Bedside critical care nurse, first-time adult, nursing blog author, and expert Pinterest-recipe ruiner.

 

jstaki asked
As a nursing student, were you allowed to start IVs, do blood draws, etc? I just completed my 3rd year in nursing school and I haven't been allowed to do these procedures in the facilities I was at. It makes me nervous for the real world because I haven't been trained in doing them!

I was allowed to do that but didn’t get a ton of experience.  I kind of felt like I started all over once I got into the real world because they had different IV’s and whatnot.  Also, they had a different policy/procedure.  It had been months since I’d done any procedural stuff once I started anyway, so you will have to re-learn it in a sense.  So don’t freak out about it, try to be familiar with it and take opportunities when and if you get them.  I know people that graduating without ever starting an IV or placing a foley and they’ve done just fine :-)  You’ll be great!

ER Time Management

ER time management question:


I’m a CCU/ER float. ER is totally different as far as time management compared to floor nursing. In my ER we have 36 beds and 2 trauma rooms with level 2 trauma cert. We certainly aren’t the busiest but we can certainly get hopping. Like with all nursing tasks you always start by prioritizing. When I first start my shift I take report on any existing patients mentally making a note of who I should see first. Once report is done I go and do a focused assessment on the top priority patient. Unfortunately you don’t always have time to do a complete head to toe right when you get there. Once you’ve laid eyes on all your patients snagged some vitals and asked about pain and nausea check your orders for what meds they can have. If none go find their doc and get some orders. After addressing a focused assessment, pain/nausea and obtaining a recent set of vitals I go through all my orders and complete any that are still hanging. Once you’ve done all that continue to stay on top of any new orders, obtain a set of vitals at least every hour (depending how critical the patient) and always reassess pain. That’s the flow that works the best for me but like most of nursing there is more than one way to skin a cat.

thisfuturemd:

"Head trauma causes a subdural hematoma by tearing some of these bridging veins. Notice how thick the dura is and how delicate the bridging veins are in the image." - from OnSurg. #neurosurgery #neurology #humanbrain #brain #surgery #medicine

thisfuturemd:

"Head trauma causes a subdural hematoma by tearing some of these bridging veins. Notice how thick the dura is and how delicate the bridging veins are in the image." - from OnSurg. #neurosurgery #neurology #humanbrain #brain #surgery #medicine

Did your patient French kiss my patient again??

Words I never thought I would have to say to a resident. (via md-admissions)

Anonymous asked
Do you have any suggestions for nurses managing their time in the ED?

The only experience I have in an ED was in a really, really small ED.  So small that even when they were full, they’d have less patients than I did at one time working nights at my first job.  I don’t have any time management tips for that speciality.  Sorry!  Are there any phenomenal ED nurses out there with good time management skills!?

downwardspiralintooblivion asked
Also. Hows psych & peds? Both clinicals and the lecture portion?

Psych was easy for me and most of my classmates.  Although it can be challenging for some people.  Mental health classes in nursing are looked at as bit easier (typically).  It’s not a black and white as med surge.   It’s less memorization and more about understanding concepts.  the clinical portion is really interesting.  I had clinicals in a group home for schizophrenic patients, went to an AA meeting, went to anger management classes, a prison, and an outpatient center.  It was really interesting to me.  Again, it was a bit easier but it is very different from the rest of your clinical experiences.

Peds was more interesting to me but what’s difficult about that in lecture is remembering the age ranges for certain things.  There’s all that developmental stuff that you don’t have to worry about with adult.  Also dosages for meds aren’t as straight forward.  You have to calculate everything.

Peds clinicals were interesting.  The kids were usually great, but the parents are a different story.  They’re also your patients. You have to teach and educate them and you have to convince the kids to let you do what you need to do.  Some parents aren’t so hot about students or new nurses taking care of their kids.  They have a LOT of questions and are usually worried sick themselves (understandably so).  You have to know your stuff because I remember them quizzing me over and over again.  

It also sucks when you have to inflict pain on them (IV sticks, blood draws, etc) but you just have to.. ugh did not like that.  I remember basically all of the kids on the unit had RSV and I got used to taking care of those patients. So make sure you know about that!

Some people adore peds.  I however did not. It was no bueno for me. I love geriatrics :-)  I know, I’m a weirdo but I love thankful old ladies.  Theory is a lot of memorization and figuring out appropriate teaching approaches for specific age ranges and whatnot.

Good luck!

downwardspiralintooblivion asked
Ever taken the HESI in nursing school? Ive got to take the Med surg & OB HESI these upcoming weeks.... Worried about them!!

I never had to take the HESI but have had people ask me about them. We did ATI in my nursing school.  Those were tough but do-able.  I’ve heard about the same about the HESI. Sorry I wish I could give you more guidance on that!