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emmjayy RN

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  1. We had a VIP in my hospital once when I was an aide. I was "technically" assigned to that room but told not to answer the call light, the nurse would take care of it. Well, the call light went off and NO ONE ANSWERED. I thought, "This is stupid," and went in to check on the patient. Their family was in there and they were very upset because apparently no one had been in to address the patient's pain and housekeeping never went in to empty the trash/clean the room up (it is common for housekeeping to do this at least twice a day for all other patients). I apologized for what they experienced, emptied the trash, tidied, changed the patient's sheets, and reported the pain level to the bedside nurse. In this situation, the patient actually experienced worse care than other patients because the nurses were afraid to let anyone in the room and didn't want to go in themselves for fear of screwing up somehow and landing themselves in trouble. It was quite silly in this case, because the patient was very easy going and if I hadn't been warned that the person was a "VIP," I would never have connected the patient in the bed to the person I saw on TV.
  2. emmjayy

    How To Prepare for Last Semester Nursing

    Unfortunately, each program is different and you won't know what topics your program will focus on until you have the syllabus. If it helps at all, I can tell you the most useful topics covered in my last semester, which were liver failure and shock. Understanding liver failure in particular has really helped me. The liver is a really complex organ and causes a complex cascade of problems when it fails. It took me FOREVER to understand all of it and I'm glad I took the time to do so during school because I have had to care for a lot of liver failure patients on the job! Shock was also helpful to have a good grasp on, but I'd recommend that anyone brush up on liver stuff!
  3. emmjayy

    Thinking of dropping out

    I think the feeling of "oh god how will I ever keep someone alive" is really common after first semester. I know I saw nurses out on the floor and wondered how the heck they were so confident and so sure of what they were doing, while I felt dumb and could barely handle caring for a single, not very sick patient. As time goes on though, you do gain confidence. You give the same meds over and over and figure out why you're giving them and what side effects to watch for... over and over. Before you know it, the knowledge is ingrained. You will deal with tasks that terrify you again and again until they don't bother you one bit anymore! For me, vents, ostomies, and NG/OG tubes were my kryptonite when I was in school. The other day as I was turning my vented ICU patient (after pausing his tube feeds - also after drawing up and giving all the meds called for during his bedside tracheostomy/monitoring/titrating his drips during it to keep him going), I realized his ostomy bag was leaking all over and needed to be changed and I just did it, no big deal. All of those tasks would have stopped me in my tracks as a student, but now those things are just a normal part of my day that I've done a hundred times before. It does help to do it on your own without an instructor breathing down your neck! I felt like I barely dragged through nursing school by the time I got to the end (the end was in May of this past year, btw). The stress of it really got me down. Being a nurse is still stressful but in such a way that when I get home, I can put the stress away and not worry about it until the next time I go to work. I don't have to think about it in my down-time or worry about being "kicked out" of the nursing profession. It's more responsibility, but it's also more fun than school, for real. Just something to think about :)
  4. emmjayy

    New Grads in the ICU

    I'm a new grad in the ICU - just came off my 20 weeks of orientation and have been on my own for a month on the floor. I'm painfully aware of how inexperienced I am... ALL THE TIME! I am very fortunate to be in a unit where all the nurses/respiratory therapists are willing to let me bounce thoughts and ideas off them about my patients when I feel stuck. I'm also happy that the clinical affiliates are generally very responsive and willing to come lay eyes on my patients when something is off and I need help figuring out what to ask for. I'm slowly gaining a little bit of confidence but feel dumb a lot of the time. I'm trying to expand my "ICU brain" - e.g., looking at trends in labs, vitals, etc. rather than going off of a single lab or blood pressure, correlating all the pieces of the clinical picture when I approach affiliates rather than just going over and saying "OMG THE POTASSIUM IS 3.0," thoroughly investigating even small changes, etc. It's tough but I do feel very supported by the experienced staff and I'm grateful for their willingness to teach since my unit has had a pretty big influx of new grads this year. It's honestly been extremely overwhelming and very humbling. I am in awe of the sheer breadth of knowledge the experienced ICU nurses have and I'd like to get there someday, myself. I know a lot of people use the ICU as a stepping stone to NP school/CRNA school/whatever, but I'd like to stick around and learn a lot of things and become a proficient ICU nurse.
  5. emmjayy

    When family fails the patient... it breaks my heart

    Oh man. I can think of about a dozen patients I've cared for in the last couple of months who this post applies to. It is so heartbreaking and one of the most exhausting parts of my job. I do try to put myself in the family's shoes. I know quite a bit about what constitutes a poor prognosis, how much suffering someone goes through in an ICU bed, etc., but to this day I do not know what I would do if it were MY dad or mom or spouse or sibling lying in that bed. I want to say that I'd do the right thing and make them comfortable, but it is so difficult to let go of that person! I can't imagine ever being ready to some day tell an ICU team that I'm ready to put my dad or my mom or my husband on comfort measures only. We see only a patient suffering... they see their dad who taught them to ride a bike, or their spouse that they fell in love with and raised children with and they just can't let them go. I feel a lot of frustration at times when I'm in these situations, but then I go home and thank God that I'm not the family member who has to choose what to do. It's awful all the way around.
  6. emmjayy

