EricJRN 26,262 Views
Joined: Nov 25, '05;
Posts: 8,741 (11% Liked)
; Likes: 1,687
10 year(s) of experience in NICU
My advice would be to practice your answers to those questions, not just post them here and then use other people's answers. Now, if you wanted to post your answers for feedback, that would be different.
Oh, and "you girls"? You are aware there are many male nurses, and some of them are right here on this very website?
I am finishing my prereqs so I can apply to CRNA schools come September. I live in southern California. I am looking for an online combo class for Organic, Inorganic, and biochem. I heard of a couple but can't find info on them or the site isn't working. USC requires 1 semester of all 3 without lab, and they can be combined. The other 3 schools that would allow me to stay in this area (Kaiser CSUF, Loma Linda, Texas Wesleyan) don't even have these as a requirement, so if I can find this all together in 1 class online I would be set. Any input greatly appreciated!
I've pretty much just observed how Brian conceived of and grew this place to what it is today. I've seen that he learned to be very creative and forward thinking with this site, with he and Joe V adding fresh content and graphics, the cartoon features and other ways of developing a successful entrepreneurial venture, along with some very talented help as mentioned.
A few weeks ago I got a "like" from Brian which didn't happen very often in the middle of an otherwise very common thread topic. It made me feel happy, and that is where I choose to leave it.
Thank you for sharing the article, through the darkness of the last 5 days this was a light to my sadness. The Brian I knew had a dry sense of humor and was always had a quick return. Generous to a fault, always smiling and had the most incredible inventive mind-his business accrue was amazing and he was always open to idea's and listened to any ideas you talked with him about. He loved his gadgets especially Apple products, you always knew he would have the latest that technology had to offer.
I want to share with you a funny story, In may some of the Allnurses team, Brian and my daughter went out on SEGWAY's. The guy who took us on the tour told us that somebody always falls off. We rode the SEGWAY'S for 90 mins and I had a couple of close calls but managed to stay on. It was so much fun and laughter-one of the highlights of my year. We completed the tour and returned to the tour office and i drove into a tiny wall outside the office and went flying off the SEGWAY falling hard to the ground. I remember lying there laughing (i wasn't hurt thank goodness) looking up to see Brian standing over me, saying "Can you do that again so I can video it'!! We all laughed so hard, and that is a memory I carry with me and smile
A couple things come to mind.
In 2010 I was fortunate enough to go to DC with the AN crew and help set up/man the AN booth. That's where I got to meet so many of the AN crew. Madwife2002 and I shared a room, which was a blast.
But one of the days I was there I took a day to wander around town in DC, not really realizing how sunny it would be and I didn't carry any sunscreen. I got a fairly decent sunburn on the upper half of my body. What was really funny was that I was carrying my purse with the strap diagonally across my chest. Which meant that my red sunburned upper chest had a big white diagonal stripe running through it. (I am a very white white person.) I will never ever forget how Brian saw it and burst out laughing, I mean a big belly laugh in the middle of the restaurant. He laughed so hard at what he called the scuba flag on my chest. Brian liked to scuba dive.
The other thing I will remember is that I PMed him here shortly after being accepted into my NP program (currently in semester 4 of 8 - woot! almost halfway there) to let him know that I'd gotten in. I told him I'd included in my school portfolio my time spent as moderator here and thanked him for the wonderful learning opportunity that had provided me. He sent me a nice note back congratulating me on getting into grad school, which I still have in my PM folder.
Whatever else he may have been doing or dealing with at the end, what I have described is the Brian I knew and miss.
I am wrapping up the capstone course for the Nursing Education program if I can help anyone with questions about the program.
I thought this was simply amazing and figured I'd share!
I saw a similar story-line on Greys Anatomy and remember thinking, "Wouldn't that be neat if that could work in real life?"
12-person kidney transplant chain at San Francisco hospital - San Jose Mercury News
No, of course not. HIPAA makes for some strange voices in people's heads-- it's the only explanation I can think of.
Muno has the right answer. I encourage you to go to the OCR.gov website and read up, or hit that little magnifying glass at the top of the page here and search for the thread that answers all your HIPAA questions.
I once had a Neo stand over a little one (I think around 800g) with a huge belly (probably CPAP belly but we were on NEC watch at the time) and ask, can we put a larger Replogle in? I told him I had already put the 8F in, did he want me to go get the 10? He's like. . . "I guess not. . . "
We use BCPAP extensively and though our guidelines call for 5 or 6.5F for less than 1250g, if they are on BCPAP, they may start with the guideline recommended tube, but in no time, there will be an 8F down. If we can keep them decompressed and off the vent, that 8F is a heck of a lot less invasive or huge as an ETT.
