BostonFNP Guide 38,096 Views
Joined Apr 4, '11 - from 'Northshore, MA'.
BostonFNP is a Primary Care.
Posts: 4,427 (60% Liked)
I think you are as good if not better off in telemetry than you would be in the ICU.
thanks for the responses; I appreciate it. To shed light on the incident in question, here are the details.
I work in a long term care facility. I had a woman who has advanced Alzheimers that I sent to the ER for a query bowel obstruction. It is the ER doctor who filed a complaint; in fact he was FURIOUS that I sent her! My reasoning for sending her was:
- No one had witnessed her having a bowel movement in 11 days.
- Her abd was distended, and she was guarding it. She hit me when I tried to touch it.
- I couldn't hear bowel sounds in the LUQ.
- She has been given suppositories 2 days in a row with no result except a hard marble sized poop. When I came on my night shift the following night no one had yet to give her an enema. We normally give supps/enemas around 6:00 in the morning but she had woke up around 2am screaming. After almost 2 hrs of screaming I figured she was probably uncomfortable d/t constipation and decided to give her the enema at 4am thinking it would give relief. I did not get much of a result so I was concerned.
- I tried paging her doctor twice (before and after enema) but he never answered.
- For the last 3 days she had straining on the toilet complaining of pressure.
- She was screaming in pain and I had nothing left to give her. I just felt like I had no other option but to send her.
Please be honest. Was I wrong in sending her, as the doctor furiously suggested?
The public will not accept us as MD's so we cannot just take our courses and have the same job prospects as an MD and go wherever and choose to live where.
Simmons is a fantastic program and they do secure clinical placements.
Nursing@Simmons and Nursing@Georgetown both help with preceptors last I checked.
I know for my BSN I only had to learn 1/3 of the bones and muscles.
NP's and PA's simply don't have the education and training to provide the same high level of medical care that physicians are trained to provide.
The best first step you can take is to find a few local NPs working in they type of setting you are interested in and shdow them for a day. You can see if you like the role, talk to them about local programs and which programs local offices hire from, meet some networking contacts/mentors, etc.
These assignments have several purposes, one of which is to get you out and networking with locals NPs! If you can try and talk to some local providers, you may just find a mentor or a great local clinical site.
At the very least you would need to carry APRN-level malpractice insurance.
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