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  1. PeakRN

    Maintain paramedic NREMT?

    I don't maintain NREMT but I keep up my state. In my opinion the NREMT (like the ANA for that matter) doesn't actually do enough to earn my dollars. Granted there isn't anything that I can do as a medic that I can't do as a nurse anyway, but I guess I still have some kind of attachment to my EMS side.
  2. PeakRN

    Checking consciousness by touching the patient?

    Yeah... if you act unconscious your going to get assessed. Whether that means tapping, sternal rub, pinching nail beds, or a pop-up timer (when they pull the NPA they are sober to read test) you will be touched. If you don't like it find somewhere else to sleep.
  3. PeakRN

    Why working as an ED nurse so competitive?

    I actually started in the ED of my current hospital specifically so that I could end up working on an inpatient critical care unit, and another nurse before me did the same thing. I don't intend on ever flying. Quite a few of my friends have started in EDs and ended up working in ICUs or PICUs very successfully. I think that there are nurses in the ED who are very ER minded and will struggle with inpatient critical care and those who can blend the two more seamlessly. The latter are far more rare but we do exist.
  4. PeakRN

    Giving up PA school acceptance to pursue ASN?

    Just a couple of thoughts. If you do end up going down the nursing route get your BSN from the beginning. It is hard to get the more desirable nursing jobs without it, and an ADN with a BS is not viewed the same way as BSN. I would strongly consider an accelerated program given your BS in bio. Whether you decide to go PA or RN you will have to put in time before you get the job you actually want, be it a matter of shift preference, care area, or FTE status. The proverb 'a bird in the hand is worth to in the bush' has existed for a long time for a good reason. I would be concerned that if you give up your PA spot that you may not get into nursing school, outside of overpriced private programs nursing school can be far more difficult to get into than you probably think.
  5. The ED is just as physical as the floor. Lifting homie drop offs onto a bed, restraining patients, reductions and other procedures, et cetera. Have you considered the NICU? There can definitely be fast paced moments and the physical demand is far less than the adult world.
  6. Have you considered something like lactation or newborn home visits?
  7. PeakRN

    PCU Nurse Feels "Second Rate"

    Have you actually applied? We want candidates to have experience in critical care, but that often isn't possible. I wouldn't test for CCRN without actual critical care experience, it can give a bad impression to nurses who worked for years in critical care before they tested.
  8. PeakRN

    Bad Interview - Should I withdraw?

    I'm guessing that you interviewed for some critical care area like the ED or ICU, so I'm going to base my response on that. We don't try to be rude in our interviews, but we do ask hard questions that can make the candidates potentially feel uncomfortable. Part of it is the slightly jaded nature of critical care nurses, some of it is us wanting to see how candidates do under pressure. I think you might be surprised at how well you may have done despite how you feel it went. I'm actually okay with candidates who don't have quick or perfect answers if I can tell that they were able to think through the question and give it real consideration. I personally wouldn't withdraw. I think it would give a better impression to wait it out, especially if you ever want to consider going to that unit again. If you have any interest at all in the unit I would reach out to the manager and see if you can have a shadow day before they make their decision. Your impression from the interview might be far different that if you spent some time there. As someone who works in the ED and inpatient critical care I can tell you that we sometimes seem unfriendly to staff outside our units, but critical care nurses have a strong bond that you won't get anywhere else and we really are a (slightly dysfunctional) family.
  9. PeakRN

    Most Burned Out Nursing Specialties?

    Burned out as in jaded? Emergency. Burned out as in uninvested in nursing? That's going to be a bit more difficult, although I think med/surg has a good chance of being the winner.
  10. PeakRN

    Nurse Charged With Homicide

    From my understanding this nurse made several deviations from the standard of care that placed the patient at risk and the patient resulting died. While I sympathize with her, it doesn't change the level of neglect that occurred and that her actions killed the patient. I also think that we should remember that she has not yet been convicted, and is legally innocent until proven guilty in criminal court. She hasn't just been thrown in the prison, she will have her day in court to defend herself and a jury will make a decision based on her and the prosecutors evidence. I don't think that given the apparent circumstances that their be a criminal investigation or a trial.
  11. PeakRN

    hyponatremic seizure

    It doesn't, but if a patient comes in seizing and we don't know why, we aren't going to get saline. We wouldn't know that they are hyponatremic until we have their lytes back.
  12. PeakRN

    hyponatremic seizure

    Yes, several times. It looks like a seizure. You treat with hypertonic saline, but if you give too much you can cause demyelination. Often these patients get a bandaid fix by a benzo or other classic antiseizure med, but this neither corrects the problem nor is the most appropriate treatment. That being said upon initial presentation we often will not know their etiology and we aren't going to give 4% saline to every seizure we see. Good luck on your homework assignment.
  13. PeakRN

    Air Force Reserves flight nursing Vs. Navy active duty

    To get a direct commission with a flight nurse billet is essentially unheard of, and there are very few for ED nurses. Without experience in that specialty you won't get a direct commission. Even then there is no guarantee that after a few years you won't be put into a different care area, and you don't really get a choice in that. Don't trust a promise that a recruiter makes unless you have it in writing. They have recruitment numbers to maintain so they will often say anything to get you hooked. The fact that they had you taking to a chief says enough about their empty promise, enlisted staff cannot commission officers. The military is also downsizing a fair number of the healthcare staff, so keep that in mind when you consider your pursuit of a commission.
  14. PeakRN

    On call pay

    Our ICUs, PICU, NICUs, critical care and pediatric float pools, as well as services like the OR all have call lists. Most of our floors don't have call. Depending on the season the EDs sometimes have a call list (when we are short staffed but our census supports us running lean), but we haven't had to in a while. As a referral center it is very hard to predict how many transfers we will see in a shift, and most of our staff would prefer to be at home than at work bored and underutilized.