techlife72

All of our pts are on monitors that are in the rooms. I set my monitors up to take bps every hour or every two hours or sometimes more frequently in certain situations. The pts mostly all have rectal probes or temperature sensing catheters. And they are all of course hooked up to tele and an SPO2 finger sensor. I go into all of my rooms and look at the vitals, compare them to previous vitals, and make sure nothing is out of wack. As soon as our vitals take they transfer over to the Unit Clerks desk as well. It takes me about 10-20 minutes to take vitals on all of my patients. Between the UC, the Nurse, and the tech the pts vitals should be reviewed at least three times every two hours. Granted not every tech is trusted to handle all vitals on every patient. It is usually left up to the discretion of the nurse. If someone is on TPA it usually takes two of us working together to get all of the vitals we need. When doing baths I usually do as much as I can by myself and then have the nurse come in and help me roll the pt and change the sheets. As for the turning we have beds that turn our pts every 15 minutes.

I am a tech in ICU and we have a 12 bed ICU plus a 4 bed step down unit. Typically we have a tech in the unit and a tech in step down. We are responsible for all baths, most if not all vitals, turning pts, most I&O's, stocking, assisting with dressing changes, compressions during codes, and any other thing that we are legally allowed to do. The only time we don't get vitals on patients are if they are nursing 1:1's. Nursing 1:1's are usually CRRT's, Hypothermia induced pts, pts with balloon pumps (sometimes), or just really really sick patients (like we had a pt code 8 times in one night, he became a nursing 1:1 after the 3rd code). There are other patients who are nursing 1:1's, but I am drawing a blank.

I work on a dialysis unit. BP's can fluctuate pretty rapidly on my floor. I have a had a few 60's/30's. The lowest I have ever had was a completely asymptomatic pt who's systolic was 52. We used a Doppler to get the systolic, so no diastolic was known. As we rolled down to CCU, he was asking if he could have a sandwich once we got down stairs (frequent flyer). He lived for 4 more days on 3 pressers not going above 76/48. They all told me he was talking until he just wasn't anymore. I also had a pt who was 58 on systolic with a pulse of 48. The new tech we had come running out of the room and asked me to come recheck a manual. As I walk in to the room the pt was asking over and over, "Am I going to die?" My response was simply, "Not on my shift!" (It was 6:45 all I had to do was clock out at 7!)

Thanks for everyone's input! I really appreciate it. After reading everything I am leaning towards ICU. As someone stated earlier I am extremely excited about my nursing career and I really want to swing for the fences and make the most of it. Rather or not I have made the correct decision to move off of my unit, it is a decision that will get me into critical care. I am excited! Thanks again!

So I have been wanting a little bit of a change in pace and am thinking about taking a job in either the ICU or CCU (Coronary Care Unit). Right now I am employed as a CNA on a pediatric floor that also doubles as a med/surg unit. While my floor is very interesting and I have learned a lot, I think I am ready to move into critical care. I also think it will give me more options once I finish nursing school. Briefly the difference between the two in my hospital is ICU has pts of varying diagnoses while CCU focuses more on heart related issues such as MI's, balloons, CABG's, and etc. My dilemma comes with this; I know most of the employees in ICU already and think that the workers there would be more easy to get along with. However, I feel like I would enjoy learning about the heart and its problems more than the randomness of ICU's pts. Does anyone have any experience or advice to offer? I posted this in the CNA forums, but I like to get RN's opinions as well. Thanks!!

One day I heard a pt screaming in his room, (the same pt who jumped out of bed wearing nothing and used a trash can as a walker to walk down the hall), so I ran down the hall and asked him what was wrong. He proceeded to tell me he had a rabbit in his rectum and it was ripping him in half. He tried to get me to give him the phone and I asked him who he was going to call. He told me he had to call 911 so he could go to the hospital. After I told him he was already in the hospital and if he was to call 911 they would just bring him back down here, he slams his head back on his pillow, lets out a big sigh, and then says, "Well, I guess I'm going to die." This same pt also told me during a dressing change that I needed to wrap those ACE bandages tight because if I didn't the saplings would stick him in the legs when he walked home later. I also had a pt tell me that I was part of a huge government conspiracy sent here to inform her she was a programed spy and that I was putting information inside of her via a large snake attached to her leg (this was her Foley). She would hide under her covers and "gather information".

