87RN

You have no ICU experience and your orientation is one day? Seriously, try not to kill somebody. You need to know your vasoactive drips, sedation and paralysis meds, insulin drips, ACLS, how to prepare for and manage art lines, central lines, PA catheters, ventilators/bipaps, ekg interpretation and so much more. If it were me, I would not accept a position without the proper training. You are putting your license at risk as well as patients lives!

I had no idea it was racist either, I've never seen it written and had assumed it was spelled *******, lol.

My ICU is about a third male staff. It isn't weird at all. It is nice to have help from the guys especially turning heavy patients. Sometimes we take turns doing each others baths if the pt is more comfortable with a man or a woman. There are also a lot of male nurses in the other units throughout the hospital, except L&D. Also there are plenty of male aides, phlebs, radiology techs, etc. I think if you want to be a nurse, go for it! Gender isn't really an issue anymore, as far as I've seen.

We use a lot of propofol, sometimes versed. I've only used precedex once and my pt brady'd down to 30's, our docs don't seem to like it much, although our pharmacists are always talking about it. I work for a small 12 bed community ICU.

I went through a whole cart of dirty linen bags to find my patients dentures because he wrapped it in a pillowcase (why???) then had a huge lactulose induced explosion all over the bed and it was my fault because i didn't check with him before I cleaned him up and took out the dirty linens. Yeah it was one of those today, I wish management would have walked in on that and I would have yelled "above and beyond!"

I would just go meet the managers and let them know you are interested. If they need the staff, they may be willing to train you.

My advice would be to wait to have kids until you have at least one year experience working as a nurse. It would be hard finding your first job as a new grad as it is but a nurse with no experience that long out of school would have a much harder time. I'm not too familiar but there are also rules about inactive licenses that you may want to look up depending on how long you are planning to stay home.

If someone from pharmacy would even answer the phone!

Close your eyes and feel for veins in your arms or your friends and families. The vein will feel bouncy. Some veins are deep and some are close to the surface. Watch your angle at insertion. Look on YouTube or Google iv insertion/ phlebotomy tips. Make sure you set up all your supplies and get them ready so you don't have to open anything once you start. It takes time and practice. Take your time and look for a good vein, sometimes patients with difficult veins will tell you where is best. As you do more, you will get more confident and it will get easier. Watch other nurses or lab techs who are good and copy what they do. Keep trying :)

I also don't have NICU experience but I think getting a position in L&D at the hospital that has the NICU would be good to get your foot in the door. You will develop a relationship with the NICU staff, pediatricians and get some experience with newborns. You will learn what a healthy newborn looks like, normal vitals etc. Then, when a position opens up it will be easier to transfer in house plus you already have some ICU experience.

You should look up your hospitals P&P for drips, if the ED doesn't have a copy, try going to ICU and see if they have one. My ICU has a reference binder with info on all the gtts with starting rate, max rate, etc. I have a little card laminated that I carry with me with all the info. Also on your days off, study your drugs, learn what they are for, how they work, the half- life, etc. Our MD's give us verbal orders and expect us to know how to titrate them they usually just say "start them on ____ drip". If your patient is being started on multiple drips you need to ask your charge to change your pt ratio and work on getting them transfered to ICU ASAP. It will take time to gain experience but you also have to empower yourself to learn more about what you don't know.

6 patients total care is a lot, are you sure there are no aides?

So lately I've been feeling a little blah/ bored/ depressed because all my patients were either terminal extubations or unsuccessful codes. Don't get me wrong, I do enjoy helping patients and their families cope with end of life issues and I am honored to be in a position that helps people at their most vulnerable moments but sometimes it sucks when you have to go to the morgue every single shift! It's hard to come home after a shift and your husband asks how was your day and you try not to sound too casual talking about people dying. I know some of you fellow nurses can relate, right? On the brighter side, we finally had some good "action" this weekend. A successful Rosc s/p vfib+ 3 rounds of CPR with neuro intact! Some adenosine magic on 2 rapid response svt patients. A train wreck septic pt weaned off pressors/ extubated. A stroke pt s/p tpa with only very mild residual weakness, she came in aphasic and nih 17. I love when my patients have good outcomes and I feel like I actually helped to fix them for a change. I work in a smaller hospital so it's pretty rare to see all of this in one day, was quite the exhilarating/ hectic day, I'm still reeling, lol.

This is a little off topic but involves a dog in my old ER. In the middle of the night, a woman came into our ER frantically crying because her dog was choking, it was a big lab mix and she was caring it in her arms like a baby. It happened to be a slow night so we brought the dog into a trauma room, suctioned and removed a plastic toy with forceps and gave the dog some o2 via mask. We saved that dog, all the patients in the ER were applauding lol. I don't think it's that big of a deal that he brought his dog. It was in a crate, and well behaved. It's not like it followed him into each patients room. Agree with others that there are far dirtier things that crawl around an ER. If it becomes frequent, then it should be discussed further but I would just try and get over it. Maybe there was a staffing shortage and he agreed to cover if he could bring his dog?

