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ptsfirst's Latest Activity

  1. ptsfirst

    Nitro drip

    When would you expect to see a Nitro drip started? I am working in a PCU where pts are experiencing active chest pain with increasing troponin levels and we aren’t starting drip (I know that they usually don’t do nitro in PCU)... we aren’t transferring to ICU either.... just want to understand why no drip...
  2. ptsfirst

    Unstable Admission

    I never said that was being reprimanded - that came later... in front of the entire unit.
  3. ptsfirst

    Unstable Admission

    It wasn't that I couldn't care for this patient. I've been a nurse a very long time. It was that they had given more than one bolus to increase blood pressure and it wasn't working. I never refused to take the patient, I simply wanted to know what our plan was. My director and charge nurse were there and neither would call the MD because he has a history of being difficult and rude to nurses. I was told to call MD myself so I did. Made a couple of possible suggestions to increase BP and was told no...we will just watch. I said ok and hung up phone. Next thing I heard pt went somewhere else because MD was mad that I made suggestions. Director mad at me, stated I shouldn't have questioned and just called RRT if I needed to.
  4. ptsfirst

    Unstable Admission

    "Extreme" Lethargy and just completed home HD.
  5. ptsfirst

    Unstable Admission

    Hi everyone. I need some input. Today I was told I was getting an admit from the ED (no big deal). They had been hypotensive for over 3 hours after 2 boluses and by hypotensive I mean a Map of less than 58 (and ESRD). Would you question the patient coming to you with this low of a blood pressure or would you have just kept your mouth shut? I work on a PCU floor - but we don't do Levophed, etc. I asked the ED RN how we were to treat the hypotension since pt was ESRD and bolus wasn't going to be an option. They said MD is ok with patient coming up like this.... ultimately I was told that I should have just taken the patient and we will deal with it when it arrives... I'm so confused and got severely reprimanded for questioning this... I did not refuse to accept assignment - only wanted a viable way to treat BP. I am not a new nurse... more than a decade of experience, mostly ICU. What would you have done?
  6. ptsfirst

    How easy is it to get TB?? Help!

    I was recently exposed to a patient that was tested positive for acid fast bacilli via bronchoscopy. I took care of that patient for 4 days in a row. Coughing constantly. I am a little freaked to say the least. What's even more distressing is that no one from infectious disease has come to talk to us about what will take place to ensure that we get properly tested or treated if need be.
  7. ptsfirst

    Travel Nursing in rural NC

    Just knowing this has happened to others, although terrible, is somewhat comforting. I have a lease on a house until May, then I am out and I will never look back. Thanks :-)
  8. ptsfirst

    Travel Nursing in rural NC

    I have traveled nursed for approximately the past 5 years and for the most part it hasn't been bad. Since traveling in the southern part of NC for the past year I am both emotionally drained and literally trying to figure out how to get out of nursing. First scenario, My first assignment was actually right alongside the NC/SC border on SC side. I was told that I would be working in ICU alone - no second nurse with an CNA (no ACLS). I refused, called my recruiter (who is awesome) and our clinical specialist backed me up. I worked out the course of my contract without incident and agreed to extend. The day before my "new" contract was to start they again told me that I would be in ICU alone. Again, I refused. They agreed to have the House Supervisor work out of ICU and they would send someone ACLS certified to be with me when she made rounds,etc. The next day I was told my contract would not be extended by my recruiter and the CNO of the facility tried to have me blackballed for the hospital system (big in SC). I fought that part of it - spoke with both Director of unit and multiple MDs who have since been references for me. This happened right before the floods in NC happened and it was 6 weeks before I could work. Second scenario, I took a job in another moderately sized hospital in southern rural NC. During the course of this assignment I was given 3 patients almost every time I worked, 2 of which were almost always vent/drip patients. When I questioned it I was told this is the way it is here. I had already depleted my savings and credit cards due to my last experience so I struggled through and it was terrifying. Third scenario, this one was actually good. I took an assignment in the Raliegh area and finished my assignment in ICU without incident. Fourth scenario, took an assignment on NC/SC border - NC side this time in ICU. I was floated to every floor in the facility without warning or any orientation. By orientation I mean I wasn't walked to the unit, I wasn't introduced to anyone, I wasn't given codes for med room/carts, or oriented to what part of the computer system they used in the lesser acuity areas. I had to find all of this out myself. I was floated to PCU (no problem) but received a patient who was not stable - new onset DKA - 80 years old with bp of 70/30 - Charge nurse was there told me to call MD and left. No rapid response per her. I called the MD - who gave me orders (not good for pt with CHF - you can guess). I managed to keep her alive while taking care of 4 other patients. In the morning I texted the manager of the unit and voiced that I had some concerns and we could talk the next time I worked. We had previously had a meeting when I informed her that patients were being admitted on Levophed being run through PIVs. Low and behold - I get a call from my recruiter stating my contract was terminated. When I asked why - he was told I was yelling and cursing at the nurses station!?! Anyone who knows me knows that I would NEVER behave in such a manner. My agency performed an internal investigation and cleared me of any wrong doing. Additionally, one of the nurses from the unit told me that they had a huddle the next day - when someone asked where I was the unit manager told them that I had decided that I no longer wanted to be an ICU nurse and was going to just focus on school?!! WTH I am again without work as it takes time to set up a travel assignment. I lined up a gig in Eureka, CA - had to wait a month but the money was going to be amazing - I paid for a $600 plane ticket (that will take 90 days to get refund) only to get a call that the hospital overbooked and cancelled my contract. So here I sit flat broke at christmas with my elderly mother (lives with me) and I am feeling completely defeated and broken. I have gone through my entire savings and maxed my credit cards out because I do the right thing. I am now trying to get on at a hospital nearby with a horrible reputation but it is the holidays and there is no sense of urgency to hire at this time. Accept on my part of course. Through all of this I have met so many amazing nurses who refuse to use their voices and do whatever they are told because they need their paychecks. I simply cannot put my license in or patients in jeopardy. But here is the kick in the gut... I believe that nursing is one giant family. We work together to save lives and to improve lives for our patients. We hold each other to a professional standard. But my reality is that everything I have experienced here has been due to the complacency of another nurse. The culture of healthcare in this area is like nothing I have ever experienced and it will take me a long long time before I fully recover both financially and emotionally. Thank you for letting me vent.