TraumaSurfer 5,741 Views
Joined Aug 8, '10.
Posts: 433 (41% Liked)
I think nurses should be able to. Even if it is only when there isn't a Doc available.
Try to get a serious focus on your health and fine tuning your body to accept night shift until you pay your dues to transfer.
Become a q3 eater. Package small portions in little containers to munch on easily and quickly throughout the night. Eat a well balanced light meal for your main break.
Drinks lots of water. Night shifter workers are dehydrated constantly.
Avoid sugar loaded products and caffeine. Yes, no coffee or only in moderation at the beginning of the shift. Drink green tea which may have some caffeine. Read the labels.
Get a routine which might be simple stretching before and after work.
Drink a warm non decaf beverage and read something when you get home. Get to a quiet place or personal space in your home or favorite park and in your mind.
Make sure your shoes are comfortable. Simple as it sounds, it sets the mood for the night if your feet hurt.
Try to at least take a long brisk walk on your days off.
Once your body adjusts, your mental outlook will gradually get better.
Cut yourself some slack. You are new. Night shift people tend to be a crusty bunch at first but most will warm up to new comers eventually. Don't be afraid to ask for advice.
But, until then, focus on your body and health. Keep work at work. I don't even wear my clothes to and from work. Once I clock out, I change clothes and become who I like most. My personal space might be sitting on a beach for awhile after work and appreciating I can do that because I work in a profession which allows me to live just about anywhere. Remember you work to LIVE and not live to work.
Doing 12 hours shifts you are only spending 36 hours at work. The rest of that time is yours. Make plans on your first day off to do something in the afternoon. Make an appointment to pamper yourself. Go to the mall and window shop. Meet a friend for a movie and/or dinner or late lunch. Make a list of all the stuff you haven't done lately like a museum, the theater, a concert or some attraction in your community or nearby.
Are you serious? All of that, and you still don't get the difference between state EMT-P licensing and NREMT-P.
Repeat after me: Eligibility for state licensure is not the same as eligibility for National Registry.
I want to do both. Jack of all trades. I think itd be best to agree to disagree, because I see an RN and EMT-P certification to be very equivelant. I dont down play anything. I know both professions are totally different. One is long term, one is short term. Like I said, in my state they are both equivelant, and a paramedic needs to be able to everything an RN can and vice versa.
I do believe in education too. I believe in being well rounded too. My goal is to make myself the most competitive applicant. So if I can be competant as both a medic and a nurse it can only benefit me.
I can see where your dislike for medics are on your previous post. I understand it.
I believe your answer to my question is stick with the BSN program. CCRN over CCEMT. And I am assuming you are not a medic either so you cannot answer my second question. Thank you for chatting with me :-)
Are you sure about only CRNAs and lifeflight RNs intubating?
NPs, RNs and RTs who work on specialty (neonatal, pediatric) also intubate in your state.
Not turning it into a nurse vs medic argument.
By the time you have finished with all the Paramedic stuff and you go through the ADN program your hospital will have gotten its Magnet status. How do you think you are going to get the necessary ICU experience in the ICUs if you can not get hired by one?
You miss the critical thinking and problem solving that goes into being a medic.
Airway/cardiac specialist and quick descision maker without a doc writting every order for you.
I think you misinterpeted. I am currently enrolled in a BSN program-, and am half done my paramedic program. I only have four more prereqs to do. I am enrolled in a UNIVERSITY. The ADN is offered through a community college. Here the flight paramedics and nurses are expected to perform the same set of skills at the same competency. They are equals. In medic school you are already taught how to intubate (I did my first one 2 days ago). I plan on getting my BSN eventually, I just was wondering if it would be smart to get my ADN in a year then bridge to my BSN. The service I am taking my medic course through offers perdiem spots 8, 12, 16 and they always have shifts available. My work schedule in not a real issue.
There is a local university here that has a Medic to RN bridge course,
You are messing up your goal of being a flight nurse.
1. You have a job at a Trauma Center. Chances are that hospital will hire you when you complete your BSN. Thus, you won't spend 2 years as an unemployed new grad RN especially if you have an ADN.
2. Most of the NE is going with BSN and have a goal for their states to be "BSN in 10". Many flight programs want BSN degreed RNs. People might tell you it doesn't matter whether you have a BSN or ADN and maybe it didn't 20 years ago. But, it will be at least 5 - 6 years before you become an RN with an ADN by the route you are taking. A lot can change and it probably won't be to lessen the requirements to be an RN.
3. You will need at least 3 to 5 years of ICU experience as an RN. Many hospitals are now Magnet and want BSN degreed RNs for their ICUs.
4. You need to prepare for the future and not just a quick cert right now. Your long range plans to be a Flight RN requires several years of preparation as a NURSE. Those who have said "the ADN has always been good enough" are finding themselves left out when there are hundreds of applicants who have gone the distance.
5. Where are you going to work as a Paramedic? Very few EMS jobs are going to be flexible enough for you to go to nursing school or at least not for the first year or two.
6. If your goal is to be a flight NURSE, skimping or taking shortcuts for nursing school is not going to benefit you. The bridge programs also just cut you some slack on a couple of classes but sometimes the material missed in those classes can be vital in bringing the whole process together.
Also, is it a university or a community college which is offering the bridge program? Universities usually offer Bachelors and higher...not ADNs.
7. It is a lot easier to go from RN to Paramedic than it is Paramedic to RN. There are programs which allow RNs to take 2 weeks of additional training and take the Paramedic exam. Some states allow the RN to just challenge the test if they have ACLS and couple other weekend certs. There are RNs who teach the Paramedic classes at some colleges and universities.
