AKav8trix

Need Survival tips for Night Shift!

AKav8trix replied to RedDirtNurse's topic in Nursing

I've been on night shift (12's) for a few years solid now. I love it! I've been blessed with being able to work my night shifts together with a good amount of time off in between. If I need to flip, it usually gives me enough time to adjust. On my first day off I've found I have a hard time just sleeping a few hours in the morning, once i'm down, i'm out for at least 6-8hrs. I'm usually able to get to bed by around 3am or so my first night off and sleep til 9-11. I try not to totally "flip" if possible, but just keep my "night" an 8-ish hour block somewhere between 0200-1800. Even though my sleep schedule is a bit different than my husband's (he works day shift during the winter), he's understanding on our days off together that I don't wake up very easily in the morning, and we adjust our plans for the day accordingly. If I do have to be alert and oriented early in the morning, I try not to have that day be right after I get off my string of shifts. Often on my first night back, I'll get a few hours of sleep in the afternoon, if I've gotten up early that day, or just sleep in til the early afternoon and stay up til I go to work. Usually works out okay. I've found keeping well hydrated is good, and being careful like others have said to make sure you have healthy munchies on hand so you're not tempted on a regular basis to go for the vending machine. :)

Are you doing this at work?

AKav8trix replied to vivasmom's topic in Emergency

giving nebs: yes drawing own labs: yes, and run them most of the time, too starting your own iv's: yes running own blood gasses: i would if we did them here (hopefully soon!) cleaning own rooms: yes walking pt to radiology, ct etc: yes, and some of the nurses here are certified to take the xrays, we don't have a rad tech testing urine: yes--ua, uds, hcg mixing meds: yes all caths, ng insertions, trach suctioning: yes i do work in a very rural facility that's not big enough to be called a hospital, but we do provide emergency care and/or overnight observation if the person doesn't need to be medevac'd to the city. ancillary services we have not the nurses pretty much do it all. :)

Anyone ever ask for more orientation?

AKav8trix replied to beatrice1's topic in Geriatric

Asking for more orientation is perfectly fine, especially as a new grad! I wound up asking for 2 more weeks, because I soon realized after a few weeks on my own (and some scary patient situations where I didn't have someone available to answer those questions when they were urgent) that I still had some things to figure out as a new nurse. I wouldn't have been able to learn as well, if I'd just done it on my own, because I didn't know enough yet to know what I was missing. Getting a few more chances to have someone available to look over my shoulder when things got crazy, helped me to build my confidence and refine my routine to better care for my patients. I'm sure in the end you'll be glad you did say something, and try to take advantage of every moment you have with your preceptor to learn as much as you can before you wind up on your own again. :) Kudos to you for having the courage to ask for more time!

Dream job if you weren't an RN

AKav8trix replied to EDnursetobe's topic in Nursing

Ooooo, professional world traveler, that would be a blast!! :) Hmmm, dream job...designing evening gowns or being a pilot for a flight-seeing tour company. I'd love to get paid to fly!

Do your Managers and Charge nurses work on the unit?

AKav8trix replied to pilotnurse's topic in Emergency

I've seen it both ways and IMO the best places I've worked have been where the NM stays active in bedside nursing, even if it's just one or two shifts a month. It seems to make a big difference in how the unit is managed because they are in tune with the realities of patient care and are strong advocates for their nurses and the patients with upper management. It seems much better though, when the charge nurse for that shift does not take a patient assignment, or at least has a lighter load. Gives so much more flexibility when things get crazy with admits or crashing patients. In the ER I'd worked in, it depended on the time of day whether the charge nurse would take an assignment or not. Usually it was only during the usual slow times in the early, early morning.

CCC A & P teachers - anyone had Watson or Kop?

AKav8trix replied to tejon's topic in Oregon

Bown is awesome!! Had her for my biology classes years ago. Came across this thread and just had to post something when I saw her name mentioned. :)

EZ IO's...problems with leaking?

