Latest Comments by deftonez188

Latest Comments by deftonez188

deftonez188 5,508 Views

Joined Mar 30, '07. Posts: 443 (33% Liked) Likes: 393

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  • 0

    Quote from Pixie.RN
    This is under the "Articles" tab at the top of the forum:

    The application process is extensive. Don't be surprised if recruiters don't return your calls until you graduate and pass the NCLEX-RN. The Army is not seeking nurses without experience (2 years) at this time. It is very competitive as our military is downsizing. Good luck!
    Heck even with your license and experience, don't expect an immediate call-back. Patience and persistence.

    The National Guard or Reserve would probably be easier to get into, but just know that they are not a path to active duty.

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    Smaller commands (ex: overseas) can expect to see more FNP use in their respective roles. Ours is a provider, and manager of 100000000 things. I don't envy her :P

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    The military won't pay for you to break a civilian contract you have that isn't education-related. Student loans? Maybe - even then they'll 'help' not clear.

  • 0

    As the poster above me said, you'll 95% chance end up on Med Surg or Post Partum. You 'may' be allowed to transfer after a certain amount of time, or you may not.

    I spent 3 years in Med Surg - but that's also where I gained the majority of my clinical skills, so it isn't all bad.

  • 0

    New sexual assault examiner here - anyone have tips for removing excess toluidine blue? I've been using surgi-lube and it does remove a good portion of the dye, but much of it remains even in non-injured tissues.

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    Shoot me a message when you get to Pendleton. I still know most of the people you'll be working with.

  • 1
    SoldierNurse22 likes this.

    Yes, you're probably right SoldierNurse22

    I've tangled with some of the administrative side of the house. Not really my cup of tea - generating endless data and 15 meetings a week really brought me down :P

  • 1
    Rondina likes this.

    Likely if you show some competence in Med-Surg and express interest in working MSW - you'll work MSW. It doesn't hurt to mention your future interests (ICU/ED).

    MSW = Ill newborn, pediatric, adult; You get occasional post-partum moms with mastitis or endomyometritis.

    It's really your best bet, in my opinion.

    A piece of advice too: Focus on learning your job, become competent at caring for a team of 5 patients, train/respect your corpsmen; Everything else is low on the totem pole. After a year, you'll be pretty decent at your job.

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    That's an option I've considered. The clinical requirements with my family obligations make it unlikely outside of DUINS.

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    Rondina likes this.

    Was stationed at NHCP once - most new Ensigns end up working on either the Multiservice Ward or Postpartum. After doing your 'time,' people often transition to other floors like the ER/ICU.

    Be aware - most new grads are very hopeful to go directly to a specialty floor out the gate. You're best served growing on the Multiservice ward first (not that you will have the option...). You can always 'float' to the ER if things are slow to cross-train, they'll be glad to have you and will use you without a doubt.

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    I appreciate the feedback.

    I've been accepted to a few different Master's programs for things I'm interested in but of which aren't nursing related (one isn't even closely related to healthcare).

    In your opinion, do you think the board would look at a non-nursing masters as an example of lack of 'commitment' to the profession?

  • 1
    jeckrn likes this.

    Hello Fellow Nursefolk,

    I’m an active duty Navy nurse (O-3) and I’m looking for some advice from people who are in the know…
    …Do I need a Master’s to make O-4 these days?

    I ask because I struggle with ‘analysis paralysis’ – I overthink everything much like many in nursing do, and I agonize over whether I’m ‘doing enough’ to prepare myself to promote.

    About me: My evals have never been an issue – I check all of the right boxes and my point grade is always above the average.

    I started an MSN program this week but I wonder, should I just work harder for the command and make my evals even better? I really don’t want to work on my masters but feel like I ‘have to.’ I’m tired of learning non-clinical information – I became a nurse because medicine is awesome, but after my RN-BSN program I feel traumatized by the never-ending ‘fluff’ courses which don’t really add to a greater understanding. This MSN just feels like a movie – Boring Paper Writing 2: The Revenge!

    Anyone have any advice?

  • 0

    We do not have needle guides (I wish!) - our kits are Navilyst and I know they make them, but they aren't included in the standard kit we use.

    I watched a few videos on insertion after reading your post - technique errors I can see myself making are: Holding the ultrasound directly straight down on the skin - no rocking or angling toward my actual point of entry - I'm essentially bringing my needle to the ultrasound, not the other way around (I never actually visualize the tip of the needle on ultrasound, that is another problem). Second, we were taught to poke at a 90 degree angle (mind you by an experienced PICC nurse, so I took it as gospel) but in every video I see, it appears everyone comes in at an acute angle far less than a 90 degree.

    I'm going to talk to our supply department about getting needle guides, and I'll try your suggestions with my next attempt. Really appreciate the advice.

  • 0

    Hello fellow nursefolk!

    I'm new to PICC nursing (my facility is military and doesn't have a 'PICC' nurse position, it just happens to be whoever is on that is qualified) and i'm doing great except...

    ...I'm really bad with accessing my vessels w/ ultrasound. I nail every other part without difficulty, but initial vessel access, I am doing horrible!

    I've only been doing basilic veins, and I appropriately pre-mark once I've determined exactly where I'd like to go.

    The problem I'm having is I attempt to poke under my probe, but once I get under the skin despite having ultrasound I can simply at best see myself moving tissue but never seem to get right over top of the vessel - I end up left, or right or what appears to be above but gain no flash on attempting to push through. I'm basically always saying in my head, "Ok, where the heck am I? I see tissue moving around the vessel."

    All I can think is I'm not using the ultrasound correctly to see where I'm really at or need to go, or maybe I'm not understanding how to correct my stick with what I see on the US. Does anyone have any resources they use that would be helpful or advice?

    I wonder if the patient type has anything to do with it - 1st stick was a young healthy marine (maybe 18, completely fit, easy poke), second was a disoriented and very emaciated gentleman, third and this most recent was a very emaciated/thin gal. I find that instead of going in at a 90 degree angle, I really have to be far more shallow.

  • 0

    Quote from deftonez188
    Had a pt with a possible small bowel obstruction (bowel sounds were great, asymptomatic pt with a prior bm that am, no distention, etc.) unconfirmed by CT that had low intermittent NG suction with a salem sump tube.

    Output changed from expected cloudy straw colored fluid to rust colored/brown and frothy - what could this be? There was no fecal odor/consistency to the new drainage, just the color.

    Also, the drainage seemed to adhere to the NGT lumen walls - with an NPO pt, are there any tricks to flushing the line without instilling large amounts of fluid? The line remained patent, but I wonder for how long thereafter...
    Yes, they weren't given anything. Of course, I can't watch them 24 hours a day if that's what you mean