8. Trying to compare CCRN and the CCEMT is a total joke. To take the CCRN you need over a year of actual work experience in an ICU as an RN. There are also separate CCRN exams for the different ages groups which you will need over a year of work experience in each unit to take the exam. The CCEMT is a 2 week merit badge teaching very watered down introductory level critical care overviews. If you are lucky the might take one day to give you a walk through of an ICU. Some Paramedic schools even tack this course on (at a very high cost) as a selling point for their new grads who have ZERO experience as a Paramedic since there are no prerequisites for the CCEMT.
9. To be a Flight RN, it does not matter if you have 30 years of experience as a Paramedic. To be a flight RN you will still need to meet all the requirements which may include BSN and still have 3 - 5 years of work experience as an RN in critical care. They do not just automatically move you to the next seat. A Flight RN brings critical care knowledge and skills to the team which are highly specialized and not something which can be learned in a weekend cert class.
10. Following through with #9, it is easier to teach a few skills like intubation and central line placement to someone who has advanced education and who has already worked in the lCUs with these procedures and devices than it is to take someone who has very little exposure to these lines and tubes and the only critical care knowledge is from the CCEMT which again does not really teach anything about critical care nor give the necessary experience.
11. As an RN (with a BSN) you may have the opportunity to work in many ICUs such as Neuro, Cardiac, CV, Pedi and neonatal. All of which would be great for making you a better Flight RN. As a Paramedic you can not work in any of these ICUs except as a tech to assist the RNs.
12. While you are going off to be a Paramedic and trying to gain work experience as one, remember the prerequisites you took to get into nursing school have a time limit. You may need to retake most of the math and science classes.
If you are looking for shortcuts, just scrap the goal of being an RN. Go to Paramedic school. Earn as many weekend merit badges as you can. Work a couple years on an ambulance if you can find one which does emergency response. Then you can apply as a Flight Paramedic and work with an RN who has lots of critical care experience.
That is the whole point of being ACLS certified, to begin ACLS treatment if you are the first to respond. Paramedics aren't Doctors, but they can administer medications without a doctors order.
Any patient with a trach collar should have a humidifier. Humidifiers come with the Fi02% dials. In my opinion, the order was written inappropriately and the charting is messed up. really scary to have nurses charting things they have no idea about.
A patient is on a high flow device. i.e. trach collar. In order to use a trach collar appropriately, the FLOW RATE must be set at 10-12LPM. THIS DOES NOT MEAN the patient receives 10L of oxygen. This is where the dial comes on. You adjust the dial percentage to a patient saturation to maintain 93% as written. That is why you get here more "noise" as you turn the dial to a lower flow. Because more air is escaping into the atmosphere. The higher you turn up the dial, you hear less "noise" because all the oxygen is being delivered to the patient through the trach collar.
The order should had been written, adjust trach collar Fi02 up to 60% to maintain sats greater than 93%. 10L of oxygen delivered from a simple face mask or high flow cannula is approximately 60% Fio2.
Its almost unnecessary to even chart the flow rate of 6L. If the trach collar is used appropriately, it should ALWAYS be at a flow rate greater than 10L. Thats a given. The only thing you should really be charting is the fi02. By charting 6L at 40%, you aren't using the trach collar appropriately. So you really don't know how much oxygen the patient is REALLY getting.
Im an icu nurse x 8 years. I know this. Or ask a respiratory therapist.
The principles still apply for O2 delivery devices regardless of location (ICU or SNF). You just have to know what type and have some working knowledge of each device.
Most of my info and references pertain more to LTC. In California we do not have RTs in SNFs, LTC or even on the med surg floors. The education is left up to nursing which is why some of us have tried to get as much info as possible. You will eventually see fewer and fewer RTs everywhere as reimbursement dwindles even more for that profession. So, study up on the O2 stuff.
I did list what some facilities have had to do in order to prevent errors. That included running the humidifier off compressed air and doing O2 bleed in. But, when some will then switch to the O2 flow meter for the humidifier you will again get error. Some don't notice the flow meter when looking at the humidifier.
The other is to tape the insert for FiO2 which comes with ever bottle to the bottle.
The other issue is some charting systems on med surg, SNFs or LTC facilities only allow for liter flow. That will need to be addressed. The same for CNA charting.
Overall, consistency. Pick a system, educate, re-educate and stick to it with frequent QA monitoring.
No, actually, if you actually read what they are saying, THIS is the same. I think you've taken your idea of a "tyrant" and substituted that definition for what is actually being discussed here. I know that your definition of tyrant exists. Of course it does, but you seem to be reading a completely different thread than I am.
It will depend on what city you are in. It is a mistake to get a full time rental car if you are in the San Francisco Bay area.
1. You probably can not park it at the apartment without an additional fee which is anywhere from $100 - $250 per month plus the rental.
2. You will have to pay for parking at the hospital if you are even lucky enough to get parking. Some of the major hospitals have a waiting list for their regular employees. But, parking runs about $12 - $20 per day. Mass transit and taxis are much cheaper.
3. In cities like San Francisco, there are so many things to do and most are easily reached by bus or BART.
I recommend checking out ZipCar or some other car sharing program. You pay by the hour and everything (insurance gas) is included. You can also travel to any major cities it is available. I use ZipCar when I fly to another city or state for a conference and don't want to rent a car and pay extra at the hotel for parking. I use the car for the hours I need it and return it. The reservations are easily made online or by the app on your cell phone so you can grab a car anytime the mood hits if you happen to pass by a parking spot for these cars. You also pick the car you like and the company has cute names for each of their cars.
If you think you will stay in CA for several contracts, drive or ship for about $850 - $1000 depending on whether you want a closed or open shipping carrier. Check references and credentials of any company. If you drive, save receipts and you will get mileage from the travel company. The rest goes for your tax filling.
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