glea1022

While I'm not done with NP school yet, I am working full-time (40+ hours per week) and have two kids (4 y.o. and 2 y.o.). I decided a long time ago that day care was going to have to be a necessary "evil" (believe me, I'd rather them not have to go at all either). It has turned out to be an absoute blessing. Both of my girls have gone since they were 10-12 weeks old and it's just part of the routine to them. Their social skills are great, and, for my oldest, it's like preschool. They go to an actual day care center (not a home babysitter), and so there is a curriculum, activities, etc. Meals etc. are provided, the kids pre-k and up go on field trips. When I pick them up, they are obviously having a good time. I think that when the time comes for them to start school, we won't have too much trouble with the transition because they are used to not being home everyday. (Mom might have more trouble than the kids--my babies aren't babies anymore! Waaah! ). In addition, I have a really supportive husband. He's usually able to pick the girls up from daycare (and even the occasional drop-off) if I can't due to school or work conflict. At any rate, I know the kids are in good hands regardless. Believe me, I wish with all my heart and soul that I could be a stay-at-home Mom, hanging out with my little ones all day. But there's just no way that will ever happen (not possible to live on hubby's salary--middle school teachers don't get paid enough), so I content myself with the idea that my kids are in good hands, they are learning and growing well, and won't likely be scarred for life by going to day care. It comes down to the fact that you have to evaluate your personal situation and values, and determine what you can live with (regardless of what field you work in--you'll have the same issues as a bedside RN). The other thing is, "what you can live with" may change as time goes by. For instance, when I first went back to work (as a bedside RN) after my oldest was born, I worked Fri-Sat-Sun, 12hr shifts. My daughter (10wks old) only went to daycare on Fridays. That worked for about 6 months before hubby and I decided we missed being able to see each other once in a while. By then, I was comfortable with the daycare and not as averse to her going more frequently. Now they both go 5 days a week (except in the summer, when hubby keeps them home).

My program in Colorado requires that, if you want to go the FNP route, you MUST ALSO obtain the ACNP. In other words, when I graduate and am licensed and all, I will be able to put "ACNP/FNP" after my name. That way, I demonstrate that I have the training in both acute care and family care. I could do just straight ACNP without the FNP, but I cannot do just FNP without the ACNP. Makes for a little longer program, but I think in the end I'll be grateful. (At least, that's what I tell myself...)

There is a major difference between the two terms "sudden cardiac death" and "myocardial infarction" although both are commonly referred to as heart attacks. Sudden cardiac death refers to an arrhythmia (like v-tach/v-fib) that usually occurs due to cardiomyopathy or an electrical disturbance. It can also occur as a result of a myocardial infarction (lack of blood flow down a coronary artery, resulting in tissue ischemia/injury/necrosis). MI's cause sudden cardiac death (VT/VF) by disrupting the electrical conduction in the heart tissue. The two terms are NOT interchangeable In answer to the original question, either or both of these conditions can occur in people of any age (especially, as someone mentioned, with the epidemic of poor diet and obesity). However, the symptoms described by the original poster could indicate an MI (somewhat unlikely, unless on drugs), PE, complications of the gastric bypass, endocarditis, or pericarditis. It would be interesting to know what her EKG showed, as well as a D-dimer and CT scan (to rule out PE). An echocardiogram would help determine pericardial effusion or endocarditis (blood cultures would be good too). BTW, anyone who has had even one episode of arrhythmia is a candidate for an implanted defibrillator. They are expensive, but save lives!