AKav8trix replied to AKav8trix's topic in Flight

Thanks for the replies. :) We haven't used another since then, but the ER I work in just started stocking them, so I'll probably have more opportunities in the future to get more experience with them. It's great that it's become more mainstream to have IO's available for adults, and not just peds, when it's near impossible to get a badly needed IV on a really sick patient. :)

How Marketable Are You as a Rural Nurse?

AKav8trix replied to Camelhappy1's topic in Rural

I can't say I really work in a truely rural hospital, it's more a community level on the outskirts of a metro area, but our ICU is often staffed with only 2-3 nurses and we get just about everything but trauma. Overall, it's around a 40 bed hospital. It's encouraging to read your comments about marketablility. This past year I've wondered if I made a mistake starting my career in a small hospital where we ship most of our really sick patients (especially cardiac & renal) to "town" and the overall acuity isn't as high as the big medical centers with specialty ICUs. Eventually I want to work in one of the big centers to specialize in trauma and/or cardiac and was worried my experience thus far would be looked down on as insignificant. Now that I think about it, I have learned a ton by having to know how to take care of any type of critical patient that comes through the door, and with a lot less resources than the busier big hospitals have. We don't have the luxury of the latest and greatest in technology, and I've learned to rely heavily on my assessment skills and critical thinking. So maybe it's not so bad after all that I started in a small hospital.

Clackamas CC interviews this week

AKav8trix replied to tofutti's topic in Oregon

I wish you well with your CCC application. They have a great program and it's so worth it to jump through all the hoops you have to to get in. That way you get to go through school with a group of students that worked really hard to get in and intend to keep working hard through the whole program, group projects were hardly ever a chore. Clinical opportunities are awesome and so are the instructors. 'Course I'm a little biased because I graduated from there.:) Good luck! (btw, the scrubs are navy blue...they're notorious for attracting the lint off the white hospital linens like crazy. )

HELP New Neuro-ICU nurse

AKav8trix replied to icunursematt's topic in Neuro

Hang in there...I'm a new grad in ICU as well, but with one year behind me (whew!). I can so relate to your frustrations. I actually had very supportive preceptors, BUT sometimes I think they would forget what it was like to be a new nurse (not on purpose, they weren't trying to discourage me, it just happened.) Most of them have been nurses for 20-30 years. I do have a baseline problem of not being very good at time management...I tend to get bogged down in the details. Finally after a good talk with my manager (bless her!) after feeling like I was still drowning and wondering if I had chosen the wrong profession, she was able to pair me with a nurse who was very good at time management AND could give me helpful constructive criticism including identifying specific ways I could do things differently instead of just telling me I needed to "kick it up a notch" constantly with no additional information. I think it's safe to say it takes a while to get the routine down smoothly, and even then all it takes is for one of your two patients to crump, or require closer supervision and the whole shift routine seems to fall to pieces and you are there at the end of it hoping you didn't miss anything really important. Nope, I don't think you're going wrong and give it some time. Depending on your preceptor try to communicate that you need more specific feedback than just "step it up". If you feel like you are still hitting your head against a brick wall, talk to your manager about your frustrations and if possible have a list ready of what you still feel uncomfortable about and maybe he/she can put you with a preceptor that will help you learn what you need to do to be successful and grow as an ICU nurse. It's not a put down on any particular nurse, but some nurses are just better at teaching than others, I think it's a personality thing. I look forward to when I've been a nurse for several years and can confidently handle any assignment I'm given without inwardly quaking in my shoes when things get crazy and no one is immediately available to help me. Good luck, and don't give up...it's so worth it. It really does get easier the more experience you get. I love being in critical care and can't imagine starting anywhere else. RNlove2fly

