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OneDuckyRN

OneDuckyRN

ICU
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OneDuckyRN has 3 years experience and specializes in ICU.

OneDuckyRN's Latest Activity

  1. This week, I learned that the number of people who show up to a code is inversely proportional to the amount of space the code is taking place in. There is one unit in my facility that still has 4-bed wards, and as luck would have it, the code was in one of the beds in the back corner. I feel like we were practically standing on her roommate's bed, there were so many of us. It seemed like there were about 50 people in there. Safety issue, anyone??
  2. OneDuckyRN

    CLEP Question

    CLEP testing will probably only help you if the school you are applying to will accept it for credit. Otherwise I would suggest retaking the sciences again and utilizing any available resources (tutoring, supplemental instruction etc.) A lot of programs require a higher science GPA than in other subjects. Good luck!
  3. OneDuckyRN

    Student wanting job in L&D

    I don't know where you're located, but where I am, L&D requires a MINIMUM 1 year of med/surg experience before you would even be considered. Plus my facility has an OB fellowship that is required after the 1 year of experience.
  4. I've done it a couple of times. Both times the patient asked if I could take it off before I ever got out of the room, thankfully. Now, I add that to my mental list of things to make sure I have in my throw-away pile: chux pad, leftover tape, flush syringe, tourniquet, angiocath(s) and cap(s), various wrappers. It all gets wrapped up in the chux and tossed in the trash (except the sharps, of course!) It happens. Like PPs have said, live and learn. Find a system so that you remember it in the future.
  5. OneDuckyRN

    Thought this was funny - From Gomer Blog

    Agreed. I usually love GomerBlog, but this one was definitely a disappointment.
  6. This. I have a colleague who insists on saying her pt is "destatting." Makes me want to tear my hair out. 😁
  7. OneDuckyRN

    Your worst nightmare (Part deux)

    Shortly after I started doing charge, I started having this nightmare that some patient on the floor was coding. I could hear the code alarm, but could never figure out where it was coming from. For some reason, it wasn't being paged overhead either. I was also the only ACLS nurse on my unit that night (this could be entirely true...we have a ton of new staff) and the code team was taking forever to show up. Glad it was only a nightmare, but going back to work that night scared me to death!
  8. OneDuckyRN

    Why don't you just read the chart?

    It's probably been said more than once, but I wanted to get my thoughts out while I still know what I want to say on this topic. Sure, I've read the chart if you give me more than 5 seconds between the admit being paged, and you calling to see if I've looked at the chart. I've also read what precious little has been charted there. Half the time, the ER has put in a Foley and not charted it. I've seen more IV's started and not charted. So...is that a field start I need to take out and re-start? Or did you start that in the ER? Also, I can't get a good picture of what's going on with this patient if the physician/practitioner hasn't actually written a note. 3/4 of the time at my facility, that hasn't happened yet. And yes, I see that you put in 7 nursing notes about this chart. "Pt transported to CT." "Pt returned from CT." "Up to commode." Those are not as helpful as you might think. I need an idea of WHY this pt is here. It's also helpful to know WHY meds were given. You gave 80 of Lasix? Great! Why? If there aren't any notes for me to read, I can only make an educated guess. So yeah, when the charting is not great, I'm probably going to ask you a few questions. Please don't bite my head off. I really want to do the best I can for this patient, but if I don't know anything about them ahead of time, it's hard for me to know what to have at the bedside, and what other things I might expect over the course of a shift. See, that's the difference between ER nursing and inpatient nursing. We're pretty much stuck with our patients for the whole shift. You get them for a little while and either send them home, or send them to me. I realize the tone of this might not come across very well, and that's not the way I intend it. ER nurses work very hard at what they do, and they're very busy. I get that. I'm busy too. But what really cheeses me off is when I'm expected to read minds. Or non-existent charting.
  9. OneDuckyRN

    BE HONEST! What part of your job do you hate?

    I hate when families have unrealistic expectations of their loved one's outcome. You know, the ones where the pt looks absolutely miserable, but the family is convinced he or she is getting SOOO much better! The prayers are really working! He's going to get off the vent and walk again! Let's totally ignore that the pt has been unresponsive for a week or so now, and has essentially doubled his original weight because he's third-spacing like crazy. (But can't we just dialyze him? Um, not with a B/P of 70/40...) Oh...and he or she had a beautifully written advance directive stating that he/she didn't want ANY of this done, but the family overrode the AD and went ahead with it all. I've seen it more times in my short career than I care to count. Direct patient-care related thing that I hate: vomit. I can handle seeing it after the fact, but the sound of someone retching and heaving is enough to send me running to the bathroom. I have been known to make deals with my colleagues: I'll go suction and do your trach care on your vent pt if you take care of my puker. You'd be surprised at the number of people who actually take me up on that! Rude pts are also not my favorite. I just had one last night...He didn't think we were quick enough to get him to the bathroom (I saw the tech go into the room, at which time the tech told him we'd be more than happy to take him, but if he had to go quickly to use the urinal), so he decided he didn't need vitals, assessments or any medications all night. Fine, whatever. You're only hurting yourself and making my job a lot easier. Jerk.
  10. OneDuckyRN

    Now THAT'S a lab result

    Not a lab result, but still... B/P 40/20. Awake and talking. Improved to 80s/40s on 30 of Levophed. And I had one HECK of a time convincing the doc that she needed to be transferred back to ICU because stepdowns don't titrate for B/P at my facility. Eventually I won that argument.
  11. OneDuckyRN

    New-ish charge RN - advice please!

