Emmers4

Great thank you!!!

Yep! I believe in total is about 9 months, and a separate orientation for each ICU, so I believe about 3 months each. Does that seem like a reasonable amount of orientation? How long is a typical orientation in the ICU?

Hi everyone! I recently accepted a job as an ICU float at a new hospital that will be starting in a few months! I have worked for the last few years on a busy Telemetry unit and felt like I wanted to try out critical care! This new job will include floating to the SICU, MICU, and CV ICU, with orientation taking about 9 months total I believe. I just want some tips on how to survive and be a safe nurse while there! I think I've learned a lot over the last few years, I work charge nurse and got my PCCN cert, but I'm quite nervous knowing that it's going to be a lot more challenging and stressful than where I am now. Any tips or hints on how to safely take care of my patients and hopefully not lose my mind in the process?? Thanks!!

Hi Everyone, I am curious as to your thoughts on what I should do? I currently work on a busy telemetry floor, and have for about 2.5 years. I recently have been looking at positions, and received an offer from a huge teaching hospital near me as an ICU float. They would train me on the MICU, SICU, and CVICU over the course of about 9 months or so. It is a SUPER cool opportunity- they regularly have ecmo patients, are a teaching/research hospital, and known to have one of the best ICUs in the country. My current hospital is a union hospital, I am two years vested in a pension (at this point doesn't equal up to much, but....), but am feeling kinda bored. I love my coworkers, but don't feel challenged anymore, and have been frustrated with the administration at my hospital. This new job would be super cool but a strong learning curve. Do I go for this new job? The pay is the same, although the new position has a lower FTE. Or do I stick with my current job on a tele floor, a bit bored, but at least have seniority and am not scared out of my mind? Also, welcome any tips for switching from tele over to ICU! Thank you!!!

Thank you guys!! I did check with our hospital policy, and it does stipulate the 1 hour rule that I had mentioned. Thank you for your thoughts!!

Hi everyone! Question for you guys! I work on a Tele floor, and many of our PRN pain medications are on a scale- for example, PRN morphine IV 2-4mg q4hrs. Let's say that you give 2mg at noon, I was under the impression that if needed you could do an additional 2mg at 2pm (as long as you stay within that 4mg range, so at 4pm, you couldn't do 4mg, you'd have to do another 2.) Someone recently told me that you have an hour to give an additional dose. So with our example, you have until 1pm to do additional dose, otherwise you have to wait until the 4hours are up. They said it's too much like dispensing. Any thoughts? Is this familiar to you guys? Also, an explanation on the dispensing explanation?? Thanks!!

Thank you so much for your thoughts! As a new grad, I'm not sure how big of a deal to make about these things, so I appreciate your response! And yes, it was Zosyn

Hi Everyone, So I have a question regarding an error that was made last week. I am a new grad, been working on a Telemetry floor for about 8 months now. I have just started precepting, which is a huge honor to be asked, although I'm still quite new myself. Anyways, I was orienting a new grad who has been on our floor for a few weeks now. We are encouraged to try to give them some freedom so they can learn, but also be there as a resource. She went into a room to hang an antibiotic for a patient who had quite a few things running at the time. I'm a bit of a stickler for this, so I labeled all the lines to make sure there wasn't any confusion. As she programmed the antibiotic into the pump, I was in and out of the room and doing other small tasks while there, and did not see her program the pump. The antibiotic was hung, we left. A little later, I heard the iv pump beeping sooner than it should have been finished. I went in, and the antibiotic had been entirely infused over about 45 mins rather than 4 hrs! I spoke to my charge nurse and pharmacy about this, who said that this antibiotic can be run over that timeframe, the frequency just has to be changed from q4hrs to q6hrs. Basically, they said not a concern! I still feel horrible about it, and I filled out an incident report regarding it. In the report I filled out, I didn't want to throw my orientee under the bus, but it may have inadvertently made me look more responsible. I'm just concerned about how this reflects on me by my manager, and how to do a better job of striking that balance between safety and freedom for orientees. Advice, thoughts?? Thanks!

