Lipoma

Can be up to a week before the start of the semester.

Don't beat yourself up over this. Where I am doing clinicals, patients take certain prescribed meds in pre-op with sips of water before we roll them off to surgery.

Mostly EI and 1 clinical question

What I am about to say is coming from someone who transferred from a community hospital ED to a level 1 trauma center cardiac ICU. I want to preface that I wanted to quit within 1 week of working there, but my end goal was CRNA school, so I had no choice but to stick it out for a year. That said, I will always recommend any nurse who works in the ED to do at least 1 year in an ICU, regardless of short-term or long-term goals. It'll only make them a better clinician, and looking back, I became way more confident in my overall skills. I would also like to agree with you that the personalities of the ED and ICU are night and day and that's why I preferred working in the ED. Now, to answer your question, you can quit whenever you deem necessary. But I urge you to just stick it out, be a sponge, and absorb every and anything.

Okay, so based on this, definitely go to a general ED to get the most rounded experience. Emergency NPs were expected to see all ages in the ED I worked at as an RN. Emergency Medicine is Family Medicine on steroids with a mix of critical care medicine. When patients don't see their PCP for whatever reason, they seek care in EDs. When the ED discharges patients, they tell them to follow up with their PCP/Family Provider. Transferring from a general ED to a peds ED shouldn't be a problem because you'll have experience working with acutely ill patients of all ages. The only difference between adults and pediatrics is dosing, fluid planning, and developmental differences; other than that, it's the same focus.

I'd recommend going to a general ED so you can gain experience caring for both adult and pediatric populations. Then, when you know for sure which one you prefer, you can decide to transfer later.

12 weeks appears appropriate for an experienced nurse transitioning from an inpatient setting to the emergency department. The reason I say that is because I was given 16 weeks as a new graduate nurse before I was cut from the umbilical cord. Then when I transitioned to the cardiac ICU 4 years later, I was given 12 weeks of orientation. That said, I didn't start feeling competent and comfortable with highly and acutely sick patients (think ESI 1-2s) until about year 2, and that was after obtaining my CEN and consistently volunteering for the sickest patients. The knowledge I gained from becoming certified gave me a sense of comfort and foundation to anticipate physician/APP orders or initiate life-saving interventions with a concrete rationale and understanding of what I am trying to achieve. Now, since you have med-surg experience, you know how to nurse and how to recognize when a patient is decompensating. The difference you're facing now vs inpatient is balancing multiple sick patients who require immediate or urgent attention. What you're experiencing at this level is learning a whole new specialty, and ED has a steep learning curve. So yes, what you're feeling is normal. Give yourself up to a year post-orientation to become comfortable managing and delegating. The beauty of the ED is it's really a team-oriented specialty. When an acutely ill patient is present, all hands are on deck until the dust settles. It's the primary nurse's job, whether they're in the ED or ICU, to initite those drips to keep the patient safe (ED and ICU nurses both manage critical care patients). Gain a deeper understanding of critical care infusions to better support your patients. I recommend Sheehy's Emergency Care.

Mostly out of habit because when I was in the ED it was automatically included during report ( B/L AC # etc) so it carried over into when I went to the ICU...however, asking the location also allows me to set up the room appropriately and also allows me to figure out if I need to remove it and place a new one if it's going to be in the way of a potential a-line or prolong vasoactive drug infusion etc. At my former facility, infusing vasoactives through the wrists or hand was a nono...but in the ED, any line that flushes is good enough!

When I got off orientation in the CCU, the ED called up for report and I legit only asked 3 questions: patient's orientation status, location of PIVs, and current medication/gtt rates... it took less than 30 seconds. My pod mate turned to me and said "that's it?" in which I replied, yup...I knew I was getting this patient the last 2 hours so I wrote down everything I wanted to know. Nursing would be so much better if everyone would get off their high horse and just focus on the patient instead of having a pi$$ing contest. ^^^ main reason why I am a firm believer ED nurses should work a month long in the ICU, and nurses in the ICU should work a month long in the ED.

I started in the ED as a new grad and transitioned to the CCU after 4 years when I decided I want to pursue CRNA school. I thoroughly enjoyed and flourished being in the ED and it definitely made me a better CCU nurse when I made the transition. I also enjoyed working with the plethora of devices in the CCU which allowed me to grow clinically as a nurse. Both experiences were great. That said, I preferred working in the ED over the CCU because I hated having the same patients day in and day out...I also hated the documentation and struggled the most with that. There were days I was bored in the CCU and was itching for something to happen. I stayed PRN in the ED to get my adrenaline fix. If CRNA school is of interest, skip the ED and go straight to the CCU. If CRNA school is not of interest, go to the ED and then pick up in the CCU/ICU PRN after 2 years.

I meant reactive* not reactivate lmao. But no problem! Keep curious as you venture into critical care transport. Good luck.

The airway may also still be reactivate during manipulation (inserting ETT and keeping it there) even after inducing the patient using etomindate or propofol. So NMBAs such as sux and roc further helps to minimize such reaction and minimize bronchospasms. This ensures the patient is able to ventilate and perfuse efficiently. Also as the above poster stated, patient safety and comfort is most important. We do not want the patient to be frightened which can cause postop delirium so its best to sedate them first before paralyzing. Imagine trying to breathe spontaneously but that effort was taken away and you're still awake.

ICU actually had no appeal to me as a new nurse. Emergency nursing was always my goal but after a few years I gave it a shot and went to the coronary ICU since I found the heart fascinating and enjoyed caring for that specific population in the ED whether it was a cardiac arrest or other cardio-pulm issue. I took care of enough medical ICU level patients and had no desire to do that. Neuro, peds, and burn also did not interest me. The ICU does bring some level of routine to it but I continued doing ED as per diem to keep my skills sharp and to "get my fix" If you find an interest in a specific patient demographic, give it a shot. This is the only way to find your niche.

I always knew I wanted to be in critical care someway somehow. Ended up doing emergency and ICU. I'm an adrenaline junky I suppose and dislike routine...

The program is what you make of it. My cohort is easy to get along with and have made some good friends so far. It's a lot of work but doable. As for those worried about their interview length...don't sweat it. Mine was 7 minutes long and was accepted with the first batch.