neuronightnurse 773 Views
Joined Jan 6, '07.
Posts: 8 (13% Liked)
Even if you don't get into a neuro icu right away, try a hospital with a neurosurgery floor. I promise you will not be bored and it is a good place to get comfortable with the subtleties you will see in patients with neuro deficits, whether it be from a tumor, hematoma, stroke, etc. You will also get more familiar most of the commonly prescribed meds, probably care for patients with lumbar drains (depending on your hospital's policies), care for seizing patients, neurostorming patients, stable post-op craniotomies, cervical fusions, laminectomies, etc. Also, depending on your floor, you may also take care of stroke patients and learn telemetry. All of this will prepare you well when it's time move up to the critical care level.
Neuro trauma and many other acute neurological conditions requiring admissions tend to absolutely terrify the patient's families (even more than other critical care units) and if you have a little more experience with this type of patient, you will be much better at helping families cope.
I notice you are a CNA. Do you work in neuro already? If so, you may have some familiarity with some of this already. It shouldn't be very difficult to find a position on a neurosurg. floor because, for whatever reason, many nurses find neuro to "scary" so, at least in my area, there are usually openings.
Many people, including myself, are astonished at the "32 vials" not raising many red flags. If I recall correctly, Dilantin IV usually comes in 50 mg per ml. and the vials come in 2ml and 5ml, so she obviously used 32 5ml vials. It also says she had to start a second IV. My question is did she use three 60cc syringes? Has anyone EVER adminstered this much of any undiluted medication IV push?
Also, if pharmacy had been on the ball, she should have been informed that IV Dilantin should never be pushed faster than 25 mg/minute - and I doubt she had the 5+ hours to push that much med.
I started working 7/70 nights as my first nursing job. If you are reasonably fit and healthy, you should be able to handle it without too much fatigue. (And there's always ibuprofen!) Don't plan on doing ANYTHING else except work during your "on" week because 10 hour shifts are never only 10 hours. Also, when our hospital began its 7/70 program they were under the impression that nurses would prefer to take their PTO as cash rather than time off since they got every other week off. Since you are new, you probably won't be able to use it right away, but my advice is to use that PTO. Also, your off week is not "vacation" any more than a weekend is a vacation for the 9 to 5 people. You work full-time just like everybody else so don't get roped into too many other obligations since you have "all this time off."
If you like to travel, this is the ONLY way to work full-time. Also, keeping your same patient load is usually beneficial (depending on the type of patients you happen to be stuck with on that week) Even "challenging" patients aren't as difficult once you know them.
The biggest downside? To quote one of my co-workers "I can't stand "A week" Mondays. I always feel like I'm goin' to jail!"
Best of luck to you!
"i agree with mvanzz999 - i would like to see the stats and here some success stories from the nps that become nps with little to no rn experience. in my area, we don't have these programs, so i have not come across any grads. however, i would love to hear first-hand accounts of experiences of these grads.
and to expand on traumarus question, what is either a minimum or ideal amount of experience an rn should have before starting an np program? nursing is a second career (and loving it, btw) and i'm not getting any younger!
I graduated from Stritch with my ADN (had a prior BS from years back) in May 2005. I work at Froedtert part-time. As for myself, I had a very good experience there. I was lucky to have very good educators and clinical instructors. I found that they really went out of their way to accomodate the needs of any student willing to put in the work. Yes, it is much more expensive than WCTC or MATC but when I started, those schools had a 2 yr waiting list while Stritch didn't. When you factored in the salary made by an RN as opposed to an aide, the 2 years as an RN helped make up for the add'l tuition.
Stritch doesn't have the greatest reputation at Froedtert but I think that is more a function of some individual bad experiences rather than the university as a whole. They tend to prefer to hire grads from UWM and Marquette because they are really trying to increase the education level of their RN staff. As for the question of ADN or BSN, unless you have the luxury of plenty of time and money - just get that ADN (and pass yr NCLEX), work as an RN and let the hospital pay for the BSN. (most of them in the area will.
Other little things that were nice about Stritch - a safer neighborhood (as opposed to UWM or MATC - that matters when you have night classes and are walking alone) a daycare center nearby if those are your needs & a staff that knows you by name.
Hope this helps!
My first post ever to any internet message board, so please forgive any unintentional breach of etiquette!
Wonderful discussion! Many important points brought out for anyone considering pursuing an advanced nursing degree. (Also, despite the deviation from the original thread, thank you, Uberman5000 for the excellent reply re: increased liability as an NP. It should be required reading for that certain portion of the nursing population terrified to make the slightest intervention without fear of losing their home. You are forgiven the "phallacy.")
It seems obvious to me that any years of experienced gained in any medical setting would be an advantage when graduating from an NP program. Despite this, there is an increasing number of direct-entry programs and it is now possible to graduate as an NP without any RN experience. Most people seem to agree that the "ideal" would be an NP with extensive experience in their specialty. However, most of you have been nurses long enough to know that the "ideal" is a fantasy. "Ideally" we would have at least 45 uninterrupted minutes to discharge a patient, much longer to admit them, there would always be a reassessment 1 hour after every pain med administration, patients would always be turned every 2 hours...you get the picture. Yet, despite the lack of ideal patient care, most patients leave the hospital with their acute conditions approriately addressed. The question then becomes can newly minted NP's be effective even if they lack the "ideal" amount of experience?
Let's turn our attention to newly minted residents. Ask any RN at a teaching hospital. July is not a good time to be a patient. Particularly on the night shift. These new residents are intelligent, terrified, overwhelmed people. Sometimes, their response to a 2am call is "What do you guys usually do on your floor?" But, pretty soon, just like most people who are capable of graduate-level education, they find their way through and learn to practice medicine in a safe, effective manner.
My guess is that Master's prepared nurses, regardless of their tenure, will most likely do the same.
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