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Joined Jan 3, '13 - from 'Bay Area, California'. scrubs&studs is a RN. Posts: 17 (35% Liked) Likes: 7

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  • Aug 10 '14

    I went in to a Trauma ICU as a new grad & loved it!!! Got my CCRN as soon as I was eligible - moved on to MSN (critical care CNS & nursing education) after 5 years of bedside/unit educator experience.... worked in all types of ICU settings &, with the exception of Neo, I have enjoyed them all.

    Over these many years (decades?? LOL) I came to realize a few things. In order to be a 'happy' ICU nurse, you need to be a "control enthusiast". Managing titrations for hemodynamics & heart rate/rhythm, Maintaining ICP parameters, Keeping oxygenation just right with mechanical ventilation & other titrations?? Those are re-assuring to me. I get nervous if I don't have access to all the "stuff" going on with my patient. My nightmare? Pregnant trauma patient - a teensy little being that I can't even see, let alone monitor..... (shudder). I don't understand how nurses can cope with all those 'walkie talkie' patients that have no monitors at all - YIKES!!!

    But I also realize that a lot of what goes on in ICU is not pure nursing at all... it's technology. We love the machines that go 'Bing' (Monty Python reference for you young ones) & hand to hand combat with the Grim Reaper. That's the easy stuff. Advocating for patients & families who are dealing with life-changing or terminal events.... that's the hard stuff. That's what nursing is all about.

  • Jul 18 '14

    I am taking 3 courses at once, 11 credits within 5 weeks and I work full-time. I'm a workaholic though... I will have completed the BSN program in 9 months. I just want to get it over and done with. I wouldn't recommend it because these courses are tough, but I have a goal each day on what assignments to complete.

  • Jul 18 '14

    That offended me as well, iluvgusgus. I couldn't believe what I read. Most of the ADN programs that I am familiar with require a much higher ACT score, and are highly competitive, just to get in. The BSN programs around here are the ones that "take just about anybody." People that couldn't get into the ADN program had to either wait, or go ahead into the BSN program. The ADN programs are designed to get nurses into the workforce quicker. They are compact, no fluff, and have no room for lazy students. My ADN program was at a teaching university, by the way. (Why do people assume ADN programs are only offered at "community" colleges? So not true.) They were originally designed to ease the nursing shortage in the 80's. I, along with thousands of others, already had a degree and didn't want to be in school forever, esp. since we already had tons of humanities, etc. The nursing classes are the same. I took the ADN nursing classes right alongside the BSN students; the BSN students could make a 70 and pass; the ADN students had to make 84 and about on everything, or they were out of the program. If employers are asking for the BSN, that's fine. But for anyone to assume that the ADN student couldn't get into a BSN program is absurd. If anything, the ADN program was much more stringent. When I went back a few years later to get the BSN, I couldn't believe "this" was what all the fuss was about. Mine was cheap back then, but no way I would pay thousands for the BSN today. The classes were a joke, and I honestly learned nothing that I didn't already know. Oh yeah. You have no idea why someone is angry, unless you ask them. Maybe they have a horrible clinical instructor breathing down their neck. I seriously doubt they are angry because they "couldn't get into the BSN" program. Wow.

  • Jul 18 '14

    Quote from Nonyvole
    I've seen good RNs from ADN programs and I've seen bad RNs from ADN programs. Same with BSN programs.

    However, I must say that my opinion is that it's up to the students to make the most of their education. Educators present the information, but they can't make the students learn, they can't make the students develop critical thinking abilities. And then once they've passed the NCLEX, it's up to the individual to maintain their competency. Nobody should have things spoon-fed to them if they're able to feed themselves.

    I will say this. In my experience, the ADN students that I've met have seemed angry. Why, I don't know. Confusion? Discomfort? Who knows, they never said and I never asked. My personal theory is that they had applied to BSN programs and were rejected, or were scared of rejection and the ADN programs they attended accepted almost anybody. (I will admit, rather selfishly, that I'm glad that it wasn't my license on the line with them. There were a couple that said they were CNAs and worked as CNAs and yet...couldn't do basic skills like check a pulse. Others were less than polite to the staff. Still others tried to do things that they didn't know how to do. But that comes down to the individual, and not the program.)

