pitt81 2,020 Views
Joined: Dec 22, '12;
Posts: 25 (20% Liked)
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1) I think you should sit down with this person and talk to her and maybe appologize that she took your tone and questioning the way she did. Let her know you were having a bad day etc. If this doesn't happen their will always be some tension and/or some awkardness between the two of you.
2) I don't think any hospital or other facility would ever allow someone, other than a nurse to draw from a PICC. A phlebotomist cannot flush a PICC and assess whether it is patent, they cannot stop IV pump meds and then recontinue them, and they generally are certified and not licensed. So I would not hold your breath waiting for them to be able to do this.
I have to be honest we have almost all been there when you are tired, understaffed, and over utilized and you feel like you cannot get out of your own way, and then someone else comes along and asks you to do something else. The frustration can sometimes enter our conversations either in words or tone, even if maybe that isn't our intention, or maybe it's a way of venting frustration, but it happens and we don't always realize another persons perception. Also never forget the patient may be listening as well, and if I was the patient and heard you speak about how someone else should be able to do whatever it is that you are doing then I would probably get a little upset that my needs were inconveniencing the nurse that is suppose to be caring for me, so also keep that in mind. Family as well...
I have been in the Army for almost ten years so far starting out as a combat medic. I performed my job for about six or seven years doing various trauma courses and operational assignments and really just having a great time. After that leg of my Army life, I went to LPN/LVN school through the Army's program and eventually applied to the AMEDD Enlisted Commissioning Program (AECP) in 2015 to obtain my RN license. AECP is a whole other information session so if you have questions with regards to that, I am always here to answer questions about packets for those of you who are Army enlisted.
The following is some information for DCC and BOLC because I haven't found any other information that is not a year or two old.
So prior to coming to AMEDD BOLC at San Antonio, I had to attend the Direct Commission Course (DCC) at Fort Sill, OK. My course only had around 36 newly commissioned officers so it was small and personal. It was stated that most courses have over 100 usually. Within my class, around 95% of us were prior enlisted E6 or E7's.
DCC is really directed to those who are brand new to the Army. We learned (relearned for most of us) how to do facing movements, introduction to hand receipts, Army History, Military Decision Making Process, land navigation, and tons of other PowerPoint presentations that were dragged out. The best part of the course was probably the rifle familiarization range or land navigation because it got us out of the classroom. A few of those within our platoon that were brand new were helped out by many of us when it came to firing a weapon and understanding land navigation. The course was 4 weeks and we were limited to post, unable to drive our vehicles, and only allowed to wear either the Army Combat Uniform (ACUs) or Physical Fitness Uniform (commonly referred to as PTs). Weekday nights were usually going to the gym or hanging out in the barracks. We had two to a room but they may increase that depending on class size. If you are brand new to the Army, make sure you have funds available to buy uniforms and all the small details that go along with them.
Now currently, I am attending BOLC at Joint Base San Antonio, former Fort Sam Houston. For the report date we were set to check in at building 592 (Holiday Inn) and single person rooms were assigned. After reporting, the rest of the day was yours. The first week was held in the auditorium as a whole class, roughly 160 officers. This first week we went over Army programs such as Sexual Harassment Assault Rape Prevention (SHARP) and the Equal Opportunity Program (EO). We also had our Army Physical Fitness Test the second day which threw a lot of people off, especially after Christmas. Other things that were done within the first week was Permanent Change of Station (PCS) information and information about life insurance, thrift savings plan (TSP), and other Army information. The end of the first week we have Central Issuing Facility (CIF) gear issue which was everything that we need for the field training exercise (FTX) later on in the course.
The second week of the course we were scheduled for the AMEDD Museum tour but it was cancelled due to post shutting down because of icy road conditions. This week we additionally gathered in our platoon classrooms. My platoon had 21 people or so assigned. Each platoon has a Platoon Advisor (PA) and four civilian instructors. From what I've encountered all of the PA's and civilian instructors are great at their jobs. You can tell they want to be there and want to further success within each Army Officer. Within our classroom we went over Army doctrine, troop leading procedures, and Master Resiliency Training (MRT). The end of the week we had a pre- Army Service Uniform (ASU) inspection. This is your dress uniform and it can be pretty expensive so once again, make sure you have funds available. I believe that male uniforms are around 300 dollars and females are a little more expensive.
Week three was more courses within our classrooms. More MRT and information about Non-Commissioned Officer and Officer evaluations. We began receiving homework this week, but all platoons were different when homework was due. Some received homework in the first week and got it all out of the way quickly. My platoon had it more spread out which was not as stressful. In addition to the evaluation homework we did, we also had to do a leadership philosophy brief and military brief. Aside from the briefing, most of the homework is done in groups.