Call me weird, but I love suctioning people out! Everyone on my floor hates it so I'm always the person they come to. In my hospital CNA's can Yankauer suction, but only respiratory can NG suction and we have to have a Dr's order for NG suction. I just think of it as a way to help the pt's breath better and prevent aspiration and any thought goes directly out of my mind of nasty. Which I also sometimes have to remember that I am one of those individuals who are always wanting to see the most gross and foul thing on our floor every time I come to work. My interest in disgusting things is so well known that other techs have come from other floors to have me help with a dressing change they couldn't stomach. Suctioning out phlegm isn't anywhere near as bad as when a pt has a bowel obstruction and they are essentially getting poopy bile suctioned out of their stomach. That stuff does have a certain odor you don't forget. My advice is to just dive in and see what actually bothers you. You will be surprised how much you can handle. Good luck!

I currently work third shift. It is 1900-0700 three days a week. Although most weeks I can pick up one to two days of overtime if I want. I did my training and orientation on day shift, however it was only for a couple weeks. So far I absolutely love my job. Yea I get stressed out, annoyed, tired, etc. but I cannot think of working in another profession ever again. In my opinion there is no better way to help people than to help when they need your help the most. I am working at a fairly large hospital and more specifically on a Pediatric unit that also doubles as a urology and med surg. floor. My typical day begins by arriving to work between 1830 and 1900. For the first few minutes I spend my time chatting with day shift and talking to everyone I will be working with that night. Then by at least 1900 I will start getting report from who ever is giving me their group. I usually have between 8-12 patients, but have had as many as the entire floor by myself (24), but that doesn't happen very often. After I get report I begin my 1st set of vitals. I usually try to chart in the room, but sometimes I am just too busy and write them down to chart later. After I get through with my first set of vitals, I walk back through and check on all of my patients and see if they need anything. This includes baths that day shift didn't get to, bed changes, water, etc.. Then once everyone is taken care of I sit down and chart. At my hospital we chart ADL's every two hours. I do all of my ADL's on the even hours so it is easy to keep up with. After I feel like I am caught up on charting I will do another round on all of my patients and then, if no one needs anything else, I start doing things to ensure that I stay caught up the rest of the night. I will set up any empty rooms in case I get an admission, file any papers possible in my pts charts, stock the pantry, make sure we have enough linens to get through the night, and other things I can't seem to think about. Then by this time it is usually time to begin my midnight vitals. I will start my midnight vitals by 2330 and hopefully be done by 0030. When my midnight vitals, ADL's, and I&O's are charted I will make one last round with my pt's and then go eat. After I get back from lunch I check on all of my pts and then start filing all of the pt's labs that have been brought up. Usually after this I have a chance to sit and talk to other coworkers and just relax. Then around 0300 or 0330 I will start my last round of vitals (4 O'clocks). During my 0400 vitals I empty all of my catheters and get all of my daily weights. After vitals are done and charted I will go around and collect hourly rounding sheets in each pt's rooms and make sure I filled it out for each pt I had. Then I hang up all of the new ones for the next shift. After I finish that I pass out ice and water to all pts around 0600 and make my last round. Since we are a pediatric unit I also collect any diapers or feeding sheets the parents save so that we can keep track of the I&O's on the kids. From 0630 to 0700 I check all of my charting for each pt, put in any I&O's I have not charted, and then prepare a report for the oncoming shift. All of this is what I attempt to get done in a shift. But you will soon learn that every shift varies. I may have a ton of down time or hardly any down time. A lot of that depends on the acuity of my pt's that night. I may get all of it done or I may not get half of it done. Another thing that factors into this is the individuals I work with. To run an efficient unit your workers have to be able to work together as a team. This becomes especially pertinent in emergency situations such as Rapid Responses or Codes. Some random things that might happen during a shift are rapids or codes, pt deaths, pt transfers, admissions, pt's turning into 1:1's, having to float to other units, turning of Q2 pt's, helping nurses start IV's, walking pt's, discharging pt's, helping with dressing changes, and/or prepping pt's for surgery in the morning. If that was too much info in a couple paragraphs the condensed version of that is getting report, getting vitals, doing rounds, stocking, getting vitals, rounds, filing papers, getting vitals, passing ice, chart checks, giving report, and everything else that happens in between. The main difference I see between each shift is day shift has a lot more staff because the administrators have this weird misconception that people sleep at night in the hospital. You also have more people to deal with on days. Physical therapy, doctors, food service, distribution, administrators, family, and lots of other people are all there during the day, when at night they are reduced in numbers or non existent. Good luck! This job isn't for everyone, but it is very rewarding.