"new" grad looking for job

AKav8trix replied to lmz's topic in First Year

I know the frustration. It was tough to get a job as a new grad in my area, so many positions had the 1-2 years experience requirement. I would go ahead and apply for any that you are remotely interested in, sometimes if they are desparate enough they might give you a chance. Some hospitals have internships that start a few times a year (especially the big hospitals) and that seems to be the best way to get started. But, of course, the competition can be quite crazy, so apply early and make sure your resume, cover letter, and application are carefully put together and designed to stand out from all the others. It doesn't hurt to get in the good graces of the HR people, too, they can be some of your best allies. I wish you well in your job search and don't give up, the perfect position is out there somewhere for you, and maybe even in the most unlikely place. It took me a few months to finally get an interview and a few more to get hired, but now I'm finally in what turned out to be the best place for me in many ways. It was totally worth the wait.

curious on pay and cost of living in oregon

AKav8trix replied to melkel619's topic in Oregon

I don't know how much surgical techs make here but in the portland metro area, rent seems to range from 500-1000+ per month depending on how big the apartment is (and what part of town it's in).

Nurses! Whats the Best Department to Work IN?

AKav8trix replied to Sirena922's topic in General Career

I think it also depends very much on the hospital you work in. During my clinicals in several different hospitals and also working as a CNA/US I found there were departments that had staff and supervisors that were wonderful to work with and other departments I dreaded floating to...not because of the patient population or specialty of the deparment, but because of the staff and way it was run. In general, ED and ICU are my favorite places, I like the wide variety in ED and occasional adrenaline moments. In ICU, I like having 2 patients that I can really focus on closely assessing frequently, and I like the challenge of titrating drips, intrepreting hemodynamic values, and again, the occasional adrenaline moments when a really sick patient comes in or someone is unstable.

Would 2 years in small ICU provide enough experience to get into Trauma/Neuro ICU?

AKav8trix replied to AKav8trix's topic in General Career

Thanks for the feedback everyone. :) I just accepted the job at the small ICU and start the last week of July. Although, I really do love the trauma/neuro ICU, this probably will be a better place for me to start, especially with the added stress of paramedic school that will begin in January. I'm excited, but a little scared, too. It seemed I would never get this far during the long journey of school, but now that I have made it, I can't believe sometimes that I am actually an RN now. I will be so glad once my first year is over and I won't feel so brand new and inexperienced. Brand New, RN

When is too soon for a future grad to apply for a job?

AKav8trix replied to Purdue_Nurse's topic in General Career

I just finally got my first job offer last week, almost a month after graduating, because I didn't start early and was too picky in where I applied. I thought 2 months before graduation was enough to start applying, unfortunately though, I didn't send applications out to everyone and for any position...I wanted a job in critical care and only at specific hospitals. I also thought it was strange that people expected me to have a job lined up before I even got through the first week of my last term. I was wondering how a manager would want to hire someone who hadn't even shown they would probably make it through the last term of school, let alone pass the NCLEX and get licensed. Here's what I would do differently next time (thank God I don't have to go through it ever again)... - Start looking for and asking about internship programs 4-5 months before graduation. If you have one health system or hospital you especially want to get a job at make sure you know well in advance when applications will be available and due for the round of internships that will occur soon after graduation...in my area those who applied early got interviews and were hired...there was lots of competition for every new grad opening - Apply for anything and everything you might remotely be interested in, even if you don't think you would want to start there...it'll give you lots more options and one of them may even turn out to be the best position for you. It'll boost your confidence and give you practice for when you get the interview for the job you really want - Make sure to put anticipated date (month) of licensure for RN in your resume and also state when you plan to take the NCLEX in the cover letter - Try to do your senior practicum on a unit or floor that you think you would like to start your nursing career on and make sure beforehand that it is a unit that typically will consider hiring new grads (the unit I was on was dead set against hiring new grads, I found out too late. Many of my classmates, however, were able to get the job they wanted by precepting in the place they wanted to start in.) Good luck with school and December is a great time to graduate...you'll avoid the feeding frenzy that occurs when almost everyone else graduates in May and June. :) Brand New RN

Length of orientation

AKav8trix replied to Grace_RN2005's topic in First Year

The ICU internship I will likely accept (trying to decide over the weekend) will give me at least 4 months but can be extended if I feel I need more time. Wow, I had no idea that some places have a whole year of orientation. That would be great. Hopefully, 4 months will be enough. :)

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