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PacoUSA, BSN, RN 42,010 Views

Joined: Mar 25, '09; Posts: 3,522 (33% Liked) ; Likes: 3,428

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  • Jun 11

    :flmngmd: Flame me if you all will, but A&P is NOT hard. If you read before each lecture (even if you don't know what you just read), sit & take your notes in the front row like a good little student, don't chit chat with your friends during class, and never allow yourself to fall behind in anything, you will do well. A better word for the class is DEMANDING - it's a lot to learn but do-able! There are so many study aids for this class out there, you just gotta use them and ask help of the professor when you're stumped. This is why they have office hours. An "A" is within everyone's reach, you just have to want it bad enough and do what you have to to achieve it. If that means giving up the Thursday night pub crawl with your drinking buddies, that's what you do. Nursing school admissions are at an all time high in competition, you need to act accordingly.

  • May 1

    Quote from icuRNmaggie
    Hi Paco,

    If you are certain about CICU and CVICU, the best way to make your resume stand out, and make it past the resume parser software, is to take the CCRN and CMC exams along with the ANA Cardiovascular BC credential.

    These certifications will make you a better nurse and open a lot of doors for you, whether as staff or a traveler. Good luck!
    That is indeed the ideal situation and I would love to take that exam. However, without working in an actual ICU for a year or two beforehand and without any exposure to Swans and vents and such, I don't see how I could possibly qualify for the exam, as ICUman pointed out. I have also read on other posts how being CCRN certified without having actually worked in an ICU is not exactly a good thing to have on your resume, same for CEN and not having worked in an ER at all. I know it shows commitment to a specialty but isn't it the cart before the horse per se?

    Quote from ICURN3020
    I don't look at the big picture in the same way as you. Yes, I am an ICU nurse and take care of the sickest patients. However, if you put me on a med-surg, OB or peds floor I'd be freaking out. If you made me work in the OR or in psych, I'd be lost and out of my element.

    We all contribute different skills and knowledge to the patient. You might think working with ICU patients as exciting and ideal, and that's great...but just remember that the home health nurse who spends time educating a patient about their twenty different medications or the drug rehab nurse who sits and comforts a suffering person going through horrific withdrawal symptoms are also contributing their part.

    I guess my point is that you should never feel "not good enough" or "defeated" that you are not, in your current role, able to care for someone who needs a more specialized setting. Think of how many patients you took good care of who may have otherwise ended up in the ICU!

    It's great that you have goals and I wish you luck! My only hope is that, once you become a critical care nurse, you remember that EVERY area of nursing counts.
    To ICURN3020: I don't know why this is quoting as icuRNmaggie, but just wanted to make sure that i was addressing your post.

    Thank you for the pep talk. I'm one of those nurses that never forgets his roots. I'm a nurse almost 3 years and still treat new nurses like they are appreciated and not EATEN. I know what it was like to be new and I promised myself long ago I would never treat a new nurse like I was sometimes treated. I never forgot how some nurses treated me for forgetting to do things that most new nurses would forget due to unripened critical thinking. A couple of these I am friends with now, and when I told them what they did when i was new they both denied they ever did that. But I never forget.

    Likewise, when I become an ICU nurse, I will never treat a med surg nurse any less. I know where they are and what they go through. The best ICU nurses ... and ER nurses ... I've dealt with have been med surg nurses prior. Those that go into ICU right after graduation just don't seem to have the sense of empathy for what the med surg nurse endures with multiple patients and the WHY certain things were not done or why they don't know certain details off the top of their head. I know there are exceptions to the rule, but this has been my experience.

    I feel incomplete actually not having critical care training. I feel it is what I need to feel more capable of taking care of patients more effectively. If a patients starts decompensating, I start to perform proper interventions but once it gets to the point that a patient must leave my unit to a higher level of care, I become frustrated because I truly do feel defeated. It's like saying, you don't have enough skills to take care of this patient anymore, so we're taking him to a nurse that has more skills to be able to. Well, I WANT to be that nurse! Why cant I be? I feel that I have more potential for that and it is being unused. That is what ultimately frustrates me.

