The Unit

 My first week working in the ICU went great! Was it scary intimidating? Of course! Did I know anything? No well not really lol and that is OKAY! I have an amazing preceptor who is a great teacher and most importantly is impatient with me! My first day consisted mainly of learning the flow of things in the unit and how the day is run from 0700-1900... EKG prints, bedside report, assessment, medications, chart, rounds (with the Dr.'s or Surgeons), RE-assessment, other medications...you get the idea! I did administer medications, injections, hang tubing and started an IV. Now every now and then you can throw in an unexpected CODE BLUE aka "cardiac arrest/emergency" being called overhead, in which we have to respond to, but I don't respond to those til much further down the line after becoming ACLS (Advanced Cardiac Life Support) certified and gaining more experience but there you have it!! There is such a STEEP learning-curve in critical care. It really is a different language of nursing that requires lots of critical thinking and detailed assessments. This week I also attended new grad orientation, which was two days following my first day on the unit, which basically was a welcome to the hospital, these resources are available to you and this is how we do things yada-yada-blah. I'd like to depict my first week of being a new nurse in the form of gifs:

                           "How I looked walking into the ICU 
                                    on my first day"

Lesson learned: Scissors? CHECK! 

Stethoscope? CHECK! No lesson learned here!! 

Just excited I'm FINALLY starting my career and 

journey as a new ICU nurse! 

"How I looked signing my 2 year critical care new graduate residency contract"

Lesson learned: Easy lesson here..  

Don't break them or you'll PAY...

big time!

"Welcome to the ICU!"

Lesson Learned: We take care of sick 

patients..really.. sick patients!

   

"When my preceptor asks me a question and...

                ..my answer is completely wrong..         

 

..my face..

                  ..BUT..when I answer correctly!"

 

Lesson Learned: Be patient, you WON'T know it all 

starting out as a new grad RN..and you're not expected! 

What you can do is: learn, ask questions 

and learn some more!

"When there's family in the room and we're about to do a SBT on the patient...

...when they insist on staying..

...patient fails the SBT..

           ...family member's response after watching..

Lesson learned: Families don't understand how 

disturbing it is to see your loved on in distress until

after it occurs.. always, if possibe, have them exit the 

room if you know it is likely to upset them.

"Gowning up to walk into my isolation patients room and realizing I forgot something" 

Lesson learned: Work from clean to dirty, which means 

go into non-isolation rooms first and save the 

isolation rooms last.. and when you do, make sure you 

have everything you need BEFORE you fully gown up and enter.. 

if some items are questionable, leave them outside the room 

because once it's in..it's in to stay!

My "I didn't kill anyone today" dance!

                                Lesson learned: Overall, my first week was a success!
                                             Your day will not always go as planned..
                                              you will start off slow and task-oriented
                                           for the most part..BUT each day gets easier!

 (Disclaimer: The clinical suggestions, advice and recommendations described on sicunurse.blogspot.com are based on my personal opinions and are not medical advice. The content is for entertainment purposes only. I, surgicalnurse.blogspot.com, do not own, nor did I create any of the animations above. I did create the captions written above and below them, customizing them to my experiences along with learning tips I have found helpful in my practice).

Expectations

Well, the time has come and my first day is tomorrow! I am excited, nervous, anxious.. the list goes ON but tomorrow marks my first day on the floor "unit" as Registered Nurse!! ((ahhhhh!)). Fortunately, I am getting an early start since I was previously working at this hospital as a PCT/CNA and did my practicum on this floor ((practicum=chose this area to work in during my last semester of nursing school)). It kind of allows me to get my 'feet wet' and get a taste of what's to come! I will start at 0700 tomorrow and will not depart until 1900...yup 12 hours..but 12 hours isn't so bad because I worked the same shifts as a PCT/CNA. I'm sure that will all change with me working as an RN. It will surely take some adjusting and getting used to..but I am READY! As a PCT/CNA my duties consisted mainly helping with the patient's ADL's and assisting the RN with any additional tasks. Now, comes new responsibilities, different tasks, in-depth assessments to perform and sicker patients to overlook..((yesss! I love it!)). I'm so OCD and detailed oriented that working in this area of nursing CLICKS! One moment someone could be fine and the next thing you know a Code met ((an emergency)) might be called with a patients life in your hands...((my hands now!)) Whatever tomorrow brings I am ready for it! I'm going in tomorrow as a dry new nurse sponge ready to suck up as much ICU as I can! Wish me luck!

