msn2008

Are any of you aware of the NCSBN's Transition to Practice Model? Are your individual states creating their own transition model, or planning to use what is created nationally? Any insights are appreciated! Melissa

My MSN has a major in Nursing Education. A MSN can have a major as a CNS, NP, Education, Administration, CRNA, etc. Some universities offer post graduate courses for nursing education, which would be in addition to a focus as a CNS or NP. Since I knew I wanted to teach in the college/university setting, I chose a MSN with a major in Nursing Education. The first year all online MSN students at IWU take the same courses. The second year we specialize and focus on our major. My Nursing Education courses have included: Professional Role Development of the Nurse Educator, Curriculum Design, Program Evaluation/Assessment, Teaching/Learning Strategies, Advanced Nursing Instruction, and Nursing Investigation. Most of these are not included in the CNS or NP curriculum. Indiana Wesleyan's website is: www.indwes.edu Feel free to ask me any other questions! Melissa

I will graduate in August, 2008 with my MSN with a major in Nursing Education from Indiana Wesleyan University's online program. If you plan to teach, obtaining a MSN with a major in education is a must! Much is expected of those in nursing education; most of which would not be taught in a MSN program with a specialization in CNS or NP. This program is doable, although I am currently in my practicum and have had a few 'melt down' moments! All my facilitators have been supportive and always willing to answer our questions when we don't understand an assignment. The program is lock-step, with one course at a time, over 24 months. It is also asynchronous, which is important to me since I work different shifts at a hospital; sometimes I will complete assignments after the 3-11 shift. Good luck with your decision! Melissa

Thanks so much for this thread! I have just spent the past hours (!) reading all the posts. Based on your recommendations, I just ordered the Gasparis DVDs, her little book, and the Dennison book, for the CD with test questions. My CCU is based on Patricia Benner's novice to expert theory, and offers classes based on your level of expertise. I am almost finished with our level 4 classes, which are meant to be a start toward CCRN preparation. My classmates want to start a study group, so I will offer to get together with them and watch the DVDs. The teachers of these classes (at my hospital) have spoken nationally and have published a book which is a prep for the newer cardiac medicine certification. They will be available for tutoring/study help. Thanks also for the continued postings from those who have passed the CCRN test. Your insights are invaluable, not to mention encouraging! My sister is also an RN and is certified in hospice and oncology. Of the few times I have seen her cry, two were after she took these tests. She felt they were the hardest tests she had ever taken. It's good re-inforcement to know you generally don't walk away from these tests feeling like you passed. No matter what the outcome of the test, the knowledge gained will improve patient outcomes! And that's what nursing is all about! Thanks again! I will keep you posted about my test date! Melissa

Thanks so much for this thread! I have just spent the past hours (!) reading all the posts. Based on your recommendations, I just ordered the Gasparis DVDs, her little book, and the Dennison book, for the CD with test questions. My CCU is based on Patricia Benner's novice to expert theory, and offers classes based on your level of expertise. I am almost finished with our level 4 classes, which are meant to be a start toward CCRN preparation. My classmates want to start a study group, so I will offer to get together with them and watch the DVDs. The teachers of these classes (at my hospital) have spoken nationally and have published a book which is a prep for the newer cardiac medicine certification. They will be available for tutoring/study help. Thanks also for the continued postings from those who have passed the CCRN test. Your insights are invaluable, not to mention encouraging! My sister is also an RN and is certified in hospice and oncology. Of the few times I have seen her cry, two were after she took these tests. She felt they were the hardest tests she had ever taken. It's good re-inforcement to know you generally don't walk away from these tests feeling like you passed. No matter what the outcome of the test, the knowledge gained will improve patient outcomes! And that's what nursing is all about! Thanks again! I will keep you posted about my test date! Melissa

Do you have access to online academic data through CINAHL, Ebscohost, ProQuest, Medline, etc? You can search by topic, and narrow down your searches by adding more words. For example: I just did a search to provide some help for a nursing student and searched for hemodialysis. There were over 39,000 journal articles available; I added the word nursing, and it narrowed it down to 1700+. I could then scan down the list to see which ones were viewable and thus printable with full text, and clicked on those which sounded like what I needed. There is a lot of reading involved, but it can be a fun search. Hope this helps! Melissa

We also started this protocol this year. I'll try to bring home a copy of the orders and post them this weekend. We've had pretty good outcomes; it is a lot of work, but it saves lives, and brain cells!

While pulling tape off male patients, "This won't hurt any more than giving birth" They are too embarrased at that point to whine!

Update: the paper is finished and submitted; I'm enrolled in an online masters course. It was amazing to cite all the different authors who have influenced my philosophy! Makes me realize I haven't had an original thought in years! I'll keep you posted regarding the evaluation of this paper.

Thanks for your help. I also heard back from some classmates and my facilitator. Their recommendation is the same as was sugested here; use 'this writer, this nurse, and then she or her'. Someone suggested I write my paper as if I was writing it about my best freind. That helped. So now, I just need to do all my citations and references, since my philosophy isn't based on any of my original ideas! It does feel strange, since we use these terms all the times, to stop and think where we learned them and then give credit where credit is due! Thanks again for taking the time to help me!

I just started in graduate school and have been assigned yet another paper on "my nursing philosophy". However, I've been told to write it in third person. I am open to any and all suggestions. How do I not use 'my, mine, I' when writing about 'my' nursing philosophy? Thanks in advance from all you nurse educators! And, yes, I have already emailed my facilitator and classmates this same question.

