murph

In the ER we had a Max Cart and it was the policy that any cardiac arrest from the street went on this cart. It weighed a ton, was a huge box shapped thing that had a thumper and a ventillator built in and IF the patient made it we would have to transport to the ICU on it. It was very painful when it ran over your toes. I got in trouble one time for not putting a baby in arrest on it. I wish I could draw it for you!!!!!!!!!

I moved from a teaching hospital to a rural hospital in the early 80's. We had a spinal cord patient come in. (of course we didn't transfer to a trauma center, there were only a few designated in the country) It took me three days to convince the physician to let me get a circle-electric bed. He wanted us to use the stryker frame that had been in the back of a storage room for years. It wobbled when you touched it. When the patient was not improving he came to me to ask for the "new" bed, because it could be the patient's only chance. The patient made it. Even before my time they used metal needles for IVs.

We would give it PO in orange juice in a glass.

After abdominal surgery the patient would get a binder that provided support. It was a piece of cotton with looked like tenticles, the patient would lay on the fabric and the tenticles were braided on over the other to form support. Thank God we have velcreo now.

Before pleurovacs we used a series of glass bottles on the floor with the same principle that water would create negative pressure, the same thing with GI suction. For decubutis ulcers we used maalox and methiolate and the ulcer diet was for the patient to ingest alternating maalox and cream every hour. I was told that before cardiac monitors the critical care nurse would tape a cotton swap on a fulcrum (folder 4x4)on the chest with the non-cotton end at the PMI, the nurse could watch the cotton tip moving to watch for dysrythmias. I did this one night in the ER in the 70's when we ran out of monitors and the CCU was full. What are you going to do, have a nurse stand a the bedside with a finger on the patient's pulse all night? It worked OK but you still had to see the patient. No alarms. Back then we did not have pulse ox.

Managers may be personally upset (more work for them to replace you) when you are thinking of leaving but if they are worth their salt they should be happy that they have managed your growth well enough to prepare you for something else or figure out what the problem is that makes you want to leave. Nurses are worth their weight in gold. I don't know the political situation there but your manager should just be happy that you are staying.

When calling report to the floor: "I'm sorry you are going to have to hold the patient, we are too busy to take report and no one has had dinner yet!" Our hospital NEVER went on divert because we were the only trauma/teaching hospital around. I can't imagine saying to a paramedic crew, "you will have to keep that patient in your rig, we have to get dinner!" :angryfire

I have been following the thread about new grads in the ICU. I was skimming articles that are out this month. I only read the abstract but you may want toget the article. Hiring and Mentoring Graduate Nurses in the Intensive Care Unit. Dimensions of Critical Care Nursing. 24(4):175-178, July/August 2005. Ihlenfeld, Janet T. PhD, RN

I just saw "the sixth sense" again recently. Sounds like you have a gift.

You need to stop thinking about this as something that is a barrier and more that it is good experience and there is a reason why there are policies about experience. There is such a thing as setting you up for success and the more experience you have the more successful you will be. I guess it is hard for you to imagine why experience is necessary that is because you don't know what you don't know! The only analogy that I can think of is riding a bike. It is safer to learn with training wheels (experience) for you and your patients.

I am not sure if a seasoned nurse could get into a program, they are hospital specific and all of them are different. There is usually a requirement to work at the hospital for so many years after completing the program. I wish that I could be more specific but really all of the hospitals are different.

No, it is just the philosephy of the hospital. Some hospitals have strong "internship" programs for ICU and some are really desperate there is no such thing as a track. But on the 2 years of med surg I say at least. Going straight into the ICU with no formal support system would be a major mistake and hospitals know that. They worry about patient safety and a new nurse without significant backup has no place in an ICU. I know that is not what you want to hear but experience is the key to sucess.

See if the company has an option for redundancy, some systems are dupicated so that if one goes down the other takes over.

Does it have to be on the internet or can it be real life? Help can come from more senior nurses on the floor and sometimes there is a psyc nurse practitioner in the hospital. I worked in one hospital where the hospital chaplin was on the code team for the patient, family and staff.

Not just for this case but for every possible case, get and keep up your malpractice insurance! I see the need for malpractice insurance as a positive thing, the public knows that we do have a major impact on care and that nursing is separatre from medicine.