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Med Surg, ER, OR
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mcknis's Latest Activity

  1. mcknis

    Nurse Manager Opportunity

    I recently made a transition to another department within my organization and during the two interviews I had with various members of maangement (including the Director of the department) the question was posed two different times about considering becoming a manager. I have not been given the opportunity to serve in the manager role previously, but these individuals must have seen something in me to raise this point. It has been a desire of mine since first starting in healthcare (just under 10yrs) to serve in a leadership capacity, so when this issue was brought up I was definitely intrigued. Several questions/ideas I have come up with include what made you decide on pursuing a role in management? What background did you have before making the transition? What salary change did you notice from working in this role? What benefit changes did you see? What have you noticed as the pros and cons to being in the manager role? The current manager recently announced retirement (and this will not take place for several months), but if I had a desire to pursue this role what would be the best way to make my desire known? I understand it could be odd being that I have only been in this department for a few months as it is and the position has not been posted as of yet. I appreciate any feedback and words of wisdom! Thanks!
  2. mcknis

    EKU online FNP program

    I am also interested in hearing more from anyone with experience. I have applied for the Summer start date and am waiting to hear back about acceptance. I already have 2 graduate level courses under my belt from another university, so hoping that my coursework can be tailored around this. From my communication with the school, I have had a great feeling about attending EKU. I understand their online program is very new (first graduating class this year), but as a student of another online program, I have no fears. Their FNP program has been running for a few years and show a 100% pass rate on national boards. The best thing is this is a 100% online program with 0 visits to campus required!
  3. mcknis

    Subspecialty requirements for inpatient

    I am a staff RN, but the NPs who worked in our ED were FNP trained, as well as the inpatient NPs. I have a friend who works as a hospitalist NP who was also FNP trained. There has been discussion to eliminate FNP or primary care trained NPs from the inpatient settings as they are not trained to the level of acute care. However, many employers are simply looking at the background of the NP as they worked as an RN and placing them in positions based upon that experience. Is it fair? It depends, but working as a staff nurse (even in an ICU) is completely different than working as an advanced provider on the inpatient side when your advanced training is only focused on primary care areas. There are many ways to look at the situation, but I do understand the logical thinking relating to this.
  4. I recently switched specialties and am working in an outpatient (hospital affiliated) ambulatory surgery center. The position is posted as a full-time position, but I have found that many of the staff fall short of the full time (40 hour) status. Having worked 36hrs/week previously, I was aware that I would be working more hours, however I am finding it is typical to work around the 36 hour mark. After taking a decrease in pay (and without shift differentials) and without having regular work hours (due to varied case times/schedules), I am wondering how to make up for lost hours? What do you do to make up for slow times/days? Do you go home early when all the cases are complete? Do you pick up hours in other departments/facilities? I am working as a single income provider in our home and like to get as much time/money as I can to keep our family unit functioning smoothly. Thanks for any advice!
  5. mcknis

    Helpful Tips for New OR Nurses

    Such a great post to share! I have no experience in the OR but will be starting Monday. It is scary to think of everything I don't know as I am coming from a 5 year stent in the ER. I can swim in the ER but I hope to not sink in the OR. Always scary going from comfort to change, but time will tell how it will all go. Thanks again for sharing this!
  6. mcknis

    Causes of sudden diaphoresis

    Yes, I was thinking the same thing regarding a vasovagal respone due to the sight of the needle...i.e. white coat syndrome
  7. mcknis

    Know How to Improvise a Tourniquet

    Had a ptcome in with a right brachial artery lac that we had difficulty with controlling the bleeding from while in the ED. Medics had already placed a pressure dressing that was saturated by the time he got to the ED. When coming in, the ED physician of course wanted it removed, but as soon as it was uncovered, spurting began again. None of our surgeons wanted to deal with the case so he had to be taken by ground to the nearest trauma facility (over an hour away). Sure could have used a doc that wouldn't have minded have a tourniquet in place to secure the bleed, or if nothing else, try sewing up something. Pressure dressings were all the doc allowed us to use and unfortunately by the time he left (1.5hrs from time of injury) right arm began having decreased pulse and less color to that limb. Doc kept saying it was the dressing, and yes may have had a little to do with that, but a brachial lac that continues to bleed is going to require some additional resources. Ugh. Done with the rant...and yes, tourniquets are very much a necessity!
  8. mcknis

    Good learning material...

    I came across this text the other day (http://www.amazon.com/Critical-Transport-American-Orthopaedic-Surgeons/dp/1449642586) and was curious to know if anyone out there has used this book for personal education or if you have any other recommended texts? Just got hired on by one of the squad companies doing MICU and am wanting to educate myself more for this new adventure. As transport is a new area for me, I am wanting to provide the best care I can and continue to expand my personal knowledge to better my care in the ED, too. Also, if you have any tips or tricks to share, please pass along to this newbie! Any help is greatly appreciated!
  9. mcknis

    My New Life as a Transport Nurse

    Thats great to hear! I, too, am hopeful that I am able to do MICU one day and keep up my critical thinking skills all along the way. Keep enjoying!
  10. mcknis

    New MICU and Employment...

