APNgonnabe

Thank you so much for posting this question. Mmcmarsh I am in what I feel is the exact same position as you are. The only advise...comfort that I've some up with is in Illinois(where I live) I do not believe there is anything stopping me from practicing in a clinic. I know we have some Illinois mods here so please correct me if Im wrong. I have thought about getting a post certificate in FNP or I think PNP would be really amazing. Anyways good luck and I'm here with you..

I too had problems with Blackberrys and programs. I got an SD card and loaded the program to that. I've also talked to others and they say to clear your messages. OP: I just got a free trial to essentials, I'll post back after using it. Im not sure how I got it. I've had the free epocrates for awhile, so I guess they just want me to buy something:).

Sweet!!!!!

I think you were right to question it. If there was no clear cut answer then yes you need to go up the "food" chain to someone with more letters behind their name. Personally I think the RN was mad she didnt think of it. good job

As the link implies this one is at Mayo...looks interesting http://www.mayo.edu/mshs/np-career.html

Here is my ...I've worked in two different hospitals one a community hospital and the other Level I trauma w/ an active CABG program. In the community hospital the techs draw blood. It transitioned from the techs being on the floors as CNA(well PCT if they had the phelb training) and now many of the PCT went to the lab because the lab took over drawing all lab work in the house except for ABG which is RT job. If the pt has a line then the RN draws the blood and sends it down to lab. In the level I the night RN would draw their own AM labs including ABG's. The RN's would not draw cultures however. The day RN did not draw any blood. I enjoyed having the ability to draw my own blood because I could do it when I wanted it. Which was usually when the pt needed it. If you have to wait for a lab tech to come do it they may not get there exactly when you want to have them there. This could be multifaceted and usually nothing to do with the actual tech but more their work load. No, I do not like having additional responsibilities but at the same time when it comes down to it the nurse is usually responsible for how or why things happen during their shift. This is not saying that the techs are not valued or needed. They would still draw all lab work on the general floors which sounds like the OP's hospital has more than enough beds. Again my .

I just went back and read some of the other posts (suppose I should have before reposting). Just keep in mind that not all ICU nurses are the same just as not all ED nurses are the same. I tend to think Im not one of the "sticklers" so I fall victim to defending "us." Keep doing what you do (which is why you do it and not me). Thank you. Oh, and send me some good sick ones;)

This is why I pointed out every place was different. By special psych room I mean one build so the walls are more or less indestructible and a locked door. As long as they are not hurting themselves they can pretty much be as ****** off as they want to be w/o having to interact with staff. And yes the communicators arent the most friendly but that is what admit says we will wear but I suppose they'd brake the pop off point (I hope). I'm sorry there isnt someone to make a quick phone call...must stink to work where you do. I suppose if that's the ER work conditions are it give me a little bit more perspective as to why ER and ICU seem to butt heads.

The ED is really an interesting place which is why so many of us flock to it. There have been several post on this subject but here is a summation from what I recall... FNP are good for the fact that they can see all age ranges. They typically are utilized in areas such as "Fast Track" or Urgent care although some have reported the NP running their own pt in the main ED. As for the EDNP progarams; some of them like vandys is and FNP/Acute Care NP. As I understand it takes a little bit longer to complete but you'd have an expanded age range. I am not familiar with many of the Emergency NP programs so there could be others out there to find, be sure to see what NP boards they prepare you to take.

atropine is an anticholinergic. And why not try to give them something instead of the good ole standbys...maybe then they dont need to be admitted.

Wow...not every place is the same. If it'd be helpful for me to come got my pt then tell me that but I'd prefer not to leave THE other nurse in the unit alone. If the psychs are causing you problems Im sorry...but guess what they are going to cause me a problem when you send them to me w/o the security & and special "psych" room. If for whatever reason it's going to be a while would it really be that big of a deal to have the HUC call and tell me that, or use that little communicator thing that is around your neck? Yeah...just play nice for crying out loud.

If places are doing a dual degree why would a PNP not work instead of a FNP? ACNP are for adults w/ both chronic and acute so I would think that would work for adult edu needs.

Why or when ED and ICU started having conflicts I am not sure. I do get frustrated with the argument of "we take whatever whenever." Sorry to point out that is what an ED is for. I have taken report on numerous pt that come up 1.5 or 2hr later, not because I told them we couldn't take it so it goes both ways. I bust my butt to get the rooms available for ED b/c I know they need to move them out either b/c they need more room or the pt has moved past the initial resuscitation phase and needs to get up to us before something else goes wrong (not saying the ED was doing something wrong, but that's how those typs of pt work). Were I work I don't really get the hx. I have been there for a year (actually worked in the ED as a tech during school), I rarely ask questions (some of the nurses down in ED have actually said what I tell you is all you need), and if they say we are swamped can I give you report at bedside I always tell them sure. Yet in my last evaluation w/my manager she told me that ER had complaints...I try to be a team player and still.... We are different worlds different specialties who need to work together

Last I checked conscious sedation does not include a level deep enough to render the pt to the point of apnea. Were the fent & versed titrated or bolus dosed? If it seems that the MD pushing the medication was doing so in a manager that was not safe for the pt then I would follow you're chain of command and or fill out a adverse medication event. It seems sometimes nursing looks the other way because they are doctors. We need to make sure our pt are safe. I hope he came out of the procedure just fine.

Dear OP- Basics learn assessment and basically the down and dirty of primary trauma management and medical calls. I worked for a Private ambulance in chicago 5 yrs ago. I started out at $9.50...as it sounds this is about what others were making. For the private services you'll probably run basic/basic. Another poster pointed out the 21 rule..most insurance companies will not insure you to drive their ambulance under 21. The company I worked for had several people that could not drive due to insurance issues(either age or driving record) but they still hired them and paired them with someone that could drive. good luck

Off the lorazepam but...is anyone using precedex for ETOH wd? And holy cow I can't believe (i really can) how much people have to give!!

Can ACNP get certified through AACN also? If so, are they any quicker?

Agreed that a Midline is probably better than a standard peripheral but I am under the impression that mid lines are not central

I caution nurses from "rocking the boat" because a code sheet was not filled out...if it was not a code when the pt got intubated then there would not be a code sheet...at least at my facility

I'm hoping that there was a typo or something that I missed because a manager asking if levophed to replace lidocaine...um wow.

Gavins Dad, If you want to be a Paramedic in Illinois then I believe you must take a Paramedic class and testing. In Illinois there is what is call a Prehospital RN (PHRN) and they typically function at the level of a paramedic on ambulances. Here is what the state says about them http://www.ilga.gov/commission/jcar/admincode/077/077005150E07300R.html If you would like to PM me and give me your location I may have some contacts for you. J

As far as why Neo isn't being used more...I think like one of the previous posters said it depends on the providers training. I worked in a busy/high acuity med/surg ICU w/ CABG pt and we used Neo often. To be fair we used dopamine and levo probably equally amongst all three. I do enjoy neo!!! I currently work in a community ICU and the providers do not seem to remember neo is an option. They have gotten on the levo band wagon from all the current sepsis recommendations.

I have found that as long as there is a nice pretty wave form our monitors have been very accurate at giving the correct value. I do agree with the end expiration is the point of measurement, but it is for both vented and non vented pt.

So in summary: as long as the state BON doesn't explicitly say that a APN can't read a film and the hospital credentials you to do so the APN should be able to do the prelim read, final by radiology.

We have a "flush protocol" numerous IV bags such as 50ml, 250ml, 10ml flush so we have the PRN on our emar. We are of the culture at my facility to us a carrier or tko line.