QuishaRN 723 Views
Joined: Aug 30, '10;
Posts: 3 (0% Liked)
The best way to avoid hypotension following NTG with CP is to get a 12-lead first. While the majority of MI's affect the left ventricle, if an MI affects the right ventricle then NTG is contraindicated and will typically cause much more severe hypotension than in a LV MI. RV MI's typically need an aggressive increase in preload, while NTG reduces preload.
When NTG is indicated the usual rule is Nursing judgement.
You have 4 solid years of nursing experience during which you have undoubtedly mastered time management, delegation, communication, physical assessment, etc.... don't sell yourself short!
Based on my own experience, I would not recommend working 3-11 while your kids are so small. You will have other career opportunities in the future, but you will never be able to re-wind the clock where your children are concerned. I discovered that working nights (11-7) was a far better choice because I didn't have to sacrifice that important evening/bedtime period with my kids.
Have you explored any LTAC opportunities? These are a very good transition to acute care - the patients are 'acute' but just have longer lengths of stay. They may even have some very high-dependency, ventilator-dependent patients which would enable you to polish those high-tech skills.
You're wise to shy away from supervisory positions due to the added stress that these positions entail. IMO, first-line nursing supervision jobs are the hardest ones in health care. They are squeezed between the demands of staff & upper management; accountable for keeping physicians happy; responsible for adhering to bare-bones budgets; have to fill-in at the bedside to fill absences or make up for high census, etc.. . . sheesh. Plus, you would no longer be eligible for overtime. Many experienced nurses are opting out of supervisory positions for all those reasons.
I'm in need of advice. I'm from PA and have been a RN for 4 years. All 4 of those years have been spent doing pediatric home care and in the past year I picked up a casual part time position at a long term care facility. I recently was presented with a nursing supervisor position at the LTC facility for 3-11p shift. Although I really could use a full time position, Im questioning a few things.
1. I never had the chance to experiencing working in a hospital. I feel like if I accept this, I may lose some of my skills or get stuck in administration. I'm young and still in the beginning so I don't mind being on the floor.
2. The only shift available is 3-11p. I have two young children. One almost 2 and the other almost 4. I would never get to put my kids to bed or feed them dinner or see my partner. Once my oldest starts school, I'd hardly see her either.
3. After being a nurse for 4 years and having never worked in the hospital, is it even likely for me to get hired?
Above are my most major concerns. Am I being to picky and missing out on a great opportunity? It would make things so much easier financially but I feel like Im selling my soul. To the other nurses in supervisory/administrative position, how much clinical/hands on experience did you have? Are you less stressed and happier than on the floor?
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