ArmyWife,RN

Silence is golden. Duct tape is silver. Don't make me get my flying monkeys. And I want kids that listen. (This is said to my kids when they start the "I wants"

Hello All! I think I will be moving to the Ft Belvoir area when DH gets back from Korea. I am looking for information regarding hospitals, pay, areas to live in, (good schools for the kids). Any info would be much appreciated! Thanks! sara

I'm bumping this up because I'm still wanting to know if anybody has articles or web-site information regarding this practice. Thanks, A.W.

Thank you! This is how I'm looking at it too. I just need suggestions on how to be a good/great charge nurse. I have some insight from my own experience with charge nurses, but I'm looking for others insight too! A.W.

Everybody is brand new on this unit. It's a new unit for the hospital that I work in. I am comming from ICU to Progressive Care - known to the rest of the world as step-down. A.W.

:eek: To make a long story short, I'm moving from ICU to "Progressive Care" because I get to come back to the world of the living, un-hook my feet from the bar in the closet, and work days. So, I go to my manager to get my orientation package, work schedule, and other informaion and she says to me, "You'll be charging, so we need to get you into these classes." I say to her, "I'm not ready for this." She says "You and XX are the only RN's on days on the new unit, so we don't have a choice." :eek: Any help or suggestions would be deeply appreciated! For those of you who are not familar with me (everybody, as I'm not here alot), I just graduated last May...see my post "What I don't know can hurt you" in the 1st year board...I'm not sure it's gotten better! Thanks again. A.W.

Wow! This is something I've never thought about/been taught/or seen done in my short carreer. Are there articles/web-sites regarding this practice? Thanks, A.W.

Hi All! I will be moving to San Antonio in June and need some help putting my resume together. I graduate in May '05 and have been working in ICU since June. I think I am moving to a step-down unit after the 1st of the year - for various resons. If anybody can help me, I would greatly appreciate it! Thanks is advance. A.W.

Hi all! Thanks for the replies! As it turns out, DH is going to WOCS and then to Korea...if we can't get command sponsorship, I'll just go back to the San Antonio area to be close to the family. A.W.

I had a patient just the other night that was admitted for persistant hypotension that had scheduled Viagra. I had to go looking for information on it - the short of it is it works as a nitrate. (I didn't give it - pt was on a dopamine drip at the time) A.W.

howdy all! [color=mediumturquoise]thank you, thank you, thank you for all the kind words and encouragement. rayrae, we will make it (with help from nurses like angie and others)! a.w.