Tips on Passing NCLEX...your 1st time!

Who's afraid of the big bad "NCLEX".. from the time you start nursing school, you know what the future holds after passing all your classes and graduating..because the battle STILL isn't won yet. It's not over until you take that dreadful NCLEX and PASS. The NCLEX uses Complex Adaptive Testing (CAT) to administer the exam. CAT is a method for administering exams that merges computer technology with modern measurement theory to increase the efficiency of the exam process. Click here for more details on CAT and what to expect the day of your test!

Just recently, the NCLEX made changes to the NCLEX-RN which now consists of more SATA (select all that apply) style questions. The NCSBN reviews the test plans for both the NCLEX-RN and NCLEX-PN once every three years. The recommended changes to the 2013 NCLEX-RN Test Plan are based upon empirical data collected from newly licensed nurses, which can be found in the study published by NCSBN entitled Report of Findings from the 2011 Practice Analysis: Linking the NCLEX-RN Examination to Practice (ncsbn.org, 2015). You will never "feel" ready for NCLEX, let me tell you now.. I don't think anyone ever does lol the key is to believe in yourself and remain confident that you can pass.. I recently passed NCLEX ((last month on this day to be exact)) so you can do this! I just wanted to give a few tips below on what helped me pass NCLEX-RN on my first try. They worked for me, maybe they'll work for you too:

1. Don't start studying until AFTER you finish nursing school. I bought an NCLEX book my first year of nursing school with the idea that maybe if I study throughout, I'll actually feel "ready" for NCLEX when I graduate....NOT! lol--save yourself the trouble. Focus on finishing nursing school then study for NCLEX..you'll have plenty of time after you graduate--trust me!

2. Choose a NCLEX test book or prep class and stick to it. It's never a good idea to take on more than one study prep book or material. Find out what works for you and use that one method. Taking on many different methods can be overwhelming and will make you feel like you aren't retaining anything. For example: I purchased the Saunders NCLEX prep book, which was a great tool for practicing questions, in my opinion, but it wasn't what I was looking for content-wise. Saunders was  a studying aid that was more in-depth and I wanted to study something that was more succinct yet comprehensive with good test taking strategies ((my struggle)). I ended up going with the HURST review prep course because it did just that.. gave me a comprehensive review minus all the extra detail Saunder had along with great test-taking strategies. I'm not saying this is for you but find what is, and stick with it!

3. The NCLEX is all about SAFETY. When in doubt, look for the answer that will or won't kill the patient! It all depends on what the question is asking you but the NCLEX is testing you based on safety. If you keep this in mind while taking the test the answer becomes a lot more clear than the one's we engraved in our minds from nursing school.

4. Don't read INTO the question. Focus on the stem of the questions and the type of questions they are asking you.. whether it's safety, priority etc and tune in to key words such as: "all except","what's most important" or what would you do FIRST"when reading the question. They put certain details in the question for a reason but look no further or deeper than that.

5. Stay calm, get a full night's rest the night before and eat breakfast. I know during nursing school it was easy to stay up and cram the night before exams but do NOT try that with the NCLEX. I didn't study AT ALL the day before my scheduled date to help calm my nerves and clear my head so I could focus day of. Rest is very important for recall..though you will be anxious and it will be hard to fall asleep but try to get as much rest as you can. Also be sure to eat a full breakfast! Yes.. it is very possible it might come out one end before you test ((joking....maybe lol)) BUT your brain needs all the carbs and energy it can get for this 6 hour exam. 

(Disclaimer: The suggestions, advice and recommendations described on this blog (sicunurse.blogspot.com) are based on my personal opinions and are not factual).

Received my offer letter! But first...let me take a vacay!!

