gregemt, BSN, EMT-B, EMT-P 1,801 Views
Joined Nov 16, '05 - from 'Florida'.
gregemt is a Flight Nurse.
Posts: 20 (15% Liked)
No offense, but then you're not doing CCT, you're simply doing IFT (i.e. won't transport unles stable, no vent, no arterial lines). And, as you've been told more then once, you do NOT have enough experience to do CCT. New Grads are NOT capable of being trained to do CCT. It appears that you don't have enough experience to UNDRESTAND that you do NOT have enough experience.
And, what exactly IS this military experience, that keeps making you so qualified as a new grad?
So, I have to chime in...
First, congrats on getting the jobs!
But I'm wondering about the CCT transport job... If CCT means Critical Care Transport then, unless you've been a paramedic for several years, you are severely underqualified and likely unsafe to take on that role. The reason the job listing had 2 years ICU experience as a requirement was that as a CCT tranporter you'll be transporting critically ill patients. That means they can be on pressors, ventilators, and might require advanced life support resuscitation.
We recently used a CCT ambulance to transport a patient (per family request) from our community ICU to a large hospital on the other side of town. The patient was on a vent, no less than 7 drips, and was in multi-organ system failure. We had the family sign the MOD with a notice saying that he might die during transport. I can't think of any new grad who would be qualified to handle that safely. Heck, I was just hoping that the paramedic really knew what he was doing.
If CCT means something else, you might be okay, with a lot of training nonetheless. I just wanted to make sure you know what you might be getting yourself into- putting your license on the line.
I saw your other post and hesitated to comment but since you've posted here and asked for tips here's mine. I would seriously reconsider this job. I'm not trying to be mean, really I'm not. I have only your best interest at heart. I'm going to be frank and say out loud what every experienced CCT RN is thinking. Under no circumstances should a new grad be riding CCT. You do not have enough experience in nursing to be remotely safe as a CCT nurse, not to mention an extremely part time CCT nurse. I do not understand why a company would hire you for such a position citing military experience as enough to do the job unless your military experience was as a medic or medical corpsman. Not "freaking out" is by no means a qualifier for this type of position. What I fear for you is a patient transport going badly and you, as the holder of the highest license (unless you have CCT physicians), being totally thrown under the bus by said company. I know you are excited but you need to step back and re-evaluate. Reputable companies hire people with at least 2-3 years of ICU experience because these are the types of patients that require an RN to be on board. Reputable companies have a lengthy prescribed orientation period so that the orientee can become familiarized with the equipment, policies and procedures. You are seriously risking your brand new license not to mention a lot of pain and financial loss if you take this job.
Usually I am all for GNs going for their dreams. The right person, with the right personality and motivation can overcome the extra obstacles in critical care nursing. I say this because in most aspects of nursing, there are all sorts of resources available, from experienced co-workers, to great internship/training programs that support graduate nurses. I simply do not agree with the old mindset that everyone has to have 2-4 years of medsurg experience under their belt before going into ER/Critical Care. Transport nursing is entirely different though. A brand new transport nurse is already expected to be not just good at their skills, but known as a clinical leader in their previous units. They are the go to people that have solid experience, phenomenal clinical judgement, excellent assessment skills, and the proven ability to apply it all within minutes to a badly injured/septic pt in a tin can bouncing through the air at 140+ miles per hour. No graduate nurse should start here. It does not matter what experience you have in other fields, you do not have what it takes, as a GN, to fulfill this role. I usually am all for GNs stretching themselves and going for their dreams, but not here. The flight program I work for REQUIRES: 3+ years experience in ER/ICU and CEN or CCRN (I have both) certifications as well as all the usual stuff: BLS, ACLS, PALS, TNCC, ITLS, NRP, ENPC, ATLS, etc, etc, etc. A GN getting a job in this field is like an MD that skips residency and starts practicing in neurosurgery right out of med school. Sorry, I know it's not what you want to hear. Go to an ER and/or ICU and get your skills down. Otherwise, you may end up looking like a fool being in this role and not having a clue what anything is about.
PS: All this isn't taking into account the increased hazards and safety risks associated with flight. This is a very dangerous job and if you cannot appreciate that or have any idea what I am talking about then you are certainly not in the right place.
I read this post this morning on my iPhone as I sat outside smoking my morning cigarette. It made me laugh at the arrogance of the poster to assume that I make a lesser nurse because of my bad habit. I enjoy smoking and yes, I know it's bad for me, I know it will most likely kill me some day. It does not however affect my judgment when taking care of my patients. I'm good at what I do and the nicotine in my system has no bearing on that. Do I smell, maybe. Do I do everything in my power to not smell, yes, I do. Not a single nurse I work with knew I smoked until I told them I did. There are precautions you can take to reduce the lingering smell. Until it is illegal, what I do on my unpaid lunch break, or on my days off is none of your concern. If I choose to hike a quarter mile off of the hospital campus to smoke, that's my choice. I don't smoke around non-smokers, I don't smoke around my kids. I never ask someone to "watch my patients" while I take a smoke break that is not a legally required break by the labor standards. As someone stated earlier, that's an awefully high horse you're going to fall off of.