I don't think 2 years away is that bad. If I were you, I would reapply for your license. Take a refresher course/ take acls/pals/NRP and apply for a job. I think it would be easier to get back into L&D since you have experience vs applying in other departments. Also, L&D of all departments should be more understanding of your extended maternity leave. It can't hurt to try, good luck!

I don't really have any experience with this but I thought that if your charges were expunged, they are erased off your record and will not show up on a background check?

Damned if you do, damned if you don't! If you ask two many questions they think you don't know enough or are too lazy to look it up. If you don't ask enough, you're uninterested or not thinking critically! At least your preceptor seems to understand you and will back you up. One of the new nurses on our floor has RBF and has a very flat tone. She had a rough start but once everyone got to know her, realized she is doing pretty good and actually has a great sense of humor. Just do your best, try to smile, help out around the unit, if one of the nurses has an interesting pt or procedure, politely ask if you can learn about it. Hang in there, sometimes it takes a little while for people to warm up to you. From my experience, in ICUs especially, you don't get the respect until you earn it.

Check your own cap refill. Normal is less than 3 secs, 1 second is perfectly normal adequate circulation. I have never heard of quick cap refill indicating high bp. My bp is around 100/65 and my cap refill is instant. If you are concerned about bp, just check it.

I've never had to disconnect a vent or deflate the cuff for a CXR. Definite pneumo/ aspiration risk. The radiologist should be able to read a CXR on a vented pt, geez! also good to check for proper placement. I would definitely bring this up with your manager as well as radiology dept. Do the ICU docs know about this? I don't understand the rationale either. And shame on your coworkers!

Pacu is the post anesthesia unit where you go to recover after surgery. One of the main things to watch for due to the effects of anesthesia and other drugs are respiratory depression, airway compromise and hypotension. Basically they need to be awake enough to breathe, let the drugs wear off and stabilize their vitals. There are many other things you need to assess that are focused based on the type of surgery they have had. This case most likely used general anesthesia or maybe an epidural/ spinal block. You do not want to be awake while a surgeon cuts your knee open. Answer A is not correct because you take vitals much more frequently like every 5 min, then every 15, etc. Answer B is not correct because while it is important to assess those things, they are expected. If the patient was hemorrhaging or the swelling was so severe that it was turning into compartment syndrome then you would notify the surgeon ASAP, they need to be back in the OR. And that leads into c. Answer C is correct. You need to check NEUROVASCULAR status frequently. This is not just a "neuro check" ie pupils, a/o, etc. think about the surgery he had. You need to check your CMS. Is the pt's foot warm, is there a palpable pulse? This would indicate that the foot has adequate circulation. Can the pt move his toes? Feel your touch? This would indicate that the nerves weren't somehow damaged during the procedure. If these aren't assessed frequently, it could lead to loss of function or possibly the limb itself. Answer D is not a priority, yes you want to assess your dressing, the surgeon will write orders for that ie reinforce PRN, they usually will want to be there for the first dressing change. Hope this helped a little. Kudos to you for studying early. There is so much to learn, as you get further along in school things will start to make more sense and the pieces will fit together. You are always welcome to post your questions, we are all here to help each other learn and to share our experiences.

I'm a size 7 and I was told to size up in danskos so I got 38. They are a little loose like clogs should be. They are very comfortable. My feet haven't hurt once and I wear them 13+ hours. Maybe you can return them or trade in for a 39.

I'm pretty sure I spike all my bags upside down. If your facility uses the same levaquin as mine, then yes you twist off the tab then spike.

I change them daily with baths.

I have heard of some colleges that let students "wipe-out" a whole semester, completely removing it off your transcript. It's not always the best idea because you would lose all the credits earned but in your case, since you only had one class that did more harm than good, I would ask your counselor if that is an option at your college. Try reapplying for FA, you may qualify now that you have a baby. Make sure that when you do take another class, you can commit to it so you don't get another bad grade. Nursing school is hard, you will have more than 1 difficult class at the same time and teachers are pretty strict. A&P and micro classes will require a lot of studying and the tests are pretty tough, you need to get a good grade in the classes to get into nursing school. A lot of us have done it with kids, don't give up, good luck!

I know of nurses who worked in nursing homes who have transferred to in hospital LTC, SNF, psych and Medsurg, then applied to ICU and got in. I think any nursing experience/ job is better than none, especially with the economy the way it is. The new grad program at my hospital accepts nurses who have not had acute care experience and graduated in the last three years, even if they have been working in a clinic or care home, etc.