Only tangentially related to pt care, but:
When your NM (who is normally a giant beast who you'd like to make a voodoo doll out of) comes in in the morning, sees that you look like he**, asks what your assignment was, blanches, and says you should have filled out a Protest of Assignment form. That was awesome. Almost made up for the previous 13 hours.
I found this from ANCC's website:
f a nurse manager has a master's degree in nursing but not a baccalaureate in nursing, will that meet the requirements that are outlined on p. 6 in the manual?
The requirement is for at least a bachelor's degree in nursing. The Commission on Magnet (COM) believes that it is essential that nurse managers know the theory base for the profession. This theory base is required in curricula for bachelor's, master's, and doctoral degrees in nursing. The criterion states that effective January 1, 2011, 75% of nurse managers must have at least a baccalaureate in nursing. A higher degree in nursing (a master's or doctorate in nursing), will meet the requirement even if the baccalaureate degree is not in nursing. return to top
I think that in general the "A&O x3" thing needs to go away regardless. Depending on the nurse, A&Ox3 might mean they are fully oriented, although another nurse might call a patient A&Ox3 because they aren't fully oriented (they are oriented to 3 out of 4 parameters instead of using 3 out of 3).
1. Afghanistan gets very, very cold in the winter. People think "desert," "heat," and "sand" when you say Afghanistan, but let me tell you that it's more like "dirt and dust," not sand. And we had plenty of ice and snow in the winter months. I was located at an elevation of 6500 feet, so think Colorado.
2. Don't let CIF tell you that they are out of your size in cold weather gear (see number 1). Take the next closest size so that you have silks, waffle tops, and a fleece jacket at the very least. When I was told they were out of small, I asked what I was supposed to do. The response was "Don't worry ma'am, it's not cold there yet." Uh...
3. Amazon Prime is amazing ... if you actually get mail. Our mail would sit at another location for about 6 weeks before we'd get it, so don't always count on the mail. I ordered a cheap coyote brown fleece jacket (see #1 and #2) from Amazon, and thank goodness I did it early enough to get it in time for cold weather.
4. Things that smell nice really matter. There aren't a lot of opportunities for good smells in Afghanistan, so having nice-smelling moisturizer, for example, was a boost. This one is more likely for the girls, but guys will also appreciate things that smell nice at some point into the deployment. lol
5. The water will not be kind to your skin or hair. Moisturize!
6. Do not drink the water. With that being said, some folks did opt to brush their teeth with it, and I'm sure I got water in my mouth while showering, but do not consume it with a purpose. Our water came straight from a well in the ground without any treatment or chlorine, so who knows what was in that water?
7. Your laundry will never really be clean (see #6 about the water source). We had one washer and dryer for about 20 people, and it was like the plumbing Olympics to keep that thing going. The pumps would burn out, the hoses would freeze, it was like Christmas when we actually got a load of laundry done. Some larger locations have local national employees who wash your clothes for you, but I've not heard great things about that service, so I'm grateful that we had to do our own.
8. Be prepared for the dirt. Afghanistan can be a dirty, dirty place. I can't even convey to you the actions of the laws-of-physics-defying dirt in Afghanistan. I kept swearing the dirt was sentient, it would constantly creep in while we weren't looking. We cleaned and cleaned, recognizing that it was a never-ending battle. In the summer and during dryer months, we had what we called "moon dust" on our compound: fluffy dirt that was as deep as our ankles, no kidding.
9. Do not become overly attached to your running shoes in Afghanistan, it's not likely they'll survive the deployment. Between the dirt and the gravel surface of FOBs and compounds, those shoes will be toast.
10. Go to the gym! Seriously, this was the best thing I did for myself. I developed a daily routine, which is a huge part of staying sane during deployment when every day is like Groundhog's Day (as in the movie with Bill Murray). When I am home in my ER I will NEVER have time to go to the gym during a shift, so I did this while deployed if we didn't have any patients. Sometimes I'd get pulled out of the gym for incoming patients, but that was to be expected.
11. Sign up for a class while you're deployed. I did a seven-week Legal Nurse Consulting course (which really taught me one thing: I don't want to be a Legal Nurse Consultant, haha). I was hesitant to take my last MSN class (last class before capstone, that is) because our internet connectivity was a little sketchy at times, but I finally signed up during the last 8 weeks we were in country, and I'm almost done with the class now. Most larger FOBs have pretty reliable internet, and even on our tiny compound the computers in our MWR really only went out during a blizzard, at which point one of our OR Techs and I cleaned off the satellite dish using a flyswatter, it worked and our connectivity was restored. We both had school work to do, we were serious!