    Thanks for your advice Flyingscot! I definitely don't think that joining a new MICU is the best decision as I would be the first that would be eliminated/accused if something were to go awry. I have accepted a position with the company that will have me rendezvous with their ALS unit and provide me with a decent orientation period. They are already established and have nurses who have been working in this environment for a while longer than the 3 years I had been told previously. Any tips or tricks for working in this environment that is new to me? Any sites out there that provide good reading info or policies/procedures I could read that would give me some additional insight?
  11. mcknis

    Satisfaction scores

    Anonymous, most of us do understand the role that the PG/Patient satisfaction surveys play in the financial makeup to an organization and we do understand that patients do occasionally have bad circumstances and/or poor care. This forum is designed to allow those in the profession, and those outside of it, to have a glimpse into this realm and help to share in its' growth. The majority of the nurses/healthcare staff on here are good people who desire to provide the best care possible for their patients, no matter the are of healthcare they serve in. The ED setting, however, is one of the more challenging areas and many of us get defensive when someone speaks negatively or positively regarding our neck of the woods. It is not meant to be bashing or upsetting towards any one individual, but it is just a callous many of us build up after working in this setting for a few years. The ED, as you have seen, gets knocked down by all department and patients because of the front sidewalk not being pretty, or the meal tray not having enough options. These are things nursing is not able to control, but the powers that be feel financially it is easier to decrease (or eliminate) wages to frontline staff regarding any complaint. PG unfortunately is around for the long haul, and like the others have stated, it's yet another game that we, frontline staff, must play in order to get our raises and ensure patients have a voice. PG shouldn't be related to finances although it is, but associate opinion surveys (of management and physicians) shouldn't be either, however they are. That's a rant for another day...
  12. mcknis

    New MICU and Employment...

    Have been interested in CCT for some time and have already done some ride time with a large company in my region that does ground and flight transport. However, I am not able to work for them due to the travel requirements (1.5 hour drive for a 12 hour shift on ground and up to 2.5hrs for a 24hr on flight). There is another company in my area that has already been doing MICU (ground) for 3 years but are only interested in doing on-call (unpaid) and having the nurse rendevous at the transferring hospital with the ALS crew to then be paid for their transport time only. Since I live about 40 minutes from some of the hospitals they are wanting me to rendevous at, I am leaning away from this option. This company had discussed with me about applying yesterday but just prior to that, another company (10 minutes away) informed me of their plans to start a MICU... This ALS company in my town (fairly new to the area, but in business about 20 years) is talking about starting up a new MICU. This is just in the talks right now, but am curious to know what everyone's thoughts are regarding new MICUs. I know everyone must start somewhere, but what are the pros/cons, risks/benefits, etc. with joining a company just starting out? Anyone been there and done that? What are your thoughts? Also, any policies & procedures/tips & tricks floating around out there that are MICU specific that would be able to help me learn some more of the ropes in this environment if I were to take a position with this company or another? Any advice/help/knowledge/wisdom is definitely appreciated! Thanks all!
  13. mcknis

    Please help, career advice for the tired ED nurse

    I often feel the same way and am in a similar boat right now, however with little prehospital experience. Start making a list of the things you love, and focus on that. I love the 3 12 hour shifts, or at least most of the time. I would love lunch, but then again who doesn't? I love critical care and being able to critically think, but would love to do more of this. CCT is where my hope is one day because of these ideals I have formed. Unfortunately, the nearest bases (helo/rotor wing) are between 1.5-2.5hrs away, and even for 24hr shifts, this seems like forever to drive. Would like to see a ground unit pop up in our area, or perhaps a medic crew that does CCT for nursing wages :) I can dream right!?
  14. mcknis

    Rn to medic

    To the OP, I had the same curiosities, and still do. This is the reply directly from the NREMT... “RN CHALLENGE CHECKLIST” for EMT-Paramedic NREMT entry requirements for Registered Nurses challenging the EMT-Paramedic Training Letter of Approval Submit a letter from the state EMS ofñce where the applicant works or is to work. The letter should indicate the state’s support ofthe applicant taking the examination. EMS Education Approval Provide a certificate/letter of equivalency indicating successful completion of the current National EMS Education Standards. The certificate/letter of equivalency must be validated by an educational program that is affiliated with a CAAHEP accredited paramedic educational program and is currently state Provide official evidence of current and valid registered nursing credential. Provide official evidence of a current EMT (Basic) or AEMT (Intermediate) certification issued by the state or National Registry. Cognitive Examinations Must be delivered at Pearson Vue Professional Centers or Pearson Vue Select Centers Psychomotor Examinations A11 psychomotor examinations at the AEMT (Intermediate) and Paramedic levels must be administered by a National Registry Representative, appointed by the NREMT. Entry-Requirements All applicants must meet current NREMT entry requirements.
  15. mcknis


    I live in Ohio and the sad thing is...that 5th degree felony crap is a slap on the wrist. If you see the wording, one must have been charged and convicted of an assault before the 5th degree felony can be attached to it. So, if a slap occurred the first time and not reported, then your time of assault gets to be the first time and nothing will be done to the patient until a second offense occurs and is reported. I am glad that the governor is taking this somewhat seriously, but I wish that more would be done about it. Oh...and if a mental health disorder is linked to the patient...we will never see felonies thrown on their record due to their protection of their mental handicaps. (I speak this from experience of having been assaulted several times) That last part is what really gets to me.