch" practitioner and believed she'd healed someone's DVT or some non-sense. She taught our first semester lecture and I've never had a more worthless class. Thinking back it's clear she wasn't really qualified to teach, she hardly had any experience. And all the nursing theory and nursing diagnoses.

Get familiar with how to look things up at your hospital. For example, if I have a question about what is best practice for a certain diagnosis, I usually start with UpToDate. Find where to look up information about diseases, medications, equipment, and policies. Write down anything you aren't familiar with or feel a need to look up and do so when you get home. Or buy a critical care text and look up your patient's diagnoses when you get home, it will help you get more familiar with common disease processes or surgeries. Ask thoughtful questions. Ask your preceptor what they expect and set goals for each day. Nursing can get really task oriented, but a good critical care nurse should pick up on changes and be thinking about potential causes and concerns.

Nursing is stressful, and critical care is stressful in a different way. I think the only way to survive sometimes is to have a life outside of work. It's not that I'm not a team player (trust me, if you need help I'll probably stay late), but sometimes our employers forget that we're people too. I'm not driving in on my day off to go to every meeting or mandatory education. The only thing that irritates me are the 'yes' people. The ones who are all too happy to go to every tiny meeting, always see good reason for the extra charting we're doing. I think we need more people who put a limit on work or else the bosses get carried way with their well intentioned but horrible ideas.

YES! Do everything in APA format up front, it will make revising easier!! Your assignments the first three weeks (I think - I've already starting blocking out the painful memories of that class) will result in a rough draft of your final paper. Do the APA up front whether or not it's required. I hated this class. I hate to be so negative about it, but I got a fairly bad group. Two members barely did assignments and I had to check their submissions for plagiarism. One made a good effort but needed a lot of correcting, she was clearly not a native English speaker. And thankfully one other person put some effort into it. I was on the fence about the academic coach until we had a disagreement over point deductions on the final agreement. I quoted my rebuttal straight out of my APA manual. Her response was that "well Purdue OWL says..." and after I looked up what they said, they she wasn't even correct about that. I've seriously considered email the course coach or dean over it because it was such a stupid response I almost couldn't believe it.