PaddyW

For me Unions have helped us fight for adequate staffing and improved pay so that we had competitive wages for the area. We are able to utilize union documentation and representation to ensure that we have proof that unsafe staffing and/or patient acuities are noted and filed for potential lawsuits. I am neither a lazy employee, nor does ALL my money go to pay for political candidates. We often do lobbying (as in nurses show up) against certain healthcare bills or ensuring that we maintain our legally mandated patient to nurse ratios.

I hope it helps. I am still hoping to attract the advice of an experience transplant RN on what to look for when I am in the thick of things.

A big thing that helped me get my current job was looking at what the local university suggested for their students. I was moving from a rural area to San Francisco. I was hitting a wall with the recruiter as she actually removed my application from some postings because I did not have experience in all the areas (i.e. I had tele, but no oncology for the tele-oncology floor). My wife suggested I look at UCSFs tools for new nurses. Once I filled out my resume to a similar format and updated it I received so many calls it was ridiculous. Fortunately I have pretty good interview skills, so I was offered multiple positions. My issue was not getting an interview at first. I would recommend trying to search for how the managers and directors are used to getting resumes. If they can blaze through a resume to see key points they are more likely to actually look at it. If it is in a strange format, they may give it a half-hearted attempt. My second advice... listen to your wife if you got one:).

Thank you for the compliment! I am trying to do just that. The 4 patients on an 8 hour shift (1500-2330) is making research hard to do when I am in the zone, but as you can see by my previous post I am trying.

Using UpToDate has been helpful. Just to get a general understanding of some co-morbidity issues like Diabetic Gastric Paresis. Additionally these videos have been particularly helpful. Refeeding Syndrom (as most are NPO for some time with TPN and occasionally TF) Pancreatic Issues (often resulting in a Whipple) Liver Issues (Cancer and possible resections) Anatomy Review (Helpful when reading MD notes) https://www.youtube.com/watch?v=XP-MdbVug_4 Diabetic Gastroparesis (I am getting the basic, but want to know more) https://www.youtube.com/watch?v=FEqBzX2Twdw

I have had a little bit more experience now. I have found a couple of excellent resources at my facility too. There is a weekly Transplant Round for physicians that I was allowed to attend and I get CE's to boot. Additionally I will be attending a Colo-rectal Cancer course Thursday 29th. I am still having trouble just matching everything together. It is a lot of work to keep track of the prograf and cellcept levels, while providing the education on medications. I am use to people coming back from a CABG/CEA and being ambulated almost immediately. Here people come to me post-op day 2 or maybe the very end of day 1. They have a PCA/Epidural and are on abdominal precautions. It just feels like mobilizing this (important as it may be) is often beyond their capabilities or motivation at the time. I have resorted to in bed active/passive ROM, plus they are anti coagulated, using IS, and with SCDs that I advertise as leg massagers. My concern is trying to find the balance of how hard to push. The other issue I was having, but has improved after attending round on the subject, is Hepatic Encephalopathy. This can be as bad as CIWA at times. Learning the balance between pain management (paracentesis, ascites, etc), patient safety (fall risk), medical treatment (lactulose and Rifaximin) has been tricky. I was hoping to find what works for you in this area. ESRD is difficult, but I understand the pathology and treatment modalities. I will share a couple of things that I have found helpful in the next post. I would love to hear from your experiences though.

Hello. I have recently accepted a position in a hospital in the Bay Area. I am coming from a Cardiac and Telemetry background (progressive care). This position is a Specialized Med-Surg position (Transplant). It is a LPK (Liver, Pancreas, and Kidney) unit that deals with post op Day 2, complications of awaiting-pre-post transplant. I am feeling a little worried. I know that I have a strong team with a lot of experience. I feel that I am still a new RN (1.6 years experience on the previous floor). I have experience as CNA/Unit Clerk/Telemetry Tech as well. I am having to learn a new charting system that is making it difficult to find my pertinent information. My time management skills are also suffering from the new unit hospital stuff. I realize that within 4-6 months these issues will be no longer present. They are simply exacerbating my anxiety regarding my true underlying fear. I do not know what to worry about and not worry about. All the medications are very different. The meds themselves are different or the dosing is not what I am used to. I know how to research meds and ask questions about the parts I do not understand. What I am more concerned about is understanding the systems, complications, and pathophysiology of said complications. I am hoping a few kind souls will be willing to post either experiences or resources to help me understand what I need to know for this floor. Thank you in advance.