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Asclepius posted:Why would you zero an EVD transducer every hour? That's just asking for ventriculitis. Zero is q4h, level and empty an unclamped drain is q1h.
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Apr 25, 2012 23:53
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Nurse Fanny posted:Y'all would have a blast with a Continuous Renal Replacement Therapy patient. I'd rather be doing crrt patients, as they're 1:1 here.
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Apr 25, 2012 23:54
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Private Label posted:Looks like it was the patient's spouse who hooked the patient back up. THAT'S WHY you always ask for help with medical equipment instead of trying to be like Dr. House or some other show you've seen on TV. Maybe some of my former crazy families can learn from that one. (actually, a good chunk of those stories come from families loving with equipment) Yeah but there was a large portion of nurses hooking up IVs to trach cuffs. And the reason why we were being shown the package is because an associated hospital had a patient die when a nurse hooked the patients peg tube feeding to her CENTRAL LINE. 
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Apr 26, 2012 04:13
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Baby_Hippo posted:Yeah but there was a large portion of nurses hooking up IVs to trach cuffs. And the reason why we were being shown the package is because an associated hospital had a patient die when a nurse hooked the patients peg tube feeding to her CENTRAL LINE. BP Cuff to IV Line and PEG to Central Line - how are those connections possible without some strange MacGyvering? IV to trach cuff is the only one I suppose would work without an issue and at least that's non-lethal.
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Apr 26, 2012 16:46
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TheFarSide posted:Q2H. "Safety Checks." Involves which ID bands a person is wearing, what signage might be in a room (difficult airway, no blood products, fall risk, yadda yadda), side rails, assisstive devices, etc. Luckily beyond your initial assessment, there is an "unchanged" option. The worst thing about technology today is that there is no unifying solution to flow tall these values from different machines into your charting program. Also for whatever reason, I'm entirely uninterested with neuro stuff. I'm looking to get into a cardiovascular ICU in Portland, maybe OHSU. Or maybe a general one, I'm not sure. I'm just starting to look around for what the best hospitals in the area are. If anyone has advice on that, it'll be appreciated.
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Apr 26, 2012 17:26
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I'm seeming to notice a cardiac OR neuro grouping forming in my AANP program. The ED-leaning people will do anything, and I'm kind of like that, but I wish I could avoid cardiac stuff. Too bad stroke overlaps with cardiac and diabetes and everything else enough that it's unavoidable. That being said, I love the look on their faces when I talk about 23% hypertonic saline. TheFarSide: Interesting you mention HHH as I just finished a neuro ICU rotation myself and they've dumped it where I am - down to Hypertension only, with euvolemia. Now for messing with, I'm sorry, optimizing the mannitol/hypertonic infusions...
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Apr 26, 2012 18:03
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Seven Five Nine posted:The worst thing about technology today is that there is no unifying solution to flow tall these values from different machines into your charting program. The ICU I went to at Buffalo General had software that could pull all the data from the various machines and put it in the chart, and it was the same EMR they used throughout the hospital.
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Apr 26, 2012 19:52
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JAF07 posted:The ICU I went to at Buffalo General had software that could pull all the data from the various machines and put it in the chart, and it was the same EMR they used throughout the hospital. Oh hello Buffalo nursing goon! That's interesting, I've been doing my clinicals at Buffalo General all semester and did not know this. I haven't been in the ICU though, just med-surg and psych. We really haven't had much instruction as to the EMR system; we can document assessments and use Kaleida Scope, but that's about it.
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Apr 27, 2012 04:29
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My hospital is trialing this new thing called the Neuron on another floor, basically it hooks up to the Dinamap vital signs machine that the techs use and imports the info from the machine and exports it into the EMR. It would be nice if it actually worked half the time though.
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Apr 27, 2012 09:30
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Enigmatic Troll posted:Different strokes. One good thing I can say about my job is that I've never had to wipe anyone's butt since school. But in psych you don't always have to deal with straight-up crazy - I ended up in a niche working with winos and drug addicts more (and tend to like these patients better - but it's still dealing with crazy folks - they're not doing what they're doing because they're sane). I've only been doing this three years, but the acuity does seem to be getting worse - we're getting crazier folks who are more medically compromised. I don't know if that's because the economy is going south and people can't afford their meds or if people are just engaging in more bad habits in general. Another nice thing about my job is that every night I learn from the patients a new way not to lead my own life. I am working on the admissions floor now, and most of my patients seem medically compromised as well. Then again, my patients really are quite crazy. Highly paranoid, bipolar, borderline personality disorder, etc. Most are schizophrenic. And I haven't wiped an rear end (or wore scrubs) since nursing school.
