ski_ER

hi there ~ i've been reading threads on here for months and enjoy reading about various subjects on this site but have to admit this is the first time i've ever responded to a thread i feel compelled for some reason to respond to yours. i can only speak for myself of course. first of all, starting in kindergarten all the way through high school when i was asked, "what do you want to be when you grow up?".... i've ALWAYS responded, "i want to be a nurse." nursing is definitely my calling, so to speak. yes, the money is good & the hours are fabulous, but that's not why i chose nursing as my lifelong career. i'm not even sure how to put it into words, but i absolutely LOVE being a nurse, LOVE helping people and can't imagine doing anything else. of course there are times when our job is stressful, whether it's b/c of political/legal issues or simply a challenging shift with a high acuity patient load and/or cleaning up contents coming out of every orifice of our patient that would make most of our family and friends gag just at the thought, but i have to honestly say that i've never left a shift, no matter how stressful, and thought that maybe nursing isn't for me. i've been a nurse for 7 years. i've worked in Med/Surg, Trauma, Ortho/Neuro, Peds, Psych... and have recently found my calling within nursing as an ER nurse in downtown L.A. (I LOVE ER!). if you're not familiar with ER nursing yet... there are PLENTY of shifts that are beyond stressful - whether dealing with comforting family whose loved one has passed after you and your team have tried your hardest to revive them, cleaning up blood/guts/poop/vomit - you name it - or having a high acuity patient load with our 4:1 patient/nurse ratio in our ER. with all that being said... 7 years of nursing in various departments... i've NEVER doubted that nursing is the best choice i could have made, as far as careers go. i have a family, with children, work 3 twelves a week-night shift, and seriously feel like i get a mini-vacation every week as i try to schedule myself for 3 twelves in a row, therefore getting off 4 days straight nearly every week. i spend PLENTY of time with my husband and children. love the hours, love the pay, but most importantly... love coming home knowing that i helped someone that day. i've seen nurses drop out while still in nursing school and nurses that started their career and soon after decided that nursing wasn't for them. it's definitely not for everyone. you have to have a strong stomach, dedication, an open-mind with continuous learning, enjoy working with people, find a way to tolerate dealing with difficult patients and/or families, deal with all of the political/legal aspects that come with working in the medical profession... i could go on and on, but i'm sure you understand. good luck to you. i hope my long response helped you in some way. i guess you won't know until you try, right? once again, after 7 years of dealing with a multitude of stressors as a RN, i still LOVE my job and can't imagine doing anything else :)

i just finished up PALS today, as a matter of fact... took ACLS 1 year ago, and i also agree with others that PALS was much easier than ACLS. as already mentioned... LISTEN, take notes if it helps you, study the notes and any handouts they might give you during the lecture phase - they gave us some 'cheat sheets' - that basically consisted of tables of the various ages of pediatric vital norms, different rhythyms and how to treat them, etc. i took notes b/c it was made fairly obvious to us that 'lecture holds the key.' i spent way too much time worrying about reading the rhythyms and there wasn't one strip to read on the test! unlike ACLS, where we did have to read strips on the exam. the test was sooooooo much easier than anticipated. of course a non-medical person would probably have quite a bit of difficulty passing the test, but if you have a strong, general nursing education, i truly believe the test primarily consisted of 'nursing common sense' answer selections. i was able to answer 98% of the questions without hesitation and got 100 on the test - and i'm not one to ace medical/nursing exams with 100's frequently. and by the way.... i didn't read one page of the book - although i usually do read quite a bit of the text to prepare for exams, they stressed paying attention & listening as everything we needed to know would be covered in lecture - and they were right! we had a blast in our PALS class - there were about 11 ER nurses and a couple more from different areas. the instructors were definitely there to make it a fun learning experience and helped us tremendously. leading the codes during our mock scenarios, and observing and assisting others leading the codes was very helpful too. our questions today were SCENARIO, SCENARIO, SCENARIO.... "8 yr old arrives in ED, unresponsive, BP 55/30, R 10, HR 60, mom reveals that pt. has been vomiting for 2 days................" and so on and so forth. sometimes there are a couple of answers that are correct, but you have to pick the one of utmost priority - so you're assessing all of these different physical symptoms of the pt., and then decide (with the answers) what the 'most right thing' to do would be at that moment. some of the answers are just flat out wrong of course, but others might have a couple of right interventions, but that's where choosing the 'most right thing' comes in. i did review some of the scenarios in the book - the lecture notes sufficed for me, but it can't hurt to review some case scenarios from the book. i'm not sure how many different tests they use, but my test had no dosage calculations, no strips to read....... and although it might sound tricky, there were no direct questions, such as..... 'The first line of drugs to give to a patient in Asystole is.....' there were a couple of questions about 'shock' scenarios - in one of them they stated the pt. was in V Fib, blah, blah, blah, ........ and how will you address the V Fib? well, of course the answer is Defib. once again.... described to you in a lengthy scenario. another one, pt. is hypovolemic, blah, blah, blah........ and the answer is that you want to immediately administer fluids - 20ml/kg over 20 min............... my point is that i thought the questions were okay, but even better, once you see all of the answers to choose from, the right one is fairly obvious. some of our questions were a paragraph, describing tons of details about a patient's condition, but just look for key events going on with the patient, that match up to the obvious treatment remedy in the answer selection. sorry so long, but it's still fresh in my mind, since i just finished up the course today :wink2: hope this helps you some. RELAX - it won't be half as hard as you're anticipating!