At the beginning of week four we had our midterm exam. The exam can be difficult for some but if you study and have a good platoon to work with for a review, it is doable. This week we also had a Chemical, Biological, Radiological, and Nuclear (CBRN) course all day as a whole class. At the end of the day we had an exam over the material, but it was open notes. Rest of the week was just more classes, some as a whole class in the auditorium and some in the platoon classroom.
The fifth week was started with going over some of our homework. We also went and worked on the EST2000 which is basically a videogame range with real rifles that are adapted towards the game screen and there to help you develop your fundamentals of marksmanship. Rest of the week was more courses on law of war, standards of conduct, a FTX brief, layout of medical platoons and medical companies, and a class on land navigation. The Friday of this week, we had our final. A little harder than the midterm. We had a couple of fails within our platoon, but they had retests later in the field and passed. Additionally, we had reserve officers come in for the field. They go through what is called the short course because they complete the didactic portion online. We welcomed about 16 of them into our platoon and everything molded together with no issues.
Week six was the first week of the field. We had to meet outside of building 592 (the Holiday Inn) at 0420 for accountability and transportation to Camp Bullis. This is roughly an hour ride in the bus and you are able to get a nap in. Once we got out to Bullis, the platoons are sent through round robin training essentially. This first week we went over Army Warrior Tasks which include inspecting and throwing grenades, disassemble/assemble an M16 and M9 pistol with functions checks, and sending up a 9-line MedEvac request. We were supposed to complete a couple of actual live fire ranges but do to weather it was pushed back so we completed day and night land navigation on the Friday of this week. To receive a go, you have to get 5/7 points for day land navigation and 2/3 for night land navigation. After we completed our training for the week, we cleaned up our training site and were bussed back for the weekend.
The second week of the field was the same meetup time in front of building 592. This week we focused on roles of care so we were given information on running a battalion aid station (BAS, level I) from point of injury to first line treatment, brigade support battalion (BSB, level II), and a combat support hospital (CSH, Level III). Don't get too caught up on trying to do a nursing role and perfecting medical skills during these as they are there to give everyone an idea of how patient flow runs and not necessarily medical treatment. Be flexible and jump in where you can despite whatever your role title and job is. Learn and get a basic idea of patient movement. We were scheduled to have a range on Friday this week but once again weather pushed it back and we completed our actual role III exercise. Other platoons completed role I or II while ours is scheduled for the following week.
We have one more week of the field before graduation. I will provide information from the final week as well as the two-week nursing track once I get into it. If you have any questions, let me know! Hopefully this helps some. Thanks all.
Don't stress. Your GPA is fine. I wouldn't let it fall much lower but if you can stay steady with a B+ average you'll be fine. The GPA just gives them an idea of your ability to study and take your courses seriously. They will probably be more interested in your science GPA over your nursing GPA anyway.
As you mentioned there are many many other hoops to jump through for them to use as a measuring stick for competitiveness. It's all relative. If you have an overall GPA of 3.2 but have your CCRN, scored amazing on the GRE, did 3 years of high acuity critical care nursing taking care of ECMO, initiated new changes in your hospital to decrease VAP numbers via research and EBP, have three letters of outstanding recommendation from anesthesia providers and managers, do volunteer medical mission trips with your local church in Kenya, shadowed a CRNA for 75 hours over a 6 month period, exceptional personal interview that made a lasting impression, etc. You get the picture. What I just described to you is the type of candidate they are looking for. So as you can see with all the different criteria they are looking for in an SRNA you shouldn't focus so much on your GPA alone.
You can have a 4.0 GPA but if you barely have a year of mediocre ICU experience, have no leadership experience, worked on no committees, a couple unimpressive letters of recommendation, come off badly in the interview, you can bet they will pick the 3.2 GPA with all the other stuff.
You're right, CRNA school is very competitive, it's very likely that you'll apply to a few different places, interview at a couple and get an acceptance to one, two if you're lucky. Just jump the hoops, show them how bad you want it and how you're willing to work for it through objective measurments they can see on paper (not just a GPA) and don't give up. If you get rejected from your first school, don't throw in the towel, most of us have interviewed somewhere and not got an offer extended, you'll apply to the right school and you'll get in. You'll become that SRNA you're hoping to be.
Then one day you'll be that SRNA, tired from being in the OR all day but taking the time to type this out so a nursing student who is just where you were at 9 years ago can widen their perspective and keep taking their steps on the path to their dream career. Good luck.
