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MsBruiser's Latest Activity

  1. MsBruiser

    Nclex-RN and License

    I always got by with printing out out a copy and using that.
  2. MsBruiser

    TUBA CITY, AZ HOSPITAL--need info/advice!!

    No direct experience in that hospital. I am more familiar with Phoenix Indian Hospital - which sucks. A lot. Challenging population (all that you mention above) with a horrible bureacracy layered into that milieu. Also, they are offering extensive relocation assistance for a reason. Tuba City is way out on the reservation - there is not much there. And the population you describe well above. Good friend of mine lasted one year as a teacher in Tuba City. I have been there many times. I would sooner pay for my own relocation and go straight to Flagstaff. Follow your gut - seems like you already know the answer to your question.
  3. MsBruiser

    Possible to break Rn Residency contract

    Your salary is a mere rounding error for one day's revenue. Just quit.
  4. MsBruiser

    Possible to break Rn Residency contract

    Just quit. They have nothing to come after you for other than a $50.00 drug test. Small fries.
  5. MsBruiser

    Nursing Judgment Vs Surveys

    I think you need a new job.
  6. MsBruiser

    $600 an hr to fill a shift?

    Oh. Wow. CV surgeons doing heart transplants do not make that where I work. Take that one with a grain of salt.
  7. MsBruiser

    Advice, tips, comments for a soon to be nurse

    Well. I once programmed an IV pump wrong and dumped an entire bag of medicine into a patient in 10 minutes. In an ICU. Thank god it was 100 ml of insulin and not Levophed. The patient could have died. I felt so awful I wanted to kill myself. It happened the same day we converted from paper charting to electronic charting. No excuse - it happened. But how is learning about that mistake going to help you? When you make an awful mistake (not if - when), it will be something you never thought dreamed you would do. I would not focus on potential mistakes - but developing safe habits that will hopefully keep you on a safe path for as long as possible. Some advice: 1) Find nurses you admire and do copy what works best for them. Plagiarism is the most sincere form of flattery; 2) Develop / copy a "report sheet" that works for you - this is your paper brain and will keep you from forgetting things and / or making a mistake; 3) Try and develop a systematic approach to everything you do. And realize you cannot do this from day one - you will still be learning. Repetition is your friend - you will quickly develop a keen sense of situational awareness and know when something is not right. 4) If your gut says something is not right - it is not right. Stop. Deep breath. Think.; 5) Always ask questions - use your cooperative coworkers for the excellent resources they are. And finally, "trust but verify." There is sometimes godawful advice here. I am sure 100 nurses will tell you med-surg is where you need to start. Really? I started in an ICU and have gone on to have a great career. Take advice with a grain of salt and believe nothing until you have either heard or experienced something for yourself.
  8. MsBruiser

    Struggling New Grad...

    You should be terrified as a new nurse doing home health. But that is water under the bridge - where you are is where you are. Some advice: 1) Use your common sense - always. If something doesn't look right - wound, med, patient symptom - it isn't. Escalate at once.; 2) Know your resources. Have someone you can call if you have a question. Technology is your friend - if something doesn't look right, take a picture and show it to someone who knows which end is up. 3) Know where you are in the grand scheme of things. As long as you maintain some decent situational awareness about patients spiraling downward, you really can't screw up that badly. They are old and sick to begin with...
  9. MsBruiser

    $600 an hr to fill a shift?

    I don't know what to make of this post. I have 8 years experience and make more than that as a nurse working an overtime shift.
  10. MsBruiser

    Return to Nursing with No Experience

    I feel your pain. I flipped in and out of clinical and more business-type jobs for the health system where I work. In fact, I took a $20,000 pay cut going back to clinical work, though overtime has more than made up for that. Believe it or not, I would just say find a place that is willing to hire you and go for it. There really is no course or magic bullet that can scratch the itch of a great clinical job. One person mentioned getting a part time job doing clinical work. That is great advice. When I was in my last non-clinical job I got a part time gig doing critical care transports. That kept me going for a good year before a great opportunity came up and I gave up all hope of every wanting to wear a tie again. It was EXTREMELY nerve-wracking learning how to do that job as I had not taken care of a critically ill patient for almost 4 years. But I got over that really fast. Once I got rid of all the extraneous "spaghetti" before a transport I usually had 2-3 drips at the most and a vent. Easy / breezy. Just jump in and don't look back. And I am a guy too - that is important and will give you a leg up looking for work (let the stone throwing begin, but it is true).
  11. MsBruiser

    confused.. Non-conducted PAC vs Type II AV block?

    Good question and good answer.
  12. MsBruiser


    Cardiac device nurse here. I will give you a simple answer. Generally, anything less than 10 beats does not really get my attention. That is a very simple rule of thumb. The most important way to look at this is by looking at the patient's clinical history. Do they have regular runs of ventricular tachycardia? If a patient has no history of ventricular tachycardia and then has 12 6-beat runs in a single month, I will kick these findings up to the attending, pronto. But lets say I was back in the PACU and a patient had a 7 beat run. With what I know now it would not get me very excited. And if the patient already has an ICD, well, what is the worst thing that can happen?
  13. MsBruiser

    EP Nurses

    I am a cardiac device nurse. I took me until I was 44 to find my dream job. Better late then never, huh? EP is like learning a foreign language - very complex and abstract. I love knowing that I work with some of the best and brightest people in my facility - docs and nurses. I always feel like the dumbest person in the room, and the challenge is just awesome.
  14. MsBruiser

    Question about ICD/pacemaker

    Beyond programmed ATP therapies, a skilled pacemaker RN or Electrophysiologist can do manual overdrive pacing. It is pretty nerve racking and I always carry a calculator in my pocket so I can do rapid VT cycle length calculations. There is always the risk that ATP or manual overdrive pacing can be pro arrhythmic and put a patient into VF. In that case, we just shock them back to Sinus. "Just" shock them. Check out Medtronic University. Excellent free resource. The only way to learn pacemakers is to go to manufacturer websites, so that is hardly a TOS violation.
  15. MsBruiser

    Pacemaker interrogation

    I am a cardiac device RN. First, you have to work at a facility that has cardiac device nurses. These places are kind of few and far between. I live in the 6th biggest city in the US (metro area of 3.5 million people) and we are the only hospital with dedicated cardiac device nurses. I honestly got the job because I became friendly with a cardiac device RN, and the manager's mantra is they would sooner train someone who gets along with everyone then hire a cardiac expert. I had no cardiac experience beyond ACLS. That said, the field is brutally difficult to learn. I liken it to learning how to speak a foreign language by being dumped in a foreign country (that happened to me too). Electrophysiology is extremely abstract. There is simply no go-to place to learn all of the devices / companies. It takes lots of time and hands on experience to learn the job. 18 months into the job, I am finally comfortable doing most interrogations and troubleshooting. Or at the very least, I know what I don't know and know how / where to get help as needed. So the only way into the field that I know about is networking. Or you can apply directly to one of the device companies and see if they will train you.
  16. The most challenging part of nursing school for a lot of folks is getting your personal life in order. Pick whichever program puts the least amount of stress on your family. I would seriously consider a more intense year rather than a lingering 2 year experience. But that is probably a decision best left for you and your spouse. Nursing school is a time consuming experience - not too academically challenging for someone who has been through graduate school. So long as you have somewhat of a support system for child care and studying, you can have this all done fairly quickly.

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