    I do know that my BSN program had more clinical hours than the ADN programs. But at the same time, it also had more clinical hours than other BSN programs in my area.
    Some of this offends me. ADN programs do not take almost everybody. They have to maintain an 85 percent pass rate on first attempt at NCLEX just like any other nursing program. They are highly competitive to get into. I have a bachelors degree in another field. I worked hard and got a high gpa. However, there were no jobs in 2008, so what did I do like everyone and their mother? I went to a community college and got my nursing degree. I also got a high gpa in this program as well. I passed the nclex in 75 questions. My ADN program was considered one of the best among adn and bsn programs and we always received compliments that we seemed to know our stuff and were more prepared for clinicals than bsn students. I went to a community college because it was close to my home and affordable. My program had single mothers and mature students who were financially independent. My program had people who were going back for their 2nd career. My program had mothers who waited until their kids graduated highschool so they could finally take the time to educate themselves. They were all hardworking, intelligent, very professional, and very studious individuals. So to say people in a ADN program are angry, no, they are extremely grateful they finally get the chance to better themselves through a great education with the hopes of financial stability. So to shame ANYONE for doing that, no matter if they are going to a tech school for hvac or a "lowly" community college for a nursing degree that gets you the same job as a BSN, is bs. At least they have a shot at a job.

  • Jul 18 '14

    Also all this going back and forth us getting old. RN is an RN. ADN or BSN doesn't make you any better and that's proven daily in the real world setting. Those who HAVE the critical thinking skills down, the WILL and ABILITY to remain calm/helpful/loving/ and available during an entire 12 hour crazy shift, and an open heart for all people - that's a good nurse.
    I don't care if you are a BSN or came from such and such. A bad nurse is a bad nurse, and a nurse with a bad attitude and ugly heart is even worse.

  • Jul 18 '14

    Say what y'all want but a girl about to graduate with a BSN was clueless about how to clean a female patient during peri care.

    I also don't understand the point made previously about "broadening horizons" as far as the BSN goes. I do however agree with those who say it's just a lot of APA and paperwork.

    My stance: same stuff, just more loans and longer time

    But whatevs right? If it means job security then may as well do the BSN, they make it easy enough with it entirely online now

  • Jul 18 '14

    I say this proudly a lot on here, "I am an ADN, my nephew is a BSN, my aunt is a diploma nurse, she can wipe the floor with the both of us ANY day of the week."

  • Jul 18 '14

    These studies were done primarily when ADN's with years of experience in the field started going back to get their BSN's in order to move into management positions. I believe sincerely, that when an ADN with years of practical experience goes back to school, he/she will come back to the profession with more innovation and creativity and perhaps more zeal for the the profession. However, I believe that in the years to come when these studies are repeated, they will find that having a BSN outright does not improve outcomes. I am a novice ADN practicing, and working toward my BSN. I can tell you that I have not learned ANYTHING new yet. Just more about what I already learned in my most excellent education as an ADN. It is nice to have the review, but to pay for it and be denied chances at employment for it, no.

  • Jul 18 '14

    A study can be manipulated to show whatever the author wants it to show...IMHO.

    Mostly it is personal agenda of the ANA

  • Jul 15 '14

    Another issue I commonly see is students who are shocked to find that their state's Board of Nursing approval is not the same thing as accreditation. We turn away many applicants that did not graduate from an ACEN (formerly NLNAC) or CCNE accredited school, but insist that their program is "accredited by State X Board of Nursing."

    Thanks for reminding students of the importance of being informed consumers of education.

  • Jul 15 '14

    Well said francoml. It is great advice. You ahve learned a lot and grown exponentially over the last year.

    10:58 am by VANurse2010
    I don't think ICU nurses are a breed of their own. It seems the people who think that are the ones who've never done anything but critical care.
    I think all nurses have their own niche where they fit the best. I think ALL nurses are a breed apart. Nursing has become very specialized over the years and each area has it's own set of skills required to survive.

    I think in each area of nursing the nurses are a bred of their own. ER nurses usually do not like critical care. Critical care nurses don't like the emergency department. Many med surg nurses would do anything to not float to ICU. L&D and OR Surgical nurses have their own thing going on and you just can't float anyone there to be helpful. NICU/PICU nurses are a breed unto themselves.

    I have spent a lifetime (with the exception of 6 months), 35 going on 36 years to be exact, in critical care/emergency department arena. I have NO floor nursing skill...NONE! It takes a special person to take care of all those patients coming and going all day long. The closest I came to "floor nursing" was a IMCU/step down unit. I love the geriatric population however I cannot stand the way they are cared for...or should I say the way they are not cared for....sigh.

    I have been a supervisor, administrator, instructor, a manager, a flight nurse, an ICU nurse and a ED nurse. Each had it's own set of challenges.

    Me personally....I do not have the floor nurse set of skills any more. I also avoid OB like the plague. I can resuscitate the mother or the child....leaving them combined terrifies me. It always has....the worst thing that came be heard at a hospital is CODE BLUE L&D. It always makes me a little sick to my stomach. I KNOW what to do....it just makes me anxious. Always has. So much can go wrong! So much can happen..... I prefer to resuscitate something larger than the palm of my hand. Hats off to NICU!