Stop working for this nurse on your day off.
You were exactly right. I would've done the same thing. Your coworker doesn't have the right to say that her sickle cell patient isn't in pain. Pfft.
Kudos to you for doing the right thing and advocating for your patient.
You need to be evaluated. That is all we can say here.
I am glad that you are interested in advancing your career! As mentioned above CRNA school is extremely competitive. Most applicants have a cumulative GPA > 3.5. That's not to say that if it is less than that you wouldn't get in. Pharmacology is VERY important to the CRNA faculty and you should retake it and get an "A". While grades are very important it is not the only factor in getting in. The GRE is VERY important as well and is a crucial component to the totality of you application. Working with CRNA students, those with lower cumulative GPA's had higher GRE scores. Clinical experience is also an extremely important factor. A minimum of one full year (OUTSIDE OF ORIENTATION, usually at least 3 months) in a critical care unit is required. The more experience the heavier that weighs in on your overall application. Certifications like CCRN, CSC, and CNRN also add weight to your overall application.
The "D" will be on your transcript, but when you retake the courses if you get an A, you can elaborate on how the first time you took it you had a rough start.
The interview is crucial, I had a friend with the PERFECT CV, GRE, and GPA and bombed his interview, he didn't get in the first time, but got in the second time around. If you interview really well and are able to explain physiological processes really well (I am sure there are horror stories about how intense this interview is, questions like how does Propofol work at the molecular level or explain the path of a PA catheter and the ECG rhythms associated with it). If you can ROCK the interview, even if your grades are slightly lower, you may still be offered a spot in the program.
All this to say, you need to re-take those courses for your future as an RN! While it is important to think about the future and going the EXTRA mile to get all A's and B's in nursing school! You will first and foremost be a NURSE! Some people are really tuned off by that, but whether a CRNA, NP, or Midwife, you are still and NURSE! The are certainly other paths to consider to be a mid-level provider (PA in primary care or anesthesia or Anesthesia Assistant), that you may want to consider if you'd rather go a different direction than nursing.
Just keep telling yourself that......
Sorry, jls, you are wrong. And I am not going to post what program I was in. It is not a matter of the program; it is a matter of if you are the type of person who can tolerate what is common in CRNA programs. The poster immed. after you is correct. There are not 'good' and 'bad' programs. This is the way it is in SRNA clinical education. Not every CRNA or MDA, and not every day in clinical, but it is the norm and you have to know it and figure out if you are emotionally tough enough to follow the all important rule: stay below the radar.
It is true that the PD of the program I was in is nuts. But no one has to hear from me what program it is: the PD is known to be nuts. If you do any type of due diligence prior to interviews, you will get an earful about this PD if you happen to be interviewing with her.
SRNAs are not going to tell the world the truth about this to just anyone. PDs read these boards, too.
Thank you for writing this, and as many have commented before...you did the right thing and advocated for your patient. So many times, it is very nerve racking to have to approach a doctor and report your concerns (especially when it questions their orders). I do find my inner strength to do so because I tell myself, even if I question them and they get angry, I would be doing the right thing and all that I can to care for my patient. I appreciate other nurses feel the same way.
Unless you're witnessing a blatant safety issue, you shouldn't feel guilty if you decide not to speak up.
When I worked in the hospital (peds neuro), we had a teenage patient admitted for elective EEG monitoring who had a history of being a sex offender. He had molested his younger sister, I believe. Perhaps this is different because it was a peds hospital, but it was most definitely documented in his notes, passed along in report and he had security planted at his doorway.
When I worked acute care we had a contract with the local federal prison and the county jail. I never wanted to know what their charge was that way it wouldn't influence my care or how I treated the patient.
I agree with the others; snooping into the patient's background online is inappropriate. I would neither chart on this information nor pass it on in report. All of these are unprofessional acts that are not undertaken in the patient's best interest. Anyone so concerned about the ankle monitor should be more concerned with checking the area for pressure points, circulatory compromise and skin breakdown in a very ill bed-bound patient than why the patient is wearing it!
That said, there are situations (different than the OP, obviously) in which the patient verbalizes concerns about legal restrictions or concerns about complying with probation conditions while hospitalized - or some other issue directly related to his/her legal situation. A social work consult is often appropriate if available. Legitimate nursing actions undertaken at the patient's request should be factually documented without going into unnecessary detail and passed on for follow-up.
Absolutely not. It's not relevant to the care that you are providing, and you shouldn't be searching for info on patients online in the first place.
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