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Apr 27, 2012 15:47
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roboshit posted:My hospital is trialing this new thing called the Neuron on another floor, basically it hooks up to the Dinamap vital signs machine that the techs use and imports the info from the machine and exports it into the EMR. It would be nice if it actually worked half the time though. That sounds amazing! How does it know which patient is which though? Does the tech have to scan them?
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Apr 27, 2012 17:08
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ApplePirate posted:Oh hello Buffalo nursing goon! That's interesting, I've been doing my clinicals at Buffalo General all semester and did not know this. I haven't been in the ICU though, just med-surg and psych. We really haven't had much instruction as to the EMR system; we can document assessments and use Kaleida Scope, but that's about it. Haha wow, didn't know there were other Buffalo goons lurking in this thread. When I was shadowing in the ICU, the nurse I was with was one of the people designated by the company to train the entire hospital (and I think the rest of Kaleida) on its use, so she knew the software in and out. Consequentially, she's also the only nurse I saw using it effectively. To be fair though, my trips to Kaleida hospitals usually coincided with that facility's switch to EMR so all the nurses were freaking out.
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Apr 27, 2012 19:12
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Baby_Hippo posted:That sounds amazing! How does it know which patient is which though? Does the tech have to scan them? Yeah, it comes with a scanner and we scan their ID and it wirelessly brings up all their info.
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Apr 27, 2012 23:49
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Man, feeling really cro magon with the newspaper spreadsheet flow charts we use. Only digital thing we have are the centralized monitors and vent which we copy down anyway.
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Apr 29, 2012 10:58
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The unit I'm doing my preceptorship on just got the Capsule Neurons also. The staff are about 50/50 split on their usefulness right now. They can scan the patient to get their data, but the staff, instead of being able to scan themselves, have to log in with a username and password that's laborious to type in. Then, the transmitted data doesn't include all the details (O2 via NC, non-rebreather, etc) so the CNAs need to sit down and add all the data anyway. I'm so spoiled when it comes to EMR. Every hospital I've done a rotation at (except one) had EMR so I'm really good at using them. Only place I had to paper chart was during mother baby. The flowsheets weren't that complicated but I was absolute crap at doing narrative. I'm also really bad at deciphering the doctor's handwriting and am really greatful that the clerks know what they're doing. 
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Apr 29, 2012 19:47
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I have a HIPAA-related question. The job I have now involves me doing home health care a few nights a week for one person. When I leave this job, future employers will ask me what I did for this person. The problem is that this person lives in a very small town and has parents that are very well known. If I explain what I did, even omitting names, its going to be very easy to figure out who I was caring for. Is this going to be a HIPAA issue or does HIPAA require me to basically not name any names, and if someone deduces the patient that's not something I can really be held accountable for? I just want to impress upon any future employers that I do regard HIPAA very seriously.
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Apr 29, 2012 20:46
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Step 1: Figure out if potential employer / interviewer cares more about HIPAA or your experience. Step 2: Cater your answer to that.
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Apr 29, 2012 21:01
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Limiting your response to: providing home health care in X way X times a week isn't a HIPAA violation, it's more of a job description. Don't disclose any PHI and reiterate that you value HIPAA for what it is.