First of all, congratulations on staying sober for one year. I am very proud of you and pray you will have 50+ years of sobriety. You need to stay in counseling and continue doing what ever your counselor says, as long as it's legal and moral! (and doesn't transfer your addictive personality to another addiction) Your wife needs counseling for herself! It's great that she goes with you to work on your couple isssues, but she has many issues that need to be addressed without you in the room! Question: how are the kids? Do they know? Are they in counseling? Prepare yourself for the possibility that your wife returned to school to give herself the option to leave you when she graduates. Again, I don't know you or your circumstances, but they hit pretty close to home, if you know what I mean. I appreciate your candor and transparency, especially regarding the most difficult addiction there is. It also has the largest number of addicts. I am so glad you are an ex-addict now! Know that many who read this forum are cheering you on from the side lines and praying your marriage survives.

Oh Boy! While I appreciate your concern and willingness to do this research for your wife, it sounds as if she really doesn't want this information. I can't imagine my ex-hubby looking for this info for me while we were still married, yet in counseling. Her graduation and seeking a job does impact your life, yet it is still her responsibility to job hunt and information seek. Good luck! and add me to the list of "thank-yous" for defending the USA.

We always follow our bolus with a continuous drip at 1mg for 6 hours and then drop the rate to .5mg. So I don't have the problem with not all the med getting into the patient, since the same line is used for the bolus and the drip. Of course, the filter is inline and both the filter and line are changed with each new bottle. Melissa

CaridacRN2006, Thanks! I haven't heard of others using it iv for renal protection pre or post PTCA, until you posted. Thanks to all other posters, as well!

This just occured at my facility, too. I spoke to several docs and one ordered a stat cxr to verify placement and the other talked about the fibrin sheath. The concensus was if the line is in the proper place and flushes easily, we can use it for meds. The docs attribute the fibrin sheath as the cause for no blood return. I felt uncomfortable, too, so I'll join the "two-headed" family of nurses!

When introducing myself to a sweet, slightly confused elderly female patient one day I mentioned my given name, my nick name and threw in for good measure, "or you can call me sweety, honey, or cutie." She laughed and said she'd try to remember my given name. Her doctor, who was in the room at the time, asked, "can I call you sweetie or honey, too?'" I replied, after looking at the third finger of his left hand, " Let me call your wife and see what she thinks!" He never attempted to call me anything but my given name after that!

What option will be granted to those intelligent nurses who refuse to give these drugs due to their own (recognized) incompetence? Who will be doing the necessary inservices and competency testing? What is the time lag between noting a cardiac arrythmia by a tele tech and getting the message to the bedside nurse? What do the cardiologists think about this? What does the nurse practice and education council think about this? Just a few questions I would ask if this were to happen at my facility!

No, and fortunately my facility is going totally smoke free, even the outside property, within the next few months.

I'll be starting MSN with Ed focus later this month through Indiana Wesleyan on line. I've met others through this site who are currently attending this program; perhaps they'll respond!

I wouldn't let the grandparents or anyone else for that matter buy my daughters "Big Wheels" when they were ready for tricycles cause that noise kept me awake my entire first year of nursing! I worked nights and tried, usually unsuccessfully, to sleep during the day, with that obnoxious noise of plastic wheels against concrete sidewalks grating through my head. I lived in the upstairs apartment of an older house and my bedroom window was a mere five feet from the sidewalk. I had to keep windows open since I didn't have air conditioning. Needless to say, my dd's first tricycle was a good old fashioned red metal one with black rubber wheels!

I , too, see this more often than is necessary. The problem is so multifaceted; patient, families, doctors, religious beliefs, etc. (not to mention, guilt!) All we can do is speak the truth and constantly update the family with observations about their loved one. Sometimes it takes families a day or two or three...to come to terms with the truth to feel comfortable enough to make the DNR decision. And somtimes that is too late; we've already cracked more ribs with compressions, burned more skin with shocks, etc. I've talked to the docs on several occasions and told them I would not do compressions if this particular patient coded, (although I probably would have in the heat of the moment), and this was enough to get the docs to talk to the family and encourage the DNR order. On separate occasions the patients died within hours of receiving the order. During those precious few hours I was able to spend my time explaining the dying process to the families and encourage them to talk to, hold, cry,etc with their loved one. We also offer to make hand prints and cut a lock of hair should the family want these. We then give them a "memory box" in which to store the handprint and hair as well as cards, etc. I try to have the families bring their priest, pastor, minister, rabbi, etc., to the hospital to help them with the decision making process. Sometimes they need to hear that it's ok to let their loved one go. Having said all this......it's still never easy and it still happens too often. Melissa

Ok Finally had a chance to talk to two of our interventionist. Of course I got two slightly different stories! Here's the scoop: 600-1200 mg iv as the patient is being prepped for intervention, then 600 mg po bid for 48 hours post intervention. However, our pharmacy will not stock the iv route as they claim it is "too expensive". Another nurse questioned, "too expensive for whom?" Evidently this is being used in Europe, and perhaps the iv route is manufactured in Europe so it is cost effective there. Our docs are still pursuing this and I anticipate seeing it ordered routinely later this year. Thanks to all who replied!

http://www.medscape.com/medline/abstract/16807414?queryText=intravenous%20n%20acetylcysteine Just found this one while searching again. I'll post later, after talking to the docs.

Augigi, I found those same articles when I searched, too. I wasn't able to find anything about giving it IV, though, except for acetminophen overdose. I work tomorrow, so I'll ask our interventionists and post again with their answer!