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  1. Past hour
  2. sabina20

    Dominican College ABSN / WABSN program 2020

    did you guys get accepted to other programs? I am looking into others programs.
  3. JenMH88RN

    Any other options??

    I have decided to enroll in a 2.5 year NP program but here’s the real dilemma: I DO NOT like bedside nursing, for various reasons(everything falls on you as the nurse, nurse-to-patient ratios, etc). It sucks because I am a really caring person . I got into it because all of the more experienced nurses told me that I need at least 1-2 years of med-surg experience. Also, I really didn’t know what I wanted to do after graduating nursing school . My question: is there anything else I could do while going through this NP program that would still allow ample study time?? As I cannot see myself doing bedside nursing for another 2.5 years. I would really appreciate all of you guys’ suggestions.
  4. ghillbert

    PMHNP Preceptor

    Have you tried contacting local NP professional organizations?
  5. FolksBtrippin

    Accepted new job - union contract negotiation

    I'm pretty sure you'll start with the new negotiated contract rate. But check with your union rep.
  6. Mercymercy

    Missouri State University CRNA

    The program is set up pretty good!! The summer when you start is tough. It is alot of information for a short amount of time. This program gives every student a mentor which is something different than other programs. Teachers are flexible and very caring. Cons, none of your clinicals will be in Springfield, so planning for your clinicals is kind of up in the air until 6 weeks prior to going to your chosen spot. No program is perfect as you will find out when you start either here or any other school. Just have to be willing to be very flexible.
  7. sabina20

    Dominican College ABSN / WABSN program 2020

    I like your spirit! They told me that acceptances are going out until the New Year. After that rejection letters go out.
  8. adammRN

    too soon to be an NP?

    Missed the point. The skills are still valuable, regardless of where you work. Sure, you can do a BSN-DNP without exp, no one will stop you. The school will still take your money?
  9. So how did you all do on KAplan test? We are playing the waiting game now and it is nerve breaking !
  10. NewGradRN_510_Peds

    CHLA RN Residency March 2020

    @Living2Learn No, news yet. Maybe I'll reach out tomorrow.
  11. I think you added the fever part, that certainly would have contributed to a more clearly defined dx of sepsis. The findings given aren't necessarily specific to sepsis, and most could also be explained by aseptic decompensated heart failure. Although it does become a little trivial, since one of the main components of sepsis is circulating negative inotropes, so in the end what you're dealing with is fairly similar. If Norepi is being given, then it's very important that the patient have sufficient intravascular volume for the Norepi to work, which usually requires a volume status more on the fluid overloaded side. Once-upon-a-time, Norephinephrine, ie levophed, was referred to as "leave-'em-dead" since it wasn't found to be all that effective, until it became more commonly understood that Norepi doesn't do much in a hypovolemic or even normovolemic patient. So to diurese a patient on Norepi would mean the patient would have to have so much excessive intravascular volume that diuresing would still leave them somewhat fluid overloaded, the only obvious indication for that would be fulminant pulmonary edema, otherwise you're going to need that fluid volume to stay in there for the time being. It may also have been that the patient was hyperkalemic, in which case lasix would be a good option but may requiring replacing the diuresed volume with IV fluids. A better option for dealing with fluid overload in this patient would be to look at cardiac output vs metabolic demand, either directly or by indirect indicators like an ScVO2, and give an inotrope if indicated, if that works sufficiently then the kidneys will get rid of that extra fluid volume when they deem it appropriate.
  12. Today
  13. SNJ_nurse

    RUTGERS ABSN SPRING 2020

    Its like an online portal through which you have to complete drug testing and background check. My friend who completed the program stated that we should have access prior to program. Have you heard anything about background checks/drug testing? Or only to "my enrollment pathway"?
  14. 6164Shel

    UT Austin Alternate Entry 2020

    Congratulations and All the best wishes to you for the interview. Share us with how it goes.
  15. If the patient was hypotensive from their cardiac history then norepi is the wrong choice. If the patient was hypotensive from septic shock then norepi is the wrong choice. If a patient is in cardiac failure, giving lasix is not going to improve blood pressure. If a patient is in septic shock, giving lasix is not going to improve blood pressure.
  16. LibraNurse27

    JP drain to suction?

    Wow! that sounds very interesting. Yes I don't think this drain was not manufactured to be connected to suction. I saw online there are some JP drains that have a two way valve and can be connected as a closed system so that even when the drain is unplugged from suction no fluid flows out. It's pretty cool! But that was not what this was, was unpossible to unhook it and keep completely sterile. Anyway, the patient did not become septic from the glove but they found she has stage four liver cancer so now the glove seems irrelevant. I will care for her tomorrow as a comfort care patient. Thank you all for your kind replies!
  17. Silverdragon102

    Question RE: National Nursing Assessment Service (NNAS)

    Moved to the Nurse Registration forum According to CNO there are other options for English. http://www.cno.org/en/become-a-nurse/registration-requirements/language-proficiency/accepted-language-proficiency-tests/
  18. PHNurse5