On February 1st 9pm, I traveled halfway across the world! After receiving my offer letter and start date for work ((yayyyy!)), my parents decided to surprise me with a vacation to Dubai! The flight was 14 hours non-stop and there is a 9 hour time difference. We arrived 9pm February 2nd, so you basically lose a day between the 14 hour flight and the 9 hour time difference departing off the eastern coast. We stayed in Novotel Suites at Mall of Emirates which made it easier to get from place to place because of the tour bus stop that was right at the mall ((walking distance from our hotel)). I'd like to tell you all the "go to" places and sightseeing you MUST do while in Dubai:

Day 1 & 2: City sightseeing Tour!
To maximize your time effectively, on your first real day, because technically your first is spent on the plane, be sure to buy a 48-hour tour ticket through the City Sightseeing Dubai Tour on the big red Double-decker bus. They operate from 9:00am-8:00pm, seven days a week and give you full access to visit staple sites, free cruises, souks for shopping and the beach! The price of an adult pass for 48 hours is AED 295 (240/3.57=$82.63 U.S) and the 24 hour adult pass is AED 240 (240/3.57=$67.22). In Dubai, the conversion of $1.00 U.S = AED 3.57-67, the currency differs in about .10 depending on which part of the city you're in. This bus departs from the Mall of Emirates and ends at Dubai mall. There are two different route lines you can take, one is RED and one is BLUE. I recommend you do the RED route line first because it takes you across the marina and has multiple stops that will take more time if you want to hop off and go on: FREE Dhow, FREE walking tours, FREE water bus, and shopping at the Souks. The BLUE route line is more sightseeing but you can visit: Burj Al Arab (Staple-the Seashell hotel), Jumeirah Beach, Wild Wadi water park and Atlantis of the Palm. Below I have specified each route so you can decide which you'd like to take but again, I strongly suggest taking the 48-hour tour, because it allows you two full days to do both tours. Each bus departs every 30 minutes:

RED LINE ROUTE:
1. Al Ghubaiba                           
2. Gold Souk                               
3. Spice Souk                              
4. Riviera Hotel
5. Dubai Creek
6. Sheraton Dubai Creek Hotel
7. Deira City Center
8. Burjuman
9.Sheikh Zayed Road
10.  Dubai Mall (transfer to blue route option)
11. DIFC
12. World Trade Center
13. Al Seef
14. Bastakia
15. Dubai Museum
16. Old Souk

BLUE LINE ROUTE:
10. Dubai Mall (transfer to red route option)
17. Union House
18. Jumeirah Mosque
19. Mercato
20. Jumeirah Beach Park
21.Umm Suqeim Public Beach
22. Burj Al Arab
23. Souk Madinat Jumeirah
24. Atlantis the Palm
25. Mall of Emirates

 Day 3: Shopping!
Visit Mall of Emirates (both malls are open 10:00am-12:00am)
This mall has about 3 levels and thousands of stores and many restaurants from all around the world. We had brunch at two french restaurants in this mall that were DELSIH! These malls in Dubai are HUGE. One moment you're passing Hollister and the next few steps you may see Hublot. The malls split according to price range, for instance, Hollister would not be found next to Hublot. It also includes an indoor Ski park called Ski Dubai which is filled with snow, penguin shows and big, beautiful ski slopes ((Yess this mall is pretty awesome!!)). That was ONE of the hilites of my trip and a MUST see! There is also Cosmic bowling and a large games/arcade located at Magic Planet which is on level 2 near Ski Dubai! Don't be surprised to hear the call of prayer while shopping. It is apart of the culture in Dubai and sounds according to specified prayer times throughout the day.

Day 4: More Shopping!!
Shopping, shopping and more shopping! Visit Dubai Mall which is also huge containing a wide array of stores and restaurants from all over the world, just as the other mall does, but unlike Mall Emirates this mall includes activities and attractions such as: the Underwater Zoo, the Dubai Aquarium, Dubai Fountain and the Burj Khalifa (tallest building in the world), located behind the mall. We received FREE tickets to both with our 48-hour Sightseeing tour. There is also an Olympic size ice-skating rink, Reel Cinema movie theatre and sooo much more! Both malls are connected to the transit lines in which you can take a straight shot to either because traffic gets heavy after 3pm=expensive taxis (which avg around AED 80).

Day 5: Hump Day
On Wednesday, we did Dinner in the Desert which costs about AED 300. We chose the company Rayna. It was such an amazing experience that included: dune buggying, 2 stops in the desert for pictures, camel tour ($$) or free camel rides (one time around a rink), free sand boarding, free henna tattooing, free desert BBQ, free apple flavor shisha and shopping ($$). The view of the desert is breathtaking!! I was told the best times to visit Dubai is September-March because the weather is pleasant and cool opposed to 125 degree weather that comes in the summer.

Feel free to comment if you have any additional questions!!