    The other frustrating thing about my job is the ratios. I find that I am more capable with less patients than with more, even if I am equally swamped. I can remember more about two sicker patients than I can with 5. The night my patient went into VTach, I had 6 patients. That was unusual for our unit usually @ 5:1 due to a nurse calling out sick and having no nurses to float to us in the entire hospital (there was also a major blizzard outside overnight). 6 patients is way too much to have on a tele unit. I am comfortable with 4 on this type of unit but even then I would prefer less. I think anyone would. But at the same time I would like to learn more complex skills and have more capability with respect to the sickest cardiac patients. Again, since I am a traveler I am limited to these units for assignments I accept until I return to staff, but I don't mind that as long as I can proactively do things while I am traveling to make me more marketable to become an ICU nurse eventually.

    I think I just verbalized above more clearly how I really feel more so than I did in my OP when I was on break

    In about a month, I will be taking a 2 day critical care boot camp course through PESI Healthcare. It's not a full ECCO course as I would like to take but it's the best I can do for now and put that on my resume. I'm hoping that will be a plus towards my goals.

    I think I'm rambling now so I'll stop here lol. Thanks for all your help guys in helping me deal.



    Sent from my iPad using allnurses

  • Apr 6

    Being too old to enter nursing is relative. Some people in their 40s can run circles around their 20-something counterparts. Yes, the body starts to decline for everyone, but not everyone is going to decline at the same rate. If the desire and the energy is there, who cares what age anyone is when they start nursing?


    Quote from Been there,done that
    40 is a little old to start nursing. It is physically demanding and we all start declining at 30.
    I am 60, can make 8 hours... but feel pretty beat up after. I have(younger) friends that are already on disability .

    38 percent of nurses report back problems. There are many more types of injuries on this job.

    Despite having the dream of nursing... the reality is ...it is BRUTAL work. Starting in your 40's , even if you only need to work 5 years to learn "raw" nursing ( an interesting choice of words as it is WILL rub you raw) is not a wise idea.

  • Feb 24

    For the record, 6 patients is NEVER acceptable. That's too many for any specialty. The charting alone makes it ridiculous.

  • Jan 31

    I dont know if I qualify as a real MS nurse, I'd like to think not as I am gradually moving my way away from MS to strictly cardiac and tele, but I still float to medicine and surgical units every so often. NG tubes are not that common, you may encounter one or two if you are lucky in your entire assignment. NG tubes are likely most common on dedicated GI units. For that matter, I dont even see too many chest tubes and it is one of the areas I feel that I am lacking in. Fortunately, you will always find an RN wiling to help you out that knows the ropes on that unit.

    Fortunately as well, I have never been in a position to insert an NG tube, and I would always defer that responsibility to an MD, as I have yet been to a hospital where this is done by RNs. What you will see most common on MS units are things like IV fluids and more than likely heparin gtts, protonix gtts, and wound vacs. Very rarely if ever will you see cardiac drips, those always go to tele units.

    As for IVs, practice makes perfect. Find out if U Colorado has IV teams, they will make your life so much easier! I have traveled to 2 hospitals already that have IV teams, coming from a hospital where floor RNs did ALL IVs. I do miss doing them actually, but I dont miss an infiltrated IV stalling my work flow!


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  • Jan 2

    Quote from SeaH20RN
    congrats! thanks for the update. what experience did you have previously? Good luck in the ER keep us posted.
    Thanks! I was a pcu/tele nurse for 4 years at the time I finished the course (about 3 years when I started). You probably read my last update above so that is what has transpired since. Good luck to you too!

  • Jan 2

    Since I am quite eager to change my specialty next year to ED nursing, I have decided to bite the bullet and begin this certificate program. I have just enrolled in the first online course and it starts next month. Seems quite interesting and reasonable, and I have to do continuing education anyway so I might as well kill 2 birds with one stone. I will keep you all posted on how it goes.

