flaerman

I have been in practice for over 23 yrs and went to a Diploma program in Phila, Pa-have never gotten a degree BSN or otherwise. If you can get into the ADN program go for it, get your education, pass boards and start working. There are multiple RN to BSN programs you can do online etc or go to school part-time, there are hospitals out there connected schools that offer BSN programs with as little as one day a week. flaerman PS: I spent a year as an Administrative House Supervisor in an acute care hospital in FL with only my experience and my diploma in nursing!!!! Good Luck!!!!!:)

I have been an RN for over 23 yrs, probably some of the hardest deaths were the pediatric pt's who died in my ER when I was doing ER. I also worked almost 7 yrs with Oncology pts(5 in a big teaching hospital on a pure Onc unit) where the majority of our pt's died. In school we are taught not to become emotionally involved but when I did Oncology it was not possible. These were people I cared for, not furniture. We became almost extended family to our pt's, I never let one of my pt's die alone-if I couldn't get family in to the bedside in time, I stayed with them while they passed. I shed many a tear in Oncology, got very good at recognizing when a pt's last hospitaliztion was, esp those I had been caring for-it just became something I could see in them when I'd admit them. I would address death with both my pt's and their family and always encouraged to talk to their towards the end when they were not responsive because they can hear, I've seen that. Had one lady not looking good, called her children to come see her where they argued at her bedside over who would get what when she passed. The next day while bathing her she woke up, first words were "call them" I asked who and she replied, "my ignorant children". I am not an overtly religious person but have come to realize several things, when we are born into this world there is time when when we will go, preset if you will and that time is btwn you and God-nothing will change it. If one codes or crashes and we resuscitate them successfully, then that day was not theirs to die, if not-then infortunately it was. Also early on in my career I would see some my pt's pointing at a spot on the wall/ceiling and after a while of seeing this realized they all died, so I've come to believe that maybe an angel or departed family member/friend has come to cross them. Then my second wife who was a psychic and very much into the spiritual world told me that was exactly what was happening. I left Onc for Cardiac Telemtry and had a lady who was an onc pt that was going to discharged to hospice. The night before I had her she had an almost died experience(SOB etc) and we talked about it, I told her God wasn't ready for her and that when he was she would know. Next night I had her she again had trouble breathing but was DNR(and not wanting intubation), my co-worker wanted to bag her but I put her on O2. Reconizing that she was going to die I went her called her nephew(no other real family and they were close) told him she dying and that he would never get to her in time short of beaming in, asked him if had any last message for her-which he did. When I went back in the room she had a fearful look on her face initially but was started looking at that "spot". I knelt at the bedside to hold her, asked her if someone was there and she could only nod, I then reminded her of our previous conseration. Told her that she had ben "sent for" by someone I couldn't see(because it wasn't for me) and told her I spoke with her nephew, whispered the message from him into her ear and told her I would tell him that she loved him and would see him again. Then I told her it was time for her to go and to take my which she did, put her head on my shoulder, smiled-took a last breath and passed. It freaked out my fellow staff in the room because that said the her face brightened(looking like a scene from "Touched By An Angel) just before she passed. One CNA grabbed me outside the room and asked me what i did, I simply told her that I crossed this lady to the next life. One year, six months, and six days ago my second wife/soul mate and best friend passed into that good night at 11:50 after suffering from a devastating brain attack that would have left her vent dependent with PEG and trach, she was blinded at birth and her greatest fear was of being on a vent at the end. We lived in Florida during that Terri Schiavo digrace when the government(state and federal-aka "the Bush boys") and the religious zealots decided to get involved in what was not their business to, and had decidied that feeding tubes and artificial means of sustaining life long term was not what either of us of us wanted. So with family at the bedside we removed her from life support and stayed til the end. That puts me on both sides of the spectrum now, in ways it has me stronger and better as a nurse, I now work with neuro pt's as well, have had discussions with loved ones regarding end of life decisions and share my own story, letting them know that they know their loved one would want and it's up to them as to how we procede. As nurses we do the best we can as long as we can for our pt's. win or lose. We always want everyone to win and get better but we know realistically that doesn't always happen either. So do what you can for them, take care of their families too, it's ok if we cry over them sometimes because we are always human. If dealing with dying pt's or death is too much of an issue, then try going into something different(school nurse, MD's office, insurance etc) because the reality is that sooner or later we will all lose a patient. Sorry this got into long-winded rant, but it's how I feel flaerman

