I feel that anytime you float to another unit, there’s some anxiety because you’ll call different providers, things are in different places and there’s usually a different patient population. Since I came off of probation, I have to float now.
My first float was at the SICU. While there, I had 2 medical patients, so at least I was used to that. Here are a couple of things there made me feel comfortable.
- A list of numbers for the MLPs (the critical care PA, vascular PA, and surgical PA), respiratory therapist, med cart code, nurses lounge. If the float unit is nice, then they will already have these on a sheet prepared for you. If not, then ask the charge nurse or the secretary for this information.
- Bringing my own SBAR form. The float unit may not have the same form as your home unit.
- A quick orientation of the unit. Having an idea of where everything is will give you the tools you need to succeed!
- Remembering names. Introducing yourself to the nurses next to you and to the axillary staff and remembering their names will make it much easier to get help (or help them!) and get the job done.
- Ask questions. As always, feel comfortable asking questions! Anything from, ‘Where can I find a 3cc syringe?’ to a patient’s deteriorating condition to ‘can I have a boost?’
Although I had a pretty good first float, I’ve heard other stories from my coworkers stating that they had too many patients. You should be able to get the same ratio of patient population as you would normally. Good luck on your first float! 🙂
Has it been difficult for you to find your first nursing job after finishing nursing school? Recruiters often say, “You need to get a year’s experience.” How are you supposed to get the year’s experience if no one is willing to take a chance on you?
The most impressive thing that I did to beef up my resume was volunteer! I had always wanted to go abroad and help those less fortunate. Luckily for me I was able to get nursing experience that helped me professionally as well!
I tried to use my license in any way possible, even if I wasn’t getting paid for it. During my future job interviews, this showed that I was motivated to get my first nursing job even though it was difficult.
Volunteering on a Navy Hospital Ship
I volunteered for five months as a nurse through LDS Charities on the USNS Comfort, a Navy hospital ship that travels to Central and South America giving free services to the local people. The main activities I helped with were surgeries onboard the USNS Comfort; medical clinics with general practitioners, pediatricians, optometrists, and dentists; and education. Education topics included neonatal resuscitation, public health, water purification, amongst other health issues.
One of my most rewarding experiences was shared by LDS Charities: “In Colombia, Lenberg helped 12-year-old David with massive burns on his hands, face, arms, legs, and back; he also had a massive infection on one hand and contractures (shortenings of muscle, tendon or scar tissue that cause deformity) in his fingers on the other hand. Lenberg said she tried “so, so, so hard” to get the boy in for surgery the next day, but was unable to do so because the surgical area was overbooked.
To Lenberg’s surprise, David was the first patient admitted the next morning for surgery.
‘My eyes instantly welled up with tears because I was so thankful that this little boy was able to get his much needed surgery done,” Lenberg said. “I don’t know that I have ever felt so much intense gratitude in my entire life as I felt in that moment. David’s dad said that I was David’s angel because I had tried so hard to get him the surgery that he needed. It was such an amazing experience to feel such intense love for someone that I had only know for such a short time.’ ”
What an amazing and rewarding experience this was for me! One of the other most prominent charities to provide volunteer nurses on the USNS Comfort was Project Hope. Project Hope provides many opportunities to educate those less fortunate in foreign countries; the next trips are scheduled for Haiti, the Dominican Republic, India, and more.
Another organization called Operation Smile is one of my favorite charities! They provide free surgeries for children in need of cleft palate or cleft lip repairs. Their mission trips are less than a month in length; they travel internationally to countries including China, Morocco, and Russia.
If you want to help with disaster relief in the United States, the American Red Cross is a good option for you. Other local opportunities can be found if you look search around your community. Talk with your public health department or local nursing homes.
If looking for volunteer opportunities lasting for longer amounts of time, the US Peace Corps provides “life defining experience in more than 60 countries.” These assignments last for approximately two years. Nurses volunteer in a variety of ways, but most missions revolve around educating and empowering people in poor communities. The Peace Corps Response is another alternative for nurses who cannot volunteer for quite as long. These assignments are approximately 3-12 months and are for nurses who have 10 or more years experience.
There are so many neat opportunities for medical professionals! These experiences will not only help you to grow individually, but it will help your resume to grow as well. If you are feeling stuck in your nursing situation whether it be as a new graduate RN or as a charge nurse of the same unit you’ve been at for a while, then try volunteering for a change of pace! Nurses change the world one person at a time!
