Who's afraid of the ICU?

I had always been very interested in critical care, and as luck would have it, a spot had just opened up in our ICU--not something that happened very often. I took a chance and applied. Happily, I was accepted.

I went into this job, one year fresh out of school, brazen and cocky. Of course I belonged there--I had done so well in school and out on the floor. This would be a piece of cake. Oh, how quickly I was knocked off my horse!

Even though I felt like I knew everything, my coworkers wasted no time in proving me wrong. My preceptor, and ICU nurse for more than twenty years, bombarded me with questions constantly, about things I'd never had to think about before. Not just the "how" and the "why" of things, but the "what else", "what if", and "what do I need to do to change this". These are critical thinking skills that I thought I was using already, but clearly was not. It is hard to critically analyze your patient's care when you're busy completing tasks. I quickly learned that we don't do tasks in the intensive care unit, we manage patients. And it is an absolute must to know what you're talking about at all times. There usually isn't time to look up references when you're not clear on something. And I knew next to nothing. Read More

Nurse Practioner: Still a nurse?

I recently had to re-certify in ACLS and during the introductions a fellow ACLS student stated that she was a NP. During the course of the day she made several references to "when she was a nurse". Just curious, do you still consider yourself to be a nurse albeit in abroad sense of the term?

Not trying to start a semantics war here (or offend anyone on either side of this), but I've just never heard anyone go to as much trouble as she did to separate herself from being a nurse and I'm interested in your opinions of this behavior. Read More

What do you do when Work calls on your day off?

Admit it this is you. LOL! Don't you just hate it when work calls you to come in on your day off? What do you do? What do you say? Read More

"Why didn't you go to medical school?"

Sorry for the provocative title ... I'm mostly curious what your responses are when a patient asks you:

• "Why did you become an NP instead of a doctor?"
• "What's the difference between a NP and a MD?"

During my clinical rotations (which are now COMPLETE!! Just waiting for that diploma), I've answered these questions ad nauseum to patients who were interested in my training. After giving a clever, premeditated answer that is both thorough and informative, it is still followed up by, "so you were an RN and now will be a nurse practitioner soon: are you going to go to medical school next?" and "what's the difference?" DOH!

Maybe my response isn't as clear as I'd like. Or maybe I'm just fighting the good fight against misinformation of NPs and it's just going to take more time. Either way, I'd love to hear how you respond to these questions! Read More

"You *Have* To Start in Med-Surg"...fact or fiction?

As a new grad, newly licensed RN, I've heard it a hundred times from instructors, other nurses, and all over AN. I understand the reasoning behind it, to "gain those valuable skills and lay a strong foundation for future knowledge."

Just wondering how many believe this to be true. If one was offered a position in a field that interests them, that isn't med-surg, do you think it would be detrimental to their future nursing career? Obviously as a new grad, with a limited number of job openings, we have to pretty much take what is offered. But just wondering your point of view and what you think of this advice; is it fact or fiction? Read More

What do hospitals mean by or consider as "experience"?

I'm a recent new grad RN, just got my RN license, and am currently looking searching for jobs. So on job applications, I find that many ask to list "nursing experience" or "nursing specialty experience" (Med-Surg, ICU, NICU, Peds, etc) I've had in a select as apply format question. I've been either told that clinical experience doesn't really count and that when they ask for experience that they mean "paid experience"; or I've been told to go ahead and list the nursing specialties where I did my clinical rotations at.

Would someone clarify what these hospitals mean by "nursing experience"? Do they mean paid experience? Or is it okay to list the areas where I had my clinical rotations at? I'm just a bit confused. Read More

Laughter...

The first thoughts in the mind of a number of nurses is "I don't even have time for a bathroom or meal break.....this is not funny and I find no reason to laugh". Or even more serious "I work with dying people, people who are not hopeful, it is inappropriate to smile and laugh".

Every bit of change starts with a first step. As a tremendous amount of literature shows, laughter decreases stress. When the stress level is so high that it is something that one can feel, then it only can reflect on the patients. Patients often can "feel" when a nurse is stressed. To lighten the mood even a little, can make the work lighter, and the patient a little more comfortable. Read More

Per-diem nurses

I am a registered nurse who works as a per-diem nurse in several hospitals in Florida and want to create awareness among the healthcare industry (mostly hospitals) about the plight and silent injustice that is being perpetrated on per-diem nurses since the inception of its concept. Read More

Overweight travel nurses!!

I'm currently a Critical care nurse and very interested in traveling. I have done my research and decided on the top 4 travel agencies that I will be applying to. There is nothing holding me back from moving forward EXCEPT my weight! I know this may sound ridiculous, but I have this mental block that I have to be more fit before I begin traveling. I am a very strong, confident person who rarely allows my weight to prevent me from doing what I want. My weight has NEVER interfered with my job performance at all. I have lost 35lbs over the last 4 months from working out 4-5 times a week and changing my eating habits. With all of that said, I have a few questions. Am I able to become a travel nurse being overweight? Are there any current/recent overweight travel nurses who can share your experience with being a travel nurse? Should I lose some more weight before I travel? Should I just try and get over this mental block and go for it?? Read More!

Silver Lining

Busy days and chaotic circumstances oftentimes lead to "reactive" instead of "proactive" mindsets. As nurses, our first priority is our patients. It's difficult to keep this in mind when we have so many things demanding our attention. This article outlines how important it is to focus on our patients, no matter the chaos around us. Read More

Interruptions during my med pass

I was working the 3-11 shift at a LTC facility. We do have a policy that nurses are not to be interrupted during the med pass unless there's an emergency. It's a policy that is easily overlooked. I counted eight times during my 8 PM med pass I was interrupted and out of those eight times I had five near-misses (or near-hits) meaning I caught the med error before the patients were harmed. It really bothered me that I almost gave the wrong meds to the wrong patient because my supervisor interrupted me to ask me if a patient is wearing a cervical collar or a family member is in a panic because her mother didn't eat all her dinner. Read More

How to prepare on working on ICU?

If one likes to work in Surgical ICU or MICU, what area in Nursing would a new grad start working? Med/Surg, Telemetry, etc? I was thinking of gaining some experiences first before joining the SICU or MICU. Would working in Telemetry be a good foundation to prepare me for MICU or SICU. Read More