12. The flies are insane. We decided that "Kamikaze Afghan Houseflies" would make an excellent punk rock band name. They are insidious, they will try to fly into any available opening on your vented patients who cannot wave them away. I spent a fair amount of time shooing flies from eyeballs, mouths, noses, ears, whatever.
13. Do not pet the animals unless you want rabies treatment. Enough said! Military working dogs are an obvious exception, we had one on the compound who was awesome and loving who loved to be petted, but check with their handler first. Even working dogs get cranky and have bad days.
14. Be prepared for some wildlife: notably snakes, spiders, and mice. I was quite grateful for the noisy mongoose under the FST, I told myself that it only SOUNDED like it was in my room, and it would eat snakes and mice (and probably spiders). The mice will get in just about anywhere they can, so limit the food in your room unless you have a mouse-proof door (which I finally did, after another OR Tech was kind enough to nail some boards down across the area where the door met the floor). Shake out boots/shoes before you put them on. I never had a spider in my boots, but I told myself I would if I didn't check.
15. Drink water. Hydration is important! Bottled water is generally plentiful, I had cases in my room (we had to bring the cases inside when it got cold to keep them from freezing, too). It annoys me now to pay for bottled water, but that's the price of being home, so I gladly pay it!
16. Solar showers are handy things to have for the times when the showers might not be working. I only had to use mine a few times, but I was glad to have it.
17. Water kettles are handy too. You can use them to heat water for the solar shower (if there's no sun/time to heat it), or to heat water for tea, instant coffee, oatmeal, etc. I ordered one from Amazon, it was like $20. I gave it to one of the green beret guys when I left. We used water kettles to defrost our shower lines, climbing up on top of the shower trailer and pouring hot water on the pipes and hoses.
18. Another handy item: a Keurig. A friend of mine sent me one, and my significant other sent me a K-cup adapter and plenty of delicious coffee from Fresh Market. There is something to be said for not having to leave your room to make coffee!
19. Don't become attached to any personal items you might receive, like Keurigs or water kettles. By the time you're leaving, you'll want to carry as few items as possible. I left as much as I could.
20. If you're PROFIS (Army professional filler system) to another deploying unit and you deploy through the CONUS Replacement Center (CRC) at Ft. Bliss, you will be traveling with about three duffels of stuff that you will likely never use. I had it all, from canteens to kneepads/elbow pads to an e-tool. I got the whole rifleman's kit, and I didn't even have a rifle! (I had an M9, a Beretta 9mm pistol.) The only way to avoid being given a truckload of stuff is to take a memo from an O-6 or higher that allows you to draw only what you want to draw. Needless to say, I was not aware of this tidbit, so I had duffels aplenty. One cool thing is that I also got the multicam Army Combat Pants issued to me at CIF, and they were comfortable and made me look all hardcore n'stuff. The rest of the FST was jealous. I have no idea why I got them, I am not an uber-tactical human and never left the compound the entire time (an area roughly the size of a Walmart parking lot, without the convenience of an actual Walmart).
21. Be safe with your weapon. If you are not proficient, admit it! If you are not comfortable with your weapon, admit it! Ask for help. The knowledgeable people don't expect all medical types to be weapons experts. This is one thing you don't want to screw up: a negligent discharge (accidentally firing your weapon) is a HUGE deal, and it's worse if you shoot someone else (or yourself) during that negligent discharge. I'm talking dishonorable discharge, loss of benefits, jail time, plus having to live with hurting someone else. Now doesn't that make asking for help with your weapon a little easier? Trust me on this one.
22. Do NOT leave your weapon anywhere and walk away from it. Leaving your pistol in the latrine, for example, is a no-go and a very big deal. Be mindful of your weapon!
23. Clean your weapon, even if you haven't fired it for a while. See #8 regarding dirt ... it gets in your weapons as well.
24. Don't use the incoming alarm as the alarm tone on your iPhone. It's rude. That sound will make people run and will cause tachycardia, then generalized anger in your direction.
25. Re-rack your weights in the gym, or risk the ire of all your co-deployed comrades.
26. Be kind to the DFAC (dining facility) staff, they are doing their best with what they have (likely to be cheap ingredients and not a lot of fresh stuff).
27. Celebrate holidays with your people. These things matter, and boost morale.
28. Call home when you can. Your people at home love to hear your voice.
29. Wifi is usually available, but may not be free or even cheap or even reliable. I paid $99/month for wifi and used it mostly on my smartphone. Skype worked well enough to make phone calls much of the time.
