wildmountainchild

I work in an ER. I just love, love, love it. The fast pace, the constant change, the opportunity to really practice some cool skills, you will be a master at starting IV's within two weeks. The first year was hell. I went into the ED as a new grad, but it gets better. I also work pediatrics on a low acuity floor. It's kind of boring but I do love getting to hold the babies. It's a good balance. Good luck on your decision.

I work in an ER. If I can, I try to wait until I know shift change is over before I transfer a pt. But I can't always do that. Sometimes I have the DR or the charge breathing down my neck to get the pt out of there so we can get another one into the room. What gets to me is when I call to give report and I'm put on hold for > 5 min while they try to find someone to take report. I don't have 5 min! The last time this happened I literally had one pt code while another LOL was trying to strip tease in the hallway. Obviously I hung up, called the code, threw a blanket over granny, and tried to contain the chaos. The floor called back and yelled at me for hanging up! If you can't take my call in a minute or less, just give me a ring when you're ready. It may sound insensitive, but when it's busy, I barely have time to give report at all. Another time I brought a pt up to ICU. As we were transferring her the nurse made a nasty comment about how I hadn't emptied her foley before transfering her. I did feel badly about it, but when I was caring for her she was on the verge of death and her foley was the least of my worries. In the ER we understand that the floors provide better care for seriously ill, time intensive pts, so we try to get the really ill ones upstairs as fast as possible. We basically stabilize them and transport. This makes sense b/c ICU ratio is 1:1 or 1:2. I still have 3 other pts despite my seriously ill one to care for in the ED. I always try to be nice and considerate. I don't mind calling back later and holding pts if necessary. I actually do that pretty frequently. It just isn't always possible.

I work 3 12's a week. Sometime 4. I really love it. I don't feel tired unless we get really slow and there isn't anything to do. Then the hours just drag by. Luckily that doesn't happen much in the ED. I wonder about the med error studies. Were the nurses making those erors only making them after they had passed the 8 hr mark, or did they make the errors in the first 8 hours of the shift? It seems to me that I always end my 12's feeling perky and as if I could easily go another 4. The 4 days off a week is the real winning point. I can take chinese lessons and work on my pilots license. I feel like I actually get to have a life outside of work.

The was working rescue in a national park. A guy fell about 500 feet to the ground. I've never seen anything like it. His face was lying on a rock with the skull completely removed. It looked like one of those rubber halloween masks. The poor guys spine had been similarly seperated from his body and was lying on a rock nearby. The blood spatter was a good 30ft in diameter. Sitting on another rock was the top of his skull...looking for all the world like a clean white offering bowl to some god of carnage. I had nightmares after that. Another sad story...a young woman was hopping across the river on boulders, slipped and fell into the rushing water and was pinned by her hips under the water. During the body recovery a 3:1 pulley system was built and her arm was lassoed and pulled....right off. It shot about 50 feet into the air and landed on the other side of the river. Her family had INSISTED on being there for the recovery, despite being told that it could be very gruesome. Even young children were there, aunts, uncles, etc, etc. Very bad scene. They tried to sue the park service after that. Didn't get anywhere w/ the suit. Her other arm was pulled off later as well. Eventually just had to wait until the water level decreased to retrieve her. The diver said he could "taste" her in the water.

I have another perspective...I don't mind, and never have minded, talking about money. I guess this comes in opposition to my upbringing where money was NEVER discussed, to the detriment of my brother and I who didn't know the first thing about finance when we left home. Hence, despite many years of making decent money I squandered most of it, got in debt and had to dig myself out. Financial independence has been many years overdue in my family precisely becasue of the taboo against speaking about money--what you do with it, how much is enough, interest rates, budgeting, etc. Sometimes I think that if discussion about finances was more open--heck, maybe even classes in budgeting and investment in high school (and living within your means)--that there would be more realistic expectations by everyone. Just yesterday I calculated how much my yearly income is going to be from my hourly rate.....I was so excited I was telling absolute strangers. I couldn't help myself. Money to me means security, safety, not having to rely on others, and the ability to help those in need as well. I feel my income is a major stepping stone in my life...I feel as if I've finally "made it." I also don't get the comments that some of you get. Most of my friends are professionals themselves and make the same as, or a bit more than me...so to them $55/hr doesn't really seem like that much. Although I'm relatively sure that my brother is going to be asking me for money at some point.

