lpn2crna1day 1,993 Views
Joined: Jun 6, '07;
Posts: 36 (25% Liked)
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families/patients who do not want to admit that the end is near and want everything done even if in your opinion you feel as if you are torturing the patient. Docs who don't know how to talk honestly with patients and their families.
Robert Bojar's "Perioperative Care in Cardiac Surgery" should be given to every new person that comes into CVICU in my opinion. I had a CV Surgeon give it to me years ago and Ive convinced about 25 people in my unit to buy it, as well as the hospital to buy it for new employees/new grads. Its the best book Ive read. During orientation I try to get my orientees to udersand three basic receptors....Alpha-1, Beta-1 and Beta-2. Instead of memorizing up and down arrows in a book or note cards, it helps them learn it easier. If you can understand that a Beta-2 receptor causes peripheral and bronchodialation and that Alpha adrenergic drugs cause arterial constriction, and that Beta-- causes and increase in HR and contractility, you can figure out that Dobutrex, Epi, Dopamine, Neo, ect...........do X, Y, and Z because of the receptors they stimulate. Also, go to PACEP.org and register (its free). Do all the programs for Swans. You can train a monkey to learn paperwork, how to shoot numbers, how to titrate drips and such, however to understand the science is something that a majority of the people you work with dont understand, Im willing to be. Good luck.
I have been told some pretty common drugs and I have seen many of the lines but where I am totally lost right now is on surgical procedures. Having a hard time finding one site or any for that matter any sites that explain cardiac surgery in depth from medical stand point vs trying to prepare the patient pre-op. Things like CABG's, LIMA's valve ring replacements, heart transplants post-op care....etc. These are just a few of the pts. that I have worked with so far and I think that brushing up on the actual procedures will help with the overall picture. Actually I think that anything...tips, study guides, books WHATEVER anyone can suggest will be a great help! Thanks so much!!
Also CTSnet.org has a lot of info about procedures (you can even watch videos). There's a book called "Cardiothoracic surgical nursing" by Betsy Finkelmeier. Hard to find, but awesome for nursing considerations about CT surgeries. Your hospital library may well have it.
Go find a GOOD, first-year med school physiology text book and start there. KNOW your normal physiology - can't learn abnormal until you know normal.
My personal favorite is Rhoades and Bell's Medical Physiology. You can google it and "peek" inside at a few pages. I got mine off Amazon for 50 bucks off list price because I bought it "used"...that thing was brand-spanking new, and this isn't an uncommon occurance on Amazon to be able to buy new as used, much cheaper.
The Bojar manual
is a good reference. It's not a complete ground level review but it gives a description of the major operations and perioperative care.
If you look on the sticky section at the top of CCU there is several threads that offer some great resources. I've bought several of them. and icufaqs.org is awesome as far as websites go.
I'm three months in and my head is still spinning, it just takes time.....A lot of time.
I can definately see the rationale in what everyone is saying. I recently had an ICU interview and debated how to answer the goal question. I knew my "in" person who referred me to the manager had possibly mentioned it so I decided to be honest, state that I felt like I someday I wanted to be a CRNA, but then reiterate that right now I wanted to focus on my RN-BSN schooling, and just pursue my career as a critical care nurse because I think it is something I will have a passion for. It worked, got the job, and will be the only new-grad to the unit. Maybe it was because the hospital is smaller and doesn't have many one-year RN to SRNA people. Also I'm a terrible liar and would have felt pretty uncomfortable omitting that from my answer and making up something else.
The stigma comes from the nurses who have come to the ICU and left after 1 year of training.
So, it's not our fault that the stigma exists. I don't doubt that you'll be a good ICU nurse, and you seem to really want to do things right. Focus on those things during the interview.
But too many nurses have come, spent $$$ orientation money and time, training, etc, and then have left at the end of the year.
Soooo, that's why I say to not mention it during the interview.
My ICU interviews were brief. They wanted to hear about my future goals (even if that means CRNA, NP, etc.). The director of the unit wants to know that you are able to learn and grow there. Most of the unit directors just spoke about what the unit was, what type of patients they get, ratios.. It was just ultimately my decision to pick which ICU I wanted. HR asked the toughies.. What is an example of how you worked toward a goal and what was the outcome? Describe when you have worked as a member of a group? What challenges you? I looked at interview general question websites to prepare. Hope this helps.
Do a bit of reading around general ICU issues before your interview, have a look through a critical care journal.
Be enthusiastic and show that you are willing to work hard and learn. Good luck
I do a lot of interviews. We don't want to hear that you just want to get the ICU experience to become a CRNA.
After reading so many threads here on allnurses.com about the hard times many new grads are having at getting jobs, I just wanted to share a few words of encouragement.
