GILady

I work in a GI clinic where fast paced is an understatement. I don't generally sit down much, even during procedures. While I may spend some time standing during procedures, more often I am assisting with biopsies or polyp removal or applying pressure to the abd to help move the scope, etc. I've actually lost weight since I started GI a year ago. I really think the activity level varies per each clinic. I would advise that you shadow a nurse in a GI clinic for half a day before you take a job there and see how it goes. As far as giving the sedation meds, keep in mind that while it may seem like patients were recieving 'larger than usual doses' there is no 'usual' dose. The amount of medication each person can tolerate is dependant on many things, not least of which being what medications they are already taking. Your number one role as a nurse is to be a patient advocate. That means if they are stable and in pain, you push more drugs. It also means that if the doc says to give them more and their BP is in the toilet that you say no to the doctor. Always remember too, that if the doctor does administer too much sedation, there are reversal agents available that work very quickly and effectively. Just read up on your narcan and flumazenil. I love GI nursing. We have a great staff and excellent doctors that are fun to work with. Mostly the patients are pretty nice too, and the grumpy ones tend to get a whole lot nicer after the versed!

In the office where I work it is not at ALL uncommon for people to recieve that much or more of Versed. Especially for younger people, though I may be wrong in assuming that. We generally do not use demerol though, we use fentanyl. When we give the drugs they are titrated so that we can avoid causing breathing or cardiac problems. You say that you are sensitive to drugs; one of our doctors says that as soon as anyone tells him that he knows to bring out the sledgehammer because they will be very difficult to sedate. Also keep in mind that other medications you take can change the way you process the meds, SSRI's in particular, causing you to need more medication.

Don't know if this helps, but when I graduated as a brand new RN in Spokane, all the major hospitals I interviewed with would have started me at 22.25/hr. I don't know about Idaho, but have heard that their wages are slightly less. I don't know where you are coming from, but it's important to remember that the cost of living is probably less here than where you are from as well.

When I applied for my job they made it clear that while they would like me to have more experience in acute care, they liked me and thought I was a 'good fit'. They trained me on the job for the things I need to watch for, the obvious stuff I already knew, such as BP dropping, etc. While it is a huge responsibilty, I am comfortable in my position because I know that if something does go wrong there is someone right outside the door if I need help. Also, the doctors at our clinic are VERY good about helping and providing the necessary cues if I forget things. We are an outpatient facility, so our patients walk in and walk out. They are basically healthy ASA 1&2. I have never had a patient crash , however, I have had to reverse patients when their BP became too low and heart rate dropped, etc. The reversal agents work very quickly and it's never been a problem. Assessment skills are picked up on the job, whether its in med-surg or a GI clinic. I was very happy when I had my three month review and one of the things I was rated the highest on was patient assessment. And one of the doctors had even commented on it! Talk about an ego boost.

You sound just like me six months ago. Newly graduated RN, I accepted an offer an a surgical floor because I thought I should get some basic nursing experience. After two months of being tossed around, ignored, moved from preceptor to preceptor, yelled at by docs, etc. I was also shoved out by myslef after only four weeks of orientation when I was promised eight. I went to my mentor and told her I hated it and couldn't bring myself to believe my patients pain levels because of how the other nurses acted she treated me like I had the plague and was so condescending I left in tears when I went to her for help. I finally went to my nurse practitioner for Xanax, or SOMETHING, anything to help with my anxiety, constant crying, etc. She looked at me, after I told her everything and said, "You know, you have to LIKE your job, or you have no reason to get up in the morning." Really stupid and simple advice and it was like someone turned a light on. Oh. I really didn't HAVE to work med-surg for a year or put up with all of that. So I quit, found a job in GI where I push Versed and Fentnyl all day, have a great relationship with all the doctors, respect and like my coworkers and have their respect as well. Also, I truly LIKE my job. And I didn't need Xanax after all.

I just recently graduated from Spokane Community College's LPN-RN program. Basically they just put you in with their nursing program at the appropriate point. It takes three quarters or nine months to finish. Depending on how recently you graduated with your LPN they may want you to retake certain classes, like L&D or psych. Give them a call and find out, I knw they only have a few spots to take LPN's. LPN's generally make $16-18/hr in LTC in Spokane, less in doctors offices. The hospitals are not hiring them at the moment.