BellionRN

I think you did exactly right, and that the patient was incredibly fortunate to have you come in that day, even though you had to deal with your coworkers hissy fit.

I don't see advocating for your patient as being an opinion.

I haven't asked them NOT to, unless it's at me ... but I have on occasion reminded them that they're not the only one in the room & perhaps could they not scream ALL OF THE swear words as I'm doing everything I can do to manage their pain. I've been known to drop f-bombs like nobody's business so I don't hold it against them.

Was he not capable of shutting your door himself? Or is that too hard, along with basic household chores... Anyway, people don't get it. Don't expect them to. & if doing all that extra stuff around the house bugs you, don't do it. He sounds like a big boy... he can probably manage.

I don't really have much of an opinion as a Canadian but I'm finding this thread quite interesting! Do hospitals have to specify upon hire that you aren't allowed to carry a concealed weapon to work?

I went to ICU as a new grad. Like you, I had worked as a Student Nurse Employee in the same ICU in which I was hired. I did a mentorship program the summer between my third and fourth years of Nursing and picked up during my fourth year. When I graduated, they encouraged me to apply there as a new grad. And again, like you, I wavered because I didn't think the ICU was any place for a new grad. I had actually initially applied to the General Surgery unit. I took a critical care nursing program that included a 3.5 wk preceptorship at the end of the 3 month program. After that, I got an orientation to the unit that was approx 8-10 wks (I can't remember exactly). It sounds like you are already a step ahead because you know the unit and the staff. It also sounds like you have a good rapport with them, so you'll have people to go to when you are unsure or have questions related to certain disease processes, drips, tests, etc. I'd also be very surprised if you were denied an extra week or two of orientation as a new grad in an ICU if you weren't feeling ready to be on your own just yet (keep in mind you won't feel 100% ready... ever! ). I think you should follow your gut on this one. As much as I didn't think I had any business being in an ICU as a new grad, I wouldn't change my experience for anything. I was careful & I asked a lot of questions. I had wonderful support from the nurses on my unit. I learned an incredible amount. In ICU, you are never alone. Good luck! I'm not from the US, but it sounds like you are incredibly lucky to be offered two jobs as a new grad from what I've read on this website re: job shortage.

We've used them before, you can titrate for output & the steady infusion sometimes seems to work better for certain patients who don't respond that well to a push dose... Don't ask me why lol! I don't find it that common, though. To the OP... We've all done it. It is what can only be described as a horrific feeling when you realize what you've done. Be kind to yourself. Learn. Move on. ETA: sorry, I don't consider myself "experienced" with 3 of my 5 years of nursing in ICU! I only saw you asked for an experienced opinion after! Apologies.

Often, if the cyst has ruptured and symptoms have resolved, there isn't much to see on an U/S. Maybe a bit of free fluid, but perhaps not depending on size. Just because your U/S was normal doesn't necessarily mean you didn't have a ruptured cyst. Speaking from experience.

Typically I have two patients, or one if it is an ICU, a sick stepdown patient or otherwise someone who is requiring more of my time (pain management problems including q5min drug Adm, confused/aggressive, etc.). I would recommend reviewing post op main management and airway management to start! :) Good luck, I love PACU :)

Why did you leave the job you loved? If you don't love it, I don't see why "sticking it out" will benefit you in anyway way, unless you are using that area as a stepping stone to something else. Would you be able to go back to your other job?

[quote=Lev Actually... Where I work we do say "call in", kind of short for "called in sick". Took me a little while to figure out what "call out" meant when I first started frequenting this forum! Haha "Are you at work?" "No, I called in!" :) ETA: (Sorry my quote didn't work! Referring to Lev's comment about "call out" vs "call in"!

I took my BN in New Brunswick. Practicing on each other wasn't included in our program but some of us did it just to get used to it. The dummy arm was a joke.

Maybe because they know nursing students (& students in general) are poor & it's a good opportunity for some easy/extra money ...?

That was a weird post. & I admit, a little concerning. My nursing related anxiety didn't start until about 1.5 years after I graduated. I look back now, to some of the situations I was in as a new grad in a busy ICU and I cringe. At the time, I wasn't fazed because I had excellent support from my coworkers and was very aware I was a new grad in a critical care area (& that I didn't know it all. Haha, or anything!? Kidding ... sort of) so I talked through things with my more experienced coworkers but, ****, really? I managed, I learned, I'm so greatful for that experience ... but now I look back and think, wow. My point is, & I find it difficult to even articulate properly ... I think the more you learn, the more you discover what you didn't/don't know. & the more you realize what you still don't know. If that makes any sense. I think it's nice that you don't feel anxious. But your post concerns me, as it does a few other posters. My anxiety was pretty unit/situation specific and with a few moves, I have been able to find a bedside job that I don't dread going to, but I do still always have in the back of my mind, "what if I do something wrong? What if I miss something? What if...?", and I firmly believe that if you don't have those questions in your head sometimes, you should be very, very careful. Nursing is stressful & I hope that those that have major problems with anxiety don't take this post to heart.

Those restraints sound like hobbles. Not something we use. Did she run out screaming or did she calmly express her desire to leave & provide a reason why? Did she express this desire to you or just try to sneak away?

We just do. Like any other high stress job. I always think it's weird when people ask that question. I, for one, am excellent at compartmentalizing. Not such a good thing. Needed to get away from ICU.

My husband is a truck driver. But I've worked with many nurses who are seeing/married to police officers!

Is it within your scope to fire people?

Do you mean Guillain-Barré Syndrome?