My feelings go out to all of you who are having a hard time finding jobs. I feel your pain and know what you are going through.
I graduated in '95, we all had the similar issues with new grads having a hard time finding a job. The market was saturated, hospitals only wanted 1-2 years experience. I found it very frustrating and scary. Months and months of applying, sending out my resumes and applications, and continually getting rejected. Eventually, I came to the realization that my dream of working in a hospital as a new grad was not going to happen.
I began applying at Long Term Care (LTC) facilities, something that did not interest me at the time, but I was wanting so bad to begin my nursing career that I was willing to take any job that I could find to begin getting some experience etc...
While my goal was to to work in a level one trauma center and ICU, or ER, I found myself in long term care, and once I accepted it, I really enjoyed long term care. I found myself learning a ton of nursing assessment knowledge and personal skills. It really forced you to become independent and autonomous, working on time management and so many skills that are essential to all nurses. I learned a ton from so many LVN's and RN's in LTC, they were amazing sources of experience and mentoring. I really felt that my experience in LTC was a wonderful asset to my future working in Critical Care. I eventually ended up working in CCU (Coronary Care Unit), and the vast majority of our patients where elderly, and I felt I had already been accustomed and educated on that clientele, and my experience with that population from LTC, it was a great source of confidence.
After a few years, I began re-applying to the hospitals and with my experience, and the nursing saturation cycle changing, I eventually moved into a long term acute care facility, got hospital experience, all while continuing to apply and followup with multiple hospitals, eventually was hired by a hospital in telemetry, then CCU and I finally moved into a job that I was wanting from a new grad. Also, during this time, I took every opportunity to get certificates in ACLS, EKG classes and other certificate classes to help make me more marketable and attractive to hospital mangers. But it was a long hard journey, but well worth it.
As you all know, the market and nursing shortage (or not so shortage) varies dramatically based on different geographic regions, cities, states, etc... I have no idea on the long term care employment marketplace where you live. But I would recommend you explore ALL employment opportunities, whether or not it's in your overall dream on how you thought you would start your career.
No one has a crystal ball on when things will turn around, but historically, they will eventually will. There are so many positive indicators that nursing is still a strong profession, and a wonderful career choice. The average age of nurses (upper 40's), the baby boomers creating more demand for health care, etc... all indicate that nursing will be a strong employment arena. I feel that the projected nursing shortage we've all been hearing about for years was and is a legitimate concern. However, the changes in the economy other industry job losses, has brought many existing nurses back into the workforce, kept nurses working later in their career than planned before retirement etc... All of these issues have skewed the projections and the nursing marketplace is not really hot for the time being.
My gut feeling and my hope is that in the next year or so, as our economy improves, more nurses will be retiring, more baby boomers putting more and more demand on the health system, the hiring freezes will lessen and that the nursing marketplace will eventually open up more and all you newer nurses will have many more opportunities.
No one has a crystal ball on when things will turn around, but by historical records, they eventually will. There are so many positive indicators that nursing is still a strong profession, and a wonderful career choice.
So my words of advice to all of you is try to remain as positive, do your best to get employment, open your boundaries to acceptable driving distances, possible relocation if that is an option for you. Take jobs that may not be your ideal job, gain any experience that you can, even if it's not what you want. Continue to educate yourselves, certificates and classes (ie. ACLS, PALS, EKG) that are related to the type of nursing you want to do. So when the time comes and the employment opportunities do open up, you are prepared and ready.
Best of Luck!
Someone whose BG levels change rapidly and for no apparent reason.
well these days and hours have been some of the longest of my life but i am happy to say that it is official.....i passed!!! i am so happy right now i could cry...lol....acutally i did ! this site has been awesome and really helped me get through it all, because i didn't feel like i was alone. people who you talk to everyday who haven't been in this position can't really relate to how much pressure we are all under and how we feel. i felt like when i talked about it they really didn't want to hear it anymore because they couldn't relate. forget about school, making the grade and graduation....it all comes down to these tests. it's a big deal!!!! most of us (maybe even all) walk out of that exam room not knowing which end is up, :uhoh21: thinking about all the things that we pushed aside and how it all couldn have been for nothing........... all the times i could have gone out with friends, all the wash that could have been done (before it took a week just to get caught up), all the things that could have been bought or paid for if i hadn't had to cut back at work to have more time to study i mean the list could go on forever (especially when you have kids......i am a single mother). when i walked out of that room i felt like i had given up a lot for nothing and it was a hard pill to swallow. well......today i can say i am very happy i was wrong! my advice to all is just try to believe in yourself a little more and be patient. good luck to all of those still waiting on results and hang in there!!!!
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