Vance

Latest Activity

1. Clinical Doctorate in Anesthsia

   Vance replied to Lambert5883's topic in CRNA

   What's the point of credentials? Wouldn't it be better if we judged 'novice to expert' by metrics such as time in service, clinical record, skill and testable expertise. For instance, compare and contrast the hypothetical: a brilliant, highly skilled...

2. Need a good ICU book

   Vance replied to erinnRN's topic in General Nursing

   We use Critical Care Nursing: Diagnosis & Management (4th Ed.) in Albany NY

3. Need a good ICU book

   Vance replied to erinnRN's topic in MICU

   We use Critical Care Nursing: Diagnosis & Management (4th Ed.) in Albany NY

4. Lovenox IV

   Vance replied to Celia M's topic in CCU

   LMWH compare favorably to UFH in prevention & treatment of venous thromboembolism and are associated with less thrombocytopenia. In addition to the preloaded syringes it's available as 100mg/mL and 150mg/mL multidose vials; pH5.5-7.5 and rather e...

5. Please Recommend A Critical Care Book

   Vance replied to EyesForward's topic in CCU

   In Albany NY we use Critical Care Nursing: Diagnosis & Management (4th Ed.) for critical care certification. It's comprehensive.

6. Advice needed please

   Vance replied to nursedaisy's topic in CCU

   What is your career goal or what do you 'see' yourself doing in 3 years?

7. New BSN Nurse with Hard Decision - Teaching Hospital vs. Community

   Vance replied to amcgraw's topic in CCU

   Community hospitals are wonderful. The gap isn't as wide as it's made out to be. What will you miss really? In turn, you'll reduce your stress, expense and maximize your time. Yes, indeed, get the CCRN and every other certificate that's important. Th...

8. 3 months in and I hate my nursing job

   Vance replied to Serenyd's topic in New Nurse

   Open, forthright communication with your manager could help your situation. Every new grad is a work in progress, it takes much time and expertise to get us up and running; every manager is well aware. So, it's in the unit's best interest to salvage ...

9. black list?

   Vance replied to hoping05's topic in New Nurse

   From experience, although not mine, you might report to HR the manager who has been giving bad reports. Request a generic letter as a remedy and be assured you'll hear no more from the disgruntled manager. You can always have someone call, and possib...

10. Mercury Exposure

    Vance replied to Sharon's topic in General Nursing

    No counter argument here...

11. Pain Mngmt in Critically Ill

    Vance replied to laurenD's topic in Pain

    Your argument for better pain control is valid. The physicians in this case are either unpracticed and/or indifferent. Our nursing role is to intelligently advocate for the patient, making the team aware of your findings and identifying alternatves o...

12. Barbiturates in Critical Care

    Vance posted a topic in Neuro

    I understand that barbiturates are neuroprotective in CNS/brain injury. Why don't I see their use, particularly when sedation is warranted? Instead, it's seems propofol and/or a benzodiazapine are used, without further consideration. Have barbiturate...

13. NP vs MD/DO

    Vance posted a topic in NP

    What are the limitations on NPs in the practice of medicine and surgery compared to MD/DO in the same clinical setting? For example, in a hospital ER or tertiary primary care setting, what skills/procedures/treatments would an NP be excluded from tha...

14. Psychiatric NPs or CNS/ starting a practice

    Vance replied to BCzito's topic in NP

    Contract Negotiation for Nurse Practitioners 4. Negotiating Compensation Determining Worth of Service: When negotiating contracts, it is important to determine both the amount of income that the nurse practitioner may bring into the practice and the ...