sweetsmiles2007

I'm with Lou! I take offense to the idea that a med-surg nurse could run circles around me. Now a nurse who has worked in med-surg for 5+ years defiantly could on a med-surg floor, and i would be grateful for the advice i'd get from them. Stick that same nurse in my ICU, and i just might do the running. It that doesn't change the fact that ICU nurses deal with situations that would send most other nurses running for the hills. I went from nsg school to the ICU, after 6 months of a hellish orientation (that i wouldn't trade for anything), i'm on my own and doing fine. yes, i still ask 5 million questions, and look up my meds, and research diseases i deal with. Recently I floated to telemetry (due to low census)-- had 3 days orientation; as opposed to the 3 months orientation for a tele nurse who wants to work in my ICU. Guess what? tele bores me stiff. ICU is a mental game, an emotional rollercoaster, a bunch of insolvable problems. Tele is a rat race, an organizational and juggling piece of art. Yes, i have dealt with 6 pts and their problems, and it's not easy, but that doesn't make the ICU a cake walk. It's just a different set of problems. I've never talked down to a floor nurse, and I never will--that's just rude. But i don't insult my team either. If I had to do it over again, I would still go straight to the ICU from nsg. school. If you find an ICU with a great orientation program, a good environment with loads of teamwork, and you don't mind coming home exhausted, or having your heart ripped out daily, i'd say go for it! It's not easy, but it's worth it (at least it is for me)

i had a long term neuro pt who actually bit her tongue nearly in half--make sure you assess that mouth before you grab the toothbrush and suction!! I prefer swabs (more gentle than a brush) q2.

that's the crazy thing though--my unit has been going through a time of low census, so i've been floating out to tele. Tele bores me out of my mind. i hate all the charting, i really don't like having 2 hrs or less for each pt and i miss the rush and the teamwork of the ICU. I love where i am, i don't want to be anywhere else. i think i just haven't gotten that hardened ICU skin yet--too sensitive. eh--i guess i'll get it eventually thanks everyone for your support!

you might also want to chart what you did about the various problems pt is having---- --85% on 5L, encouraged coughing/deep breathing, RT and MD aware or whatever you did about it. --alert, oriented x2, RN reoriented to date, pt pleasant and conversing appropriately (most everyone will deny being confused--you want to give a substantial reason that the pt is not confused despite their only being oriented x2) looks great!

what's your opinion? My unit is planning to go to computer charting in a few months now, and I'm wondering if it's as easy to trend as on paper. it probably depends on what system is used...hmm.

I went into a SICU (w/ majority of post-op CABGs) immediately after graduating from a BSN program. had a 6 month orientation and loads of classes---and it really sucked, but i learned a ton! After being there for 9 months, I decided to float to the tele floor because our ICU has had a really low census for the last 4 months, and my paychecks started suffering. Annoyingly, tele has bored me out of my mind. I obtained the organizational skills to care for 5 pts from caring for 1 pt in the ICU, and i'm constantly informing other tele RNs various facts about labs, assessments, ect. I miss the pace of the ICU, i miss the brain work, i miss doing everything for my pts. My opinion is that working on the floor was not necessary to make me a good ICU nurse. Part of what makes me such a good ICU nurse is my team--their willingness to teach and my willingness to learn, another part is my compassion for the pts, also my technical skills (which you cannot learn anywhere but an ICU), and among other things, my personality (able to deal with chaos and stress without freaking out) all of these things have also made me a very good floor nurse, but i prefer my ICU. thanks!

I went into a SICU (w/ majority of post-op CABGs) immediately after graduating from a BSN program. had a 6 month orientation and loads of classes---and it really sucked, but i learned a ton! After being there for 9 months, I decided to float to the tele floor because our ICU has had a really low census for the last 4 months, and my paychecks started suffering. Annoyingly, tele has bored me out of my mind. I obtained the organizational skills to care for 5 pts from caring for 1 pt in the ICU, and i'm constantly informing other tele RNs various facts about labs, assessments, ect. I miss the pace of the ICU, i miss the brain work, i miss doing everything for my pts. My opinion is that working on the floor was not necessary to make me a good ICU nurse. Part of what makes me such a good ICU nurse is my team--their willingness to teach and my willingness to learn, another part is my compassion for the pts, also my technical skills (which you cannot learn anywhere but an ICU), and among other things, my personality (able to deal with chaos and stress without freaking out) all of these things have also made me a very good floor nurse, but i prefer my ICU. thanks!

