CC NRSE

the pay will probable not be good. That area doesn't pay well. where are you going to be working? Didn't know they were using travelers now.

It really just depends on the school. The best thing is to try and find someone attending that school or someone who has interviewed there. Most of the school want to know your skill level and how you will pay for it. Some schools have a panel of people conducting the interview others will just have one or two. There is a forum web-site much like this one but I don't know the name right off. You might do a search and see if you can find it. Good luck!! :-)

it just depends on where you work. some ccu's have very sick patients. balloon pumps and the works. others are very mild. sometimes i don't mind getting a float from floor. other times i really don't have the time to keep an eye on their patients. if your not comfortable,.....dont do it. you could really get into alot of trouble if there are more than a couple of bad patients in the unit. it's not fair to the nurse or the patient.

actually, several of the hospitals I have worked have used the "oral protocol". This usually involves Peridex (a mixture of mouthwash and peroxide, also called cholrahexadine) every three hours. They did have evidence based studies that showed decreased hospital acquired pneumonia but I am not sure where they got the info.

It means they have added everything back into the hourly rate. For example, you will get $30/hr + $5/hr housing for a total of $35/hr. You really have to watch them about this. They can be pretty sneaky. If you are interested in it the best thing to do is call and have THEM break it down for you.

yes, the working conditions are very unfortunate. it is a beautiful state but they don't respect nurses. you are absolutely correct about the bon. i have heard horror stories about obtaining license there. it used to take as long as 6-8 weeks but now you are suppose to (by law - enacted by jeb bush) obtain a temp in as little as 30 days. i have still heard of people having problems if they didn't push to get their license. i guess they just assume that b/c florida is a destination state they can pay and do what ever they want and people will still come. there are a few good hospitals there, but they are few and far between. that is why i travel. tampa is a nice area, i hear tampa general is a good place to work but couldn't tell you from personal experience. i have worked at mortan plant in clearwater and can say that isn't bad. i can't help you with the salery b/c i was a traveler at the time.

there is a lady from pensacola, fl who had one a couple of years ago (2001). she did have some difficulty along the way, but made it through. i saw her in the hospital one day when i was working (she was visiting someone) and she looked great!! :) she was at university of pittsburgh medical center in pittsburgh for her surgery.

well, the staffing ratio should be 1:2 but when you are short or have call ins, this is what happens. they don't believe in closing beds. that means patients must go to other hospitals and they lose money. they had rather work the poor nurses for little money and no help. i can't say those patients are less acute either. they don't staff based on that. if your thinking about orlando, stay away from the florida hospitals. they are also known for that type of treatment. i'm afraid closing beds in florida is almost unheard of. they just don't do it. i had a friend who refused a thrid patient and was told by the manager she probable needed to find another place to work. the next day she transfered to pacu.

i don't think they use their icu nurses as float pool simply b/c they don't have enough of them. at one time (last summer)they were using alot of agency. even then the staffing ratios for icu were 1:3. it is also a hca hospital which typically means short staff and low pay. most people choose to drive to pensacola to work.

angie, i am so sorry.......... your friend truely is lucky to have you.

the answer to your question about your friends father won't "fit", most ct tables will only accomodate a patient weight of 400lbs. the other issues,..if his pupils are blown, no cough, no corneal or gag reflex,....chances are he was down to long and suffered an anoxic injury which he will not recover from. there probable was no eeg preformed because these are pretty definate signs knowing the history. i have seen this many times and can't recall seeing anyone recover. (although that doesn't mean this is the case with your friend's dad.) your friend could insist on an eeg just for her own knowlege and sanity. i don't think that would be out of the question. she just needs to understand even if he is not clinically brain dead (no wave activity) he may never recover any more than what she sees now d/t the injury already substained. also keep in mind,...your friends dad may not be sedated with anything. if he is not responsive, then there is no need. sedation would not indicate the pupils being blown. when did this happen? i am very sorry this happened. it is always a difficult situation.

if the family has stated "comfort care only" then you shouldn't cont accuchecks, labs, antibiotics, ect. sometimes if the patient has been on oxygen,i will cont it.(more for the family, for some reason it seems to make them feel better) otherwise, i only give morphine (or painmed) and ativan (if ordered) prn. i would clerify with md regarding orders and if he told you to cont accuchecks, i would remind him of the families wishes. if he insisted, i would go up the chain of command. also you could ask the family if they wish to cont. them (if md still wants them). usually, they will say no.

i agree. of course tell me the pertinent information (they do have a foley, trach, ect.) but don't tell me breath sounds, opinions on family ect. i will figure that out soon enough and had rather have "just the facts". as far as neuro, (i realize it is different if you have more than two patients,) but i personally like to do a bedside assessment with the oncoming nurse so there is no questions as to what is new and what has been. only thing i want to know regarding an assessment is if something is abnormal and has been that way. that way i am not calling the md about something he/she is already aware of. (no pulse in r foot, cool to touch but no pain, been that way for 10 years!!!)

yes, there is away around the 6 month quarantine. by having a rabies titer drawn 6 months before you plan to go to hawaii, you only have to quarantine your dogs for three days. problem with that is, what is available now (jobs) may not be available in 6 months. if i remember correctly the titer was a little expensive. (it could only be sent to a certain lab. university of kansas i think??) i would love to go to hawaii, but not willing to spend the money on a chance they might have a job for me. at least it was that way last time i checked. it may be different now because that was a couple of years ago. good luck!! :)

