CANewRN

I am currently a pediatric ICU RN. My passion is cardiothoracic critical care. I want to get my NP and become a part of the intensivist team. Because my goal is so focused, I am debating whether to do pediatrics or adults. Ideally I would do both, but for my masters track, I have to pick either acute care adult, or peds NP. Does anyonne have any advice? I am at a loss.. and am figuring out whether to apply for the 2010 class or not. thanks!!

No, havent applied. What is the application process like, and how competitive is it to get in?

I too have a post grad depression going on... but I had a job lined up 6 months before graduation! I think for me it was multifactorial: 1 Being done with school and now an "adult". School is all Ive ever known 2 New responsibility and a new career 3 Moving a few states away from home/family to take this job. When I first got here (8/08)I was sooooooooooooooooooo EXCITED!!! I had just got my licence, living in a place I had always dreamed of, and was finally a NURSE, and starting in a unit/hospital that many can only dream of. But... reality set in after the few months and the honeymoon was over. I had put this job on a pedestal and it wasnt exactly how I had pictured it. The reality of not having scheduled breaks to go home for holidays also was very very hard, and pretty much this was the first time I hadnt lived near family. So the stress and money spent trying to go home for as long as possible has been a big issue in the last few months. So Ive come to the realization that moving back home later this year is probably the best thing for me. Once I finish my new grad commitment here and have a year under my belt, I hope to be able to get a job anywhere. Though Ive been very sad the last few months and dont want to leave my job, I know it was an opportunity that I couldnt pass up :wink2:

Tay, Would you be willing to relocate? UCLA has a great new grad program, that hires groups (of about 15 or so per unit) of new grads twice a year (August and February).

Hi All, I am a new RN working in an ICU and one of my long term goals is to become a NP of Cardiology (I know that UCLA has several NPs on the Cardiothoracic team). I am looking at UCLA to get my NP... has anyone gone through the program recently? Also is anyone out there a cardiac NP in the LA area? Thanks!!

From what I understand now, pushing Dilantin doesnt require a filter because it precipitates in NS if it is piggybacked into it. Im not sure how fast it precipitates or how much NS it takes to cause it to precipitate... When I gave IV dilantin (without a filter) I diluted it to appropriate concentrations and infused it via syringe pump, not IVPB because my pt was fluid overloaded/restricted. I didnt have any problems with it precipitating, but should have still used a filter. Well, I learn new things every day...

I never heard that about lasix... but it does definatly make sense! Our lasix drips are never shielded from light.

On my own in the ICU for about 6 shifts and lets see: 1. Infusing phenytoin without a filter (but I did use a filter needle to draw it up) Infused fine. Figured this out later on. 2. Infusing an electrolyte into a piggyback setup that wasnt connected to the pt (he was laying on both tubings... one was connected to him, one wasnt. That setup hadnt been used since the shift before me) I let the next RN know that it had leaked and labs may have to be re-drawn. 3. Infusing an electrolyte into a dilantin setup (it went in fine... but Im worried about precepitate) Figured this out when I got home that night, I should have trashed that setup in case some was still in the line. :banghead: Good learning points for me... Ive definatly learned but still

Once I figured out that it was leaking, it was still infusing. So I stopped it, switched the correct line to the patient and continued the infusion. I let the next shift RN know that a portion had leaked on the bed, and that a redraw of labs would be needed. The pt who recieved dilantin that was filtered via needle not inline recieved the med with no problems.

I work in an ICU and have been off my 10 week preceptorship for about a week. When I have one patient, things usually go really well. But when I have two... I feel like an idiot. Last time I worked I had two stable (but very busy) patients. I am on night shift, and had to hang dilantin. I drew up dilantin with a filter needle as my drug book instructed me to, but didnt use an in-line filter. Was this dangerous to the pt? Also on another patient I was hanging a lyte replacement (mag sulfate I believe) My pt had two IVPB setups with just normal saline on each. He was sleeping and laying on both. I piggybacked the replacement in one of the lines, and ran it. When my pt woke up, he told me he had been laying on a wet pillow. Turns out I piggybacked the mag into the line that WASNT connected to my patient's central line, it was just laying underneath him :banghead::banghead: This was also the line I had used for Dilantin, and later realized (after being off shift for about 6 hours) what if this precipitates in line and the next nurse uses it to run more Dilantin? I feel like an idiot when I have two patients, like Im running back and forth against the clock. I always always always do my proper med checks, but its these other mistakes that make me feel like maybe Im not careful enough for the ICU... Any advice?

Just wondering.... Is ECMO done strictly in CVICU/pedsCVICU or can it be done in PICU? I am a PICU new grad RN who is absolutely fascinated by ECMO and hope that I will get to see it in action, and learn to take care of kids on it. I know it all depends on the hospital, but I was just wondering if you all see ECMO in your PICUs

It took about 4 weeks to process the paperwork and issue temp licence. However when I recieved it in the mail, it expires in over a year instead of the 6 months a temp license did. So I checked online, and I guess what I have now is my permanent (i verified myself on the BRN site) So get all your stuff in quickly!

Thanks for the tips Jan, I appreciate it!!

I am going to be starting in a week or so, and I know I will have to do some bedside assessments before I start patient care with my preceptor. So going through my notes from peds.... I just wanted to make sure I am not leaving anything out. Heres what I plan to do for my bedside assess: HR/RR auscultation and looking for presence of retractions, pulsations Skin assessment including cap refill, turgor, fontanelles Head circumference if 2 or under or if history of hydrocephalus Corneal light reflex Coma scale if applicable (lets hope we dont have to do it from pure memory) Bowel sounds Reflexes (is it routine to check primitive infant reflexes?) Assessment of hemodynamics (is the normal PAWP/CVP different in peds than adults?) Assessment of vent settings, and if lines are running as ordered. :eek: Is this a good start? I did my peds rotation a year ago

YUCK!!! Who said that to you?