  • Jan 2

    Wanted to post an update to this thread. Since writing my last post I successfully completed the two online courses for this certificate program. I will soon begin the process of seeking a mentor for my preceptorship, the last requirement for the certificate which is 60 hours in an ER. I am hoping to arrange this at the ER at my next assignment (I am a travel nurse and work currently in telemetry/stepdown).

    The courses are taught by an experienced nurse in San Diego. They consist of pre-recorded lectures (with Powerpoints) posted on Blackboard from a previous live version of the course. Each course has five or 6 lengthy lectures covering a variety of topics and conditions that can be encountered in an ER. Although some of the information will seem repetitive from what you may have learned in nursing school, the lecturer injects anecdotes and tips from her vast experience which many will find good learning. Along with the lectures are 5 assignments in each course which must be submitted to the lecturer for grading (she is good with getting your assignments back quickly, graded and with comments). The assignments consist of case studies, multiple choice exams or short essay answers. They are not immensely difficult but by the same token they do require some thought to complete. Along with the lessons and assignments is a discussion board, which to be honest was not used much at all to interact with other students during the course, except to introduce ourselves at the beginning. Outside of that, I felt like I was pretty much on my own with the learning with no interaction with other students. That is probably the one disappointing part of the whole experience. The lecturer however was very responsive to questions during the course.

    The courses are offered every quarter so it is possible to start the course sequence during any of the four per year. The preceptorship from my understanding does not need to start with a quarter, it can start anytime as it is arranged separately from coursework. You are also required to complete the requirements of the certificate within 5 years of filing your intention to pursue the certificate.

    I have yet to start the actual process of finding my preceptor. I have been sent the paperwork required and will have to likely wait until I am on site to speak to ER staff in person at my next hospital. If I were in San Diego, I would likely have had an easier time finding a preceptor as I am sure many have completed their preceptorships at the UCSD Medical Center. I however am on the East Coast and not sure the program has enough ties outside of California to assist me with locating one.

    This certificate is not something that is required or guarantees to get a job in the ER of course. I decided to embark on it on my own just to have as something on my resume so that my future employers can see that I am serious about transitioning to the ER as an experienced nurse. I also learned many things along the way, so in that respect it was worth the time, money and effort I put into it. The coursework also offers a generous amount of CE credit, so that was also a plus towards the RN licenses I have that require them.

    I will update further on my progress as things get rolling, especially with regards to how my preceptorship goes and whether or not the certificate was a plus to have on my resume in landing my first permanent ER job.

  • Jan 2

    It has been about 6 months since my last post, so I thought I'd write a little update. I am not even sure if anyone is following my thread but the info I am sure is good for anyone who chooses to look for it later.

    So as of right now, I have started the ED preceptorship at the same hospital at which I am currently completing my travel assignment (I hesitate to post the name of the hospital where I am at this time due to anonymity, but what I can say is that it is one of the top 10 hospitals in the USA based on US News and World Reports). My current hospital did not have an existing relationship with UCSD to allow their students to do preceptorships there, so I had to go through a little red tape to make this happen.

    I started the process by contacting the nurse educator of the ED, who in turn referred me to someone else, specifically someone whose job is to arrange student externships and clinical experiences. She was spot on the person I needed to speak to. She explained to me what was needed to establish a relationship with the hospital and the school. She forwarded me the information and I in turn sent it to UCSD. They already knew what to do with the information, having already done this with other hospitals, so as far as my legwork this was done. My only problem was that I discovered that this process would take about 12 weeks (!!!) to complete, and was told that their affiliated school's nursing students would take priority in clinical placement before I would. I understood that. So what I ended up doing was extending my travel assignment another 3 months so I could accommodate simultaneous preceptorship and work. It was a success.