I've got several... 1) A CNA falsifying records (You emptied that foley bag at 2:30? Reaaaaallly. It's now 3:00 and the bag is about to burst. Dang, what diuretics is THIS guy on?) 2) Not taking the clear plastic backing off a Duragesic patch before applying it to the patient (that one was mine, folks!) :imbar 3) RN sent a transfer to tele from extended care with a brand new bag of TPN--which she had poked through with the spike and was leaking ALL OVER the pump, stretcher, floor, etc. It takes forever for pharmacy to make TPN anyway, never mind on a transfer. 4) ICU RN calling cath lab because a patient 2 hours post-cath has a "gigantic hematoma." Upon arrival, we see the RN with his fist in the patient's groin applying full weight of his upper body to the site. Pt is vagaling (sp?), c/o nausea, bradycardic, dropping BP. Site is assessed by cath lab team--absolutely NO bleeding, swelling, oozing, or unusual findings. The source of confusion? The nurse saw the green tint of the skin prep that had been used to prep the patient from lower abdomen to halfway down the thigh and assumed it was a hematoma. Did not palpate the site or otherwise assess anything (much less think that a hematoma would not be green within two hours--try several days). Didn't even recognize the patient's vagal response. And this is an ICU nurse!!:trout: I can think of so many more...just give me time!

Thank you to all who have participated! I plan to leave the survey open until November 20.

I have to agree with the other posters in that youth can be either an asset or an obstacle, but either way it depends on how your present yourself. If you go into a situation feeling inadequate because of your age/lack of experience, others will sense it and it will be a problem. However, if you have an appropriate level of confidence in your abilities and knowledge, carry yourself well (head up, shoulders back, with a smile), dress professionally (dependent on your work environment, of course), that confidence will also show. If necessary, seek help from a stylist or something to give you some ideas on how to present yourself in a mature and professional manner. While it's true that people should not judge others based on appearance, it's a fact of life. They say that first impressions are made in the first few seconds after meeting someone--not enough time to judge their brains! My point is--have confidence, project a professional image, and go for it! (BTW--I went to my BSN program right after high school, was the youngest in my class, and graduated at the ripe old age of 22 and looked about 16. If I had a nickel for everytime a patient said "are you sure you're old enough to be a nurse?" I'd never have to work again! I've worked hard to project that professional/mature image--although the grey hairs I'm getting are starting to work a little TOO well "

To the OP: I hear you! I am in my second semester of my master's program. My original plan was to go the Nurse Educator track, but I am rethinking and seriously considering just getting my NP while I'm at it. I figure if I'm shoving bamboo shoots under my fingernails, I might as well do the same to the toes! I've said all along I need to have my head examined for trying to do this, work full time (40+ hours per week), and all with two kids (4 and almost-2). :eek: Somehow, I'm getting through it. I realize that I may well need to cut back on my work hours later in the program, but I figure I will cross that bridge when I get there. For now, I'm hanging in there. I keep trying to remind myself that I don't have to climb the mountain in a single leap--just take one obstacle (rock, stream, fallen log) at a time and one of these days I'll look around and realize that I'm at the top! WHEEEEEE!!!

Scrubs are available at Wal-Mart, and even uniform shops don't require you to produce a valid nursing license to by them.:chuckle People need to realize that just because they see someone in public wearing scrubs, doesn't mean that person works in a hospital etc. That being said, I currently work in a cath lab, which means I wear street clothes to work and change into those plain blue scrubs when I get to work. My work shoes stay in my locker. When I worked on the telemetry unit, I would occasionally stop by the grocery store real quick on the way home and of course day care to pick up my girls daily (wearing my work scrubs). I wouldn't run errands in my scrubs unless I absolutely had to, just because I felt uncomfortable. If nothing else, I would rather people not know I was a nurse when I'm on "my time." What if I inadvertently do something that would reflect badly on nurses in general or my hospital? Anyway, I've personally gotten sick from stuff the girls bring home from day care more than anything I've encountered in the hospital. Talk about your germ factories!!

