Where Do I Go from Here?

Isn't it always the way that once you've gotten one HUGE problem under a semblance of control, another rears its ugly head? My husband and I just received a new lease on life......and now I have to figure out what to do about work.

I had a very honest-and very upsetting-talk with my boss on the phone yesterday after we'd gotten the great news from the university hospital about hubby's stage IV pancreatic cancer being treatable after all. Frankly, I'm shocked that all this emotional whipsawing hasn't triggered my bipolar illness-I feel like I'm on the rollercoaster ride from Hell-but my daily gut-checks tell me that I'm only experiencing the normal ups and downs associated with major life changes. Which is a good thing, even as uncomfortable as it is. Read More

Visitors that are drinking in patient rooms...What do I do?

Recently we had a patient who was not expected to live more than a few days, and she was actually dying from cirrhosis of the liver, brought on from years of alcohol abuse. Her visitors actually brought alcohol to the room and were drinking, acting out loudly and causing a huge commotion during visiting hours while other families were also having visitors. So, what would you do? Read More

Every mom, dad, sis, uncle believes they know better than the nurse...

Every now and then we get someone who thinks they know better than us. They read it on the Internet so they know what is best. They seen it on TV so they know what is best. Has this happened to you? How did you handle it? Please share your stories and tips below. Read More

Have we lost the "art" of nursing?

As a member of the "aging baby boomer" generation, I have often wondered where has the "art of nursing gone"? There is little doubt that medical science is an integral part of nursing. However, it is often difficult to see if the "art of nursing" is practiced. In fact, I find myself asking if this unique art has been lost. Is it being taught to nursing students in the 21st century, or is it simply a lost art? What is the art of nursing, you may ask? Simply put, in many ways, the art of nursing has to do with the logical and common sense approach to nursing. Read More

New NICU nurse seeking advice!

I just accepted a position as a NICU nurse! I have been doing hospice for 3 years but finally got the opportunity to pursue my dream as a Neonatal Nurse and I absolutely can't wait to get started. However, seeing as my experience is primarily geriatric, I am scared to start a completely different type of nursing. The hospital I will be working of offers a 13 week training program in which they will teach me all I need to know but I would like to prepare prior to beginning the new job. I was wondering if anyone had any tips and/or resources they would be willing to share with me to prepare me? Read More

Handling a central venous line port

I have a few doubts lurking in my mind regarding the handling a CV line port during IV administration for which I could not find satisfactory/consistent answers by searching. Hence I'm asking them here.

1. Is hand hygiene and a 'no touch technique' of the ports sufficient or is a sterile glove mandatory prior to every use of the port?
2. Is cleaning of the ports with an alcohol/chlorhexidine based antiseptic solution mandatory before every use of the port?
3. How can the cap (which has been removed from the port for an IV infusion) of the CV line port kept sterile till the IV infusion gets completed? Is it safe to use it again or a new cap is required after each infusion?
4. Is it the usual practice everywhere to have the individual lines (lumens) of the CV line (for example the three lines of a triple lumen catheter) 'dressed' with a sterile gauze pack? Not doing so makes the lumens gets separated in different directions and sometimes they get contaminated by reaching unsterile areas like the hairy chest.

Read More

Warm Fuzzies Story

You were one of two patients I had during the start of that early week in January. Your story wasn't unlike many others I've read, but little did I know how much your recovery would impact me in the months to come. Everyone needs a friendly reminder now and then of why we do what we do- here's mine. Read More

Please tell me why you dreamed of being a nurse from a young age

I love being a nurse! However, I am that nurse who did not dream of becoming a nurse as a child. Even when I worked in the nursing home (a job that I loved), I swore that I would never be a nurse!

It was not until I was older in college that I met a nurse that inspired me through her nursing philosophy of life that I knew that this was the career for me! She was absolutely right! Nursing has become my adult dream!

What I would like to know is your story or the reasons why you knew you wanted to be a nurse from a young age? Read More

I'm presenting at a national conference!!! Help!

In addition to my work as a staff RN, I do research into all things night shift related. My MSN capstone is being published later this year in a peer-reviewed journal.

Anyway, I have submitted several abstracts to national conferences - and I actually got accepted to the Nursing Management Congress, 2013 in Chicago next month! It's a poster presentation, and, while i realize I will not be speaking to the group, I will be able to put myself and my research 'out there' to a much wider audience.

Any of you who are experienced in this sort of thing- I beg your advice. Anything you can share will help me. Wardrobe, protocol, networking tips - anything! Read More!

How critical is your ICU?

In my shiny new MICU job, excited to be taking care of some crazy sick patients, and... I signed my two year contract before ever being on the floor. I was in critical care classes prior to then. Now that I'm having shifts on the floor, more than half of the patients in the unit can look up and wave at me when I'm walking by. I'm honestly confused. In the ICU I did my preceptorship in, it was a pretty common saying that once they woke up and could recognize there were other people around, they weren't ICU material anymore. Now I'm working somewhere with a ton of walkie-talkies who are somehow ICU material. This isn't a tiny hospital so I'm really surprised at the low acuity of the ICU patients. Where are my sick people? I am frustrated with the unit and with myself because I moved several states away for this job, thinking it was my dream job, and so far it has not been what I wanted. I got offered a med-surg position in my former state, and now I'm thinking I should have just taken it if this is the "ICU" experience I'm going to get where I am. I'm pretty sure I had sicker patients in some of my med-surg clinicals than I have now. I wish I'd shadowed here beforehand, but it's obviously too late at this point. I don't have the money to break this contract so I'm stuck.

I'm just wondering how common all of this is. TL;DR - how sick are your ICU patients? Are they typically crazy ill with a million drips, or are they just glorified med-surg that have no business really being in an ICU? These patients aren't overflow, by the way... they really are "ICU" patients. Read More

Chest Tubes and Tidaling

I had my first patient with a chest tube the other day, to drain peritoneal fluid. The tube was not hooked up to suction. I noticed there was no tidaling of the float ball. I informed my colleagues and neither of them thought this signified an occlusion. They argued that it would only tidal if there was a pneumothorax. Everything I have read about chest tubes has said that a tube that does not tidal signifies an occlusion. Is this incorrect? Read More

Learning to navigate the insurance companies

Up to this point I haven't been paying much attention to the reimbursement side of things, but I realize that to support my own professional development I need to become more aware of things like what the reimbursements are for various codes/procedures, what drugs/treatments are or are not covered by particular insurances, etc. How do you get this information? I don't do billing and don't have access to the books. I know what the list price is for each CPT code but I don't know what they actually get from the insurance company. Read More