Hi All! Ya'll know I don't post here often, but I really need some support right now! The other day I had a patient that was c/o pain in his legs. He had had lortab 5 about 3 hours prior and it would be another hour before he could have it again, so I gave him tylenol 325 x 2. Then an hour later I gave him the lortab when he asked for it. When I was reporting off to the oncoming nurse (who graduated with me and is miles ahead of me) looked at me like I was stupid and said "what about the 4000 mg limit?" I had no idea what she was talking about!!! I feel so stupid!!! This is basic nursing stuff and I don't know it. I've been beating myself up over it for days now. Don't get me wrong, I'll not forget it now, but I just keep thinking about how much damage I could do with what I don't know. As if this isn't bad enough, I got an admit the other night who's ABGs were showing metabolic acidosis and I couldn't figure it out. The nurse who I reported off to gave me attitude...let me sum up... I had one patient and was waiting for the admit from ER. At 2030, I gave my patient his 2100 meds so I could be ahead of the game when the admit came. I missed his zantac. I gave him his lipator and flushed his SL with NS and Hep-Lock solution. My admit came in and I got her settled in and assessed. She was pretty out of it. She would wake up long enough to answer a question or two and then fall back asleep (snoring). She was real thick tounged and wasn't oriented to time or place. She started wriggling around on the bed and moaning, so I went back in (I was at the desk tring to get the chart together b/c the doc was there) and she told me she had a bladder infection and it hurt "down there". So I asked the doc if he wanted me to get a UA. He said yes and I asked if he wanted me to cath her. He said "what ever it takes". Well, I got her OOB to the bedside commode at her request, got the sample in a nurse's hat, and sent it to lab. The nurse that was taking my place came on at 2300 and started going thru pt A's chart. She immediately found that I missed the zantac and asked - demanded - what I was going to do about it. I told her I would take care of it before I left, but I was trying to get the chart together and the orders done for pt B so she wouldn't have to do it. (Nothing makes the nurses on my unit angrier than leaving unfinished orders for them.) Then pt A calls and says, of all things, his stomach is upset. So she says, "I'll get you something for that" and tells me she is going to get the zantac for him. I say "thank you". Then she comes out of the med room and says "Are you sure you didn't give the zantac because it's not in his drawer." I say "No. I only gave the lipator." She says "Are you sure, it's not there. Are you sure you didn't give it?" I say no, "I gave two lipator and flushed the hep-lock" She says "but it's PO zantac" I say, "that's what I'm saying the only PO med I gave is the lipator and I flushed the hep-lock" She says, "Calm down. I just need to be sure" (so the 1st 2 times I told her wasn't good enough?) Anyway, by this time it's 2400 and RT comes to draw the ABG on pt B, comes back, gives the results to the other nurse and says "She's compensating somewhere, it obviously metabolic". Now the other nurse go in to look at the pt, comes out, goes to the supply room, and comes out with a foley kit. I ask why she is going to cath the pt and get ignored. I tell her that I got her up to the bedside commode and I don't think she needs cathed. She says "Well do you know how much she put out when you got her up?" I say yes, and tell her the amount. At which point she goes into the room to cath the pt. Then she tells me the pt is getting septic and needs to be cathed because we need to keep and hour by hour update on her output. I remind her that we don't have an order to cath - the doc only said to do it if it was necessary. (This gets ignored) I then tell her I'm going to ER to get pt B's pm meds and that I'll get the antac for pt A. (this gets ignored too) I go to ER, get the meds, come back, give the PM meds to pt B, the zantac to pt A, wrap up a couple more things, and left for the night. Again feeling like the stupidist nurse in the world. How do I know when a pt is "going septic" and is in metabolic acidosis and...and.....and...... I know this post is long, and I apologize for it. I don't know what I'm looking for - support, acknowledgement, sympathy, empathy, all of the above.... Thanks in advance for reading this. A.W.

Depending on the length of the hospital stay and the agressiveness of the doc (in treating the pt), stress ulcers born from the hospitalization/illness/dz process would be the reason. A.W.

Thank you all for your replies! It helps just to be able to come here and talk to others who understand. :kiss A.W.

Hello! I don't have a lot of time because I need to leave for work, so I'll make this short. I'm a new grad RN in a small ICU. I was hired along with 2 other new grads. I don't consider myself dumb, but I know I'm not the quickest to pick up things either. My question is, do some people just "get it" faster or better than others? One of the new grads I work with is already taking new CABG pts while I am still being given two (or three) IMC or Tele status pts. I can't say that I feel ready to take new CABG pts, but I can say that it is a blow to my pride. (before anyone says it, I know nursing isn't about pride, but it hurts) I am begining to think I'm in the wrong place, but then I think that "God doesn't give us what we can't handle" Thanks in advance for reading and responding. A.W.

I haven't read all the posts yet, so I don't know if this is here or not. Pants that are long enough for people like me! I am 5'6" and my legs go from the floor to my neck!!! :chuckle If I buy "large" pants they are too big up top but (almost) the length I like. If I buy "medium" pants, they fit up top, but are not as long as I like. The companies that design blue jeans finally figured out that just because you wear a size 11 your legs aren't the same length as every other size 11 on the block, why can't scrub designers? Thanks, A.W.

Hello! I have posted this in the 1st year nursing board as well... I currently work on a small, 12 bed, ICU. Recently, two of the patients I have taken care of have died. Neither have died on my shift, but I have come in to learn about it. (in one case it was after several days off and in the other the patient passed right before I came in for report) How can I deal with this? It really screws me up and I end up sleeping for days - I would have overslept yesterday if my husband hadn't made sure I woke up and went to work. Thanks for any help or suggestions. A.W.

