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ICU.RN23 has 6 years experience as a BSN and specializes in ICU.


ICU.RN23's Latest Activity

  1. ICU.RN23

    Peer Eval

    I do try and talk to them as much as I can and ever since they came back from leave, its been worse. They don't think that they're causing any problems and deflect what they did onto something else. We had a very long discussion about everything. I'm not sure if it's just their personality, but I feel like our weekend is very passive and we need to do better at talking to each other, which the charge nurse and I have done and I feel like our work relationship is that much stronger. It's like whatever I say doesn't really matter because we're friends outside of work and its okay that they can do these things to me, but it's really not.
  2. ICU.RN23

    Peer Eval

    There was a day where the charge and the nursing supervisor had a plan in place for when the 8-hour nurses left at 3 pm, but this nurse (and another one that normally doesn't get involved) decided to micromanage the charge nurse without his knowledge. This caused so much confusing and frustration, but this individual thinks that they are being so helpful. I work the same weekend as this individual and we work the same shifts and FTE, along with the charge that they like to micromanage, so it's hard to try and make it sound like it's not coming from either one of us. Outside of work, this person is my friend, but when it comes to work, I just get so much anxiety because this person is so bossy and tries to be in everyone's business. I really like the staying in their own lane!
  3. ICU.RN23

    Peer Eval

    I have to do a peer evaluation of another nurse that I work with almost every shift. In the room for improvement section, I need help finding a professional way of saying to let the charge nurse do their job without that person butting in all the time. I just don’t want to make it sound like it’s coming from me so I’m struggling. Any help would be greatly appreciated!
  4. ICU.RN23

    Help with new grad RN orientation/Added shifts

    RNNPICU, she could handle one patient, but not a critical one as of now. I had to tell her to turn off sedation for the sedation vacation. I had to tell her to titrate down on pressors since we had more than adequate blood pressures, but she only did it because I told her to and didn’t take initiative to continue to titrate. Also, I told her that any fluids running less than 15 mls an hour needs a tko (our policy) on one day, then the next day...same patient, same med, running at 2.89 mls for a couple hours and she didn’t even realize it, but said she wanted to ask for an opinion since we were diuresing. Valid statement, but she should’ve spoken up sooner because we could’ve tried turning off the pressor or ask the providers if they wanted to try albumin. Turned off the pressor, pressures dropped to 70-80’s and she was reluctant to turn the pressor back on. She’s also afraid of speaking to the providers, which the nicest ones in the world were working that day, and their recommendation? Turn the pressor back on. I feel like I do well at helping my orientees recognize what they struggle with and try to come up with solutions, but it’s like every day we start all over again and she’s forgotten important things or she focuses on one aspect of the patient rather than the whole entire picture.
  5. ICU.RN23

    Help with new grad RN orientation/Added shifts

    ruby_jane, our manager is very receptive and appreciates our opinions, which is a huge plus and it’s probably the reason why she got more orientation shifts because she wants her to succeed. I haven’t talked to my manager quite yet because it was only day two and I didn’t want to come off as negative. I want to try a different approach with her; she will assess the patient in the room then chart right away, but it takes her a very long time to chart because she sees something in the documentation that she forgot and she goes to assess again. It’s very broken up and takes a very long time. She also doesn’t 100% understand why the patients are admitted either. My approach that I would like to take is to have her assess to the best of her abilities, sit and chart all the way through, and keep track of what she missed so she can go back and do a mini assessment. It just seems so scatterbrained and also if she never leaves one patient room, how does she know what’s going on in the other room? I’m also going to make her read the H&P and the most current progress note so she knows what’s going on with her patients. I’m just hoping a few little tweaks will allow her to be more efficient and more comfortable.
  6. ICU.RN23

