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DesertSky, BSN, RN 2,355 Views

Joined Feb 21, '12 - from 'Missing the desert...'. DesertSky is a Critical Care RN. Posts: 76 (38% Liked) Likes: 69

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  • Nov 9

    Quote from Wuzzie
    I'm very curious to know where this is occurring. I have never heard of or flown a patient straight from a scene to an ICU. Does this ICU implement the American College of Surgeons trauma process? If so, what level are they? Is this a new process hospitals in your area are trying? That must cause some serious chaos with all the staff that is required.
    […]
    Nearly all of our interfacility trauma transfers, both adult and pediatric, are taken directly to the ICU. If the patient arrives from the scene, they are initially seen in the ED, but the goal is to get them out or the ED and to the OR or ICU as quickly as possible.

    I am unsure as to the “American College of Surgeons trauma process” that you reference? If you mean trauma center designation, then yes, Level 1 adult and pediatric.
    Quote from HouTx
    It's not very relevant to ICU practice…
    TNCC can be very relevant in the ICU. The TNCC trauma nursing process (TNP) follows the same format at the ATLS trauma assessment. Regardless of whether the patient arrives from the ED, or via the transport team as a result of an interfacility transport, application of the trauma nursing process can facilitate a smooth transfer of care. Also, we are required to complete 16 hours of trauma continuing education every two years and TNCC meets most of this requirement.
    Quote from HouTx
    …I'm assuming you are already ACLS certified because that is usually a basic requirement, so if you're looking for additional development you'd be much better off working toward your CCRN.
    TNCC is a two day course, similar to ACLS. And similar to ACLS, upon completion the participant is awarded a course verification, not certification.
    Quote from LoveMyBugs
    […]
    I understand taking TNCC if you are a trauma ICU, but TNCC is starting to fall away. My system encourages ATCN instead, but we can get either one
    I agree that ATCN is another good trauma course, but don’t necessarily find it any better than TNCC, and there are still many states in which it is not available. At the time I was able to attend it had to be given concurrently with ATLS. If this is still true, I think this is what greatly limits its availability.

  • Oct 20

    Usually when i get patients back from OR, the PACU/OR nurses tell me a bunch of info that i don't actually care about. Like i don't care that they got one dose of ancef before the surgery, seriously i don't. I do care about who did the surgery, who's on their case, have they given any PRNs, what are their activity orders....etc. But every floor is different and want to know different things

  • Oct 12

    "What lies behind us and what lies before us are tiny matters compared to what lies within us as long as we have the courage to follow our dreams".

    So don't discredit yourself until you've actually tried. You got through your pre-requisites already didn't you? Have the courage to follow through and the universe somehow aligns itself to the path you've set in motion.

  • Oct 9

    Quote from DesertSky
    At my hospital, nurses are split into 2 teams as well. The initial "A" team arrives at the hospital prior to the hurricane and is expected to stay at the hospital until the storm passes and members from the second "B" team can safely make it into the hospital and relieve them.

    Team A is paid double time for each 12 hour shift worked and regular pay for the 12 hours they are "off duty" but still required to be at the hospital. Team B gets no special incentive/pay, but are not required to spend the night or stay at the hospital.

    Your hospital sounds like they are being very cheap and inconsiderate about compensation regarding activation of its personnel. I hope you and your family made it safely through the storm.
    I agree, I feel like my hospital is being very cheap. I am very blessed that my family made it out safely and there is no damage to my apartment, but there are many of my fellow coworkers that were not so lucky. This is all the more reason I feel we should be compensated appropriately so we can start putting the pieces back together.

  • Oct 9

    Quote from DesertSky
    Any advice about how to transition into the OR would be great!
    Take a look at my article, Tips for New Operating Room Nurses. Basically, be prepared to have to do some studying outside of work hours, set realistic goals for yourself, and many other things that are touched on in that thread.

  • Oct 9

    I just want you to make sure it's the right decision for you and that there are job prospects upon graduation. Much like I've heard about nursing, research the job market near you. You may be surprised that you can get a job without an MBA - or there may not be jobs available even if you have your MBA. Be cautious.

    I do want to say that I loved my MBA program and really did learn a lot. I just wish the job market was better.

  • Oct 8

    Everything is sexualized. Our society is messed up.

  • Sep 23

    WOW. Still a student and asking for the highest paid, lowest stress job. Perhaps you should obtain your licensure and work in a few areas while you figure that out.

    WOW.

  • Sep 20

    I highly recommend the AACN review course available for purchase on their website. I know it prepared me to pass the CCRN exam!!

    Good luck!!

  • Sep 5

    What makes someone ready this is YOU. YOU are ready to go for it. You have taken it on yourself prepare for this.
    Trauma and cardiovascular ICU patients are not comparable. Choose where you want to go. You've got this.
    Best of luck, let us know how it's going.

  • Sep 4

    Quote from orangepink
    That helps a lot but work ethic is just as important. It doesn't matter how much experience a nurse has if he/she is lazy
    But someone who is lazy may get hired based on his/her RN experience on paper- you can't see laziness on paper; this usually gets discovered later.

    When I was searching for my first NP job, I got a lot of interviews based on my RN experience and many of the questions asked during the interviews focused on my role as a RN. No one asked my about my experience during my NP clinical rotations, other than the job I ultimately accepted and they really didn't ask either. I mentioned to them about my experience and exposure at a outpatient Diabetes clinic during my last clinical rotation.

  • Sep 3

    -Crash cart parked outside your patient's room

    -You have one patient. Everyone else has 3.

    -You can smell the stool as soon as you get off the elevator

    -You pass one of your most obnoxious frequent flyer's wife walking out in the parking lot. Without her husband.

  • Sep 3

    It varies but surely can't hurt to have experience and professional contacts in the specialty you will be pursuing. Personally I think it shows poor planning to have no experience or professional contacts in the specialty where you want to work as a NP. In my situation I have heard of opportunities and gotten offers due to my connections in this specialty which came directly from my RN experience. At one interview the executive director told me the medical director "drooled" when he saw my resume because I had years of inpatient psych experience.

  • Aug 31

    "It is your responsibility to take your breaks and to take care of yourself. "
    A fellow nurse giving me another responsibility! I already have responsibilities coming out of my ying -yang.
    The ability to get a break.. depends entirely on the individual unit. I have worked on units where I got 3 breaks in 8 hours. I also worked in a float pool, and I was pulled every 4 hours to a different unit.. a break was NOT going to happen.

    Please enter the real world.

  • Aug 30

    First and foremost, you did a great job. A first day post-op with TWO interventions and difficulty with weaning SHOULD have been a 1:1. Doubt that could have changed the outcome, though. I am not a cardiovascular surgeon ( I was a cardiovascular nurse for 3 years) but I am thinking one or both of his grafts blew. Nothing YOU could do would prevent his death.

    Not all surgical patients survive. For ME , researching the mortality rates on various procedures would reassure ME that I did all that I could.

    Let the emotions fade until reason can take over. Then, I am confident.. you will get back on the horse.


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