    I was later informed by mid-summer that I was able to start in late August (after all the nursing students completed their summer externships) and was given the name of my preceptor. She and I got in contact and arranged a schedule around her. The beauty of the 60 hours is that I can complete them in five 12h shifts. I have already completed one shift with her, and tomorrow will be my next. As long as I complete them before I leave (but according to UCSD, complete before the current quarter ends in Dec), I am good. So far, the one shift has demonstrated to me that I am on the right track in choosing this specialty. I really enjoy the dynamic and the fervor of the ED and I am sure I will enjoy working in one in the future.

    BTW, I must make mention that I am happy to report that I have ALREADY secured a full-time RN job in an ER back home! This will start 2 weeks after I leave my current assignment. I have been blessed to have gotten a job even before I totally earned the certificate. They were actually impressed that I was pursuing this certificate as it shows that I was committed to ED nursing and that it shows my eagerness for advancement and learning. So even though I have not fully earned the certificate yet, I believe it served the purpose I intended it for, and that makes the cost worth it to me in this competitive environment.

    In my next post later on, I will talk about what I have to do paperwise to complete my preceptorship aside from attending the 60 hours.

  • Dec 28 '17

    Quote from OCNRN63
    If you had to deal with people constantly saying something negative about something important/personal to you, you would understand. What usually happens is when one person says something bad about JW, it turns into a dogpile. There have been threads that had to be edited heavily by the moderators (and I appreciated that) because of things that were said.

    It certainly was about my faith; I've never made it a secret that I am a JW. Even if it were a post saying something negative about another faith, I would still find it offensive. This is supposed to be a site where everyone feels welcome. Badmouthing a religion runs the risk of offending others.
    I have to assume you're referring to my post, and I sincerely apologize if you took offense to that. It was NOT my intention to bash an entire religion and I feel that I did no such thing in my post. Thankfully, other posters recognized that as well.

    My sister could have been any other religion for all I care, but the "my life is better than yours" attitude and shooting down everything my life what about because her religion was not part of my life is what caused me to cut ties with her and her family. I have no regrets about that and really don't care to renew a relationship with her. She was pushing the envelope way too much with me and she would not stop.

    So that you know, I have several friends and a coworker who are Jehovah's Witnesses and I adore them all, they don't judge me or my life or try to pronounce their faith as superior to mine. I respect their religion and beliefs as they should respect mine.

    Please don't condemn me for specifying my sister's religion in my story, as this is how I am used to telling it generally. Perhaps I may be more sensitive to this now that I know it might be taken heavily by some. By the same token, I've never used that story as a license to stereotype the entire religion, because I know people are different despite religious beliefs.

    Just don't use your religion, any religion, to tell me how better your life is than mine or how guaranteed to hell I am ... only one Being can tell me that. Otherwise, we can be great friends! 😊

  • Dec 28 '17

    Come to think about it, church or religion is just never discussed at work. I don't even know who is what religion or who is an atheist or agnostic. But I certainly know all my coworker's menstrual cycles, just sayin'

    My sister is a Jehovah's Witness (converted when she married her husband), and I purposely distanced myself from her over 10 years ago because she kept injecting her religion into every conversation we had, even got to a point where she was judging my life and everything I chose to do with it (i.e., going to the nightclubs was evil per se). Unbeknownst to me at first, she even tried to set me up with someone who I assume was from her church, probably in an effort to welcome me into the fold. That was the last straw.

    Life has been quite happy for me since. Similarly, I wont tolerate this from coworkers either. I'll be happy to hear about your church outing, but don't proselytize me like you're selling me a used car. I'm quite happy with my relationship with God as it is and I have no intentions of changing that.


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  • Dec 8 '17

    In my experience, PCU is easier than med-surg due to the lower patient ratio. More time to critically think about your patient's needs

  • Nov 13 '17

    It has been about 6 months since my last post, so I thought I'd write a little update. I am not even sure if anyone is following my thread but the info I am sure is good for anyone who chooses to look for it later.