    Help with new grad RN orientation/Added shifts

    jess11RN, the new orientees have touch base meetings scheduled with our manager throughout orientation with and without the preceptor so they can discuss how things are going. It has been discussed multiple times about time management, assessing situations, etc., but I don’t know if my manager is trying to do as much as she can before a decision can be made with management and the new nurse to find a position that could be best suited for her. I wanted to start ICU as a new grad and I was so glad that I didn’t because I learned so much on med/surg and had that extra skill set when I transferred up. A lot of us nurses agree that new hires should have a year of med/surg experience to get the basic skills of passing meds, IVs, assessments, time management, or have extra time, but it’s not the case unfortunately.
  7. ICU.RN23

    Help with new grad RN orientation/Added shifts

    Thank you for this. There’s so many of us that agree, she can handle lower acuity patients, like med/surg or PCU, but when it comes to ICU patients, it’s like she freezes.
  8. Hello everyone! I currently have three more shifts with a new grad, who has already had three months of orientation, but isn’t catching on and got six extra shift of orientation. Her preceptors for her orientation were very good and our hospital follows a skill-based orientation and we have to follow tiers based on their skill set. Her preceptor and I worked a majority of our shifts together and so I was aware of the progress she was making throughout the past three months. Confidence, managing two patients, delegating, and assessing a critical situation are some of her weaknesses so her preceptor held her back on the tiers because she couldn’t manage assessing AND passing medications at the same time. My struggle is that we had two patients the last two days and it was like I was her crutch. I had to remind her that she had another patient, to pass meds, and just other basic stuff. She would stop people walking by to have them check on our other patient or have them get her stuff when I wasn’t doing anything and she could’ve called me and asked me. I understand that starting out in the ICU is definitely different, especially as a new grad when you’re learning all the basics plus having critical patients, but I just feel like the hands-off approach, reminding her to do things, is giving her too much freedom to be relaxed and not focus on the tasks at hand. Does anyone have any recommendations or suggestions for me? I want to make sure she's successful, but it’s almost to the point where the ICU is too much for her unless we can find something that works for her.
  9. ICU.RN23

    SCRN Unofficial Results

    Today I took my SCRN certification exam and I unofficially passed. What I was wondering if it's still possible to fail the exam even though I unofficially passed?
  10. ICU.RN23

    Orientee with untreated ADHD

    This is extremely helpful and thank you so much for giving my your insight. I'm a very passive person and I just didn't know how to approach her about this. I have ADD and we talked about it one on one, but I've never suggested medications for her. I don't want her to fail because that would reflect badly on me and I know she's going to be great, I just need to change my style of teaching to help her more. What I mean by her not focusing is when I try to explain something to her, she interrupts me like she's always in a hurry, but we have plenty of time. The other night she called me into a patient room about a medication order and that she swears the Pyxis told her to take out two rather than one. I went to look at the order in the MAR and she kept going on about it in front of the patient, after I told her a few times that we would go look after we were done in the patient room. Then the count was off for the med and I told her that we would act like we would take out another dose, put the extra one back, and press cancel all meds so that the Pyxis count would be normal, but she seemed like in such a rush that she closed the pocket and the count was definitely off. IV starts have been a little nerve-wracking because I know she knows how to start an IV, but she's not familiar with the new product. She'll just stop and say she doesn't know what she's doing with the needle in the patient's arm. I think for IVs I'll have her watch me first and she could do the next. I think that instead of walking things through step by step, I'll just pull her aside, explain what we're going to do, and let her fly on her own. I'm working her this evening so I'll definitely utilize this information to help her grow. Thank you :)
  11. Hello all! I've been working as an RN on an ortho/neuro/trauma med/surg floor and I've had one orientee that was AMAZING!! She worked on our floor as an aide so she was knowledgeable on our floor. My current orientee told me that she knows she has ADHD and isn't taking anything for it. I'm having a hard time with her because she doesn't focus, she forgets what I tell her, and she tells me she's not scared or nervous of anything. I feel like I need to stand next to her with everything that she does and she doesn't give me a chance to explain since she's going a million miles a minute. She's already on shift 11 out of 30 and I would love some advice on how to change my preceptor skills to accommodate her.