MikeyT-c-IV

I have heard in the past, on this website, that some employers do not like to hire nurses who are looking to move from rehab to acute care. In my state, Oklahoma, many hospitals would appreciate any nurse... I frequently check out the various job websites just to see what's out there... So many available jobs. For my personality, I could never work rehab/LTC, just not enough action. In any case, I wish you the best of luck!

Yes, generally. I'm kind of lenient on this issue. If I am placing a PICC say, in a very large E.D. room and the family is sitting in a chair 10 feet away, no. In one of our small inpatient rooms everyone wears a mask.

I agree with Carrie_RN. Look at your in-state universities. You will take advantage of lower resident tuition fees plus probably get a similar quality education as some of the schools listed above. I finished earning my MSN in Leadership this August and I'm now in to my 3rd week of a new job. While it is not my dream job or location, I still get to learn a ton that will benefit my future. I took an leadership job in quality/infection control. It's a huge area that offers various learning opportunities... YAY!

I would probably advocate for a midline or a PICC. It sounds like multiple meds are infusing. Given the nature of her vasculature and especially this pt's plan of care, I think a PICC would probably be best. Remember though, your docs are going to be hesitant because they don't want a CLABSI on their hands. A midline would probably work fine but they don't always draw blood so well, especially after a few days. In my experience, even when we know a patient is going to be on long term antibiotics, the doc will wait until the last minute before discharge to place the order. ugh.

With the smaller veins, depending on assessment, I'll access the vein a bit closer to the AC area than I normally would since it's a bit more superficial. I always use the 1.75" IV cath that comes in our kit so I can cannulate and not worry about losing access. Sometimes with the smaller veins it's also helpful to decrease the insertion angle to prevent going through the vein.

I've been placing USGPIV's for about 11 or 12 years. I'm on a vascular access team. I started using ultrasound a couple of years before I started placing PICC's and midlines. I haven't kept track of how many central lines we have avoided due to utilizing ultrasound, I imagine it has been quite a lot. I have been pushing leadership to give us some hours to train more nurses on the ultrasound, but you know... money is always tight. Good job on keeping track of your stats and choosing the most appropriate line for your patients!

My advice is to go to your doctor if you are unable to work due to illness and get a note. At least you will have a paper trail. I haven't called in sick for over 15 years! But finally this year I had to "call" in sick... well, I was in the ICU on the vent at my place of work... So I guess they knew I wasn't faking. :)

Exactly this. Unless you have a contract to provide formal education this could be a bad situation a brewin'.

•Do you have a preference for a particular glove material? (if so, why?) I have used all three materials. The vinyl is horrible, difficult to don and too thick for certain assessments. I could go either way, nitrile or latex for non-sterile use. I prefer a super-sensitive sterile powderless latex for sterile procedures. The material is flexible and I can feel everything. •Do you feel glove use affects your performance? (if so, how?) Only when trying to remove dressings from a patient (when I could lightly use my nail to get the corner started) or similarly, trying to open certain supply packaging. •Which tasks do you most commonly wear gloves for? (including most common procedures) Sterile gloves for PICC, Midline placement, and dressing changes, non-sterile for IV placement. Also, any cleaning of patient areas and equipment and when using cleaning solutions. •What bodily fluids are you likely to come into contact with? Blood, potential for any. •What are the main issues with glove use? quickly donning gloves after sweating, washing hands, scrubbing with alcohol foam. The moisture causes the material to stick to the hands. I need to carry my own sterile gloves for sterile procedures. Sterile gloves that come in pre-packaged kits are always too small for my hands and nearly impossible to put on without ripping them to shreds.

Same. I'm in a 2 person department. So when they see our survey... well, you know.

I'm glad you posted this question. I've been curious about the ballpark figure for online adjunct positions. I think it would be worth it for the experience and an opportunity to figure out if it is your thing. If not, 16 weeks will fly by.

Also remember a PICC is much longer than a PIV so there will be more resistance with the gravity flow. A regular PIV may only be a couple of cm long but a PICC can be quite long up to 55cm depending on the size of the patient. The 5fr Bard Solo, each lumen will be 18g but gravity flow will be slower than an 18g PIV.

I took online classes at a University in my State. I did not take the education route but I do know it is only 11 classes (3 credit hours each) and each class was around $315/hr. None of my books were expensive, most of them I rented. I went part time, each class was 8 weeks so I took a class the first 8 weeks then another the final 8 weeks. I am also busy, family, jobs, all that good stuff. One class at a time is easily doable. I chose the University that I attend based on several strong recommendations. I'd also recommend looking at in-State Universities for the best cost of tuition.

I completed an online RN-BSN program a couple of years ago. Each course required a major paper, weekly discussion posts, and assigned readings. I had one group project (not a fan) that involved creating a powerpoint presentation. I found that I was most engaged with my papers when I picked a topic in which I was completely (or mostly completely) unfamiliar with. As far as working, I had a full time and two PRN's at the time. It was very do-able. I always read the weekly assignment as soon as it was available then spent the day thinking over my responses. By the time I sat down to complete the assignment I generally knew what I was going to say. My college offers an online library for research. I usually had no problem finding peer reviewed articles for my research papers. I also highly recommend PERRLA. I purchased a lifetime subscription when I started. I knew I'd be using it for years. The software has saved me countless hours just in formatting references.

Every time I go place a PICC I need to use the bedside table. More often than not, the table is a complete disaster and needs a good cleaning anyway. I'm happy to do my part.