Hi All! I was wondering how your unit handles the "on-call scheduling"? There is a big issue about this on my unit right now and it's causing tension between the day shift and night shift. I feel very stressed about this because I work the swing shift and I hear it from both sides - not to mention, I've been dragged into the scheduling issues..."oh, she can be on call from 15 - 19" or "she can take call from 19-23" (this is usually done so someone else can get hours or something of the kind) I'm new both to nursing and on this unit and I don't want to cause waves, but some people involved are teetering on the edge of ...okay they are...doing un-ethical things and others are getting cheated out of hours. Are all units this disfunctional or is there a good way to do this? Thanks, A.W.

Hi All! I'm new here and to nursing (obviously, I'm posting here :) ) and I am looking for some support. I work in a small (12 bed) ICU. I have been off orientation for a few weeks now and I still don't feel like I'm "getting it". Yesterday, it was me and another nurse (experienced) with 4 pts - all of them "IMC" status. At one point the more experienced RN looked at me and said "I have to go up to Med-Tele to start and IV" and left. So, I was alone with four patients for around 15 - 20 minutes (it seemed like hours). As soon as she was gone, ER called with an admission so I had to assign the room (pick a room, any room). Also, one of her pts called (he doesn't like the call light, so he just yelled) for his pain med (he's a frequent flyer and watches the clock for it). After she got back, I was trying to get myself together to do my 2000 assessments on my two pts (still hadn't opened my notes yet) and she tells me "ER is calling to give report on that admission, you need to take it" (huh! can't you see I'm flopping around like a fish on the deck already?) So I get report from ER LVN (who happens to be a friend of mine) and ask her to give me 20 minutes. I then hurry through the assessments and give one pt meds (he threw 1/2 of his potassium chloride pill at me but he's a sundowner and there was no reasoning with him) but before I can give the other pt his meds, the admit comes in. I haven't had time to set up the room, so I'm completely unprepared for him. I get him settled in the room with the help of the other RN take the 1st set of vitals and leave him to give the meds to the other pt. I get back to the new pt and find out he is deafer than a post so I'm yelling at him to get his health hx info from him while the other RN is putting the orders into the system for me. (Thought she was being nice, found out later that she "had to do it" because she was the charge RN.) So, now I'm behind even more and the next shift RN comes on. I told her I could give her report, but I would need to finish the charts before she could have them. Now, I know all that sounds like a typical evening, but here's the part where I don't feel like I'm getting it. In the ER, they started 2 grams Rochephin on my new admit pt and the doc wrote for him to then have 1 gram qd IVPB and 750mg Levaquin qd IVPB daily. When I give report to the oncoming RN, I said, we could probably time the Levaquin for the AM after the pharmacy opened (we don't have a pixus on our unit) since he just had the Rochephin. I'm thinking that in order to make the oncoming shift easier this is a good thing - otherwise, she has to go to ER and get the Levaquin from their pixus which means time off the floor and finding someone in ER to get into the pixus for her. I'm then informed that "he needs it now". Why? This is the part that I don't get. Really, if anybody has an answer, let me know. So, this is how my shifts go. I don't feel smart enough, good enough, or fast enough and at this point I don't think I'm ever going to. Thanks for letting me vent. ArmyWife,RN

MaeMae, As a recent graduate, I feel I can offer some advice to you. I agree with the poster who said to elave your mind open. When I started nursing school, I thought I wanted to go to L&D. After my 1st year, I just couldn't wait to do my OB semester in the Spring of my 2nd year because I was still convinced that is where I wanted to be. After my OB semester, I applied to the ICU (and got hired). It isn't that I didn't like L&D or OB (I really liked post-partum more than L&D), I found that I liked ICU better. So, again, keep your mind open. Good Luck to you! ArmyWife,RN