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Apologies for a follow-up post here when I could have asked this before, but I just made a post here as well, with a bit more background on why I am asking this. Could you or anyone else be kind enough to take a look at that post as well? What I'm looking for is which one of these units [including bone marrow] would offer me the opportunity to perform the most types of hands-on care? I guess they all will, at some level, but which one is likely to give me the best experience if I did have a choice to make. Thank You again.

Hi All, I am a new grad nurse with no healthcare experience who a recruiter reached out to and told me which jobs there were open for me to apply to. One of these was for a Bone Marrow transplant unit, that I asked a question about here. 3 other (all MedSurg unit) roles are: Acute Spine Neuroscience Telemetry I've been trying to read up about what the nurse roles in each of these units looks like from the multiple posts in each forum. What I'm really interested in though is which of these will I do the most in? What I really mean by that is which one has the most variety of hands-on skills? I ask this because that is what I am most lacking in (being a new grad with no prior healthcare experience) and want to go into a place where I will be busy all day and doing a lot of skills, and getting better at them. I totally get that patient education, communication etc are very very important and I intend to get better at that as well - but I would love to work in a specialty where I am doing more patient care. I hope I am conveying what I want well ? but if not please do ask more questions. Thank You Arvind

Thank You David - that's helpful. I'll post in the other forums regarding the other roles that are open that I am considering applying to.

Hi, I'm a new grad RN with no experience. Nursing is a second career for me. I am trying to apply to a unit whose recruiting consultant told me there are openings on a Bone Marrow transplant unit. I always wanted to go into ER and am trying there - but I guess I can't be too picky hence considering applying here as well. I get that this is a subset of Oncology Nursing - but could someone explain a little bit about the job of a Med Surg nurse on a Bone Marrow transplant unit? What skills can I hope to learn? Thanks Arvind

Looked at all those labs and the notes closely - everything seems very normal lab and scan wise, but you mentioned chronic pain so I'm shifting brain that side :). There's also the constipation bit which is the only mild symptom that's abnormal. So I'm rearranging our facts: * The pain comes randomly and is not constant and when it comes its extremely sharp. This may point to something neurological to me which is triggered when something specific happens - maybe some inflammation in the pelvic area? * Also because of this inflammation, it could be pushing on some part of the GI tract and compressing the path so it becomes harder to have a bowel movement * The pain is left lower abdomen, so I wonder if she will consent to a colonoscopy for her constipation, in which we can also assess if that is the part that is swollen. Also does she tend to hold her stool for long times, which has caused the colon to swell up? Does the pain usually follow constipation, by any chance? * Might be also worth looking at her myoglobin and CK levels as well as ESR right now when she has a lot of pain to check muscle inflammation. * Has she visited a neural specialist so far? That might be interesting to know as well. That's all for now haha. This is so much fun for me as a student :)

I'm not familiar with the reproductive tract that much but do think its valuable to rule out any general GI and urinary tract concerns once. So I'd: * Urine culture to make sure no UTI * General GI assessment (bowel sounds, swelling, pain etc) * Check for occult blood in stool. Ask about BM in general * Tests for pancreatitis - verify amylase and lipase levels * CT scan of abdominal area (stomach, liver, pancreas, gall bladder) Also given that the patient has had ovarian cysts, it might be worth convincing the patient to do cervical scans and a biopsy of the ovaries & cervix if all the above tests come out as normal to rule cancer out. I'm curious why the patient is hesitant to do any internal exams as well. Is she hiding something? What? She's not pregnant like you said, so I'm wondering what else it could be. Maybe ask about sexual trauma? Like @nursej22 mentioned above. Maybe that's why she doesn't want to talk about it?

Yeah I agree. I would definitely probe that angle more as medically she seems reasonably stable apart from the poor nutrition and dehydration which hints at not having enough to eat and drink. The agitation each time the daughter is mentioned and the hurry to get home makes this more plausible. I'd gently ask (and I don't know the best way) if she would like to speak to someone who is skilled with domestic violence cases. But that might get her more agitated. We can say we'll call the daughter and explain she is hurt and if she still resists there's definitely something up there. How does the patient react when we say its our duty to check for domestic violence issues? Has she ever had similar injuries in the past? Who has helped out then? Also can we check for any other signs of Alzheimer's? (not sure that MMSE already covers this?)

First ever participation in one of these and I'm still in nursing school (Q6 of 10 - Medusrg 2) so I'm hopefully not too off the mark :) but I wanted to try and participate and learn: - I would also ask her about her appearance a little more; maybe she has financial difficulties? Maybe its just dementia but who knows. - Are there any neighbors or friends she talks to? If its not the daughter then maybe its someone else she might be talking to? - Specific gravity, color and odor of urine are concerning but UTI scan appears to be clear? So my question is does it make sense to do a urine culture at all? Could there be other kidney or GU infections that are present but don't show up in the urine scan? - BUN & Creatinine is high too which makes me wonder if kidneys are fine at all. Can we do tests that check urea, uric acid levels in the blood? - CT scans would help for sure, maybe ICP check to see if there is a hematoma? Just some things I thought about :). Do let me know if my thought processes are off. Thanks.