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Apr 29, 2012 23:26
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Hellacopter posted:I'm so spoiled when it comes to EMR. Every hospital I've done a rotation at (except one) had EMR so I'm really good at using them. Only place I had to paper chart was during mother baby. The flowsheets weren't that complicated but I was absolute crap at doing narrative. I'm also really bad at deciphering the doctor's handwriting and am really greatful that the clerks know what they're doing. Amen to that. My pervious hospital had everything electronic except the doctor's notes. And those were the things that killed me. I can't count how many times I would run up to a clerk to have them decipher what the doctor wrote. God bless clerks:
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Apr 29, 2012 23:53
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Oxford Comma posted:I have a HIPAA-related question. The job I have now involves me doing home health care a few nights a week for one person. When I leave this job, future employers will ask me what I did for this person. The problem is that this person lives in a very small town and has parents that are very well known. You could also change small details about the story that don't even really matter but would prevent them from figuring out who it is. Private Label posted:Amen to that. My pervious hospital had everything electronic except the doctor's notes. And those were the things that killed me. I can't count how many times I would run up to a clerk to have them decipher what the doctor wrote. On my floor I do all three tech roles, unit clerk/monitor tech/floor tech but by far the hardest thing I do is interpreting the MD's lovely rear end handwriting. 10+ years of education and you'd think they would be able to write like a normal person. I'm getting better at it but every once in a while a nurse will drop a chart on my desk with an order that says exactly that. At least we're going to switch to a physician order entry system later this year so we won't have to deal with it. Hellacopter posted:The unit I'm doing my preceptorship on just got the Capsule Neurons also. The staff are about 50/50 split on their usefulness right now. They can scan the patient to get their data, but the staff, instead of being able to scan themselves, have to log in with a username and password that's laborious to type in. Then, the transmitted data doesn't include all the details (O2 via NC, non-rebreather, etc) so the CNAs need to sit down and add all the data anyway. roboshit fucked around with this message at 07:20 on May 1, 2012 |
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May 1, 2012 07:18
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Really general nursing jobs type question: I applied for my schools nursing program. It's a pretty competitive program, but an advisor told me a week or so ago that it would be "highly unlikely" if I didn't get in. I was thinking about jobs. Getting ahead of myself, sure, but why not. I live in Ohio and one thing I've always said the past few years is gently caress this state (mainly gently caress winter in Ohio, but I digress). When the time comes and I graduate, how hard is it to get a job out of state? Is it something employers would look at and say, "This dude lives halfway across the country, throw him in the trash." Basically, I know people get jobs out of state. Is it as simple as 1( Accept job 2) Take a test for that state But I mean, if I get a job right out of school here in Ohio I'll definitely suck it up and get a year in to open up some opportunities. Hell, maybe I'll end up loving the job and the people and never leave. I'm just daydreaming. e: Basically, my dream is to get my year experience, pick a handful of regions in the country I'd love to live, and just start throwing resumes out and hoping one sticks. Maybe try a traveling nurse agency out for awhile (Are these legit opportunities or are they just a pain? Somebody told me about it recently and it sounded pretty interesting)
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May 2, 2012 03:02
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CancerStick posted:Really general nursing jobs type question: I think your chances are actually a lot better if you're willing to move. We were talking a few pages back about how some states are hard up for nurses, and offer bonuses if you stay and work there for a year. The towns may not be the most exciting places, but you can start at a hospital full-time. You have to first get your RN license in one state, then apply for reciprocity. Google "[state name] RN reciprocity" and most will have instructions on how to do it. Usually you pay a fee, send a copy of your license and your transcripts, and you get awarded a license for that state. I don't know anything about travel agencies firsthand, but I've heard good things from some nurses. The money is apparently very good, but in my area at least, travel agencies want 2+ years of experience before they will take someone on.
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May 2, 2012 04:08
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leb388 posted:I think your chances are actually a lot better if you're willing to move. We were talking a few pages back about how some states are hard up for nurses, and offer bonuses if you stay and work there for a year. The towns may not be the most exciting places, but you can start at a hospital full-time. Thanks! I would definitely be willing to move, but will just have to see where the market is in a few years. I plan on trying to get a job in a hospital about a year into the nursing program and seeing what kind of advantage that would give me as long as I am not a worthless sack. If I can't get that job, or the job doesn't give me a future opportunity, then moving straight out of school isn't a problem. e: bummer about the 2+ years for travel agencies. But that does make sense, less time holding my hand for a short temporary job anyways. Would have been a great way to get a taste of other parts of the country and see where I would want to settle.
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May 2, 2012 04:38
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CancerStick posted:I was thinking about jobs. Getting ahead of myself, sure, but why not. I live in Ohio and one thing I've always said the past few years is gently caress this state (mainly gently caress winter in Ohio, but I digress). When the time comes and I graduate, how hard is it to get a job out of state? Is it something employers would look at and say, "This dude lives halfway across the country, throw him in the trash." Basically, I know people get jobs out of state. Is it as simple as 1( Accept job 2) Take a test for that state I'm in Ohio and just graduated. A couple of my friends from my class lined up out of state jobs pretty easily. They were actually some of the first from our group to get job offers. Unless you get a foot in the door somewhere as an aide or tech, I'd probably say it's easier to get a hospital job out of state.
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May 6, 2012 19:53
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Don't come to California. There are no jobs.
