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Thinking of relocating to Spokane (dtr may be going to Washington university). Been a float nurse for many years. Best hospital? Do they treat staff well? Good benefits? I know I will take a pay cut but is there good differential for nights?

Sorry you have had some disappointments. Should a med be pushed faster than recommended? Probably not. And according to guidelines definitely not. Does it happen often? You bet. Should a sterile field be broken? Definitely not. Does it happen? I bet more than we realize. Are nurses human? Busy sometimes? Trying to manage patients with different accuities and take care of them the best they can? Most of the time. My advice is to learn what kind of nurse you want to be and do the best job you know you can. I bet in a few years you won't be pushing a 1ml vial of morphine over 4-5 minutes, but maybe not quite as fast as 2 seconds. (and by the way, I have been made fun of by the crises team for pushing morphine over 1 minute in a central line, and pushing atropine on a totally alert patient with hr in the 50's over a minute.) Just live and learn and don't judge to harshly or quickly until you walk a mile......(but that doesn't mean to EVER endanger you patients!) Hope this helps (haven't slept yet)

That is sad. They should have spoken to that nurse in private. Confidentiality just does not apply to patients only. And we have all made med errors, whether big or small, and that feeling in the pit of your stomach is horrible. I hope it worked out for both the patient and the nurse. And at least she noticed her mistake before more time had passed!

Our cafeteria is open all night until 3am. It shuts down to be cleaned until 6am. At night they offer premade roll sandwiches or grilled food such as burgers and stuff. The cafeteria lady will even make breakfast for you if asked. Guess we are pretty lucky in that respect. I think we have like 400 beds or so, can never remember! An unhappy employee is a hungry employee (not to mention brain function can sure suffer!). Hope you can make it work!

I have worked night shift since I graduated from ns 3 years ago. I really like it, but then I am the type of person who likes to sleep in. I have 3 kids, 1yr to 14 yrs, with school age kids it was no prob with night shift. I find I can work 6 shifts on nights and make more money than if I work 7 day shifts, thereby freeing up an extra day for my family. Now that I have the baby I work just about every fri, sat and sun. This allows us to not have to pay for daycare, and I really only miss the kids 2 days a week, but tend to just sleep for 7 hrs so I can see them for a couple hours during the day. My kids don't have a big extra curricular activities sched so the weekends are good for us. Now working 3 in a row is tough (especially if you have a sucky, confused group) but not having to switch my sleep cycle back and forth more than once a week is worth it! I love my 4 off. Good luck!

Oh, and FYI. I too live in California. And on the maternity disability web site they use the example of a cosmetology type person not being able to stay on their feet all day and needing to go on leave before 36 weeks. SDI insinuates that is acceptable for jobs that are a strain on the pregnant woman. I was going to print that out and take it to my dr or his nurse cause they did act like it was unacceptable to really leave before 36 weeks unless there is a medical necessity (mine ended up as premature labor with lots of contractions, etc). But if Califonia thinks a hairdressers job is too physically diff. for a prego then they should try being a floor nurse on 12 hours shifts with 5-6 heavy patients, and no nursing assistants to help!!!!!

I feel your pain. I am getting ready to return to work 9/1 after being on maternity leave for 5 months. I to had severe back pain, was depressed, had a difficult time just walking at work. Would have to get down on my hands and knees just to check chest tube levels. Swollen feet big time. My ob/gyn was sympathetic and took me out at 31 weeks. I was exhausted! But I felt so guilty because there were several other nurses pregnant at the same time who did not have these same issues as me. They worked til their 36th week (and had the same dr), and some of their dr's (not the one I had) refused to sign them out until their 36th week, if they were experiencing probs, unless they actually had to become hospitalized for problems. Start talking to your dr now, let him/her know what is going on. Document any contractions you are having. At the end I was calling the dr almost everyday telling him I could not handle this. It was the best when I was finally able to leave. My body and baby appreciated it! So hang in there! And stick up for yourself, you know what you are capable of and what is just too much!