This kind of idea might appear good on the surface, but is the start of a very slippery slope. Once you start forcing your nurses to be healthy, well, why not the patients? Shouldn't we hold them to the same standards of self-care as we hold ourselves? We'd save an awful lot of health care dollars and lower nurse-patient ratios right quick if we refused to treat smokers, the obese, risk-taking teenagers, alcoholics...
A person's private life should remain private, and we are long past the days when we demanded that nurses should be paragons of virtue. So long as someone's vices and addictions don't affect the quality of the care they give out, they aren't anyone's business but the nurse's.
Wow, What an intro to the world of anesthesia! I think you have heard a common line of thinking amoung young anesthesiologists. They are threatened/worried that CRNAs are going to 'take away jobs' (and actually regretful that they chose anesthesiology.) There is some basis as areas that have not utilized CRNAs much in the recent past-mountain states and west-are beginning to utilize CRNAs more. I know of at least 3 large practices that went from all anesthesiologist, to approximately a 50:50 split between CRNAs and anesthesiologists.
As for closing the schools, that was tried in the early to mid 80's. The American Society of Anesthesiologists challeneged the accreditaion of the nurse anesthesia programs and tried to take the accreditation function away from CRNAs and they had the support of several CRNAs (the 'Dr knows best' line of thinking). They were not successful thanks to a group of talented, committed CRNAs, most prominently Ira Gun. A lot of schools were closed, but they are back now and graduating more CRNAs than ever. Read 'Watchful Care" by Marianne Bankert, it's very interesting. I am a little surprised that the 'we're closing the schools' threat is still being spread.
I'm not sure how different the role is in the US, but in Canada the sky's the limit for RRTs. Like nurses there are multiple options away from the bedside, research, sales, education, etc. Salaries here are higher for starting RTs than they are for starting nurses, with the ceiling being the same for bedside. Starting for an RT in Toronto is $30/hr, with top for bedside RN and RT just below $40/hr at 6 years. It can go higher for both in management positions...there are RRTs who are CEOs. With OT and other opportunities many RTs make >$100K/year. My track was 3 years bedside, 2.5 years in research and now I'm an educator in the hospital and at a school...6 years and have salary of $80k, Mon-Fri and love the work. As for the job, like nursing the role depends where you work. If you work in rehab or a clinic your role will be different than that of an RT working in a busy ICU. Here our RTs manage extremely complicated cardiac defects in terms of invasive and non-invasive ventilation, etc, and some have completed additional training to run ECMO (think bedside heart-lung bypass). In Canada we have RTs that complete additional training in anaesthesia to manage non-complex surgical cases (eye, hands, etc). The group works autonomously under the supervision of an anaesthetist. I have travelled extensively for work (Mexico, all over the US), presented at conferences and the like. This is not atypical for motivated RTs who get involved. I'm working on a Masters at the moment and have been asked to develop a Mock Code Simulation program for the hospital. Basically, your career path depends on where you work and how you get involved. If you want career progression, look for a large centre with good resources.
I chose RT over RN because I liked being able to move around, and not be tied to a single patient for most of my shift. Like others had mentioned, I'd rather deal with secretions that poop, blood or vomit on a regular basis (I had jobs doing enemas and manual disimpaction). It is a challenging job that requires people skills and intelligence. Although we are smaller in number, this fact with the aging population only increases our opportunities for the future. The interprofessional collaborative push currently sweeping healthcare is also opening many doors. Like other professions, grad school is your best bet to move up. If bedside is where you'd like to stay, nursing and RT are basically the same...just a different set of variables and equipment that you're dealing with. But if it's autonomy your after, go for RT.
Hmm. Since this is a nursing site, I do expect you to get anti Respiratory Therapy responses.
I am a Registered Respiratory Therapist. I love it!
Responsibilities don't include: cleaning poop, cleaning vomit, dressing changes, inserting foleys, baths, etc.
Respiratory Responsibilities include: airway management.
Typical night at work: Shift change, called STAT to ED to resp distress coming in. Setup bipap on CHF pt. Leave go the floor to do resp tx, get called stat again to ICU to get ABG on vent pt. Run by ED to check on Bipap. Go back to floor to attempt to give Bronchodilator to asthma pt, get called stat to sx a pt on another floor. Trauma activation in ED, stab wound to chest, intubate, then to ct, then transport to ICU or surgery. Attempt to go give that bronchodilator (b/c RN keeps calling me) NOPE pager goes off. Need you stat in NICU! drop everything and run. Get that done, how about a bathroom break. Pager: cardiac arrest coming in ED. Code that pt. setup vent. get abg, go to ct, then transport to ICU. Rapid Response Team called. pt needs lasix, not resp. Eat granola bar. Go to give that bronchodilator to the asthmatic that the Rn keeps calling about. BBS Clear. Pts states tx helps her sleep better! What??? Its not ambien! gonna sit down, take a break. Eight hours left to go. Cath lab is calling me stat.....
