FlowerbuddRN

I am about to start two jobs too. I work FT at one hospital that I worked at for 3 yrs with my LPN in renal, which though busy is for the most part easy and routine for me since I know all the paperwork and everything, I start the 15th at the other hosp in town full time in ICU. I am sooo nervous. I don't really know the system, or anything about critical care, but I wasn't being challenged on renal, and I want to get all the certifications and advanced stuff. I will be making awesome income, which I really need, but I just want to make it all work so much, any tips on doing it all together appreciated. I also have 5 kids, 16, 14, 12, 10 and 8 and thank goodness they are good kids and manage quite well w/o me. I chose nights because that way I can sleep while they are in school or do errands I need, and then still be able to eat dinner with them every night. When I worked days I never saw them but 15 mins before bedtime or such.

I never intended on staying an LPN. My brother who is a NP advised me to get my LPN so I could work as a nurse ( as long as it was in a hospital) while I went to school, then bridge, and then do my BSN online. I am grateful I have taken his advice because I have gotten such fantastic experience and assessment skills! My co-workers are sometimes asking me questions. I was fortunate to get in on a med-surg unit where I was able to team lead on patients, and then transfer to pediatrics, where all I do is take my own patients. All I am restricted from doing is pushing IV, ( we never have anything but IVIG in way of blood products ) working the unit with just a unit secretary when we are low census, and the RN I work with has to sign her name under mine on my chart. Basically I work totally independant, and I love it. They let me work the same when I did med-surg, of course being available if I needed help or had questions, but we each had 7-8 patients and it was busy there. I feel more than prepared for the bridge program I am starting in January. I've run into prejudice sometimes about LPN's which upsets me, because I think people have a skewed view on what an LPN does. Having a friend who does LTC, they don't realize often there is no RN on premises, and LPN's are often the only nurse there... 1 nurse to 30-40 pt's, maybe more! While I do know a few LPN's who have no desire to take on the extra responsibility of an RN, and can fully understand that, I agree that there are areas I want to work that are not open to LPN, AND at work I am required to function almost in the same exact role as my RN co-workers, I even had to take PALS..and I make at least 10.00 less without diffs. For someone who is young, and doesn't have to worry now about kids I'd def take advantage of that. I am doing school with 5 kids and a husband.

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from what a clinical preceptor showed me- have the pt dorsal/pedal flex while you feel approx where you expect the muscles to be.. now you can't do a thigh on a lil old skinny lady.. you've got to have someone who has a muscle there, and then i grasp that area between my thumb and forefinger. i've only used that spot if i feel the muscles flexing when they do it, and if i can feel muscle to "grab".. if i have an overweight patient more than likely they are getting a deltoid IM

i hate rocephin, working on peds at my main job.. we always use the thigh on our lil ones, and it goes smoothly, except i hate how hard it is to push.. but it is mixed with lidocaine. I have a prn job with adults however, and have always used the deltoid or thigh on them, since i get nervous trying to LM the ventral glut or side when the pts are sometimes overweight and its hard to dig and find their iliac crest etc. Also some of the lil ladies are so damn small.. it just doesn't seem anywhere has muscle.. kinda like when you have to give heparin or lovenox to one of those 78 lbers with noooooo fatty tissue anywhere

giving IM's into anywhere but the deltoid, or Vastus lateralis make's me nervous, because most of the people I had in clinicals were very overweight, and we were unable to palp the bony landmarks, and just went by where the preceptor showed us. Any great easy tips on finding these places even on overweight people, and everyone in general? I'm always nervous about hitting a nerve so I have always avoided them.

I had always been on the track to do FNP, and then DNP when I learned about it... but after looking more into the D.O, and working with them I realized that a D.O is the philosophy I was hoping to implement as a FNP. (where i grew up D.O's were not viewed as "real docs" like they are where I live now") So I too have decided to use my BSN as my bachelor's and then apply to med school. The best part is that they are discussing opening a program right here in my town, within the next two years, which is when I would be ready! Otherwise I'll be driving and half living in Tulsa. The hospital I work at does not really use FNP's and I was concerned about that, plus the idea of having to be "overseen" and the knowledge that I'd be familiar with the nursing process, and my order writing would be familiar, as well as knowing what is possible to implement in a shift and what is not, and I look forward to the idea that when I round and write I can explain to the nurse exactly why I am doing what I am doing and have an open line of communication... she knows what's going on since she/he is the one who spends 12 hours there.