I started on tele for my first job because once you learn rhythms you can go just about anywhere. Another bonus working in a cardiac area is I have also learned about oncology. If a patient comes in with cancer issues but also has a heart issue they are going to tele. I would imagine that would be the same for your cardiac ICU. So it is my personal opinion that cardiac can open more doors eventually.

I felt that same way. That test is waaaay to stressful emotionally. I bet you did great. Just try and relax (easier said than done) and try not to think about it. HA!

There is never a stupid question among nurses...Never be afraid to double check yourself (has saved me a couple of times so far). And beware of over-confidence...no one can know it all in this field.

Have you thought about hospice care through a home health agency? One visit at a time. There is some clinical care with the patient but you also educate and are supportive with the families of the dying patient. This would/could involve spiritual care depending upon needs of the family, but you would also have a resource/interdisciplinary team to help provide care. It can be a very fulfilling area of nursing.

For my paper I wrote about Ritalin/meds being good for ADHD. My son is on drugs for this and it helped educate me re meds out there. So if you can, use this paper to educate yourself re a subject that affects your own life. Makes it more interesting also.

let me correct myself. wenckeback. 2nd degree heartblock type I!!!

wenkebach (something like that) or 2nd degree heart block type I. Is where the pr interval before the qrs keeps on getting wider and wider until a qrs is dropped. Then it starts all over again. a great web site to check all these rhythms out with easy to understand explanations is richacls.com. Sometimes this rhythm is hard to spot because the pr lengthening can be subtle or it can be obvious. Don't see them very often on our floor so we get excited when we do. wooo!

Hi! I worked in home health/hospice dept as a secretary for 7 years before getting my rn. Though never did the clinical aspect I think I have a pretty good idea about what is involved in this california area. At our facility the nurses would get a load of about 6-8 patients to see a day. Could be follow-up from dc from acute setting, or monthly foley change. could be for ab needed to be infused or wound dsg changes. There are case nurses at the office that would be the contact person for dr calls and orders. Your milage is reimbursed at a pro-rated rate. It is much more layed back then floor nursing but can be very busy. Some people love it, some hate it. Hope this helps.

if the bp has been charted as being checked within 30 minutes of me giving bp or beta-blockers than I will use that if checked by someone I trust. (what is the point of having aides if you cant trust any of them?). If it is someone I don't believe does quality pt care I will retake myself. I hold if it is borderline, or I check there trends from the previous day. On our floor we use acuscans where we can chart in the system the hr and bp. Won't necessarily call md for perameters right away, will ask when they come or if it is someone that is taking beta-blockers to prevent recurrance of svt's or a fib will then call for hr perameters if hr is at a questionable level, like 59 while awake. But I am still learning myself. And I know a lot of RN's on tele who don't necessarily check the bp when they give and I think that is asking for trouble.

Thank you for the confidence booster Beary. And next time I will remember my lesson from this one!! It just makes me upset with my self that I couldn't have brought it all together sooner and got her to the unit quicker. When something like this happens at the end of the shift I feel like I have been missing something from the beginning. I take everything so personally I guess, but what else can you do sometimes. I need to develop healthy seperation from my job!!! It also seems like I get some bad patients!! My charge says they can give me nice healthy ones but I just seem to make them go bad! (Don't see how I can MAKE someone go septic, but hey.....) Thanks again for the support.

Again, I think I dropped the ball. I had been watching a patient all shift, thinking something wasn't right. Had even told my charge an hour before that something wasn't right with the patient. A fib, hr increased to 100-130's (had perameters if hr maintained > 130. last bp 110/60. agitated, trying to poop constantly, non-english speaking. (had called family earlier for interpretation when agitation began). when i went in at 6am son was there, i took one look at the patient and knew, uh-oh. Ashy color, diaphoretic, states she felt okay though. me and the aide went in there together. I had her get bp while I ran and got pulse ox and more help. Now WHY WHY WHY did I go get pulse ox and help and not just call or send the aide??????? These are things that make me really question my judgement sometimes??? Pt did not code or anything at the moment, but called rapid response and sent to unit. pt septic and not expected to make it. Am I scared? Am I just not getting it? Patient was sitting up conversing with son, I think if she was lethargic or seeming to really dump I would not have left the room at all. But I think I can really be stupid sometimes. Hind sight is 20/20 and I guess I will just have to learn another lesson. Anybody else feel this way?

