I.C.UNurse

Do not worry about it, were all human and can't be perfect in every situation. You might find yourself in a situation later on in your professional setting that sometimes patients need you to be tough on them to push them to get better. Live and learn, everyone loses their cool once or twice in their career.

Here's what I did and I recommend. The Laura DVD's are a good study tool, but not necessary. Do not do the Kaplan CCRN study tool either. Get Pass CCRN book because not only is the book give you the in-depth details you need to answer questions, it has an online test bank of over 1000 questions. All these questions give you a rational for the answer which is awesome. Second, get the certification and review book 6th edition and the exam book which is the 72 page one, both from the AACN bookstore. Lastly, they give you the blueprint, so make your own study guide on each topic and put in your own words and mindset. If your long term plans are to go to CRNA school, there will be a lot of hiccups along the way and you need keep trucking on. I have just been accepted into CRNA school and CCRN is a good certificate have to back up your ICU knowledge. Good luck!

They can tell if you had to take the NCLEX or CCRN more than once in your interview. You will be grilled on critical thinking skills and no answers include "I would talk to the physician". CRNA is becoming SUPER competitive and the new DNAP programs want the shiniest and brightest. And that includes a good GPA (average applicant where I applied and accepted was 3.5+), multiple certificates, not just your CCRN, PALS and ACLS (everybody has that) and good experience (charge, preceptor, know how to use ultrasound, etc). Some people will say don't worry about your GPA but with the growing number of applicants for CRNA school you need your GPA to be better. (Some schools have 20 to 30 applicants for 1 spot). Attempt to finish school with the rest of grades bring A's and retake classes if needed in the future.

I am an ICU Charge Nurse and can be classified as a "new" nurse, I can take care of septic patients, balloon pumps patients, swan ganz patients, trauma patients, intraventricular drain and monitoring patients, be a rapid response team member, expert IV access member, code blue and trauma leader, while being an expert consult to the rest of the hospital staff (nurses with 30 plus years experience mind you), but I don't care scissors in my pockets so I must be a total failure as a nurse and human being. Man I didn't realize that not having scissors and not doing a immediate skin assessment while my other patient is coding and dying meant I was a horrible nurse and failure as a human being. What a joke! This nurse needs a big dose of reality and realize not everybody is perfect, including herself.

I do too not understand why nurses like to post every credential they have on nametags, writing letters and emails (like really your emailing me about a car and you have to put Jimmy John BSN, RN?!) I have multiple national certificates and a BSN, but I don't put my credentials after my signature at all, just my name. Sure you should be proud of what you accomplished but those accomplishments mean nothing if you can't put them into practice and it shows to other people. You should let your work do your talking, not your credentials. I digress, in the end it would be more of a headache to explain everyday to everybody about your jacket. If you dead set on it and do not want that headache then get your jacket done and don't wear it until you have graduated with your BSN. If you don't care, then go for it, just tell people your a registered nurse because you are one and going back to school.

I'm confused, you are a RN coming off orientation and you have not done any IV's? What about nursing school? And to give medications? You need an order to do that unless you become an advanced practice nurse (i.e. CRNA, DNP). You seem very puzzled about what is basic knowledge for a registered nurse, make sure if you are not ready to come off orientation you request more time.

Why does it matter? She can't assess and shouldn't be but in the end it's you that makes the assessment and intervene when needed. I think there is bigger things us nurses have to worry about and fight for than stuff like this. If the STNA continues to do stuff outside scope of practice then they will lose their certificate it's just a matter of time.

Going into a different job and field is a hard transition. Words of advice, keep your head down, work hard and ask questions. Do not be afraid to ask for help. I have to orient nurses to my critical care with 10+ years in different fields and I tell them "You will feel like you do not know what is going on, so please ask questions". Starting over is hard, like your a new nurses almost like that feeling. I am going through a similar experience by going back to school this upcoming fall for CRNA and have started reading textbooks already and feel like the biggest idiot because I know about 5% of what that book is saying, but that is good because I realize my own limitations and I know that I should not know this stuff yet, but want to introduce myself to it regardless. Stop talking yourself up, keep a low profile and you will do fine.

This is just plain ridiculous. End of story.