    So as of right now, I have started the ED preceptorship at the same hospital at which I am currently completing my travel assignment (I hesitate to post the name of the hospital where I am at this time due to anonymity, but what I can say is that it is one of the top 10 hospitals in the USA based on US News and World Reports). My current hospital did not have an existing relationship with UCSD to allow their students to do preceptorships there, so I had to go through a little red tape to make this happen.

    I started the process by contacting the nurse educator of the ED, who in turn referred me to someone else, specifically someone whose job is to arrange student externships and clinical experiences. She was spot on the person I needed to speak to. She explained to me what was needed to establish a relationship with the hospital and the school. She forwarded me the information and I in turn sent it to UCSD. They already knew what to do with the information, having already done this with other hospitals, so as far as my legwork this was done. My only problem was that I discovered that this process would take about 12 weeks (!!!) to complete, and was told that their affiliated school's nursing students would take priority in clinical placement before I would. I understood that. So what I ended up doing was extending my travel assignment another 3 months so I could accommodate simultaneous preceptorship and work. It was a success.

    I was later informed by mid-summer that I was able to start in late August (after all the nursing students completed their summer externships) and was given the name of my preceptor. She and I got in contact and arranged a schedule around her. The beauty of the 60 hours is that I can complete them in five 12h shifts. I have already completed one shift with her, and tomorrow will be my next. As long as I complete them before I leave (but according to UCSD, complete before the current quarter ends in Dec), I am good. So far, the one shift has demonstrated to me that I am on the right track in choosing this specialty. I really enjoy the dynamic and the fervor of the ED and I am sure I will enjoy working in one in the future.

    BTW, I must make mention that I am happy to report that I have ALREADY secured a full-time RN job in an ER back home! This will start 2 weeks after I leave my current assignment. I have been blessed to have gotten a job even before I totally earned the certificate. They were actually impressed that I was pursuing this certificate as it shows that I was committed to ED nursing and that it shows my eagerness for advancement and learning. So even though I have not fully earned the certificate yet, I believe it served the purpose I intended it for, and that makes the cost worth it to me in this competitive environment.

    In my next post later on, I will talk about what I have to do paperwise to complete my preceptorship aside from attending the 60 hours.

  • Oct 30 '17

    I love Nurse Jackie!

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  • Aug 18 '17

    I found myself in a similar situation, except that for me it involved the legal profession. For almost 10 years I had jobs in private practice and legal aid as well as stints as a solo practitioner and with the U.S. government (mostly immigration but some jobs explored a few other areas of law as well). None brought me complete satisfaction and it was a year ago when I started to think about nursing (and when I originally started college I was a pre-med major, so I feel I have come full circle now). It's too long a story as to how I ended up in law, but for the sake of time and money I too should have listened to my inner voice and quit law school that first semester when I was drowning in memos, case briefings and the Rule Against Perpetuities. Oh well, I continued on, graduated, passed the Bar and went on to work in hopes things would get better, and they really did not. I was good at most of what I did, but there was always a missing link and life I found was too short to continue feeling that way.

    What I did to confirm my intuitive decision was take a computerized career inventory at my nearest One-Stop career center (not sure if they have those where you live, they are often associated with unemployment agencies). It was free to take and you spend an hour answering questions that more or less determine what careers best suit you. Well, not to my surprise: the health care professions came up on top of the heap, followed by social services and business. Law was not dead last but somewhere in the lower half (agricultural occupations was dead last, of course - I grew up in NYC and can practically kill a plant with my eyes ... LOL)! Can you believe it? Where was this thing 20 years ago

    Well, my point is: try to get one of these done and see in what direction your interests lie. Perhaps there is a career path that will complement your nursing background, many here have suggested fine options. I don't intend on abandoning my legal background altogether. After some years in nursing, I plan to reintroduce my legal experience into nursing and THAT I feel was the missing link.


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