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st4304

st4304

Critical Care, Emergency, Infusion
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st4304 specializes in Critical Care, Emergency, Infusion.

st4304's Latest Activity

  1. st4304

    Smoking during pregnancy

    OB Nurses: Is there any condition during pregnancy in which a physician would recommend a woman not stop smoking? Pre-eclampsia? Epilepsy? Can any of you provide a link to a study or literature that shows quitting smoking cold turkey is harmful to a fetus or mother? Thanks! Sherri
  2. st4304

    New IV/PICC Team

    It's hard to know what advice to give when everything is going great! LOL Anyway, helping PICC teams evolve is what I do for a living. Training, in-house precepting, etc. I'm also in Indiana! If you have any specific questions, let me know -- I'd love to help. Sherri
  3. st4304

    CRH or Schneck Medical Center

    I worked at CRH for 10 yrs, and many of the nurses I worked with left Seymour to work at CRH, so I guess that tells you something! LOL I feel the need to defend a few things the previous poster stated. The new NM on the PCU was left a mess by the previous NM. People were leaving, but once she adjusted to her new role and the staff adjusted to her, it is now a very pleasant floor to work on. I also feel the need to defend the NM of the CVU. She doesn't hire new hires, if she can help it. I transferred to that unit after working 3 years in ICU and 5 years in the cath lab, and I was overwhelmed at times -- and I am a very seasoned nurse! She believes, as I do, it isn't a place for a new graduate. If she hired a new grad in the past, I am sure it was because she was desperate for staff -- it happens. I have been a nurse for several years and have worked at Methodist, Wishard, and St Francis Hospitals. I keep coming back to CRH. I'm not sure why you feel they don't care about retention -- I felt they were bending over backwards to keep me there. I am currently part owner of my own infusion nurse agency and recently quit CRH to do this full-time. But if my business fails, or I decide to go back to the bedside -- I'll go back to CRH. I should mention, though -- CRH has the worst human resources dept -- they are so slow!! But once you get through the hiring process and onto your unit, the people at CRH are a great group.:cheers:
  4. st4304

    How do you get to be an infusion nurse ?

    If you live in or near a large city, most of the larger hospitals will have an IV team or PICC team. You do have to have specialized training in PICC/MLC placement, but most train you on the job. I am part owner of an infusion nurse agency. We contract with smaller hospitals that don't have teams/trained RNs to place their PICCs/MLCs.
  5. st4304

    Clean vs Aseptic IV Starts

    I didn't take the time to look for research (sorry!), but according to the Infusion Nursing Standards of Practice to which nurses are held in the US regarding invasive line placement, only midline, arterial, central, and PICCs are required to be placed using sterile technique. Im not sure if you are familiar with setting up a sterile field, but that requires a hat, gown, mask, sterile gloves, and sterile drapes/towels. I believe that is overkill for a simple peripheral IV start. As far as contaminating the site with a clean, gloved finger -- if the site was cleansed with alcohol, it is considered a clean site - not sterile, so touching the skin to palpate the vein 1-2 cm above the insertion site I believe is not really doing harm. I know not everyone will agree with me, but I have worked in the ER and I know first hand that sometimes you just have to get access the cleanest way possible. Many facilities have policies that all IVs started in the field or ER must be changed within the first 24 hours after admission. Just continue to place IVs the way you were taught. Check with your facility's infection control nurse to see if he/she is collecting data on phlebitis (with insertion) rates and be proactive. Sherri
  6. st4304

    Graduation gift for new nurse

    Thank you all for your wonderful suggestions! In fact many of them sounded pretty darn good for gifts for old and tired nurses like me (especially the foot massage and spa.............aaaaaaah.) Anyway, again thank you and I just want to say one more thing -- I am so proud of my daughter I could just burst! And I am pretty sure I will cry during the entire ceremony -- my baby a college graduate and a nurse to boot!:cheers: Sherri
  7. This may not be the reply you want to read and I am sure there will be other posters who will disagree with me, but if you have not adjusted to night shifts after 2 years, then I think you probably never will. Also, isn't life too short to sleep through and not spend enough time with your family? Look very closely at your finances/budget and is there nothing that you can adjust/sacrifice to make up for the loss of night shift differential? If you have high car payments, sell it and get a nice, cheaper used one. Do you have satellite/cable with premium channels? Drop the premium channels and change to the basic package. Do you or your husband smoke? Stop, save the cig money. I am sure you will be able to find something. Keep your eyes open for dayshift positions that open up, because they eventually do become available. It may not be in the unit you want or it may be out of your comfort zone, but make the sacrifice to be with your family. I worked nightshift for 3 years and never adjusted to it. I was always exhausted, crabby, and felt no energy to do anything on my days off. After 3 years, I went to my manager and requested the next available dayshift opening and was told it would be awhile before that would happen. I went to my employers website to check out open dayshift positions, and saw that a dayshift position was open in the cath lab. I was never interested in the cath lab because I had heard horror stories about the call, the docs, the stress, etc. BUT I called the cath lab manager, interviewed and ended up working there for 5 years and loving it! I took a pay cut, and had to wear a pager on my hip for 5 years but I was home every night with my husband and kids, (except for the occasional call-in for an emergency with double-time for pay), and I was awake and alert, and actually felt human again for the first time in 3 years! Look back over the last two years and how many of the people you have worked with now work days? If you are working with the same people because no dayshift position has opened up for 2 years, then you should look in another facility. If you are worried about loss of differential, pick up an extra shift every once in a while! Trust me, with the nursing shortage, you will have no trouble making up that loss of income with a dayshift position! I guess what I hope you get from my advice is that we have to make sacrifices in life, wouldn't you rather the sacrifice be monetary or material and not your family? Best of luck to you! Sherri
  8. st4304