I am sure you have learned a lot but just don't realize it. I have learned a lot my first year (got my license last June) and I work tele, eventually want to go to the unit. How come your ICU doesn't have unit appropriate pt's, though I heard our unit is a dumping ground for the chronical ill pt. Do you have a CICU or CVICU at your hospital, those are other units that may be more to your liking. You will find that no matter what, you are learning something. And when you have free time and someone has something interesting going on, ask if you can help or observe. I try and do that sometimes, but lately if I have any free time I try and horde it.

I think I made a post with the same title a few months ago!!!! Don't feel bad!!! I still have moments when I feel like a horrible nurse and terribly paranoid!!! I work on a tele floor and we have a lot of acute pt and have the most codes in our facility. I am constantly second guessing myself (even though I know!!!!!) and just feeling plain paranoid! It will get better!!! It will be a year for me next month and I do have better days more than not now. I think nursing can be very overwhelming when you are new, and you just have to take it a day at a time. Just take your time, mentally go over steps in your mind before you do them, and then double, triple check until you become comfortable with the task. Learn from your mistakes because you are human and you will make them!!! Hang in there, it will get better!!!!

try richacls.com. Has fun tutorials and you can see what the heart is doing. After awhile, reading strips will become easy. And if you don't know, ask. Never a stupid question, especially re someones rhythm.

I have worked telemetry for about a year now as a new grad. What I remember from working clinicals and what I have carried out to this day is when you start your shift make a note of your patient's electrolyte's and other pertinent labs first thing. This includes Potassium, Na, Ca, Creat, BUN. And also their H/H and Platelet counts. I don't know if this is something standard noted on med/surg floors or not. but in a crisis situation these are good to have handy. Also the BNP is good to know for CHF. Good luck, cardiac can be fun!

I beat myself up all the time!!! I made an IV fluid mistake for the first time the other night. And I always double check those!!! Even triple check!!!! We have scanners at our hospital but unfortunately the scanners can't do IV fluids unless they have an additive like potassium. I thought I hung LR, but dayshift said I hung LR with D5!!!! I felt awful!!! Plus the pt was a diabetic!!!!!! But her bld sugars were all in range thank the good Lord!! Now I will be quadruple checking my IV fluids! Just another thing to be paranoid about. Letting go though. Pt is alright and I learned a lesson!!! I hope that is as bad as it will get, but I am paranoid enough to keep a close watch out!

I graduated last May and started on Tele. I like it for the most part. As mentioned before the patients wear portable leads/box to monitor cardiac rhythms. At my hospital there is a monitor room where monitor techs watch the rhythms, as well as at the nursing stations. What is good about starting on a tele floor is you learn all about the heart. Learn to read rhythms, learn about cardiac meds, learn to take care of patients with higher acuities, get ACLS training, open-heart pt training, cath lab training, 12-lead training, etc. And once you have cardiac under your belt you have a whole lotta choices opening up to you. (CICU, ICU, open-hear surg, plus cardiac dr offices, really anywhere you want to go). Of course now adays (at least where I live) you don't really have to have the experience to start where you really want, but a lot of my friends have pigeon holed themselves in certain specialties and have mentioned they wish they would have started out in a broader enironment. At my hospital we have 2 floors of tele, with about 70 beds. No step down unit so we are it. And the staff I work with are very supportive. I am constantly asking questions and verifying rhythms and getting advice from them. I have learned alot!

I signed a two year contract with my hospital. I was already a long time employee, I got to choose what department I work in. They say they can sue you for back tuition if you quit, but no one I know that has left has ever been sued. But now there is a waiting list at our hospital to get into the nursing program, we call it paradigm. It was totally worth it.