Courtney, RN from www.fromnewtoicu.com, guest posts to talk about her struggle getting her first nursing job and how she overcame it – she volunteered! Now, she works in the medical ICU. I personally thought that this was a great idea and wanted more people to know about it.
Her website is great too — its goal is to make finding nursing school information as easy as possible. This will make it faster for both high school students and high school counselors looking for nursing school requirements, such as the GPA requirements, tuition information, prerequisite classes and more. Go check it out!
When you graduate from nursing school, do you ever wonder where you should put your new credentials? And what order it should be in? I know that I wanted to know!
First things first. As a nurse, you will have to get licensed first (this is your RN). After you work a year or two, you can then pass an exam to get your specialty certification (medical surgical nursing, etc – thus becoming a RN-BC). You can find the different certifications at the American Nurses Credentialing Center (ANCC). There are also Nurse Practitioner and Clinical Nurse Specialist Certification for who go back to school for their masters. Another national certification is the CCRN – Critical Care Registered Nurse.
According to the ANCC, the preferred order is:
- Highest earned degrees (BSN)
- Licensure (RN)
- State designations or requirements (FNP)
- National certifications (RN-BC, CCRN)
- Awards and honors (FAAN)
- Other recognitions (EMT)
So after you graduate and you pass the NCLEX, you want to write your title like this:
Your Name, BSN RN
And whenever you’re signing anything in the healthcare field, sign your name as such:
Your Name RN
Now you can be confident when you write your name.
While I did sign a confidentiality agreement not to discuss the specifics of the lab, I can briefly state that it was similar to being at work in the hospital. When you receive a patient, you do a Head to Toe assessment, and determine the next step in care. Is he stable or unstable? If the patient doesn’t respond to your care, what is the next step?
It’s exciting to be off probation now, considering that I’ve been on the unit since December 2013! Now I will have to float to the SICU or CTICU, stepdown, PACU and ER. I’m a little scared to not know everything is (again), but it should be ok!
In Off the Charts, the official blog of the American Journal of Nursing, it states that 71% of bedside nurses use Google to search for Evidence Based Practice to better their practice (and here’s how to do it better). However, how do you know about the quality of a journal? There are 100s of nursing journals. One of the best ways to evaluate a nursing journal is through the Impact Factor (IF).
The Impact Factor tells the reader that how often the articles in that journal have been cited in other journals. The higher the number, the better it is. On this website, it has links to nearly all of the nursing journals and has a impact factor written next to it, if it has one at all.
The American Journal of Nursing has a impact factor of 1.319, which places it at #18 out of all of the nursing journals for 2014. A couple of the ones I’m interested in are the Journal of Cardiovascular Nursing (1.431), American Journal of Critical Care (1.656), and Critical Care Nurse (1.077). While each article may not be the best, the journal as a whole tend to produce quality information.
Now, in order for these journals to make money, they charge for the articles. But there are a few ways to get them for free.
- Join the Nursing Association that is associated with the journal. For example, joining the Preventative Cardiovascular Nurse Association (PCNA) for $75 includes the Journal of Cardiovascular Nursing (normally $129/year) for free. Plus, by joining the PCNA, you’ll also receive other resources, discounts on meetings, etc. Another great organization is the American Association of Critical Care Nurses (AACN), which also includes the American Journal of Critical Care and Critical Care Nurse.
- Go to the Nursing Center. They have updated new and free journal articles. Even better, they offer a free journal for you to look through every twice a month.
- Go to your college’s library website. Part of your tuition goes into purchasing these journals for students to use (because they can get very expensive if you bought them on your own!). If you are attending NYU, go to library.nyu.edu, go under find resources, then click on journals. Or go to getit.library.nyu.edu. Be sure to log in to read the journals!
I hope that by understanding what the Impact Factor is, you can make better decisions on which Nursing Journals you should read or even buy. Maybe you’ll even join a nursing organization! Keep updated on the latest and greatest in this constantly evolving field. And share what you learn with other nurses. Maybe it’ll even make a difference.
He so in control, even when he’s ill
Demanding that the TV’s on
as he rolls into the new room
“Sir I need to make sure you’re breathing”
“No, the TV will keep my sanity”
Even when he can hardly breathe
Nothing’s my way
only his way
“But dad when you do it their way
you get better
and you do it your way
and you’re back in the hospital
So just listen to them”
No I don’t want that
then what do you want
I want what’s best for me
what is best for you?
I don’t know you tell me
let’s keep this on
He wants control, his decisions
because slowly but surely
he’ll lose one thing at a time
So he’s demanding
I get it
but what do I do?
How do I deal?