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May 6, 2012 21:12
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Nurse Fanny posted:Don't come to California. There are no jobs. Ugh. I'm calling up some of my coworkers travel reps in the hopes I can get a travel job somewhere nice before I have a year of experience. I'm burning out of tolerance for this city quickly.
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May 7, 2012 00:18
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Seven Five Nine posted:Ugh. I'm calling up some of my coworkers travel reps in the hopes I can get a travel job somewhere nice before I have a year of experience. I'm burning out of tolerance for this city quickly. Hang in there! When is your year up?
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May 7, 2012 02:49
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Any goon nurses here from Seattle? I'm currently working in a MICU in Texas, at a hospital that's catching all of Parkland's poo poo as the community tears it apart. (Parkland, in case you've missed it, is the county hospital in Dallas, with massive underfunding and understaffing that's led to lovely patient care, staff burnout, and demonization by the entire community due to CMS fails.) Since Parkland's come under fire, patients that would normally go to county instead get routed to my hospital, and things are getting ugly. Don't get me wrong, I take care of some sick-rear end motherfuckers and I love it, but as a new nurse-- one year of experience in critical care-- I don't want my license to take the hit when my five-day weeks and excessive patient load catch up with me. My husband's side of the family is entrenched in Seattle, and I'm wondering... what's the medical environment like up there? Would I be able to get a job in critical care, or would I be destined for a decade in an LTAC? What's the trauma situation up there? I know Harborview is a coveted employer-- are there any other awesome hospitals worth checking into?
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May 8, 2012 12:21
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I finally finished my second block today! Now I have to wait until grades go up sometime tomorrow. It feels weird knowing school is over for three months; no studying, no care plans, no patient prep. How do I adjust to being a real person again? Luckily, a friend of mine has an in at a screening clinic, and I may be able to do some volunteer work.
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May 9, 2012 01:26
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This is a lecture week during our critical care fellowship and we got to spend the afternoon at https://www.medflight.com doing some simulator stuff and tour the helicopters/mobile ICUs. It was a good time. We also got our final rotation assignments before we are placed in our home unit, and I'm at the level 1 trauma hospital's ED, so should be a good final four weeks.
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May 9, 2012 23:56
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TheFarSide posted:This is a lecture week during our critical care fellowship and we got to spend the afternoon at https://www.medflight.com doing some simulator stuff and tour the helicopters/mobile ICUs. It was a good time. We also got our final rotation assignments before we are placed in our home unit, and I'm at the level 1 trauma hospital's ED, so should be a good final four weeks. What city is this in?
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May 10, 2012 02:28
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Anyone know about the nursing jobs in Florida? Specifically the Sarasota FL area, or any towns/cities on the gulf coast? I currently work in a Washington DC suburb at a decent hospital but I am unhappy with the high cost of living and the real estate prices in the area. Florida looks like it has great opportunities real estate wise and an overall lower cost of living. Keep in mind I'm talking suburbs, not Miami/Orlando/Keys etc. Basically I'd liked to know if there are any nice towns with decent hospitals that treat their nurses well. I had a rough time after graduating from nursing school in 2009 (pretty much at the brunt of the financial crisis) and ended up at a job that abused me quite harshly. I had no choice but to stay or pay a $7,500 bounty if I left before working there for 2 years. My two years is up this June and that sour taste has never really left my mouth.. I know that I need a change. I know that I have made my bed and now I have to lay in it but I am overall very unhappy with my career choice thus far. Perhaps it is the area I work in (lots of African and foreign nurses) or the specialty I have been in for the past two years (Acute Rehabilitation) but I literally hate my job. The problem is that I still have $11k owed to Sallie Mae for my undergrad and I can't fathom going back to school to assume more debt without paying that off first. I am also not keen on going back to school to have even more responsibility thrown at me and not be well compensated. I am also incredibly good at my job, I am an excellent nurse and my customer service is second to none that I have ever met, and I am proud of this.. which also makes it difficult to leave the profession. It would be different if I hated my job AND I was horrible at it. I don't know, maybe living somewhere else and actually working toward owning a home and building a life would knock some cynicism out of me. I really do need to find a way out of direct patient care that isn't a management or educator role but still using my nursing education. I looked into Nursing Informatics but gently caress going back to school to learn pointless things when I could already do the job with my eyes closed. It sucks that it's such a saturated field already, the people I have talked to in the Informatics department at my hospital are saying that you NEED a masters degree to even be considered for entry level nursing informatics these days.. If only I could return to the days when Nurse Informaticists were grandfathered into the postitions because no one else wanted them or knew how to use a computer.. ghostwriter80 fucked around with this message at 06:01 on May 10, 2012 |
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May 10, 2012 05:58
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Hughmoris posted:What city is this in? Columbus, Ohio.