30. We had regular 110 outlets where I went in Afghanistan, but this might not be the case everywhere. If you travel to or through Kuwait, you will probably need an adapter to plug things in. However, as long as your computer/phone/whatever chargers say "100-240v," it's generally safe to plug them in using the adapter (but don't sue me if you fry your stuff, see what others are doing first).
31. You might not have all the equipment you want as a nurse, but you will have everything you really need. It's amazing how we can adapt to varying levels of austerity.
32. Whole blood is not the devil. Repeat after me: whole blood is not the devil! I know the idea of whole blood transfusions is appalling to some, but let me tell you: it is lifesaving. I've seen it.
33. Be prepared to wear many, many hats beyond nursing, from patient movement coordinator to combat refueler to shower pipe defroster to sandbag filler to builder of shelves to latrine housekeeping. Your rank doesn't mean a lot when all hands are needed to accomplish something for the good of many, don't count on the "Joes" to do all the hard labor. Get your hands dirty, they probably already are anyway: this is Afghanistan!
34. Don't assume that the Afghans don't speak English. Many do, or can at least understand what you're staying.
35. "Afghanis" refers to money, "Afghans" are people.
36. If you have an opportunity to urinate, take it. Sometimes you don't know when you'll get another chance to do so, like after drinking four bottles of water while being on baggage detail in Kuwait in 120-degree weather and having to get on a bus for an hour ... the bladder Olympics can be painful.
37. When you're notified of incoming patients via MEDEVAC, you'll have a few minutes. Hit the latrine and grab a snack.
38. Clean up after yourself. Your mother likely didn't deploy with you, and CIF does not issue maids (at least to lowly LTs, haha).
39. Share your care package items with coworkers. It's amazing what can perk people up, and they'll likely share right back.
40. If you have opportunities to do cool things like weapon ranges or firing mortars or blowing things up with EOD, take advantage of these opportunities. Where else can a nurse do these things?
41. Keep an eye on your buddies. If someone looks sad or upset or seems depressed, ask them how they're doing. Deployment is more difficult for some than others, and problems at home don't go away just because you're in a war zone.
42. Check your LES every month. If you're in Afghanistan, you'll want to see some extra pay: Hazardous Duty Pay (HDP), Imminent Danger Pay (IDP), and Family Separation (FSH) if you have dependents back home. Also make sure that taxes are not being taken out. Make sure you are accruing leave at an appropriate rate.
43. Get an Eagle Cash Card before you deploy. This card is linked with a designated bank account (your own, haha), and you can load money onto the Eagle Cash Card at kiosks in various locations. Most vendors accept Eagle Cash Cards. Do NOT use your debit or credit cards in Afghanistan anywhere outside the PX/BX unless you want your accounts plundered.
44. Take your laptop, but be prepared to have it broken. I know a few people whose laptops got broken during travel, when IDF rattled their rooms and knocked things over, when the Afghanistan dirt crawled inside of the laptop, etc.
45. Take an external hard drive. People usually have a lot of movies and TV shows on external hard drives, and they are handy to have. Some people brought media players, which can be attached to TVs via HDMI cables; the hard drives can be plugged into the media players. We watched a lot of movies in our downtime.
46. Nap when you can.
47. Females, there is something called a "Freshette" that allows you to urinate standing up. I didn't use one personally, but some of my female counterparts did. That allowed them to pee into empty bottles in their rooms, which the guys did all the time (without using a Freshette of course, haha). I know, you're grossed out by this, but think about what you'd do when you wake up in the middle of the night, it's 10 degrees outside and snowing, you have to go SO BAD, and the latrine is a five-minute walk. Don't judge!
48. Don't take your best stethoscope, it might get lost and/or damaged.
49. Take underwear that you really don't care about. Bras too. And socks. I threw a lot of things away as I moved from Afghanistan to Kuwait on my way home because I knew I had the nice stuff waiting for me at home.
50. Remember that life is simple in Afghanistan: our choices are limited. Our people back home have the same level of daily information-inundation on top of missing you, so make sure you thank them for holding down the fort.
I recently transferred to my hospital's level IV NICU from adult world and I have to say I KNOW I made the right decision. I love it there. It's like night and day compared to my old unit and all for the better. Some people automatically think "I can't deal with sick babies" and disregard the NICU as an option (I know I heard that every time I told someone I was moving there) but this unit really is pretty amazing and I feel like I am holding the best kept secret that is right out in the open - NICU Nursing is AWESOME!
(And yes, I have seen some very sad things in the time I have been on my new unit, but the good far outweighs the bad and being able to help the babies that we can makes every thing we do worth it. My husband refuses to listen to my day and can't understand why I would want to see such sad things, but there are many great things too)
Even with all the sad/bad things we see, NICU nursing has adult world beat!
Not having to wear real pants
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