LivewellRN

Thanks guys. I ended up giving her 2T of MOM on Sunday at noon. Had BM 4hours later and another today. No signs of discomfort. Definitely feeling better about things. :)

Hello all, I'm new to Hospice nursing and actually work on the community education/marketing side. That said, I've been a nurse for 6 years on a Med/Surg floor of a hospital, but find myself with questions re: hospice patients and care. Add to that, we recently put my MIL on Hospice and moved her to our home to care for. She has advanced Alzheimers and is total care, bed bound at this point. She may drink 1/2 can to 1 can of Ensure per day with sips of water and maybe 5-8 small bites of food total. Often, she says she's just not hungry or just shakes her head no. I'm okay with that. I get the whole decreased appetite at end of life reality. However, should I be concerned that she hasn't had a BM in 6 days? Abdomen is soft, non-tender, non-distended. Bowel sounds active. So.... with as little as she eats, how often should I expect a BM? Your help is appreciated. I have MOM and glycerin suppositories on hand and thought I might start with some MOM.

OR vs. ICU update: Yesterday was very busy. Had an interview at 0630 for an ICU position and then followed up with shadowing in the OR for a 4 hour Ortho surgery. When I left the ICU interview, I was all excited and thought, "I'm going to love this job, and can't wait to get started on my CCRN!" Then... I went to the OR and thought, "Boy!, this is really fun!" Geez..... I think I would like the automony the ICU can provide. (It's up to you to monitor your patient(s) and be aware of what systems are working well, and what is not, and adjust drips accordingly.) But.... I loved the teamwork I saw in the OR. Everybody together in a closed room working towards the same goal and each doing his/her part. I liked the pace (busy at times, slow at others). It seemed like the RN had to know so much.... where to get this, who to call, what forms to complete, answering doc's pages (a ton), charting screws and plates used (and wasted) during surgery.... I think my "heart" is with the OR, but my "head" is with the ICU.

Thanks for the insights. It looks like I have a lot to think about.

Hello all, I have been a med/surg RN for 2 1/2 years and would like to make a change to either OR or ICU. I know they're both very different. Nursing is a second career for me. I hope to experience many areas of nursing in my career (maybe I'll do both at some point), and will probably jump over to the management side in the long-term future (management background--old career). For now, I love nursing. While some days (and docs, and pts, and families, and mgrs) can be rough, I still believe I am making a positive difference in the lives of others. I understand the amount of direct patient care required in the OR is not the same as the floor, but I think just being there and able to contribute to a smooth work flow is contributing positively to patient care. That said, if I find an area I absolutely fall in love with, I may never want to leave. Any thoughts? Does one pay better than the other? Are jobs more plentiful in one area than another? If so, why? What about career opportunities for advancement? Thanks for your help.

DaVinci RN, Glad to hear the positive feedback. I have an interview with an ICU unit on Tuesday, followed by some time spent in the OR shadowing. Hopefully, I will get a better feel for everything then. I consider myself smart, with good critical thinking skills and a lifelong learner. I'm not so concerned about what others may think about RNs in the OR. I do want a job that is challenging that I can become proficient in.

I'm looking for a career change from Med/Surg floor nurse. Looking at both ICU and OR. I have been told I should be an ICU nurse because becoming an OR nurse would be wasting my skills. I don't get it either.

Thank you for the info. It's good to hear from others who feel the same way. Tamara

Hello, I am a new ADN grad who has worked the last year at a great metro hospital as a Med/Surg nurse. This is a second career to me. I had previously worked in insurance claims and have a bachelor's and master's degree in business administration. I've been told that despite my MBA, I will never leave the "bedside" without a BSN---so, I'm considering going back to school for it. Actually, I've already signed up to start this Fall, but I'm not excited about it. I love being a bedside nurse but would like to keep my future career options open. Anyway, today I attended a WOCN conference and found it very interesting and useful. I spoke with our hospital's WOCN and did some research on WOCN.org and realized I could get my certification in WOCN using my work experience and unrelated bachelor's degree in less time and for less money then a BSN. I think I could be really good as a WOCN (I don't mind the gross stuff and smells. I'm compassionate, patient, good at critical thinking and like results.) My gut is telling me to go for the WOCN because it interests me more than pursuing an RN to BSN program, but my brain is telling me that WOCN certification may not get me anywhere in my career. I'm told the RN to BSN program is mostly theory classes and community nursing. I appreciate that there may be some useful info in these classes, but I think I can benefit more on a day-to-day basis with what I could learn from obtaining my WOCN certification. Any thoughts would be appreciated. Do I do what appeals to me, or what I think I should do? Tamara