The antidote to anxiety is preparedness. Continue to soak up knowledge and work on other certs (ie TNCC and CCRN) while working there. If your level headed and handle stress well you will do okay. If you don't know please always ask your charge for help. Mistakes in the ICU can be disastrous for the patient. Good luck!

As a leader in my critical care unit, you need your ACLS to work in my ICU as well as having some noticeable attributes. Such as being driven, independent, hard working, intelligent, willing to work overtime, etc. TNCC is also a good course to take if able.

As a critical care nurse K+ of 2.4 is something to worry about but the way you handled it was wrong. The patient had no adverse effect of not being on the monitor (i.e. No lethal arrhythmias) according to you, so you should have put the monitor on and did what you needed to do and had a right then and there convo with primary RN. That should have been the end of the story. You are going to make enemies and in ER you need to rely on each other, you are going to make your life harder. What happens when a patient comes in with a problem you have never dealt with before and don't implement a timely intervention bc you didn't know? Now you have opened Pandora's box for the other nurses to write you up.

I hate to be the critic here but you went through your first three attempts and did one "winging" it and you think you still want to be a nurse? If you can't take a refresher course then take some time off and reevaluate what you want to do. If you can't pass it on three tries then either you don't know the material or you can't put it together which is neither good.

I think it comes down to people need to just take a stand and don't tell with that bull crap. Telling someone they are acting like a jerk is not going to get you fired and if it does then you do not want to work there. Tired of people saying "did you tell the manager", well have you tried to talk to them first? Have you realized that some people are just jerks and can't make them happy, therefore do not give them the time of day? I get it when you have to work with these people, but you can always tell them to "figure it out" when they want your help 24/7 and not get sucked into their vortex. I would know because I am management and charge nurse. And the first thing I ask when somebody is being bullied is "did you talk to the person"? Nurses are expected to be mentally strong individuals and take some criticism, it comes with the territory IN ANY JOB!

As someone who was just accepted into CRNA school I will tell you GPA matters a good amount, especially the science courses, but is not the all to be all. They look at everything (GPA, GRE, years experience and where, leadership in nursing, certifications, etc.) and use that to base their decision on whether to grant you an interview or not. You do not need a perfect 4.0 to get into school, but if you have a strong GPA that is one less thing you have to justify or explain in your interview. Also, you never know what is going to be the tie breaker between you and the other candidates. Also, realize that CRNA school there is no such thing as cramming or procrastination. They look for candidates and expect them to be over-achievers and extremely driven, you can't "cram" for a graduate level pharmacology or chemistry class. So, I think your GPA is fine, but the attitude toward studying should change because you first need to pass nursing school before even thinking about CRNA school, so concentrate on passing nursing school first.

CTICU is a place many ICU/Step down RN's want to go, but you have to put in the work at the same time. Get into a step down unit, get your PCCN, show you have the skills to advance and people will take notice. Some people get very lucky and graduate and go into a residency program, but if your like most RN's, you have to work the floor and work your way up over the years. That is just how it is sometimes.

So.... We know you cant keep float pool staffed like a regular floor or else low census would be given like crazy and nobody would make any money. You can have 4 float nurses and now 3 nurses called in on the medical floor that requires 11 nurses and 3 decided to call in sick? Now you have only one float nurse for oh lets see, the OB, tele, PCU, Surgical, SPU, etc? Staffing isn't abvious, it's a very touchy scale and requires PEOPLE to fill those holes! And if people make a habit of calling in sick even 3 times a year, times 11 nurses, then you missing staff for 33 days, no way to plug those holes! Think about how you feel when your short staffed because I know alot of nurses complain about this but then turn around and call in sick because it's my best friend's 2nd cousin twice removed birthday party.

I'm a little confused about you saying your envious of people being on disability? If you have two trained eyes and see that half (very consrvative estimate) of people on disability SHOULD NOT be on disability it does not make you envious, it makes you MAD! Why should I pay somebody to sit at home and abuse my money because they have a "ETOH" "Drug" or ADD ADHD problem?! Does not make any sense, people are again lazy and I should not pay somebody to have a nicer phone and car than me because they like to drink and do meth (but who knows I can be wrong). No lie, one time a patient came onto the floor and the physician asked what the patient did and the patient said "I am disabled" and he said "Why?". The words that came out of her mouth was "Umm, well, because I have anxiety". They use and abuse the system that is in place that is for the geniune people who need it (congenital birth defects, TBI's, and that sort). Not alcholics, meth abusers and people who have ADD, ADHD or anxiety problems.