Oh, and garaunteed ratios. 5 pts to one nurse on the floor. 4:1 in the ER. Only 2:1 max in ICU or if critical care in ER. I WON'T work as a nurse in another state. To go from caring for 4 pts, which at times seems crazy, to caring for 8, or 13! Yikes.

San Francisco. The cost of living here is pretty high, but I actually live outside of the city and catch the train in. I think the Bay Area (as in San Francisco Bay) has the highest paid nurses in the country....and I'm working at the best paying hospital in the Bay. My impression is that nurses are really valued, hence the pay....with a raise coming in June.

Money, money, money. If a hospital wants to retain high qulity staff then they have to pay for them. I recently got a job as a new grad. I will get paid $55 an hour. My friend who has been working a similar job in another ED for the past 10 years is getting $1 more an hour than I am. I don't think she's going to be staying there much longer. She'll probably get close to $70 for her experience where I work.

I appreciate your forthright presentation of your feelings. Some people consider me to be.....very honest. For lack of a better description. However, I care very deeply about my patients and have realized at this stage of the game that playing well with others makes my life easier, even if I have to deal with what I feel are petty and useless upheavals in my work environment. As mentioned above, you have to have experience before you can become a travel nurse. Most places want a minimim of two years full-time RN experience. Why go through the hell of nursing school if you already know that it isn't for you? Sounds like a losing proposition to me. There are other ways to get to travel. Be creative. Find another field that doesn't require much in the way of people skills (I mean, you're going to have to tell people that thier mother, child, loved one is dead...you really need to be compassionate). Accountants actually get to travel a fair amount if you get the right gig.

Gosh...let me see if I can remember. The heart isn't pumping effectively, blood backs up from the left atrium into the lungs. Pressure increses in the pulmonary venous system....bladdy blah...fluid in the lungs. That's about all I'm willing to give you. Being that it took me all of 5 seconds to look up what I didn't remember. Google! Or your pathophys book will help.

I must have applied to 30 or 40 different positions before I was hired into a new grad program. The market here if fairly saturated as well. It's not that nurses aren't needed, it's just that you can't run a hospital w/ all new grads. I'd given myself until this summer...if I handn't landed a job in an ED I would have done something else. Hang in there and keep plugging along. Make sure you apply to positions that may not list new grad, as has been mentioned above. I found that actually going to the department you are interested in and introducing yourself to the nurse manager was very helpful and universally well recieved. It shows initiative and motivation. Always bring a resume with you! Are there any job fairs in your area? Sign up on aftercollege.com and they will send you listing of career fairs for nurses and postings of new jobs in your area. I got a lot of leads from them. It took me 3 or 4 months to get a job...the one I wanted anyway. Good luck and get ready to hit the pavement. Looking for a job was almost a job in itself.

I've got a littmans book and the saunders comprehensive review. Make me an offer that covers shipping and they're yours! They are both recent...2007 anyway. I took the NCLEX this February and passed in 75 questions. I don't have the CD's that come w/ the books as I've already given those away. PM me if you're interested and we can work something out.

I got my preceptor a pocket knife like the one I have and that she had admired. She loved it and she wears it all the time (we've stayed great friends). She even got me a gift when I was done w/ my preceptorship...a sweatshirt form the ED where I'd precepted. I think it's a sweet gesture..and a good way to be remembered favorably, although I know that's not why you're doing it.

The AANP renectly had an article in thier publication stating that NP's should be certified in thier area of practice. However, in reality that is rarely the case BUT for liability reasons I think it's a good idea. How much time do you have? The DNP takes about 2 years while an additional cert only takes 1. While I think the DNP is the wave of the future I think you can get more real world mileage out of an ACNP cert. Look around at different programs, mayber there is one where you could end up with both the DNP and the ACNP. The DNP is still in enough of it's infancy to allow some flexibility in how it's arranged...I just don't know how much. If it were me, I'd go for the ACNP first.

I don't mean to sound rude.....but look it up! Google it or hit your Davis' Drug Guide. I don't know if it's safe or not, but good on you for checking.......now go check :wink2:.