    I agree that I think nurses in very specialized critical care areas are a little different that other nurses. They thrive in the critical environment. The anxiety, anticipation, and complexity is intoxicating. They can be aggressive and opinionated. They appear harsh and unbending...intolerant. They are passionate and protective. They don't mince their words.

    I'd rather triage a bus load of senior citizens with chest pain and care for an open chest with 13 drips and all the equiptment in the department in thier room than care for 8 patients on the floor. The thought of caring for that many patients fills me with anxiety. Sure I know how to code them...but care for them collectively? Shiver.

    Hats off to floor nurses.

  • Jul 15 '14

    I have been an ICU nurse for about a year now. I have learned a million and one things and still have a lot left to learn. I just wanted to offer a little help to new grads trying to get into the critical care scene and newly hired nurses in the ICU.

    First....


    If you want to be an ICU nurse go for it. It is one of the biggest learning curves you can take on but if that is your passion don't let anyone shoot your dreams down.

    Second....

    Apply to a large teaching university hospital. Usually those hospitals will have an internship program that lasts 4-6 months which includes one on one patient care, constant supervision by a preceptor, and critical care classes to teach you critical care medicine.

    Third....

    Study on your own time. Pharmacology, pathophysiology, A&P, ect. This will all be things that help you tie the whole picture together.

    Fourth....

    When in clinical (students) or once hired as a new ICU nurse, participate in everything you can if your patients are stable. If they are intubating a patient, ask if you can record or push meds. When coding a patient be the first one to hop on the chest and due compressions, bag the patient if needed, record everything that is going on ect. Watch the nurses place lines with ultrasound and ask them to teach you. Basically, as long as your patients are taken care of and stable, go around and ask if you can watch and learn or help out with procedures.

    Finally....

    You have to love what you do. You will see more death then any other form of acute care nursing. Some of the things you will see will tear your heart out. You have to go into this career path knowing that there is a very high turn over rate in this field because of how stressful it can be. That being said, there is nothing more rewarding that seeing the 19 year old girl who should have died, walk out of the hospital with a full recovery. It is the "little miracles" that keep you coming back for more even though the day to day can be gut wrenching.

    I hope this helps, ICU nurses are a breed of their own. It has been the only job that I have ever had that I truly wake up in the morning and am excited to go to work. You will either love or hate working on a unit and you will most definitely develop a dark sense of humor. I wish all of you students and new grads the best of luck in your nursing careers and always remember, there is a lot of people out there that are "dream killers." Don't listen to the negative people out there. You can accomplish anything you want as long as you put everything you have into it.

  • Jul 4 '14

    Yeah, but do they want those young things that go straight from high school to an MSN? Or will they accept those bridge type nurses, who put themselves through school, raised a family and then found the time and money to go back to school themselves?

  • Jul 4 '14

    Quote from TheCommuter
    I've listened as nursing instructors and professors stereotype ABSNs and DEMSNs as individuals whose first careers failed to launch.
    Wow, what a horrible, insulting generalization. I suppose the could extend that to ANYONE who didn't get into nursing in their early 20s.

  • Jul 4 '14

    Quote from TheCommuter
    Many recruiters and nurse managers differentiate between traditional BSNs and ABSNs.

    In some hospital systems, ABSN graduates and DEMSN (direct entry master of science in nursing) degree holders possess a certain type of reputation, and it isn't terribly positive.


    I've listened as some unit educators, nurse managers, recruiters and other folks in the nursing profession gripe that ABSNs and DEMSNs have trouble comprehending the concept of the 'worker bee.' I've listened as nursing instructors and professors stereotype ABSNs and DEMSNs as individuals whose first careers failed to launch.

    I will emphasize that there are many excellent nurses who earned ABSNs and DEMSNs. Unfortunately, some hospital systems give hiring preference to traditional BSN degree holders due to preconceived notions conflated with previous negative experiences.
    That is the biggest misconception I have ever heard. Who are these idiots? I work with many direct entry BSN that have no desire to place themselves on committees or even work an extra day. They are happy pulling their 3, 12 hr shifts and be done with it. It's the RN-BSN, or BSN-MSN that I'm seeing on committees (such as myself), driving PnP.
    Many of the direct BSN feel they have done their work, and are finished. The RN-BSN usually has an agenda in mind, IMO, and are more willing to change their workplace. Gosh, every one of our nurse leaders, such as charge nurses, nursing supervisors, such as myself, are RN-BSN, or BSN-MSN nurses.
    We are employees of the year, Daisy award winners, some of the BSN-MSN are even published.

    I'm happy I work with a very large national organization that not only encourages the RN-BSN route but also many non traditional schools.


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