I'm sorry to hear your bored w/ nsg. school-- just wait till you get out--you've jinxed yourself already ;P yes! it gets crazy busy in a cerebral way!! go find an anatomy book and try to figure out the heart. EKG's will boggle your brain, cardiac output, hemodynamics, then, try to figure out a cardiac bypass pump! that should have you reeling ---hehehe or, if cardiac isn't quite your thing, try to understand the brain--why are people psychotic? how can they fix it? did you know that 10% of people with mental problems have some kind of physical defect (brain tumor, ect)? should 'stupid' be a diagnosis? try reading Sybil. sad, but fascinating story about multiple personality disorder. the ICU--is a matter of figuring out why someone is going bad, than figuring out the best way to fix it. yes, that's a load of brain work. cause you have to know what your dealing with in the first place, and nsg school doesn't come close to teaching you everything there is to know. Luckily for us, the MD's do lots of the figuring out part, but if we're not on our game, informing them of pertinent info, the pt's never gonna get fixed. good luck, enjoy getting the basics down!

just wondering if any of you other ICU RN's feel like you walk around with blood on your hands all the time? Been in the SICU almost a year now--night shift. Don't get me wrong, i love my job--love doing all the cares for my patients, love having an amazing team of MDs and other RNs around me, thrive on the challenge of constantly learning new things, and a billion more tiny things that make my job wonderful. but, seeing something as violent as CPR and ACLS, watching people younger than myself dying with questions still in their eyes--it haunts me. it's like a shadow constantly on my shoulder, like the alarm bells that i dream about at night. I've got friends on the tele and medsurg floors that i try to explain it to, but they just don't seem understand me. I love my job! i relish it! but i just don't know how long i can do it--like the violence of it all is wearing me down. I don't know if it's just cause i'm naive, and this is growing up, or if this is me starting to get burnt out or what. I don't want to get burnt out. I just wish i could forget some of the things that i've seen, that i've done to try to help someone. I want to forget the cries of the wife of the man we just coded three times after we finally called it at 1548. I want to forget to way a pt's orifice gapped open from the FMS. I want to forget about the pt with a black right foot due to a clot that happened in a different hospital from a perfed bowel. I want to forget the mom (who happened to be my age) and the fear in her eyes as 4 MDs tried to decide how they could/should fix her aneurysm, while her baby... but i can't. maybe that's just an ICU nurse's burden. but it's a ******* heavy one. I'm on vacation right now. trying to get away from the shadow that i can't seem to get away from. You know the phrase--do unto others as you would have them do unto you? well--the last thing in the world i want is to be a pt in an ICU, even my own. I know i would get compassionate RNs and MDs, and the best medical and nursing care available, but given the choice, i would much rather just be dead. I think part of my problem is that i feel guilty. Guilty for condemning anyone to something I wouldn't be able to deal with. Guilty for knowing that the definition of 'torture' is too similar to the definition of the ICU (taking away dignity, restraining, no sleep, pain, no ability to speak, ect.). and angry at friends for not understanding why i want them to make their parents in the hospital DNR/DNI. angry at my MD dad and sis for not understanding the burden i carry, despite their understanding of my medical terminology. angry at the public for not seeing what we do, and not discussing things like codes and ventilators and such--for hiding from it. and angry at myself for not being able to grieve for the patients i've lost--for burying it with laughter and jokes and pretending like i'm strong enough to carry them all. am i the only one who feels like this?