I guess what I am trying to say is....Yes an RN can give resp txs. Yes an RN can make vent changes. But do you really know what it will effect? (some do, most don't)
Do I make good money? absolutely! Do I have job security? sure! Can I do other jobs with my degree? Yes! I can do PFT's, sleep lab, Asthma Educator I can even be CEO of a hosp. (there is a local hosp with a BS RRT as CEO)
There are many exams to take out of school.
I can have several different titles...CRT, RRT, CPFT, RPFT, NPS, etc....
I am sure I haven't made friends with this post. But, dang...don't hate me b/c I chose a different career than you. I love my job. I make a difference.
So, when you walk by the RT room and see RT's sitting down relaxing....Please don't think they have been in that chair all day or night. They are just taking a break!
The way I look at is that you can do anything if you've done burns. Any other ICU you go to, you don't have the demanding level of wound care for every patient that you do in a burn center.
So, take burn care out of the equation, and any other ICU job almost seems easier. I know I'm making a broad assumption here, but that's the way I look at it.
I'm also a new grad that startedand currently works in a burn ICU.
i think it's a good place for a new grad to start their ICU experience. Burn injury is multisystem. Granted, burns are as mentioned "non- discriminatory", but you will not see some types of ICU cases and may not be as experienced in other areas--- i'd venture to say cardiac mainly. I have found as with any surgical service, you'll find doctors neglecting pt comorbidities--- this is where it's important for a nurse to be the patient advocate and to be knowledgeable of various disease processes and their management-- this only comes with exposure.
That's why nursing is awesome... you can dabble in any field and walk away with more knowledge and experience.
I also started as a new grad doing Burn ICU in a level I trauma center. You will be fine.
As Faithmd said it all goes together. People get burned while also getting injured in an MVC, while someone is attempting to murder them (burn + stab or gun-shot wounds), and also remember that a burn unit is not just burns. It is injuries caused by road-rash (more trauma), wound care that needs the ultimate (often immunocompromised pts) and pts. with TENS or Stevens-Johnsons may also have numerous other medical co-morbidities. We even had advanced CA and COPD pts with facial burns from smoking with their 02 on.
After all I saw and did there, I could handle anything after some specialized orientation. Our burn unit did peds also so I came out with a lot of experience.
Good luck! It's not easy but it is worth it.
I have personally taken cared of a burn patient wtih 98% TBSA burned.
Previous posts were right when they said that the Burn Unit is "non-discriminatory." It is multi-organ, multi-disciplinary approach and deals with extremes of cases. I've had a pediatric patient who has nephrotic syndrome who sustained a scald burn. I had a schizophrenic and a bipolar patient who both sustained flame burns.
Do not fear knowing and caring for the burn victim. I have been a burn/ trauma nurse for 34 years.
Because of my Burn Nursing I can care for adults and peds. I learned many things and became a very caring and compassionate person. Remember all burn patients have other diseases and multiple health issues.
Burn Nurses care for the sickest patients in the hospital.
We can float to any unit and work. Your education and experience is totally in your hands. Be a Burn /Trauma nurse you will learn alot. I wish you success and always push forward to learn more. As I said I have been a Burn Nurse for 34 years. I learn something new everyday. Good Luck.
I seriously doubt that there is a nurse here with any time under their belt that has not at one time harbored a negative thought about one of their patients including thinking "they got what they deserved", "I hope it hurts, maybe they'll learn their lesson", "You did this to yourself so shut up" and many others along that line. Just because we are nurses doesn't mean we are saints. A number of years ago we had a drunk driver come to our ER. He had just plowed into a minivan with a family of four critically injuring the children and leaving them orphans. His only injury was a scalp laceration. He presented screaming that he was dying and the pain was so bad he couldn't stand it. When we didn't meet his needs immediately (due to sicker patients requiring attention) he screamed that we didn't understand he had just been in a traaaaaauuuummmmaa! You can bet every one of us wished the PA stitching his wound would use a dull, rusty needle and clean the area with spit.You can bet that we weren't overly friendly to him. You can bet his discharge instructions were given to him without a smile or overt sense of concern. And you can definitely bet that when he left in handcuffs we all hoped he'd get the chair. What he did get was professional treatment by every member of the staff, careful cleaning of the wound, pain control, and 45 minutes of careful suturing to minimize scarring to his scalp and forehead. He didn't get the chair and I'm betting that selfish bastard probably only thinks of that day in the context of how it has affected him. If the worst thing the OP does is verbalize those black feelings EVERYONE of us has then he's guilty of only one thing...being human.
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