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May 10, 2012 11:03
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I just submitted my application to my school's nursing program. I'm very excited but at the same time this is not going to be a fun 6 weeks waiting for a reply if I get accepted or not.
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May 10, 2012 22:16
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breebellucci posted:Anyone know about the nursing jobs in Florida? Specifically the Sarasota FL area, or any towns/cities on the gulf coast? Why not a metro area in Florida? Orlando and Miami are hiring lots of nurses, especially with experience (and even a bunch straight out of school). I don't know about Tampa though. C'mon down and buy a previously $500k house for $200k. We don't mind.
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May 11, 2012 03:20
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breebellucci posted:Anyone know about the nursing jobs in Florida? Specifically the Sarasota FL area, or any towns/cities on the gulf coast? My friend has worked at a variety of hospitals in the Orlando area and she says how nurses are paid and treated is poo poo and the cost of living is horrible, up there with California.
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May 12, 2012 19:55
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Baby_Hippo posted:My friend has worked at a variety of hospitals in the Orlando area and she says how nurses are paid and treated is poo poo and the cost of living is horrible, up there with California. I agree that Orlando isn't the place to go if you want to make a fortune as a nurse, but I don't know how someone could think the cost of living is horrible. I don't know where your friend has worked, but rent and home prices are at least 1/3 to 1/2 less here compared to the northeast (I don't know what CA prices are like) and while you won't be making a ton of money the pay for nurses isn't that bad. Keep in mind that Disney employs 50,000+ people here and most are paid little above minimum wage, which pretty much drags down the pay for everyone else in the area. What would you consider poo poo pay? How you're treated really depends on where you work. My wife has worked in 2 different Orlando Health hospitals. One had horrible management and she absolutely hated it. The other is run very well and she loves it. I'm a nursing student here and I've asked nurses on my clinical training floors how they felt. Most love working there, some don't and want to move to other departments.
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May 12, 2012 20:55
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She told me that rent in her area is comparable to California (800 - 1000 for a one bedroom), while RNs make a third of what they would make in California, and have a higher patient load. Which is probably why it's so hard to get a goddamn job in California. 
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May 12, 2012 22:49
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Baby_Hippo posted:She told me that rent in her area is comparable to California (800 - 1000 for a one bedroom), while RNs make a third of what they would make in California, and have a higher patient load. Which is probably why it's so hard to get a goddamn job in California. I guess the rent price is based on the area, we pay $1000/mo for a nice 2 bedroom. I always though CA would cost more for rent. When we lived in Salem, MA, we paid $1500/mo for a one bedroom, so $1000/mo for a 2 bed was a bargain. Houses are cheap though, (we've got one of the highest foreclosure rates in the country) brand new townhouses in the medical city area are ~$150-200k. What is RN pay in CA like? Base pay rates start around $22/hr for an ADN RN I on AM shift with shift differentials up to $7/hr for working at night and $3/hr for weekends. Shifts are typically 12hrs, so a lot of RNs will take an extra day of OT for more money or go pool at another hospital. Also, Floridians don't pay state tax, so figure that in your earnings as well. CA got some law passed to limit patient load right? That would be nice. That varies from floor to floor, but I haven't heard of anything more than 5 per nurse on a med-surg floor, 3 per in PCU and 2 per in ICU. I'd actually be interested to hear what it is like in other areas as well.
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May 13, 2012 02:20
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The Antipop posted:CA got some law passed to limit patient load right? That would be nice. That varies from floor to floor, but I haven't heard of anything more than 5 per nurse on a med-surg floor, 3 per in PCU and 2 per in ICU. That's what they tell you, and it might be true on a good day but I would love for it to be a law  We've all had days with 7,8 patients.. I remember one night shift I had 11 (in an acute care setting mind you with an orintee and an LPN.. ) Nursing can be really hosed most of the time. I'm three years in and I'm already burnt out and cynical, I need a change bad. Anyone can vouch for homecare jobs or desk jobs with insurance companies and things like that away from the bedside? Florida is catching my eye because of the lower home prices and the tropical climate, I would love to live near the gulf.
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May 13, 2012 04:04
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