With your experience you will not see the kind of money you currently making, I lived out in Phoenix and have over 20 yrs of experience in nursing and wasn't making that kind of money. If you do go out there stay away from Good Samaritan Hospitals, was treated very badly by them, much as they claim they care about their employees, they really don't.

Lasix can lower BP so maybe they wanted to see how the pressure responded to the Lasix dose, then decide on anti-hypertensive therapy. As far as NTG- was the pt having chest pain/pressure? That would be more an indication for NTG. Lasix and O2 use are more first line tx's for CHF. flaerman

Just a quick note to everyone regarding my wife. Life support was discontinued at 5:30 PM on Wed(01/23/08) andd my dear wife and best friend slipped quietly into that good night at 11:50 PM surround by her loving family(myself, her 3 children, older sister and favorite neice and nephew). I had to do was right for her, it hurts she is gone but she is in a better place and will never have another headache, GI problem or SOB. Traching her and a PEG on long term vent support would not be what she wanted along with total L sided paralysis, severe speech/cognitive deficits, and inabilty or servere swallowing deficit would not be the way she want to live either(being blind she'd already lost one sense and had enough of a disability and she always told me her greatest was being on a vent and not being able to speak). I fly home to Phoenix later today to try and piece my life back together, also gotta get my "babydog-EMMY" from my co-worker(she is Sharon's semi-retired guide-dog who doesn't travel well so on "mom's" trip- so she stayed home with "dad"(she's always been as much my dog as Sharon's). I'll figure out what to about returning to work and being an ICU RN again(if I can without thinking of my wife every time my pt's are vented). I want to thank everyone who has responded with much needed, kind words of support which have been a great help to me during this time. This was a time for me where nurses did not eat their own and showed great class. flaerman

My ordeal to my current stressful moment as a nurse continues on. I am now with faced continuing on agressively with a trach/PEG and long term vent(nsg home for weeks to months and possibly the rest of her life-per her neuro intensivist) for my wife which I know is not what she wants versus removal of life support and letting nature take it's course. In my 22 years as a nurse I have dealt this too many times from the non-attached professional standpoint, so this is extremely difficult for me. We lived in Florida during the Terri Schiavo incident and had discussed what we wanted and didn't want, just never put it into writing due to our cross country move and difficult adaption to a state we don't like(also when you are early 50's it wasn't quite a rush to do kinda of thing). Her older sister is in agreement with me but I also want input from her children as well so that everyone understands and is aware of what's going on and where we may need to go with this. I wish tyo thank everyone who has responded with much needed kind words of support. I am holding on at present thanks to my family,friends and support from folks such as yourselves. Flaerman:o

My ordeal to my current stressful moment as a nurse continues on. I am now with faced continuing on agressively with a trach/PEG and long term vent(nsg home for weeks to months and possibly the rest of her life-per her neuro intensivist) for my wife which I know is not what she wants versus removal of life support and letting nature take it's course. In my 22 years as a nurse I have dealt this too many times from the non-attached professional standpoint, so this is extremely difficult for me. We lived in Florida during the Terri Schiavo incident and had discussed what we wanted and didn't want, just never put it into writing due to our cross country move and difficult adaption to a state we don't like(also when you are early 50's it wasn't quite a rush to do kinda of thing). Her older sister is in agreement with me but I also want input from her children as well so that everyone understands and is aware of what's going on and where we may need to go with this. I wish tyo thank everyone who has responded with much needed kind words of support. I am holding on at present thanks to my family,friends and support from folks such as yourselves. Flaerman:o See support thread for Flaerman: https://allnurses.com/forums/f8/most-stressful-moment-nurse-spouse-vent-decision-making-276023.html