    PICCs in Indiana hospitals

    Indiana Nurses Rock BTW! Sherri
  9. st4304

    Sites for PICC preceptorship

    philly22-- I'm sorry! My question about starting an infusion team was referring back to the original poster - ART96. I was just thinking back in the day when I was a new PICC nurse how daunting it would have been for ME to start a new infusion team/company with only 3 successful insertions under my belt. . .talk about sweaty armpits! -- I should have added that I also precept nurses in hospitals where they only place PICCs once every 3-4 months, and I have been called to assist in every placement even after a year or more. My experience as an independent preceptor is quite frequently with nurses from small, rural hospitals that have been sent to a large facility to learn, they get their 2-3 successful insertions, and they leave the larger hospital with a great learning experience, all excited to poke someone and show off their newly learned skills. BUT when they return to their own facility, it may be a month or longer before they get a chance to stick someone again and by then they have forgotten what they learned, lost their confidence, or the equipment they have to work with is nothing like what they learned with and they are not successful. I recently signed a contract with a small hospital to precept their 2 new PICC nurses in their facility -- it had been 6 MONTHS since their training at a larger hospital. Their ultrasound machine was a huge monster with 10 different probes and no one had trained them on how to use it. But we got that first PICC in and had a great time doing it! May all your PICCs go SVC! Sherri
  10. st4304

    Sites for PICC preceptorship

    "The criteria is that you come for 2-3 days and have a minimum of 3 successful insertions prior to finishing your training." I precept nurses in hospitals where 10-15 PICCs are ordered per day and we get to do as many as we can without killing ourselves (maybe only 3-4 the first few days) and it is still at the very least a couple of weeks before the student and I feel they can go solo. . .so starting an infusion team with only 3 successful insertions? Wow. From your original post, I am a little confused: are you starting an independent infusion company/agency or are you starting an infusion team within a hospital? If you would like to PM me, I can give you sooooooo much advice since I have experience doing both! Check out these websites: http://www.infusionknowledge.com and http://www.vascularaccessspecialists.com Good luck! Sherri
  11. st4304

    PICCs in Indiana hospitals

    I know that most of the hospitals in the larger cities have their own infusion/PICC teams, but what about the smaller hospitals in the rural areas? Do you use infusion agencies, or are all IR placed? Are the patient's sent to larger facilities for PICCs? Does your facility have a few trained nurses that place your PICCs? Or maybe your facility doesn't ever use PICCs? If your facility does not place PICCs/midlines, what do you do with patients' on vanc or TPN? Please take the time to respond to this as I am trying to find out if there is a need for independent PICC nurses in your area (especially in southern IN). Thank you so much for responding, Sherri
  12. st4304

    Graduation gift for new nurse

    My daughter is graduating from nursing school next month. Any unique ideas for a gift? She has requested a PDA, and I will probably get her one, but other family members keep asking me for ideas and I have run out. Thanks, Sherri
  13. st4304

    Will Nursing's Reputation Suffer?

    Thank you! I have been wondering what happened to those nurses and the physician accused. My heart went out to them and everyone involved (accept the prosecutor, of course). I guess the charges being dropped is not "newsworthy" or juicy enough to make it to the national media. Sad. Sherri
  14. st4304

    Hospital or LTC Facility???

    When you write LTC Facility do you mean nursing home? Just curious. I use to work in a staffing pool for an LTAC and floated between three LTACs. For those who don't know, an LTAC is a 'long-term acute care' facility. I would take care of patients on ventilators, critical drips, etc. Actually, there were three levels of care there, but because I was an RN with critical care experience, I was always sent to care for the sickest patients. Most of the patients there are trached and are being weaned off of ventilators, or getting intensive physical therapy before going to a nursing home or to home. The rewarding part of LTAC nursing is that the patients are there for at least a month or longer and you get to see their progress, plus get to know the families as well (of course, sometimes this isn't a plus!). Sherri
  15. st4304

    Do you enjoy TV surgical/medical shows?

    Early in my nursing career, my husband would tease me for watching ER. He worked in road construction and would say "You don't see me watching shows about pouring concrete or laying asphalt!" Of course, my response was, "If it was a show of Pamela Anderson pouring concrete, you would definitely be watching it!" Anyway, I guess I did get burned out on those shows. Haven't watched them for years, but just recently started watching ER reruns on TNT. I do have to laugh sometimes, though. The one doc from Bosnia the other day ordered a "Stat 12-lead ABG". It gave me a chuckle. Has anyone seen the movie "Children of Men"? The delivery of the baby does look pretty realistic. But then I am not a L/D nurse, it may look fake to you experts, but looked pretty real to me. Sherri
  16. st4304

    Reconciling professionalism with patient attitudes.

    Right on, Tazzi. Make sure his doc knows about this behavior -- this patient is going to be noncompliant post-surgery and post-discharge too. AND he'll be the first one to sue for malpractice when his leg never heals, so document everything and CYB.