I think that recruiter is full of crap!!! You never accepted the position, just agreed to be submitted. These are two totally different things. Please do tell us what company and recruiter this is so the rest of us will know to stay far away from them. There are some really good companies out there. You shouldn't have to put up with the threats. Just be thankful you didn't take an assignment with this company, or at the least, this recruiter. It is very important to find a company and even more important to find a recruiter you can trust.

you are correct. most crna schools want icu experience and don't count er as critical care. alot of the even prefer (not required) cvicu for the experience of "recovering" a post anesthesia pt and working with (pa, art, & la) lines. i think sometimes it gives you a better picture of what anethesia does to people!! even though i consider some er's as critical care, (you get codes, trauma, resp distress) you don't usually see the long term effects (complications). i guess that is why some anesthesia schools require icu experience.

dansko has an outlet. if you know what size you wear this might be the way to go. they are a little cheaper here. http://www.danskooutlet.com/

i think the shoes just depends on the person. i have tried several different kind. i just don't think anything is as comfortable as a good pair of tennis shoes. that just gets rather expensive replacing them every six months. i have a pair of birks (everyone raved about them so i tried.). they really hurt my feet and legs. i also have a pair of klogs, those wear good, but after one day (when working several in a row) my knees hurt. the best thing i have found is a pair of teva clogs. (these don't come in white.) i can wear these shoes for several days in a row without them hurting my feet knees or legs. i think the birkenstocks and danskos have more arch support. they are rather hard in my opinion. i am very flat footed so these don't work for me. good luck in finding something that works. this is very important b/c we spend alot of time on our feet. it can make for a miserable day if your shoes are not comfortable.

I am currently on an assisgnment where they have an "open door" policy. Visitors walk in,out and around the unit peering in every room and listening to every conversation at all hours of the day. I personally think this puts not only the patients at risk, but us as nurses at risk for harm not to mention violating the HIPPA policy. Just the other day we had family puching each other and fighting in ICU. I was terrified and my poor little patients were even worse. Although secruity was there in a matter of minuets, it only takes one person with a gun to wipe out several. Having been on both sides now, I don't think this helps the patients recovery. In some cases (most) it even hinders it. Also not to mention it puts the families and pateints in a bad position. Most people don't feel like "entertaining" when they are in ICU. I know I wouldn't. They also don't want a room full of people in there laughing watching TV and having a good time. Maybe the idea behind this is to have family involved, but I personally think it hinders patient care. Families seldom help with care and some are even offended if you ask them to help. I figure if they are going to stay in the room and expect me to wait on them (as well as the patient) the least they can do is help me with little things. (as well as they are able) I also think it takes time away from the pateint. I have spent more time explaning to family or doing things the family wanted me to do than taking care of the patient. Families don't always see the big picture. "yes I realize dad hasn't eaten in 24HRS" never mind the fact that he has had a big stroke, can't swallow and possible going for EMERGENCY surgery ASAP. As I am trying to get my patient ready for surgery they are hounding me about the fact that he hasn't eaten. What's more important at this time? If I don't get dad to the OR ASAP we might not have to worry about him eating, EVER AGAIN!!!! This actually was a little extreme and once I explained surgery took priority, they understood. But such things have happened and sometimes families just don't get it. My first priority is to my patient. I don't feel I can give as good of care as I should with people constantly walking in and out of the room and staying round the clock. Never mind the fact the patients have no privacy. I feel we should have set visiting times, then at the nurses descretion, one family member could stay as deemed appropriate. I also find when familys are allowed to come and go freely, they are disrespectful to staff. They deem this as their right to come and go freely. If posted visited times are posted and they are allowed to stay, they seem to be more respectful. Sorry this was a long vent, but I just don't see where it helps the patient. I think this is more for family than the patients. I am very much a patient advocate and this is why I am very strongly opposed to it. Unfortunately, with management it all about pleasing visitors and making them happy.

i have often said it should be a prereq for medical school. then maybe we wouldn't get so many stupid and unreasonable orders!!! if only they could walk a day in our shoes!!!

lpn's can also push drugs in fl. i don't know the exact stipulation, i do think they have to be iv certified. it may also depend on the hospital. i think about the only thing they can't do (in fl) is hang blood. not really sure though. we don't have any working in the critical care unit i am in. i know in al, they can't give ivp drugs. in some hospitals, they couldn't even flush a central line!!! to me this seems a little ridiculous. some of the best nurses i have ever worked with were lpn's. i guess there has to be some division b/c of the pay. that's the biggest difference, which i also don't think is fair.

i have seen many times where initial ckmp & troponin were neg only to see the second set extremely elevated and find out the patient had a big mi. i am not an er nurse either, (although i worked an 8 week travel assignemnt there- which by no means qualifies me as an er nurse!! ) but work in the unit. many times we have questioned patients being admitted only to find later, it turned out to be in their best interest! :) also, as you probable know, not everyone has "chest pain". more often women then men never experience the chest and left arm pain. i can't tell you how many 40-50 y/o patients i've had in the last few weeks. (i work cvicu) most of them never experienced the typical chest pain we so often associate with an mi.

nursinrox, i use the patch. i also live in fl. no problems with it coming off. during the summer (and alot of the winter!! ) i live at the beach. never had one problem with it. but, as others have mentioned, it is still hormones. i too had the nausea, h/a, night sweats and mood swings with the pill. (even the low dose ones). i still have mild s/e with the patch but nothing compared to the pill. i tired the shot (depo) and as someone else mentioned, i gained alot of weight. good luck in finding something that works!!

we use the pyxis for all meds,...including refrigerated ones. i am in a cvicu so it is not so bad with 1-2 patients. i can't imagine having 5 or 6!!!! :eek:

i'm not a dialysis nurse either,... but work critical care. we always give post dialysis. those particular drugs are dialyzied out.