Unfortunately some of my older nurse compatriots will always believe that GN's don't belong in specialty areas, however they forget that they too were once brand new nurses as well(none of us are born with RN after our names). Do well in school and continue on as a tech in your unit, you are gaining invaluable experience and insight. Start asking other nurses questions, "why are we doing this?" or "how does this help?" etc. I was working ER a few years ago with a bright young man as a tech who went onto nursing school came out of school to the ER and did just fine, matter of fact much better than the GN we hired because of his years as a tech. So don't be disheartened, unless your maanager/director tells you they can't use GN's, let whatever this other nurse not bother you. Welcome to the wonderful world of nursing.:cheers: flaerman

Right now is my most stressful moment as a nurse. All my wife wanted for Xmas was to go and visit her mom(she has Alheimer's and lives her older who relocated to SC within the last 18 months or so) so I sent her there. My wife is blind and has multiple medical problems including being the world's worst migraine sufferer. She had the usual H/A's etc but either late Xmas eve.early Xmas day she had a really bad one(all of her H/A's were always bad to her) with N/V which is not out of character sometimes(she was sick in bed and never got to spend Xmas with mom anyway). US Air wanted $600-700 to fly her home early so we had to crash some low level credit cards to get airfare and was due to fly home on Friday. Unfortunately she collapsed and was rushed to ER, and is now on a vent in a neuro ICU. In 22 yrs it has never bothered me looking at a sick pt, but then again there was no emotional attachment as my wife and I have. This is absolutely killing me and is moving me towards wanting to seriously give up on nursing as a career. I work in an intense med/surg ICU and am sure I would not melt down taking care of my next vent pt. Sorry for the long winded message but I am just so lost right now and trying to hang to whatever I can that we(she and I) will get over this and continue to be together(as I always tell her, "we will grow old, and fat together baby"). Flaerman

Right now is my most stressful moment as a nurse. All my wife wanted for Xmas was to go and visit her mom(she has Alheimer's and lives her older who relocated to SC within the last 18 months or so) so I sent her there. My wife is blind and has multiple medical problems including being the world's worst migraine sufferer. She had the usual H/A's etc but either late Xmas eve.early Xmas day she had a really bad one(all of her H/A's were always bad to her) with N/V which is not out of character sometimes(she was sick in bed and never got to spend Xmas with mom anyway). US Air wanted $600-700 to fly her home early so we had to crash some low level credit cards to get airfare and was due to fly home on Friday. Unfortunately she collapsed and was rushed to ER, and is now on a vent in a neuro ICU. In 22 yrs it has never bothered me looking at a sick pt, but then again there was no emotional attachment as my wife and I have. This is absolutely killing me and is moving me towards wanting to seriously give up on nursing as a career. I work in an intense med/surg ICU and am sure I would not melt down taking care of my next vent pt. Sorry for the long winded message but I am just so lost right now and trying to hang to whatever I can that we(she and I) will get over this and continue to be together(as I always tell her, "we will grow old, and fat together baby"). Flaerman

I have been a nurse for going on 22yrs now, all of it hospital based and everything from M/S to ER and now soon to be ICU again. When I started out in school in 1982 and first did patient care it became my passion, I thought that once I got paid for it, then it would even better. That feeling has lasted throughout most of my career. But of late I can't say that remains to be true anymore. I have been a nurse in 4 different states and always as a staff nurse. Right now all nursing is to me is a paycheck because I've done this so long there is nothing else that will pay me what I make. This never comes through to my pt's because I am a professional and my pt's care is number one. I think it is time to go back to school to find something new that I want to do and feel passionate about. When my pt's are truly sick and in pain I do feel for them and try and make a difference for them, but I have seen so much abuse of the system and have had to be nice to so many people who were not worth my time or effort. Maybe ICU will help change this for me. I guess I'll just have to wait and see. flaerman:o

