raininghere

I rotated through a VA and although the pay is (probably) lower, I loved it. The patients were a gem, you had a decent amount of autonomy and ability to do your own spinals/epidurals (where I'm from that's unusual), and the teamwork mentality was great.

I'm looking for a little advice - I was admitted to the nurse anesthesia program at VCU for class of 2012. I applied also to Barry in Miami, UMaryland, ODU, and Georgetown. ODU recently sent me a letter saying their program folded, I cancelled my interview at UMaryland, and I plan on canceling my Barry interview. I was waitlisted at Georgetown, largely (I think) due to the fact that I'm in the (rather early phases) of completing the required chemistry course. GT told me that would be an issue with my application, but I was doing applications and moving and planning a wedding, so that just wasn't going to happen. Anyways, I really liked VCU's program, but it requires either (a) asking my husband to move, not such a problem but I don't think I'd want to settle in Richmond and it's not fair to ask him to change jobs again in 2.5 years or (b) living separately Mon-Thurs in Richmond and then coming home on the weekends (we live about 1.5 hrs outside of Richmond). He works in the nonprofit field, and it wouldn't be super easy for him to change jobs. I can stay on the waitlist at GT and then go there if accepted, but the program is nearly twice the cost, plus it's a pain to commute in/out from DC. Any thoughts? Thanks!! BTW, my stats were: GPA 3.7 something, traditional nursing student GRE 1420 + writing 4 Will have 3 years general ICU (med/surg/non surgical cardiac/neuro) experience

There should be no reason why not - even prescription narcotics are often ok when prescribed by an MD. I took adipex for a few months, did a great job decreasing my appetite. I started having shortness of breath at rest and as a precaution, my MD took me off it. Unlikely that it was related, but just to be safe - I believe adipex WHEN COMBINED with other weight loss meds can lead to pulmonary hypertension. Just fyi . . . it did make me jittery, but I definitely don't regret taking it.

Goodgrief - Thanks for the info! Hopefully I'll get the question correct, I'm interviewing tomorrow . . . nervous and excited!

I have an interview on Nov. 19th too! A friend of mine did it last year and said that there were no clinical questions, but "get to know you questions."

What is your experience with postpartum patients and infant visitation? We are having two issues in my ICU right now, first is that we're having difficulty getting the mother-baby nurses to let the stable infants visit their moms in ICU. Second, once the mother is discharged from ICU, their policy prohibits her from returning to the post-partum unit - she must go to a med/surg unit (and therefore cannot room-in with the infant). This is especially distressful for 1st time moms since they usually cannot learn infant care prior to infant discharge. The rational for this policy is that after ICU, these patients are "dirty." To clarify, we keep the moms on the neurosurgical ICU part (the "clean" unit). Is there any research backing this up? Thanks!

NurseyPoo7 - YOU DID THE RIGHT THING!!! That irks me so much . . . how awful to spend the last moments of our lives gasping for breath! It is impossible to know your patient's morphine tolerance from the information we have, but absolutely, titrating per your protocol (and calling the MD if, even with the protocol, you still can't get your patient comfortable). Some patient need the synergistic effect of having a bit of Ativan or Versed with the morphine. Ugh, people are so shy of medication at end of life! I had this patient in her 40s, with end-stage interstitial lung disease, and we ended up putting her on a Versed gtt at 30mg/hr (she was on Dilaudid too but I forget the dosage, something like 15-20mg/hr). She wasn't intubated. Tragically, the patient was never "comfortable," and in retrospect I wish I had asked the docs to put her on ketamine also. This patient had a long history of IVDA, and likely had developed quite a tolerance. Thankfully I have a palliative care team in my hospital that is "in the know" regarding pain management. Does your hospital have a palliative care team available? Even if they don't, someone you can get a MD or nurse from their group to give a talk at your hospital regarding pain management at end of life. I would definitely talk to your boss . . . this nurse needs some education.

I definately think 8 weeks of orientation is going to be a little short . . . can she work as a tech for 3 months and then orient to the unit? I know where she's coming from though . . . I went to a BSN program and worked as a secretary/aide/tech part-time during nursing school. I was appalled during my second med-surg rotation that my clinical instructor (THE INSTRUCTOR) had never seen a small-bore feeding tube or a Perma-cath before . . . and didn't know how to program an IV pump. We spent so much time doing care plans that a lot of the technical stuff got ignored. We have a similar issue at my hospital regarding IVs; I'm an ICU nurse and we get called all the time to start lines on the medical floors. Frequently the primary nurse has not even attempted it. We all miss lines sometimes, but one night I had to do four on the same 21 bed unit! I think that should be a competency built into orientation . . . I know that I was not permitted to work (or be paid) as a tech until I was able to get 3/5 IV starts, which I think is a reasonable target. In short, clinical time is WAY too short in BSN programs - look at med students in their 4th year, they stay overnight with the residents and learn a ton because they're in house all the time . . . how can you glean that much info from 2 6-hour shifts a week in clinicals?

Dear warmblanket: no need to jump all over me . . . I didn't say that nursing WAS the only profession that didn't require a masters degree, just that many others require more education (pharmacists, physical therapists, wound and ostomy nurse specialists, etc.). I also didn't attack any diploma/associate degree program - don't take it so personally. If you feel like it's a problem that you don't have a BSN, no one else does so get over it. You could make the argument that associate's degree programs have more hard science class requirements than do BSN programs who get lost in nursing theory nonsense. However, nurses have NOT done a good job promoting our professionalization. How many med students complain about having to take chemistry? Having more educated/smarter nurses (WHATEVER DEGREE YOU DECIDE TO GET) is only going to promote more evidence-based nursing care. And whatever you think my attitude is, I don't really know how that could be a bigger problem than a nurse who doesn't understand metabolic acidosis.

I went to a BSN program that did not require chem . . . big mistake. If you want to get any respect and know what the hell you're talking about with physicians and other staff, get all the education you can. Nursing is one of the only healthcare professions that doesn't require a masters degree. We really shouldn't be eliminating courses from the curriculum on the chance that "maybe I won't need to use it everyday."

I'm hoping to find out GPA/GRE numbers of admitted applicants to CRNA school. I'm looking for grades/scores that will be highly competitive . . . I went to an average nursing school and hated it . . . it was boring and the preparation for nursing was terrible. My GPA was 3.64 total (somewhere around 3.78 for nursing school), GREs were 690/730. My SATs were around 1430 and I didn't get into a lot of the undergrad places, so I don't want to be surprised this round. If I need to retake the GREs to improve my chances I will. Thanks!!!

Thanks for all of your advice. I thankfully had a great group of patients this week (and reasonable family members!), so I'm going to stick in out in the ICU. I'm definately planning on shadowing a CRNA this summer and a few other professionals before making any further decisions on school. Thanks so much!!!

I am exploring graduate career options, and I wanted to get your opinion. I currently work as a ICU nurse (med/surg), and I'm not happy there at all. The things we're doing to the patients should be illegal; yesterday I put an 88-year-old patient with end-stage Alzheimers on CVVH. 90% of what we're (the healthcare providers) doing is expensive, painful, and is likely to result in no improvement in either the patient's condition or quality of life. I'm good at my job, I love the intellectual challenge that ICU provides, but I don't like coming to work wondering what ethical codes I'm violating that day. Did any of you feel this way? And what direction did you pursue after wards? Thanks so much!