    How To Prepare for Last Semester Nursing

    Wait until you get your syllabus for the last set of classes. Get ahead on any papers you're assigned and try to get a jump on whatever NCLEX prep they give you to do. Look at the topics being covered and do some of the reading. I stressed myself out on my last winter break of nursing school attempting to teach myself to interpret EKG's. I got nowhere with it and had a week long class upon being hired that taught me everything I ever needed to know about strip interpretation. Just goes to show I should have trusted the process!
  7. emmjayy

    As seen on TV

    I cringe at the thought of even asking another nurse to help me start an IV, I can't imagine what a doctor would do if they had to throw an IV in my patient!!! Funnily enough, I have worked with some MD's who have stuck their head in the room during a tough transfer from bed to chair, thrown some gloves on, and helped us out without being asked or having it be expected.
  8. emmjayy

    NCLEX to job, how long?

    Totally depends. I had a job offer in March, graduated mid-May, took the NCLEX at the end of May, and then had a nice month off from school/studying/work before I had to start my job. Most of the people in my program had jobs lined up prior to graduation, because that's just the way the job market works around here. Hospitals post their new grad positions anywhere from three months to two weeks prior to when schools are set to churn out their next batch of new grads. Not a single hospital waits until after graduation time to start posting positions. Obviously it's different in different parts of the country, though! You would probably be better off asking students who graduated a year ahead of you what it was like.
  9. emmjayy

    ATI Predictor Exam

    There is literally no way to tell. How have you been doing on ATI so far? In my experience, you will do about as well on the Comprehensive Predictor as you did on any other ATI exam you've taken.
  10. emmjayy

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Can't tell you the number of times that I've been able to calm down "problem" patients by sitting down and talking to them for a few minutes. I always try to go that route first, even though it's devilishly difficult due to the time constraints we're all familiar with. It really is remarkable how far a little TLC can go with an anxious patient. Just drawing up a chair, sitting down, giving them your full attention for five minutes, speaking kindly, slowly, and calmly, offering reassurance, then coming back in 15 minutes to check in on them and see what else you can help with. I mean... this strategy is like magic for your run-of-the-mill "omg I'm in the hospital and no one will talk to me and I don't know what's going on" anxiety. It's a different story when you have someone with psych issues who needs their PRN valium, of course. But taking a minute to talk and connect is, IMHO, way safer and kinder than just throwing anxiolytics at the patient and walking away. The problem is that it takes some time, which is at an absolute premium for any healthcare worker. I wish I could go back to being a student and having time to just sit and chat with my patients! And I wish there was a way for practicing nurses to do that regularly - whenever I get a chance to do it, I usually walk away from my shift feeling like I really made a difference instead of feeling like I just ran on a hamster wheel, slinging meds and talking to providers all day. It really makes a difference, and it stinks for patients and nurses alike that we can't give them that type of time.
  11. emmjayy

    Survival guide for women of color

    Agree with previous posters, I don't really see how any of this information posted by OP specifically applies to women of color. I think all moms should be educated on the dangers of postpartum hemorrhage, hypertension, embolism, etc. This piece makes me so angry: Maternal mortality rates rise as hospital safety measures go unused I just don't understand why so many moms who experience these life-threatening complications don't get the monitoring and treatment that could head off tragedy. I have cared for moms several times who didn't get the care/monitoring they needed on the postpartum floor and ended up in the ICU after delivery. I don't want to get into specifics of those stories, but how the moms got from point A to the ICU makes my head spin. Hours and hours of people ignoring really crystal clear signs that something was going wrong. It's like no one ever taught the staff how to track and trend vitals, labs, patient complaints, and put the clinical picture together. Truly mind-blowing.
  12. emmjayy

    Reminder why the seven rights are important

    I work in an ICU and over-ride the med cabinet very frequently when emergencies are going on. I know my meds well enough to know that a bottle of Versed looks very different from a bottle of Vecuronium. I honestly find it pretty tough to make excuses for this nurse, as it doesn't even sound like this was an emergency situation where adrenaline is running high and there's pressure to hustle with the med. I am usually the last person to hop on the nurse-blaming band-wagon because I know horrible things happen, mistakes get made, and it's not typically reflective of the nurse's competency. In this case, however, I can't help but wonder what on earth was going through this nurse's head.
  13. emmjayy

    Taking my NCLEX tomorrow... any last min advise?

  14. emmjayy

    Should I take my NCLEX sooner or not?

    You will never know if you've prepared enough until you actually take the test. No one feels good going into this test... the best way to end the uncertainty about it is to just take it! If you fail, okay... you wait 45 days and re-take it. Best of luck to you!!
  15. With liver patients, keep an eye on the CBC, particularly H&H/platelets. See if there's an ammonia level checked as well. Those numbers might lead you towards more applicable nursing dx.