Also would want to check his PT/PTT and D-Dimer(if elvated could have PE which could explain SOB and CP)-then would need CT chest /angio study, and did he have a CT of head/brain, the BP (150's/90's) although sl elevated would not always cause a H/A(the initial presenting BP would be more a cause for H/A)-need to R/O CVA especially with H/A, disoreientation and drowsiness(and H/O fall as well). flaerman

1. Paul 2. Diploma nurse, never went back to complete a degree as I was already doing what I trained to do and was not looking to management or anything. 3. Originally Phila, Pa; have spent 2 1/2 yrs in El Paso, Tx, 7 yrs in Kissimmee, Fl (outside of orlando) and currently live in Phoenix, Az. 4. ER at present(over 21 yrs experience-M/S, Oncology, PCU/Tele, ER, Nursing Supervisor, ICU and ER again). 5. Grew up hanging on street corners(gang fights to football playing and a bit of a hell-raiser), wanted to be in helping my fellow man and esp. wanted to do peds but never got to do so because of appalling things I witnessed people had to done to their kids(wouldn't have been licensed for long). 6. Reading, movies, weekend retreats, Reiki, Harry Potter. 7. Know what you want from school, study hard but take some sanity time for yourself, and know where you want your education to take you. 8. Wanted to be a Paleontologist when I was a kid, then a fire-fighter, tried the USMC but got a medical discharge, nursing decision made at age 25 and glad to have done so. 9. Would go to nursing at an earlier, maybe got degreed so I could teach, but am planning on going back now and becoming Nurse practitioner. Hope this helps and is not too late.....flaerman:balloons:

Sorry guy, but I am also male and have been an RN for over 21 yrs in 4 different states now all hospital based in a variety of positions and I have never seen any male(either RN or LVN/LPN) ever discriminated against. If you fired from back to back positions I think it is time to evaluate yourself and whether or not you are cut out out for nursing. When people were terminated it was mostly justified and related to either something they had done in their practice, patient interactions/complaints or just didn't fit into their institutions framework and ideals. And not to get off topic here, but as a male I have never been offered a salary comensurate with having testicles(as I saw a discussion recently about men making more than females in nursing) and with the exception of 1 yr as a Nursing Supervisor all of my experience has been bedside pt care from M/S to ER to ICU and back to ER..... flaerman In the words of Maxwell Smith; "Sorry about that chief!!!":nono:

I am an RN with over 21 yrs of hospital based practice and when I went to school we were taught to never get attached to our pt's too. Well since we work with real people who have real issues and problems(as opposed to working with furniture etc) it's nearly impossible not to get attached if you are genuinely interested in making a difference in people's lives. I did Oncology for 7 yrs during my career and that was real hard with attachments because my patients ultimately died from cancer anyway. I just tried to do the best I could for them, their families, and help prepare them for passing on. I did get burned out from Oncology as I got too good at knowing that my patients were going to die on a particular admission, and had to start to distance myself from them a little bit each day. It was getting to where everyone of my "pet pt's" died I was losing little chunks of me too, that and my pt population who were dying were getting younger and younger. When it got to where I couldn't sleep at nights it was time to move on and I have since done cardiology/PCU, ER, ICU, nursing supervisor and now ER again. I still have feelings for my pt's and treat them the way I'd want to be treated and do whatever it takes to relieve their pain and keep them going. I had a little lady (only a yr older than myself) who was homeless(though she didn't want to admit it) and after we treated her initail complaint; I fed her, took longer to give her meds(she wanted to sleep til at least 6Am-that's when the buses started running) to keep her until 6:15AM. On discharge I gave her my own lunch and even slipped her $20.00 to pay for her prescriptions(for ehich she cried and hugged me before leaving). So no you are not wrong for caring about this lady, because when you get to the point where you don't care.... Then it is time go do something non-people related(insurance etc). Good luck with school and your future career in nursing. In nursing success section I have about a patient I had in ICU who went bad on me and some of what I did-if you want to read it. flaerman