Thanks for the advice. It is REALLY useful! It's good to hear I'll be able to find a place without paying a fortune. Also, I found out KY is indeed a compact state with AZ, so I could sit for the NCLEX in KY and work in AZ. They did say that if I decided to live in AZ as my primary residence that I would have to apply for a license from them, pay a fee, and drop my license in KY. KY requires 120 hours of paid work experience after graduation (besides role transition in school) before you can sit for the NCLEX. It's good to hear there isn't any problem with taking the NCLEX in AZ. I would hate to take a job in KY just to get the hours in to pass the NCLEX, then turn around and leave. So-o-o-o-o, now I just have to figure out how to get everything done. What comes first. Jesse, did you two have jobs lined up already when you came to AZ? tc

Good point. Oh boy! I'm really not sure on a specialty or location!! (How do you know what you want to do when you've never done it?) From what I've read on other threads, I figured I really needed to have 6 mths to 1 year of Med-Surg before I jump into a specialty. (I know this topic is hotly debated.) Anyway, I'm leaning towards Operating Room or Mental Health! What a difference! As far as location.....Geez. There's just my husband and myself. We want to downsize so I'm thinking a house or a townhome with a courtyard under $150,000. We're ok with fixer-uppers. (I know the real estate market is crazy. I've been on the web and have seen what's out there.) I prefer the north side of Tucson. My mother-in-law lives on the NW side, but I find the NE side prettier. I hear the south side of Tucson is dangerous and the air force base is loud with planes? Central, downtown Tucson is also attractive. Again, I'm just looking for a small old house with some character that can be fixed up. However, if I'm going out there to get tabs on my relatives, the closer I am to my mother-in-law the better. I found that I can get from the west side of town to the east in about 30 minutes. Not too bad. So you see, ANY advice is appreciated. Thanks again. Keep it coming. tc

Thanks for the comments from everyone. I find it very helpful to hear from those who have worked in Tucson. I know a little Spanish, but not anyone to practice with back here. I've been to the AZ BON website, but didn't find the info I needed. I did jot their number down so I could call them after the holidays. Any recommendations on good places to work for a new grad? I don't really care what area I get into at this point. (It's all new to me, and anything is good experience.) TC

Hello all, I will be taking my NCLEX exam soon in KY, or OH (I live near Cincinnati), but am thinking of moving to Tucson in Summer/Fall '08. As a new grad, can I do this? What is involved in getting my license in AZ? Any help is appreciated. Nursing is a second career for me, I'm in my 40's and my mother-in-law lives in Tucson with my only brother-in-law. Both are in poor health but refuse to move. I'm tired of worrying about them (and the cold winters in KY) so-o-o I'm thinking it would be good for me to make a move. We've lived in Tucson for a couple of years many years ago and loved it. Any help you can give is appreciated. tc

Thanks for the info and new terminology. It's comforting to know. The doctors act like its no big deal but it was worrying me. Your explainations make sense. Tamara

Hi, I'm brand new here. I will be starting nursing school this Fall--so forgive me if this seems like a dumb question. My dad just underwent a triple bypass, aortic valve replacement, and modified maze (sp?) procedure on 6/21/06 (1 week ago) at the age of 79. He has been mentally alert before and after the surgery but now his nurses are telling me he's getting "confused" for long periods of time (i.e. can't think of words, forgets the names of his wife and kids, etc.) They have him off of pain medication so it's not the drugs that's causing it. He's still in SICU at this time but his vitals have remained stable. Is it common in elderly patients to become disoriented or confused this long after major surgery? What has been your experiences? I live 4 hours away so I'm not able to see him daily. I have read that physiologically--the elderly tend to recover more slowly and are not able to respond to stresses as well. What do you think? Thanks for any insight. Tamara