Hi Everyone! I'm trying to gauge opinions on my situation, and wanted to ask people who may have experience with this! So currently I am a nurse on a Telemetry floor working straight 8s evenings. It is going well and I enjoy my work, but recently an opportunity has come up for me to switch to straight 12s day/nights. It would be every 3rd weekend instead of every other, and I would work on a rotation of 6 day shifts then about 2 night shifts. Has anyone done a rotation like that? Or have any thoughts on how that would be? I would be interested in switching things up because I feel like on evening shift, you're on the opposite schedule with everyone, and I don't get to see me roommates very often. Thoughts? Thanks!

Thank you very much, I appreciate your thoughts!!

Hi Everyone! So I am going to be a new graduate nurse in a few weeks, and have been searching for jobs these past few months. About a month ago I had an interview at a hospital for a medical position. They are offering great pay and benefits, but I am not super excited about the floor as there are a lot of detoxing patients there. I went ahead and accepted a position there, although I didn't get great vibes from the HR people and my manager. I .outlying accepted this because it is a job. Even though I had accepted the position, a hospital that I really like called and asked for an interview with me. I interviewed yesterday and absolutely loved it. I got along with the manager super well and they're offering me a spot on their cardiac floor, which I ultimately really want. They're also offering me evenings, which is crazy as a new grad, and a much better orientation process! It also is far closer to home, and pay is still very decent. My question is, can I tell the first hospital that I'm going to go a different direction and take the second position? I dont want to go back on my word, although no paper work or anything has been signed and I still wouldn't start for 2 months. Is this incredibly unprofessional? Also, any thoughts on a new grad on a cardiac floor vs a medical floor with lots of detoxers? I've heard they can be incredibly difficult... Thank you for your thoughts!

Hi Everyone! So I am going to be a new graduate nurse in a few weeks, and have been searching for jobs these past few months. About a month ago I had an interview at a hospital for a medical position. They are offering great pay and benefits, but I am not super excited about the floor as there are a lot of detoxing patients there. I went ahead and accepted a position there, although I didn't get great vibes from the HR people and my manager. I .outlying accepted this because it is a job. Even though I had accepted the position, a hospital that I really like called and asked for an interview with me. I interviewed yesterday and absolutely loved it. I got along with the manager super well and they're offering me a spot on their cardiac floor, which I ultimately really want. They're also offering me evenings, which is crazy as a new grad, and a much better orientation process! It also is far closer to home, and pay is still very decent. My question is, can I tell the first hospital that I'm going to go a different direction and take the second position? I dont want to go back on my word, although no paper work or anything has been signed and I still wouldn't start for 2 months. Is this incredibly unprofessional? Also, any thoughts on a new grad on a cardiac floor vs a medical floor with lots of detoxers? I've heard they can be incredibly difficult... Thank you!

I have a question regarding PICC lines, or just all central lines in general. I understand that these lines are placed for either long-term IV access, such as antibiotics, poor IV access, or medications such as TPN. I have been told that they also are helpful if medications are incompatible with each other as well. However, even if incompatible medications are run into different ports, they all end up in the same line. Unless, do they have separate tubing within the single internal line? And then do they have different exit points into the blood stream? But then they all end up in the blood stream together, so aren't they still incompatible then as well? I apologize if this is confusing at all! I am a nursing student that is just curious and I just want to make sure I am understanding everything correctly! If you can shed any light on the subject, that would be fantastic, thank you!

Thank you very much for the advice, I will take all of it to heart!

Hi everyone! I am very excited to be graduating in the spring from a BSN program, but I'm having some concerns about whether nursing is for me. I love taking care of patients and my clinicals at the hospital, but I am becoming very aware of how little I know and how easy it is to make a mistake with serious consequences. This gives me a lot of anxiety about graduating in the spring and being responsible for patients on my own, especially when considering how some orientations areally being cut shorter due to short staffing. Any tips for new grads and how to find their niche in nursing? I have heard that the first year is more successful if you find an area that you do well in. Or just any tips in general for a soon to be nurse and how to adapt from nursing school to actually practicing? Thanks!