thanks for your optimism! the good news is that i already have acls and tncc. being a supervisor at the pediatric hospital i just left, due to a cross-country move, it was highly recommended of course that all supervisors be well trained in the event of a crisis. i performed many stat ekgs as a supervisor, but definitely feel weak with reading abnormal ekgs accurately. hopefully an ekg course in addition to the critical care training and experience over time of course will help me feel more confident reading those darn things. i can't predict the future or anything, but i'm 99.9% sure that i'll stay in the er for years to come. every single other job i've had i always found myself doing everything i could to go into/get a glimpse of/converse with.... the hospital's er department. it's the only field of nursing that i've always said... 'i just have to do this!' i know the critical thinking skills required in the er will come with time, practice, lots of questions, watching, jumping in, training, etc. - i'm just a little nervous and sincerely hope that i'll succeed in becoming a skilled er nurse like the rest of you guys. i also agree with 'jojotoo' in that there will be a lot of tricks & tips to learn that you just don't find in a text book - that's true with floor nursing as well of course. i always said that i learned more during my first year out of nursing school in a trauma unit than i did in four years of nursing school & i'm sure you can all relate :) thanks so much for everyone's input!

just wanted to say hi to the California Nurses forum. i've been a RN for 6+ yrs and have worked trauma/ortho/neuro/med-surg/pediatrics... and am now finally venturing into the world of ER - something i've wanted to do for years. i moved to L.A. recently and after applying/interviewing for the overwhelming abundance of nursing opportunities here, finally chose a position. i begin critical care training next week and am VERY excited! if anyone has any suggestions (for you ER or Critical Care nurses) on particularly good learning materials/books to boost my 'lack of' ER knowledge on my own time & purchase (or get online) in L.A., i'd appreciate your input. also... i love to snow ski (& water ski - but my friend's boat we used to ski on is back in Virginia) - absolutely my favorite sport (other than tennis too) and have explored East Coast ski slopes and Silverton, CO - where my sister lives, but am not very familiar with my options around L.A. i've heard of Big Bear and Mammoth Lake, and Big Bear seems to be the winner of the popularity contest on the news and such, but was just wondering if anyone has any suggestions/experience with preferable ski resorts around L.A. i want to purchase a season pass, but don't know enough about local slopes to know which place would be the best one to get a season pass from. is Big Bear the closest one to L.A.? i obviously haven't explored the internet much yet to find out about CA/LA ski resorts. if there's any nurses out there in L.A. that love to ski - let me know if you need a ski buddy sometime! i don't really know anyone here and as far as priorities go, in addition to getting my L.A. career in line... have to become informed about the slopes too! :wink2: thanks a bunch!

just wanted to say hi to the ER forum... i've been a nurse for 6+ years and have worked trauma/med-surg/ortho/neuro/pediatric... but am finally about to start my dream job, aside from wanting to be a nurse since i was about 6 years old, i've always wanted to work in ER and am VERY excited, although a little initmidated - i know i'm a good nurse, love action, trauma, critical thinking, etc. but just hope that i'm 'good enough' for ER. next week i begin the critical care training program and am elated to begin my new journey. since there's so much to choose from out there, is there any particular ER education learning tools/books out there that would be especially beneficial to my education in addition to the hospital's critical care training program, that i can study during my own time? i live in los angeles, so i have an abundance of resources to obtain books/tools from. thanks a bunch!