From my personal perspective, I have absolutely no problem with male care providers in any area, including OB. I had a male L&D nurse with my first child and he was one of the calmest, most competent nurses I have ever witnesses. I was a little nervous at first, but as things progressed and we (my husband and myself, as well as our families) got to know him, we felt as comfortable with him as we would have been with a female. I still see him in the hallways on occasion and rather than feel embarrassed, I recall the joy of that day--the birth of my first child. That nurse will always have a special place in my heart, just as the nurse who cared for me with my second does. My OB/GYN is also male, by my choice. I chose him based on reports of his being the best in town. If a woman MD had been reported "the best," I probably would have gone to her. Was/is my husband uncomfortable with a male MD or nurse caring for me? Perhaps, but he does not make a big deal of it and recognizes that they are professional health care providers, not some random guy off the street trying to get some jollies. (Also, my male OB nurse always examined me with someone else in the room, and my OB/GYN MD always has his--female--nurse come in the exam room during "intimate" exams). That all being said, as nurses we have to respect our patients' wishes to the extent possible. We must consider religious and cultural aspects and accomodate those beliefs as much as we can. As previous posters have noted, some religions prohibit males from caring for females under any circumstances. If no female provider is available, that does create a tough situation that must be handled on a case-by-case basis. At the same time, if a patient or family member has a problem with a male provider, they need to SPEAK UP at the very start. This will allow for adjustments to be made and prevent misunderstandings and offense. How can I accomodate your wishes if I do not know what they are? Mr. Panic, my impression of you is one of two things: either you have religious/cultural objections to having male providers care for your wife , or you have some serious anger and control issues regarding your wife. In either case, you need to let your wishes be known in advance in order to prevent the kind of "long term consequences" you mentioned. I am not intending to offend you, so I apologize if I have. I am simply saying, you can't assume that doctors and nurses know your feelings--you have to tell them in such a way that they will understand. Trust me, if those caring for your wife understand that you have objections to males in the room, they will do what they can to accomodate you. However, if someone were to display the kind of anger that I have sensed in you, they would be within their right to have that person removed from the scene (in an effort to preserve the safety of all patients and staff). My suggestion to you is to come to terms with your issues and find a healthy way to express your concern. Again, I apologize for any offense. Just my opinion on this discussion as I see it.

From someone who has been a nurse for a long time: Don't be so hard on yourself--as long as you learn from your mistakes. It WILL get better, I PROMISE! You are not stupid, just inexperienced (and that's not a crime). As you go along, you will learn to avoid most mistakes. I've been a nurse for over 9 years and I still make mistakes on occasion. I just try to learn from them and not make the same ones over and over. Hang in there and try not to let others get you down.

In addition to IM injections and renal problems, you have to consider what else might have happened to the patient within the last few days. Any falls? Unusual exertion (like moving furniture or something)? CPR? Car accident? Anything that causes muscle damage can cause the muscle cells to release the CK enzymes. Those are not specific to cardiac muscle. Troponin IS specific to cardiac muscle tissue. Our cardiologists put much more stock in what the patient's troponins are than what the CKMBs are, and don't hardly consider total CKs. I do ACC database collection, and they don't even ask for the total CKs, just the MBs and troponin I.

At the university I'm attending, you can only get FNP if you do ACNP, but you can do ACNP by itself. You couldn't do just FNP even if you wanted to.

"Heart Problem" (yeah, we're gonna get reimbursed for THAT one!) "Dead Battery" (for pacemaker generator change-out. What, we need a Sears Die-Hard?) :trout:

Too many to just choose a favorite (of course, all used judiciously)... "I practiced on my cat last night." (prior to any procedure) "We drive like drunks on payday" (when transporting a patient by stretcher with another cath lab crew member) "Don't worry, all bleeding eventually stops." "I promise I won't drop you. Too much paperwork." (best when turning a patient. If said on Monday, can add "heck of a way to start the week". If said on Friday, "heck of a way to end the week") "It's cold in here, but at least it keeps the beer cold." (hey, the cath lab is a COLD room!) "This procedure is totally painless, especially if the crew gets some chocolate chip cookies afterwards." (ooohhh, we are soooooooo bad)

I'm a cath lab RN, and my opinion of expressing a groin hematoma is to relieve pressure on the nerve and vasculature in the groin so that you don't end up with lack of distal flow.