Just wait for 12 hours to be over?
For a number of reasons, we travel to a new state, such as Michigan, after we’ve already obtain our first nursing license. Since I plan on working in Michigan, I have to get my Michigan Nursing License first. Here’s how I’m doing it and the related costs.
Ease – Easy
Time to Invest – 2 days
Time to Completion – from 1 to 3 months
Total Cost Minimum / Maximum – $146.50 / $181.75
This does not include the cost of an envelope and stamp to mail. If possible, use credit or check to pay. Otherwise getting a money order may cost more.
Step 1 Go to the Michigan Nursing License website and download the RN by Endorsement Application. Fill it out, attach a check for the State of Michigan ($54 or for $10 more, you can get a temporary license first for those who currently have 2 licenses), and snail mail the form.
Step 2 Decide if you will get your fingerprints done in Michigan or Out of State. If done in Michigan, go to www.identogo.com. Pick a location, book an appointment (date and time — it’s suggested to schedule your fingerprints 7-10 days AFTER you’ve submitted the RN by Endorsement Application), fill out your information, and submit $62.50 with credit or pay at the site with a check. After your fingerprinting appointment, keep the Livescan Fingerprint Request Form and receipt as it will contain the TCN Number.
If done Out of State, go to your local police state, get a hard stock fingerprint card (in New York State, it’s $25), and mail in the fingerprint card WITH the Livescan Fingerprint Request Form (page 11) and check of $62.75.
Step 3 Have your nursing license verified through www.nursys.com. They will send the verification for you for $30.
Step 4 Wait for the State of Michigan to process your application. After about 3 weeks, you should receive a Application Confirmation containing your customer number, which you can use to check your status online at www.michigan.gov/appstatus. According to others on allnurses.com, if it’s been over 8 weeks, contact your local rep or senate with your complaint. Typically, they find that the application is completed shortly after that.
Step 5 If after 8 weeks, you can call them (I waited 25 minutes!) or email firstname.lastname@example.org with your TCN number that is found on it Livescan Fingerprint Request Form, and your customer ID number. They emailed me 2 days after stating that they found my fingerprint and they will forward it to the processor. 2 days after that, I got my license. I hope your experience is smooth.
I was about to ‘boost’ a patient up in the bed with a colleague and I noticed how strong she was. I hardly did anything! Later that night, a patient coded and she started CPR. I noticed that she could do it for such a long time with so much force. She’d take a break just for a few minutes before she took over again.
When I took over, I realized how little endurance I had. I was wiped out after a minute.
After the code, another colleague mentioned how she heard pumping noises right before the code was called. She knew that it was that strong nurse doing CPR.
After I went home for the day, I felt my abs hurting.
This made me think about all the strong nurses there are. Especially in the ICU. Especially her. So she’s my strong nurse idol. I want to be a strong nurse.
I bought new running shoes and workout clothes yesterday from Adidas. I haven’t had a sports bra since high school (I’ve been swimming instead). I have to build my endurance. Do free weights. Etc.
It’s time to be a strong nurse.
And I’m bringing my boyfriend along for the ride.
I’ve taken care of my fair share of intubated patients. But over the last 2 nights, I encountered something different. They went from calm to wild in just a few minutes. If the sedation was down, then I increased that. Normally it works pretty fast.
But it wasn’t so in this case. Both patients were ‘bucking the vent.’ One didn’t have a PRN order ready so for one I had my coworker help me get an order and prepare ativan. But in the meantime, I remember reading critical care nursing journals about the experiences of previously intubated patients. They said to always assume that the patient can hear you. They said that when the nurse talked to them about where they were, what’s going on, and what to do, in a strong confident voice, that the patients felt comforted by that. So that’s exactly what I did.
This patient kept biting down on the tube (which is a big no no because we don’t want a punctured tube!!). “You’re in the hospital and you’re very sick. I’m Jessica, your nurse. Right now you’re having trouble breathing so you have a breathing tube. I know it’s uncomfortable but you need this. Try to calm down and take slow breaths. Open your mouth. Your face is very red but calming down will allow you to breathe better.”
Once I said this, the patient did calm down and opened her mouth.
“Good, your face is looking better and you’re oxygenating better. We are going to turn you to the side to clean you because you had a little accident, ok?”
She was able to cooperate much more at this point. And this happened before giving the ativan. My coworker then came in, administered it (“we’re going to give you something to help you relax now”), and she was at peace again.
Even though she couldn’t focus her eyes and couldn’t follow simple commands, it seems as though what I said did make a difference.