peds4now

Hi, I've been a nurse for a year, all of it in Peds. I'm at a magnet children's hospital, and I actually am not required to have PALS certification. I like where I am, but I want to be marketable in case I want to change jobs sometime in the next couple of years. I want to stay in straight PEDS, or maybe make eventual moves to NICU/L&D/postpartum. What do I need to be able to get hired in these areas in other hospitals? Do those other areas actually prefer 100% new new-grads over people with experience? So far I am scheduled to get PALS and ACLS by the end of the year. I have chemo certification, but have never given IV chemo, just the oral drugs as an aside on my floor. Is 1 year experience plus those certs enough to make me "hirable" in Peds in a non-children's hospital?

you cannot auscultate lower lobes from the front, so I hope you are not charting them if you only listen on the front. Very few patients cannot be turned at all. And in fact you should be turning them to cya concerning that giant pressure ulcer they have on their sacrum...

Thank you all for your help. Now I remember being taught prime the NS to the filter to stop hemolysis. I think that's what I'm gonna do in the future. Makes sense. It's good to see there are people doing it the various ways too. Thanks!

Hi. I'm a newish nurse and there seems to be some disagreement on my unit about blood administration. Yes, I'm gonna look it up in books, but there are so many very experienced and knowledgeable people here-maybe you can help? We've got the transfusion tubing, right? NS one side, blood the other. NOW, people on my unit are doing it 2 ways: 1) prime completely with NS, then with blood 2) prime only with blood, leaving NS in the bag, not even primed to the filter Something in my gut says the NS is there for a reason. and it ain't for reactions, cause we are gonna change the tubing ASAP if that happens. So, I've been doing it way #1. But that leads to some weird mixing and even sometimes hard to see air in tubing, which is not good with precious blood! I'm thinking maybe I should go with way #2 but prime the saline to the filter. What do you do? What are the rationales for different techniques? Is any of the above outright WRONG, or is it just different styles? Our policy and procedure doesn't say-it's probably intentionally vague to protect us-or the hospital!

As an RN, assessments are one of the few things only you can do. Maybe you are very task-oriented and are thinking about everything that must be done, but ASSESSMENT is #1 on that list. By 4-5 hours into your shift you should be on your first follow-up focused assessment on a stable patient! Please don't wait until the first time you find something potentially major wrong with your patient/the equipment at the end of your shift to develop good habits. When I come on and get my assignment, I take a deep breath. I still have to remind myself to stop and organize my day and not run into the rooms. Review all the orders (the current ones on the computer, not just your printout that may be hours old), make a matrix of what drugs are due when, prioritize who needs to be assessed first, then go in there. If it is a pretty stable patient, I'd take all the 0800 POs with me, but then do a full head to toe. You can do it in 5 minutes even if you are very slow. Check the ID band, check all the equipment and see what tubing needs to be changed and stuff, check the O2/chest tube setup, open up the bed and look at every part of the patient so you know what's there (don't chart what you heard in report). Add all needs to your "brain" sheet. Give the first meds to them, if all tubing is in order hang an 0800 IV, stop to pick up the next person's 0800 meds, and continue on. By 0900 (if you start your rounds at 0730), you should be done, even if you have a ton of patients. I think you will find that your mind will be much more at ease if you give yourself the time to assess your patients-there will be far fewer surprises during the day! And don't forget to give report to your CNA so s/he knows what's expected that shift!

IMHOPEFUL, I'm so sorry. You can do this. It is worth it. Once you are an RN, you can have that license forever if you keep it up. In the greater scheme of things this is just a little setback. When I was younger a horrible thing (that turned out to be for the best, of course) like this happened to me, and I of course called Dad since it involved financial hardship, and he just said, "well, that's what makes life interesting." I hated him for it then, but he was right. I worked it out. Take a breather, plan your next plan of attack, and get your RN! Let us know how it goes.

buildingmyfaith57, I wore solid black scrubs with a bright T underneath once as a student nurse intern, and a nurse pulled me aside and told me people don't like to see that color in the hospital (it was preop, I was learning to start IVs). LOL! I thought I looked hip and I DID brighten it up with the T. Oh well.

I also just became an RN and also am taking a Versant Residency position. I actually think that by the 5 month mark I'm going to be dying to be off "probation" as it were and on to doing my thing, but I figure you only get to be a new grad once. My program has 150+ classroom hours, compared to 48hrs. at the other 2 major hospitals in town. BUT, the pay during the residency is horrible, which is kinda sad. AFter that it goes up to being comparable with other places (as far as I can guess! Each hospital has their own little shtick about explaining pay structure and shift differentials, etc.), but I still wonder if I'm "selling myself short." In the end though, I think the training will be worth it.

1st of all, ty for all the you're not fat posts. Technically, I am edging into the obese category, and my BMI is really hi, plus my waist is way too big (truncal obesity). Take my word for it, I don't carry it that well. I guess I'm also totally unhealthy and zitty and feeling down on myself post nursing school-at a time when I want to be energized and positive. I need a week at a spa and a makeover. Anyways, so do I understand shorter tops can be flattering? OK. I'm gonna stick with basic looks, not go all high fashion. Loose enough but not swimming in it. And try to lose some weight over the next year while working nights and becoming a real nurse-who knows, maybe I can! Ya, I saw some nice scrub tops at Walmart, I'll try there too.

I am fat, and not bold and beautiful fat. I'm 5'4" and 148 lbs. I wear a size 12 if it's generous, otherwise a 14. I look small (bones, arms, below knee), but my hips are 44, waist 35, bust 43. And I'm a new grad. Yes, my goal is to lose 20-30 pounds, but that's probably on hold as my stress level just continues to stay high. SOoooo, what's the deal with scrubs for fatties? Scrubs seem to be becoming such a fashion statement, what's a girl to do?! Do short tops look better, or is it best to go traditional long and cover up the hip area? Keep it medical like you don't care, or go all out cutsey/fashion and hope fo the best? This is a serious question. What do all the RNs (and I know there are tons) who don't look like they run 10miles every a.m. wear? TY.

Peds surgical floor

thanks for your replies! I hope to move to PICU, NICU, CTICU within a couple years, I hope the competition isn't still so thick!!!!!

I'm a new RN (like, as of today I have a license number!). Anyways, an instructor told me to choose a couple journals and keep up with them, but I have a hard time judging which are respected and good, and which are fluff. I'm also going into Peds, may end up in NICU eventually, but starting on a surgical floor. What journals are relevant, meaty, and good for Peds nurses? Thanks!

I would continue doing questions, but maybe take a "breather" and read that content you mentioned. Review medications, what you would use them for, and any weird side effects or admin. instructions Good luck. I had 75Qs and have joined the nervous waiters. Every day I become less convinced I passed.

I took mine July 26, still waiting. Right now the website says it was updated July 27, so it would be a bit early. Don't lose hope. 2 days was exceptionally quick for bogeyboy. Maybe your file is being handled by a different person who has a big backlog. Remember, this is a gov't office... Maybe your transcripts aren't in or haven't been processed. Maybe the person entering names just was done with his/her day and went home. I felt nervous but okay after my 75Qs, 2 days later I'm thinking maybe I really did fail! This sucks! My kids are done with Harry Potter, so I've started reading that. That will keep me for a day or 2.