    I should have clarified what I meant by staffing decisions not being within my control. The staffing office tells me how many nurses/techs I get, and who gets cancelled if I have too many on the schedule. I misinterpreted what I was told and cancelled the wrong person. Hence the upset/hurt feelings. Once I know who's working, the assignments are up to me. I try *really* hard to make them as fair as possible but our floor is one of very high acuity. This was the basis of the pile-on during morning huddle, and it was done with our department manager standing there. I kind of think she was testing me to see how I would handle it. Some of the people who were complaining had a legitimate gripe; others, not so much. One other issue I didn't bring up in the original post, mostly because I didn't think it was pertinent at the time: our dept manager has been with us for about 4 weeks. I'm thinking she has bigger issues to tackle than how the charge nurses are treated, and I know very well that I need to thicken my epidermis a little bit . I think after she's been with us a little while, she'll probably address issues like this one. She seems like the type that would. I want to thank everyone for their feedback...this has been kind of a stressful transition for me that is added to stress in my non-work life, and I feel like there is a HUGE learning curve.
  12. OneDuckyRN

    Well, Isn't This Special

    What in the ACTUAL H#$%? Problem is, there are some families on my unit right now who would TOTALLY go for something like this. If they ever got wind of this app, I would seriously consider quitting my job on the spot.
  13. OneDuckyRN

    New-ish charge RN - advice please!

    I have recently started doing charge in my unit because almost all of our charge nurses left for other jobs. I was given a little bit of (very) informal training on doing charge, but never got any real orientation to the role, and sort of had it dumped in my lap. Up until last weekend, things seemed to be going pretty well with no complaints about assignments and no staffing issues. However, I made a blunder with staffing and caused some hurt feelings. It's kind of a long story, and staffing decisions are not really made by me, but by our nursing resource office, and I misinterpreted what they told me. I 'fessed up to my error, and while some individuals were upset with me, I think everyone pretty much got over it. Lesson learned. The bigger issue: we have a morning "safety huddle" in which we talk about census, staffing, and safety issues on the floor. People (RNs and techs) were unhappy with their assignments and publicly raked me over the coals. I know VERY well that people are not always going to like their assignments, and there is no way to make everyone happy. My question is this: should I have addressed this somehow? I am willing to listen to people if they have concerns about their assignments, but doesn't it seem like they should have come to me individually instead of ganging up on me in the huddle? I ended up making some last minute adjustments. I'll pre-empt some of the comments I'm anticipating and say that I *know* I need to grow a thick skin. I get that. I'm looking for advice from seasoned charge nurses on how you would handle a situation like this in the future. Thanks!
  14. OneDuckyRN

    The Official I Hate School Thread

    I had to wipe iced tea off my MacBook screen after "adolescent rectal orifice." Just sayin'. I live across the street from a non-adolescent rectal orifice who can't understand why my protective dog goes bat-poop crazy when said rectal orifice starts yelling at her human. *sigh* More to the original point of this thread...with the weather turning nice, I can't for the life of me figure out WHY I thought going back for my BSN was such a great idea. Guess how much homework I'm getting done right now?
  15. OneDuckyRN

    Sepsis Screening?

    Our protocol is similar to this with one difference: nurses can order lactate levels independently (per protocol, no cosign required) for 2/4 SIRS criteria met. If the lactate comes back >2, then we notify the physician and get orders for the sepsis bundle. I work on a medical stepdown so a lot of our patients are already on the RRT radar, but I'll give them a call and just let them know if I have someone headed down the sepsis pathway. I won't call a full RRT unless something is changing rapidly though.
  16. OneDuckyRN

    "Don't Work" Isn't An Answer

    Not working (or working very little) would be the IDEAL situation. But you're right, it's not realistic for everyone, or even almost everyone. I held down 2 jobs while doing my ADN and managed to keep a 4.0 throughout. I was in school pretty much full time hours on top of working about 50 hours a week, plus completing assignments and studying for exams. Was it hard? Yup. Did it suck sometimes? You bet. Would I do it all over again? Sure would. But I'm the one who chose to go back to school, and had to find a way to support myself and my (disabled) husband while I was doing it. Between the two jobs, my tuition was covered, and one was full time so I had benefits. Our parents helped out with groceries once in a while, but we managed to survive without my having to take out financial aid. Fast-forward to right now, and I'm doing an accelerated RN-to-BSN while working full-time (slated to finish in December). I'm also going through a divorce. I would have to say that this trip through school is more stressful than the last one. I'm not sure if this is due to the divorce, or if work stress is a bigger factor. Either way, time management is absolutely crucial. This time around though, I've tried to let go of some of my perfectionist tendencies. My grades are still high, but I'm not stressing out about not having a perfect 4.0 this time. I'm determined to graduate on time, but at the same time, my mental health is extremely important. I guess my point to this little diatribe is that working full-time and doing full-time school is entirely possible, but it means that you won't have much of a life outside of work and school. Making a schedule and sticking to it is so important. I worked every single weekend for 3 years and missed a lot of family activities. Completely worth it in the end, though!