Okami_CCRN, ADN 11,277 Views
Joined Oct 15, '07.
Posts: 783 (44% Liked)
There are a lot of factors to consider, one of course would be to transition straight to ICU. Some places will hire and orient new graduate nurses for about 6 months with multiple classes to aide in the transition.
The other would be to work in a PCU or Step-Down unit to wet your feet before you jump in. If you want to do the step-down route then I recommend at least a year to really get a feel for the patient population and what to expect. Best of luck.
I would not recommend ER/PACU as usually the length of stay of patients is too short.
Thank you for the reply Okami, I am still currently practicing my Nursing Profession, what do you mean by refresher course is it reviewing before sitting for the exam, I will surely do that before anything else.
So I should just register and pay the 200$ to receive the new ATT? is that right?
You should contact the board of nursing in the state you are seeking licensure; you may need to take a refresher course before being allowed to sit for the NCLEX exam.
You will most likely need to re-apply for licensure via examination as well as register via NCSBN for a new ATT.
Nurses are required to take college level chemistry, microbiology, anatomy & physiology I & II, as well as pathophysiology and nutrition.
Beginning in an LPN program and transitioning to an RN program would still require you to fulfill the science requirement.
Science is an inherent part of nursing, and a thorough knowledge of it will be of huge benefit to not only yourself, but your future patients if you chose to become a nurse.
Like Jdub6 mention, Narcan has a specific assessment that goes along with titration, we rarely use narcan as a drip.
Pentobarb we do not use often, we prefer to use Versed for our status epilepticus patients; that is titrated based on the continuous video EEG in collaboration with an epileptologist.
We titrate Nimbex, Levophen, Neo-synephrine, Fentanyl, Morphine, Ativan, etc to set parameters. Vasopressin is set at a standard .04 units and it is not titrated.
Being afraid and feeling incompetent is quite normal, especially when working in a high acuity setting such as the ICU.
I hated, and I mean hated coming into work my first 9 months. I would have nightmares about crashing patients and what not, but eventually you get into a grove and start feeling better about your skills and practice. I encourage you to stick it out and work through your issues, maybe reach out to an EAP to help with some of the mental health issues you may be experiencing.
Our facility was using the sage products as well, we were able to contract another company for some oral care packets, but I will say I miss the sage stuff.
I don't think that is an ethical dilemma, that is more of exerting some control in a situation where they have little to no control.
I never printed power point slides; instead I would bring my laptop to class and type up my notes within the power point program. The cost of ink and environmental factors of utilizing so much paper were a huge deterrent to printing.
I would attempt to alteplase (tPA) the line as per protocol/policy. If it isn't patent and the patient no longer requires central venous access I would discuss with the team about discontinuing the line. If they require some sort of access you could request a midline.
Regarding the swelling, like you suggest upper extremity doppler study would be appropriate. Sometimes its small superficial thrombi that do not require intervention.
I know of someone who first became an RN, didn't care for it and went back to school to become a radiology tech and worked as one for quite a long time. I'm sure someone could do it, but the amount of money for education would definitely be something to consider.
You should submit your application to the state you intend to work in, you can take the NCLEX-RN exam in any state you want, the results will be sent to the state you applied for licensure.
You cannot apply to positions until you have a license, most hospitals do not hire graduate nurses any longer. best of luck.
One of the things you have to think about is the patient population, usually a medical PCU which is what you described the patients will tend to be older with chronic health conditions that are presenting acutely ill (think acute on chronic liver failure/renal failure, etc).
In the Surgical PCU the patients tend to be younger with the surgery being their main health concern. These patients tend to do well post-operatively and move on to live good lives.
The ratio of 1:4 is pretty standard for a step-down PCU unit. However, what management says is the ratio and what actually happens is a whole different story.
Things you will likely see in medical PCU: BiPAP/CPAP, high flow nasal cannula, stable trachs/vents, wounds of all sorts (pressure/venous/arterial), GI bleed, pneumonia, sepsis; I think you get the picture.
In Surgical PCU you will see: all sorts of complex surgical patients; whipples, ex-laps, HIPEC, colon resections, ostomies of all sorts. These patients usually need aggressive fluid management, blood transfusions, and lots of ambulation.
To be honest, I would have just given him the cup of coffee when he asked for it, and educated him on his fluid restriction and why it is in place. If he wants to follow it great and if he doesn't you can inform the physician and document.
I think that everyone saying let me ask your nurse/let me check your chart/let me talk to the doctor probably made him feel like people were avoiding him and his request.
I do not understand why you would waste the time, energy, and money in studying in a foreign country where you will have to apply as foreign educated nurse and have to have your transcripts evaluated, etc,. to work in the United States.
Why don't you look at an accelerated nursing program since you already have a BA in psychology.
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