SC-Tele-RN

I carry Macksey's Pediatric Drug Guide with me everywhere. You never know when you'll get a peds case thrown in your room, and just having it with all its instant drug calculations for every weight calms my nerves. You can buy it on Amazon. Macksey's other book, Nurse Anesthesia Pocket Guide, is good too, and has saved my $$$$ a couple times when I get pimped. But if I had to choose between the two as a MUST HAVE, I would choose the peds book.

This thread is waaaayyyyy too valuable to be buried.... so BUMP! Note to administrator: Can this thread be made a sticky?

If the CVICU can give you experience with swans, a-lines, vents and etco2, iabp, etc. then you should definitely choose that unit. That is the type of experience the programs want you to have because not only do you learn your vasoactive drips (like the back of your hand) and fine-tune your critical thinking skills, you also learn the equipment and how to interpret the numbers, which are things they want you to have a good handle on BEFORE you start the program. I worked in MICU before I started in CTSU (cardiothoracic surgical -- post CABG pts), and I got lots of experience with vents, but not much with lines or even with drips (they have a tendency to use dopamine a lot in that MICU, and you see other drips less frequently). I work in a large hospital with many ICU units, and those with the equipment and drips that you really need to know were found in SICU and CTSU. We also have a CCU, but the equipment is not really utilized as much there. I don't hear of lots of people from our CCU going to anesthesia school... the majority of our candidates come from CTSU and SICU. A few from MICU end up going to school, but based on my experience on both units, I am certain that CVICU or CTSU will better prepare you for school, and also look more attractive on your application. I guess the exception to this would be if you worked at a smaller hospital where your MICU is sort-of a "catch-all" that takes all kinds of patients, and you might see more equipment and a wider range of vasoactives there. Also, if you take the position where you are only "floated" to the MICU, I am not sure an admissions board would consider that as full-time experience. If you are only floated to that floor, would you receive the intense orientation that they would give to their full-time staff? That's imperative. I did a 9-week orientation in MICU and another 9-week orientation in CTSU. Both were absolutely invaluable. I used to work at a small hosp in SC that would sometimes float nurses to their MICU if they were short-staffed, and not only did these nurses NOT receive any special training, they were only assigned "stable" ICU pts without pa caths or drips that had to be titrated. Good luck in your endeavors!

I just got a phone call today confirming my interview in about 3 weeks! I was told that I would receive a letter in the mail with all of the details. If anyone has any insight on the Duke interview process, I'd love to hear from you. Also, I don't know how many people they accept each year.... anyone know that? I hope you all get your calls soon... :balloons:

Hey everyone... I have an interview with a hospital-run HHA tomorrow and before I commit to anything I wondered if I should also try to interview with Medi Home Health. I understand MHH has many branches and would love to hear any comments from those who have worked here, either positive or negative. Thanks in advance for any help you can give! :)

Hello all. The other night, I was charge nurse on a telemetry unit with a couple of LPN's and an agency RN. The agency nurse had a patient who had been on this floor for several weeks now with GI problems. The pt has a mild cardiac history, but no active problems. Anyway, in the middle of the night, with no known precipitating factors, she goes into SVT. Her rate starts at 140's, drops back to SR, then goes up to 150's, SR, 160's, SR, and so on until she has rates over 200. Each time she goes into SVT she stays in it longer and longer (3 - 5 minutes of SVT with 15-20 seconds of SR in between). I din't worry about the pt too much to start with because her nurse has more experience than I, and she works in ICU a lot. I saw her calling the MD and knew that she would get an order to bring this woman down. A little later I noticed that the woman was still having SVT on the monitor. I asked the nurse what the MD ordered, and she said that he had ordered no drugs, just to arrange a cadiology consult (her admitting physician was GI specialty). So she called the cardiologist on call who had never seen the woman before (but she is known by her cardiologist in that practice), and he told the nurse that he would be in to see the woman in a couple of hours when he made rounds. He made this decision because the woman's BP was stable and O2 sats were okay. He ordered no drugs or anything. When the nurse told me this, I was flabbergasted. How long can a person sustain rates near or above 200? I offered to call the MD back and ask him to order something, but the nurse became offended and told me that because the woman was stable, she would be okay for the next 2 hours until the MD came to see her. I went to her room and talked with the woman. I had taken care of her myself 6 days earlier, and the woman that was lying in the bed now was not the same woman. She was pale and weak, not exactly diaphoretic, and feeling really bad. All systems might have been stable, but the pt herself was in bad shape. Can anyone tell me if I was right to be concerned? I still believe that something should have been done, but the woman's GI MD, the cardiologist, and the agency RN (who also has ICU experience) all seemed to think that this was no big deal. I felt that adenosine should have been given as per ACLS algorithm, at the very least. That is why we take the ACLS course, isn't it, so that we can act in the absence of the docs if they have not seen a patient (with his order, of course). What is the consensus out there? Thx ps- by the way, the woman came out of this situation ok. The agency RN had been attempting to use vagal maneuvers to bring her out of it, and I was aware of that, but it wasn't initially successful. She either spontaneously converted back into SR or the vagal maneuver finally worked, I am not sure which.