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Thanks for all the input!

At your hospital, do you save a "Code bed?" I'm asking, because I recently got called to the carpet at my current job because I held a code bed "just in case." I was told that we NEVER hold a bed for a potential code and we don't plan for the what-ifs. I'm the house Supervisor and I am expected to fill every bed in the ICU (it's only 8 beds). I cannot have a code bed and I cannot leave an empty bed in the ICU if there are patients boarding in the ER, even if it means stretching the nurses beyond the 2:1 ratio. At my previous hospital, I was spoiled, because we always had a code bed, and a free-floating charge nurse that could take a 2nd code if needed. Here, I have to cross my fingers and hold my breath that there's not an in-house code because I won't have a bed for them. So, do you have a code bed?

On my first night at the job I'm at now, the RN training me was taking me around introducing me to various staff members. One female member of the security staff said "Oh, we hug here." I am not much of a hugger, especially with people I don't know well. And I said (as she was hugging me) "I'm not much of a hugger." And she laughed like I was joking. Over the next year, I tolerated it some, hid from her some, reminded her that not everyone wanted to be hugged and it all fell on deaf ears. One night in the ER, I saw her hug another RN and that nurse said, "I don't like that." And the hugger laughed and said, "You're so funny." People all over the hospital were talking about her and how she was inappropriately touching the staff. I wasn't the only one who would hide when I saw her coming. One day, I was sitting at the nurses station, talking on the phone the the CMO about an issue we were having and she came up behind me and hugged me from behind. It was the last straw for me. I went right to her supervisor and reported it. She was put on probation, but couldn't help herself and a few weeks later she was fired. The moral is, some people don't get the hint.

At our hospital, we have 1 tele tech that watches everyone on tele, except the ER. This is usually about 45 patients, but this is her only responsibility. There is typically a US on the Med/Surg floor, but she doesn't watch tele. At my old hospital, the tele techs (also their only job) were limited to 40 patients each to watch. They watched med, surg, and PCU. ICU and CVICU has a US/tele tech combination on each unit.

I am not a manager of a department and I never have been, but I am the house Supervisor, so I deal with a lot of charge nurses, and of course, I was a charge nurse when I worked the floor. I would say that there are a few big key elements I would look for in a good charge nurse. 1. Knowledgeable- a good charge nurse has to know the unit. You need to have a good concept of how it runs, the flow, the culture, the expectations, the strengths and the weaknesses. That also means knowing your staff. 2. Time management - a good charge nurse has to have good time management skills. For me, it was always important to try to stay at least one step ahead of the game and to have a plan for the "what-ifs." 3. People skills - People have to like you. No one wants a charge nurse that they don't like and you have to be able to deal with conflict. You have to be able to stand up to your staff when needed, but also stand up for them when needed. 4. Be calm! You cannot lead a unit in a panic. If the person in charge is running around in a panic, the staff will feel that panic and next think you know, everyone is stressed. So, a good charge nurse keeps calm. In my years as a charge nurse and a House Supe, the thing people always seem to appreciate about me is that I am very calm. Good luck!

I'm not sure, maybe in NS to make 1mL? Did that low dose even do anything? I've never given less than 2mgs.

I'm impressed that you've only had to call a doctor twice in 8 months! Or maybe I misunderstood and only twice in 8 months has a doctor been rude...still impressive! Let the rudeness roll off your back. You're there to take care of the patient. I've had a doctor hang up on me mid-sentence and I just called right back! Remember, you don't work for the doctor. He/she can get as annoyed as they want to, but it's their job to take our calls.

In my unit, it would be a HUGE deal if we restrained first and then got an order. I work nights and the on -call docs and NPs DO NOT like to give orders for physical restraints. They will try every med in the pharmacy before they restrain. I'm not risking it. The day shift docs are a little more free with the restaint orders. In fact, we will fight with a patient all night and try to sedate the crap out of them, and day shift will have them in restaints by 0700. Also, we can't restrain patients on bipap either without a sitter.

I started this program in May 2015. I just finished my coursework for the BSN portion, so it took me just over 2 semesters. I will finish the MSN in 2 semesters, so it will take me 2 years total. I have moved at a slower pace than I hoped, but I have been working 4 shifts a week the entire time and I've been exhausted.

Since I've never heard of CIWA, I'm guessing we don't use it. We used to use Librium a lot more than we do now. Now, it's mostly Ativan, on a taper. We do give Librium PRN to patients who don't have a problem taking PO meds. We do occasionally have a doctor who will order wine or beer for the patient. I wish more doctors did it.

We don't have to piggyback with NS, and we use different tubing for each abx. The tubing for secondary lines is good for 24 hours per our policy, but I generally hang new secondary tubing with each new bag.

I don't know what my problem is, but I really struggled with biochem. Every task got returned with little adjustments that I had to make. It took me twice as long to complete than I hoped for. I turned in my last assignment today. I can certainly see why you all describe it as childish and dumbed down, but drawing those diagrams was very difficult for me. I certainly don't consider myself a dummy, but that class certainly made me feel like one!

No visiting hours at my hospital. I work nights, so after about 9pm most visitors have left anyway. And a lot of patients will have a family member spend the night. We don't have an age restriction, but kids under 12 aren't allowed in contact rooms. All that being said, we had one pt whose girlfriend would drop his 10-yr old son off at the hospital at night so he could spend the night with his dad. Kid slept in the hospital bed with daddy and everything. I was scared that that man was going to code one night...he wasn't a healthy guy...director said it was okay... We have a pet visiting policy, too.

I did statistics in a week last month. Granted, I was on vacation and had a lot of time. I took the pre-assessment, worked through the course work (which has a lot of mini assessments or checkpoints) took the pre-assessment again, worked on my weak points. Asked my 16 year old daughter to explain things to me, took the pre-assessment one last time to make sure I was above the cut then took the test. I prayed a lot. And passed.

I have my PCCN and I'm going to be trying for the Cardiac Medicine Certification soon.