    Kaiser Inexperienced RN Baldwin Park

    I recently applied for a Kaiser inexperienced/new grad position for Baldwin Park. I got an email to fill out the required snapshot questionnaire and sent it in before the deadline. I received a call from a recruiter, and we spoke a little about the start day and about my resume. Has anyone received a formal interview invite? She told me the start date is at the beginning of the upcoming year so I assume they will be sending them out soon.
  19. rhubarbstrawberry

    Gateway Fast Track LPN Spring 2021

    Wow, really? Do you know when they were thinking of rolling out the second cohort? Many congrats on completing the program! I’ve heard it is challenging, but 100% worth it. Looking forward to learning and working hard. P.S. If you have any tips on prepping for LPN study, I’d love to hear them!
  20. Yes, I read the history of CHF and Afib. One of the questions is why is the patient hypotensive and requiring pressors. If we believe that the patient is hypotensive not as a result of sepsis but rather advanced cardiac disease then that needs to be addressed, and norepi isn't the drug for it (or at least not the only drug). If we believe that the problem is the heart's ability to squeeze them we should be giving an inotrope. Patients with a history of heart failure typically still require some fluid resuscitation during sepsis/severe sepsis/septic shock. If the patient requires volume resusitation, then giving lasix isn't going to help anything.
  21. Learn to sift the wheat from the chaff. This person is not giving you harsh criticism; she's just being a b. True criticism (even harsh) will give you something to learn from. This person is just sliming you; that's why you feel dirty when you're around her. It's her dirt you're picking up on. I think Turtle's advice is right on. Otherwise, just nod and verbally agree with everything your coworker says while mentally dismissing it. She'll sooner or later figure out that she's blown the priviledge of being taken seriously by you. Meanwhile, find some mentors who will give you solid advice and an accurate assessment of your progress. Every new job has a coworker like yours. Her behaviour is about her, not you.
  22. Patients in early spesis/severe sepsis/septic shock do not need to be diuesed in the ED. They need volume resuscitation, the pathophysiology of sepsis results in 3rd spacing (which includes the interstial spaces ot the lung) which decreases intravascular volume. Giving lasix in early sepsis isn't going to reduce that 3rd spaced fluid in the lungs, you can't just pull it back into the vascular space simply by reducing the free water volume volume in the intravascular spaces. If you have the desire to really aggressively prevent 3rd spacing during sepsis you can make sure they have optimized osmotic/oncotic pressure and give blood products (especially PRBCs, platelets, and albumin). Lasix is just going to decrease intravascular volume leading to vascular collapse, while doing nothing to address the 3rd spaced fluids. Pressors are not a replacement for fluids in the setting of intravascular fluid deficit. If you put the patient on a NICOM, Flotrac, trending CVP, trending CO with a PA cath, or doing repeat U/S of the venacava and RV while providing small fluid challenges or passive leg raises they you could argue that more fluids aren't going to help. It doesn't seem that any of those things have been done (nor do most EDs and many smaller ICUs). You could also make an argument for volume replacing with 5% albumin or other colloid, although this isn't supported in the literature. Many patients don't tolerate CPAP/BiPAP well. A precedex drip, ketamine drip, or a small amount of ativan can all greatly improve tolerance when given with good education and coaching.
  23. Yesterday
  24. mpest17

    california license by endorsement

    Hi there, just wanted to contribute my timeline since all of these helped me when was getting antsy and waiting. Oct 26- Submitted application online, I was out of state so I requested the fingerprint cards. Those took about a week to get to me and I got them done the day I received them and sent them the same day.I emailed the BRN because I started reading that the fingerprint card method took the longest, I explain that I was planning my move in about two weeks so she recommended I just get the live scan finger prints and to write a request for a refund. Nov 25- I was in California got the live scan fingerprints and then waited... Dec 13- Checked the breeze account and my application went from pending/open to showing an actual license number. so that was 5 weeks and 6 days since I submitted the application! I'm still super surprised, but super happy that I can start applying to RN jobs! As far as the refund goes I don't think I'm getting it, but to be honest I'm ok with that
  25. AshleyCRNAdriven

    UTA RN-BSN Program Answers 2018

    Hi, I have two questions In 2010 I earned my B.S. in Health management and decided to go back to start the nursing program. I am currently taking the last of my Pre reqs at HCC, and another student told me that in order to get accepted you have to take UTA's pre reqs before they will accept you in the nursing program. I would like to know if that is true? My second Question is what is "3 Considerations" mean? Thank you for you time and willingness to answer questions
  26. I'm confused by all of this lol But I'm not going to accept anything unless Dominican sends me a mail with a decision themselves, whatever that decision is.
  27. LibraSunCNM

    Plant-based (vegan) mandate for NY hospitals

    I think for this situation to be the actual can of worms you describe, most vegans would have to be ridiculously unrealistic and rigid, which in my experience, they aren't.
  28. Has anyone bought their all white shoes yet? I’m having a hard time deciding what shoes to get! Can you all tell me what you bought?
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