Whether you undermined him or not, he has no right to yell at you in front of 15 other people. I understand the point some of the PPs make about hearing him out and seeing it from his perspective, but if he indeed came raging out and yelling at you, I see no reason why you need to extend him an ounce of respect by "seeing his POV". You wouldn't let anyone else talk to you like that. A doctor is no different.

Ive been following this thread since it started but usually don't post much, more of a lurker. I briefly worked on a gen surg floor prior to starting my CCNP and going to ICU. Because I have worked in different areas, I can appreciate the challenges each area faces. For example, when I worked in ICU I remember getting patients from ED that were in a literal mess ... Shattered glass (not big shards or anything) under them when we moved them over to the bed from the stretcher, pieces of cut up clothing, random caps off fluid bags and wrappers from whatever was used in emerge to stabilize said patient, lines tangled everywhere, not labeled ... just plain dirty sometimes. I remember thinking "man, how do they leave people like this? How is that safe? Tsk tsk". Then I went to Emerge, I realized that priorities shift. Making my patient clean, organized and presentable is literally last on my list of things to do. First is lines, bloodwork, monitoring, head to toe assessment, calling appropriate support (RT, docs, more staff, CT, ECG, etc.) diagnostics, wound care (if they are bad), preparing drips and medications (like NOW. Preferably 5 minutes ago), finding an old chart, sometimes running a code or near-code ... My priority is to stabilize and send to ICU where they will get the appropriate long-term care. Basically keep them alive so they can get to a more appropriate care area. All that to say, report priorities are different for each area, as well. As an emerge nurse, just give me the basics, the rest I can figure out as I go. We are used to working "on the fly" with little to no info about our patients. Floor nurses have different priorities for a more long term care plan, so sometimes I would get (what seems to me) an odd question but hey, if that's what you want to know I'll do my best to answer. Just because I think it's irrelevant doesn't matter. But it goes both ways ... One of the things I find really frustrating about nursing is that each area thinks they have it harder than the next, and we are all so hard on each other. I wish people would understand that most of us do our best no matter where we work. I can't really put in my two cents about reading the chart ahead of time because I've always worked with all paper charts. I do think it would be challenging considering how busy the floors can be, but I also understand the point the OP is making that if you're both sitting in front of the computer while on the phone, the floor nurse could maybe sign in and peruse the chart as well. (If you don't take report in front of a computer then you need not quote me saying that. I said "IF you're both sitting in front of a computer while on the phone" ).

Hello all: Looking for insight and wisdom from Canadian travel nurses. I've done some research on agencies and plan to peruse the site for tidbits of info, but I'm also interested in getting a Canadian's point of view. I have 4 years experience in critical care areas (ICU, Emerge, PACU). My life lately is in a bit of a limbo and I am considering doing some travel nursing. I've always had an interest but never really got the courage to do it, or the opportunity. ...not that I've magically found courage yet but I'm trying to arm myself with some knowledge so I can make an informed decision. So. Did you enjoy it? What was the biggest challenge? What was included for you by the company? Did they assist you in getting registered in other provinces? Was the company easy to work with? Did you get offered a variety of placements? What sort of reception did you get on the hospital unit? What was the schedule like? What are some advantages you find to being a travel nurse vs having a home hospital? I know it's easier to respond to questions sometimes so I've included a couple of my burning ones, but please feel free to add anything else you think is relevant or useful to someone considering travel nursing. Really appreciate your time, thank you!

Wow! Missed this post by tacomaster until you quoted it. (So I'm quoting yours...) How in Pete's sake do you think it's possible to not get any more patients simply by "holding" the ones we already have? Unlike a regular floor, where you can only have so many patients before your floor is full, the ED is NEVER full. If someone comes in and needs a spot, they get one, doesn't matter where, just as long as they get one. Not to mention the flack we get from our change nurses or team leaders for not moving our patients ASAP!

I'd just take the job. There's so much emphasis on starting in med-surg but honestly if you like post-partum, then just go for it. I started in a specialized area (ICU) and guess what, I turned out just fine, and no, I don't wish I had spent a year on a med-surg floor. I DO, however, remember thinking to myself back then that I should probably work on a floor for a few years, so I understand your thoughts on this. But I didn't. & I have no regrets. If you get another job in a few years (say in med-surg), then you get out your books and do a refresher. I've seen nurses who started in the OR, or NNICU and after three years wanted a change and came to Emerge. They got out the books, refreshed their memory on basic assessments, etc. and did just fine. I've never worked post-partum (well not since school!) but I can tell you some things that you'll likely learn: time management skills, medication administration, focused assessments, head to toe assessments, patient advocacy, building rapport with patients, dressing changes, suture/staple removal, being alert for changes in status of your patient, when to call the doctor, patient teaching, admissions, discharges etc etc. You know what you'd learn on a med-surg floor? A lot of the same stuff! Just because one area is more general doesn't mean it's better. The foundation of your learning will be similar & if you've got some common sense, you can transfer what you've learned from one area to another. My two cents! Good luck!

OP, I "liked" your post not because I enjoy what you're going through but because I can empathize. I thought I'd clarify so people don't think I'm sadistic I second the posters that suggest restraints & sedation, although the type of assault you describe (head butting, pinching...) can easily be done while restrained so perhaps you are already using them. I do hope you have adequate support from your coworkers. When I worked ICU and Emerge and we were dealing with this sort of situation, we always ran to help out. Having a good doc on your side is always helpful too. I definitely recommend documenting (professional practice, patient safety reports etc) & being vocal about the danger you are facing with these patients. No wonder you're getting compassion fatigue. One of the many reasons I left ICU. I get it. Good luck & stay safe!