I find it very funny that the nurses that say that people calling in sick every once in a while (more than 3 times a year) when it's very obvious they are not sick (posting pic's of facebook, texting people at work they are partying, saying at work the night before they are calling in sick because they can, etc.) complain the most when people call in sick on THEIR shift. I have picked up about a month's worth of extra work the last year in OT, but yet the people who do not pick up any OT ever, complain when I don't answer my phone and come into work (Why don't you answer your's when we call?). Work ethic comes hand in hand with this not calling in sick because you can. Sick time is for sick time, physical or mental. People are just lazy.

"Yes, I would like the chocolate mousse that looked like my patient's bowel movement today. Is there peanuts in that dessert?"

Yes, C is for circulation in that a possible future complication, especially since your patient has MRSA, a documented infection, low platelet count, DIC could potentially happen. If that's the case, platelets could be a difference between life and death, especially since you said this patient is staying at these levels. Explaining this to the oncoming nurse and M.D. I hope would be sufficient. You might get a wiggle finger from pharm if they ordered a peak and trough, but that could be shrugged off. Also, one potential side effect from vanco is abnormal bleeding or bruising. If your platelet count is low and you have any kind of bleeding, your body will have a heck of a time combating this without sufficient clotting factors.

I would hang the platelets first due to the count being 7,000 and any future invasive tests would need some platelets on board. Very often in my hospital, if a patient is a hard stick on the floor, they call the ER nurses or us ICU nurses to come give it a stick, otherwise the patient may need a central line. The antibiotic can wait, remembering your ABC should be able to allow you prioritize medications (i.e. patient having stridor post extubation with low blood pressure, you would give racemic epinephrine first before going for the levophed, neo or vasopressin). Hope this helps!

The women on here may be able to give you more fashionable advice, but what I have seen more and more of is showing up in a pressed suit with a light button up shirt underneath with pressed pants or knee length skirt. Also, polished, closed toed shoes. If you do not have a pressed suit, a nice blouse would do. This is what our director of nursing wears everyday. Hope this helps!

I recently just interview last June for 3 jobs and all got offers from them, here is what I did. 1.) You probably already know this, but wear something professional that makes you stick out 2.) Answer their questions truthfully and prepare to defend them (they may give you a situation that could happen and want you to answer and defend it if it arises) 3.) Know the facts about the place you are interviewing (are they a magnet hospital, how many beds, what awards they have attained as a hospital, etc.) 4.) Speak clearly and with a sense of confidence 5.) Bring a couple of resumes with you because there may be more than one person interviewing you 6.) Speak of accomplishments you attained while being in Germany as a RN that would help the place you are interviewing 7.) Show up at least 20 minutes early 8.) Get a good nights sleep before (don't sign up to work the day before your interview if you have another job) 9.) Lastly, shake each interviewers hands and look them in the eyes and say thank you for choosing to interview me at the beginning of the interview and at the end. Hope this helps, with all your experience and expertise I have no doubt you will do great and your possible future employers will see that.

I agree with some of the nurses and nursing students on here about laziness and sense of entitlement is not pertained just to "our" generation, there will always be people like that of all ages. Yeah, I would agree there is probably more in this generation of new grads, but where does this stem from? It came from parents who grew up after the Great Depression and did not know the meaning of "having" nothing. Believe me, my grandma told me all about it (she was a child during this and would go days without food and had to drop of school to help with making money for the family, she was also in grade school!). And she told me I think the parents of my generation screwed it up by wanting our kids to have everything, because we grew up having nothing and I don't want my kid to go through what I had to. If you want to know where these "attitudes" come from, look at these parents demanding their kids get straight A's with them putting no effort in them, spoiling them rotten and then being surprised the act like rotten brats or demanding that Jimmy get a trophy just as glamorous for his 255th place, compared to the kid who worked his butt off who got 1st (These parents are in their 30's and 40's!). What is this telling the kids in my generation and future? There are still hardworking individuals part of "my" generation that were not given everything and still played outside as kids with sticks and rocks (oh yeah I did that!). The student who got stuck with that needle was a mistake, but don't act like you have never made a mistake. Were human, we make mistakes, it happens. I wish you were more worried about her future health when she stuck herself then filling out paperwork.