8 months ago, I was exactly where you are--only i work in the ICU. I remember really wanting to see a code and thinking that it would be all exciting and dramatic like on TV. Than it finally happened--again and again--not on the geriatrics either--on young people--for random or unknown reasons. I think everyone of us must have awful memories in our heads of patients who have gone wrong. my best advice for you--from my limited knowledge--concentrate on having one good day. go on a vacation--something just to get away and relax, if only for a weekend. No matter what happened, realize that you did the best that you could in the situation. finally--and the hardest thing to do--quit obsessing-think about something else, DON'T BLAME YOURSELF!!!! good luck! don't stop now, it gets better!

1. what degree did you get? eg: aa, bsn.. have you had other degrees in different fields? bsn, no other degrees 2. why did you pursue this career (demand, family request, your own interest, money, passion, etc) to travel, so i will always have a decent paying job, so i'd never be bored, and cause it will always be a challange 3. when(or how old) did you realize you wanted to become a nurse?in highschool-- didn't want to go to school for 10 years to get a job 4. where do you currently work (i dont need a specific address or something like that)? a private doctor clinic? hospitals? schools?hospital--icu 5. what is your salary?currently $24.85/hr. 6. by far what is the most challenging thing you have faced so far? slow codes, pts with clots, young people who are really unlucky, moms/babys gone wrong. 7. what do you find the most rewarding? transferring someone out of icu 8. do you have a family? if so, how often do you spend time with them? parents--dinner every couple of weeks. 9. would you say you get days off more or work more? definatly more work. 10. if you could choose a different career, would you do it? nope. i chose this career for a good reason. 11. how long have you worked in the nursing career? 10 months. 12. when you graduated and got your first nursing job, were you able to handle the situation well? was it demanding? did you get yelled alot? were you happy? i like to think that i handled that situation the best i could---no i didn't enjoy it, it was really crappy and i felt stupid and terrified and confused and wondered if i could really be a nurse every day---i still do! it was extremely demanding--took up more of my energy--physical and emotional--than nursing school ever did. i got yelled at four times, and every one of them i smiled, said thanks for the guidance then went home and cried. it is my firm belief, however, that medical/nursing people are some of the most patient people on the planet--my unit was extremely patient with me and i'm grateful to them for that. am i happy now? yes. i have a fulfilling job that i do well. i still go to work scared that i'll make mistakes, i still get emotionally involved with my patients, i still spend a rediculous amount of energy--physical and emotional--giving my patients the best care i can. 13.how demanding was your work hours at the beginning? 12 hr shifts 3/4 days a week plus 8 hrs of extra classes 14. are you happy with your job now? if not, why? yes. 15. how many hospitals have you worked? which is your favorite and why? 3 hospitals, and i like the one i'm in the best--that's why i chose it. choose what you want--don't debate for years, choose, then give it everything you have and be happy. good luck!

our policy has us doing q15 vitals while the pt is on any vasoactive drips. once they're off the gtts, we go to q30 or hourly vitals depending on how stable the pt is. That can't be easy for you--5 min vitals while your trying to stablize a pt. ugh. When our post-op OH come back we usually have one nurse hooking up and the charge charting and helping out. good luck!

Wow! I don't know much about nursing in Flordia, but, having recently gotten out of nsg. school, I can definatly say that a lot of possible nurses were lost because of the courses and the professors. We started out with 60 people, and only 35 graduated. In my last semester, we were required to pass a practice NCLEX test, if we didn't pass we couldn't graduate. Talk about a headache and stress level through the roof. As well as the times I've gone to profs for help, and was advised to "think critically". No suggestions how to think critically, or ways to know that i'm suceeding. It's frusterating, stressful, time consuming and just plain difficult to become a RN. On top of that, I really feel as though I have learned everything I know on the job, not from the classes I have taken. In the end, I paid $80,000 for a piece of paper that says I have a bachalor's degree in nursing science, for some classes in which I promptly forgot most everythign I memorized, stress and no social life to speak of. :/ In end, it was worth it to have that RN behind my name, but i just wonder if all that stress was really necessary.