TXTraumaRN

I went through Tech's traditional BSN program, graduated in 2005, and loved it. If you're not from Lubbock or West Texas, be prepared for a little different scenery. It's flat, but that's because it's all farm and ranch land. My family is all from West Texas so I appreciate the scenery a little more than most. You can see forever. Lubbock is the central source for healthcare for a large area of West Texas. It's not uncommon for patients to travel over 100 miles to come to the doctor in Lubbock. One of the advantages of Tech's nursing school is having the medical school, pharmacy school, and allied health school all in the same building, on the same campus. The 2 hospital systems are University Medical Center (UMC) and Covenant. All your clinicals are done within these 2 systems. Also, I don't know if this is still offered but, one of the perks of being a nursing student was the ability to be seen at the Family Practice clinic for free. It's on the first floor of the HSC and very convenient.

I'm single, live in a one bedroom apartment and drive a 13 year old car (no car payment) lol In all seriousness, it's less expensive living where I do compared to living closer in town.

I just moved to Austin about 6 months ago and work in the ER at Brackenridge ( part of the the Seton system ). I have also worked for Scott and White in Temple. Both facilities are good at what they do. Because Seton is a Catholic based system, they have a little more focus towards indigent care, which is greatly needed in this area. Scott and White is a very respected research system associated with Texas A&M College of Medicine. Brackenridge is moving more towards becoming a larger teaching facility; they currently have several residency programs with UTMB and are supposed to be starting a partnership with UT Southwestern for an ER residency program. I personally like both systems and would have no problem going back to Scott and White if I needed to. The Scott and White hospital in Round Rock is a fairly new facility; it was opened right after I left Temple in 2007. One of the unique things about Scott and White is that the board of directors is physician oriented; 10 of the 22 members are physicians. Only 3 of Seton's 19 members are physicians. Having a physician heavy board gives the system a refreshing mentality. I have also been a Scott and White patient for 29 years and have rarely had a negative experience. Hope this information helps. Also, I live in Southwest Austin towards Bee Cave and LOVE my side of town.

I think we work at the same ER. That patient showed up here a few weeks ago.

An ER nurse's definition Crumping AKA "circling the drain" , "He doesn't look good" , "Come quick! I think my patient is dying!", getting really close to passing the point of no return

I have worked in 3 different Level 1 trauma centers and a 20 g has been sufficient at all of them. Placement is another thing. One hospital it didn't matter if the IV was located in a forearm or AC, whereas where I work now, it has to be in AC or as close as possible. The argument of 18g vs 20g is a moot point when you take into consideration that the Luer lock caps we place on our IVs turn an 18g into a 20g. It sounds to me like it's a case of a newly minted ED physician who still believes in doing things "exactly" by the book.

You can still have a TB skin test after BCG vaccination, just know that it can cause a false positive reaction. I have seen numerous cases where there was a history of BCG vaccination but the skin test was negative. One thing to consider about the blood testing is the cost. It is significantly more expensive than a skin test and you will have to see if your insurance will cover it. I know at my last facility, we charge $15 for a TB skin test and $75 for Quantiferon. The way I presented it to my patients was this: You can do the $15 test, just know that there is a possibility that you will end up needing the $75 if you have a positive reaction to the skin test. As far as adverse reactions, the most common reaction to a TB skin test is localized swelling, redness, itching at the injection site. Remember, that the result is determined by the size of the induration, not just redness. This is why they tell you not to scratch the injection site or cover it with a bandaid.

BCG vaccination can cause a false positive reaction to a TB skin test (TST). The gold standard for a positive TST used to be a chest x-ray, then sputum cultures if indicated clinically. The drawback of using a CXR alone, is that the CXR cannot determine latent TB status. It will show evidence of active disease or damage from previous disease. Mycobacterium tuberculosis can remain dormant for a significant period before a person shows signs of an infection clinically. This is a latent TB infection (LTBI). In the last 5 years, two different blood tests have been developed that are being used to better determine a person's LTBI status. They have been shown to be more specific than a TST and can detect a LTBI. These two blood tests are Quantiferon TB Gold and the T-spot TB Test. A person who has a positive Quantiferon TB Gold or T-spot TB Test is considered to have a LTBI if there are no other clinical signs of TB present (including a negative CXR). Because of the specificity of the the two tests, a false positive is rare and is usually the result of improper draw technique, processing time, etc. Essentially, if you have a positive TST, but a negative Quantiferon or T-spot, it is safe to say that you are negative for TB. On college and university campuses where there is large scale TB testing for incoming international students, many have gone to using these blood tests, either exclusively or in conjunction with skin testing. However, I haven't seen as many healthcare facilities using it until recently. Before going back to the ER recently, I worked for the last 3 years in college health as the nurse manager for the student health center at a major university that did a significant amount of TB testing. We used both the skin test and the blood test in conjunction.

Like every post before this, I thrive on the variety of patients. I like having new patients every shift. I really like the problem solving involved with trauma patients. To put is simply, I like to fix people's broken bodies.

Have done the whole giving IV decadron orally, with the hospital pharmacist's blessing. Have not given IV Zofran orally, but have dissolved the oral tablets in juice (or the like) and given it to peds that way. They seem to tolerate it better than having to let the tablet dissolve on its own. This especially works for the toddler/young kid range.

Hey y'all, I am moving to Austin from College Station and am looking at working in an ER in the Austin area. I have 5 years of experience with the first 2 spent in a Level 1 trauma center; the last 3 years I have been working in college health and am currently in nursing administration. I would really like to get back into the ER but am not very familiar with the Austin hospitals. Anyone have any information they would be willing to share? Also, can anyone give me an estimate on pay for an experienced nurse? Thanks for taking the time to read my post.

I worked at in the ER at UMC about 4 years ago before moving to College Station. I loved it! I don't know if they still do scheduling the same way but when I was there, you were assigned to a crew and worked a set schedule. It was nice because you knew who you were going to work with and when. The scheduling allowed you to have every other weekend off. I still know nurses who work in both hospitals and they usually have sign on bonuses as well as relocation bonuses. 4 years ago, I was given a $5000 sign on/relocation bonus. UMC is a Level 1 Trauma Center and Covenant is a Level 2. With the somewhat isolated location of Lubbock, both hospitals get a lot of transfers from outlying hospitals. It was not uncommon to have trauma patients flown in from New Mexico, Abilene, Midland/Odessa. UMC also has a burn unit so you get burn transfers as well. Both hospitals have children's hospitals with Covenant's being a little bigger; they also have a separate pediatric ER.

I worked in a Level 1 trauma center straight out of nursing school and loved it. After a few years, my family situation changed significantly and I felt I needed a more regular schedule. I interviewed with the student health center at the local university and accepted a position as a staff nurse; I am now the nursing supervisor. I have been there 2 years now and while I still miss the ER, working in college health has allowed me to expand my nursing experience and interact with a different kind of patient. I firmly believe that my experience as an ER nurse has made me a better clinic nurse because of the critical thinking and time management skills I developed in the ER. You are correct that the pay will be less but I find that the other benefits outweigh the pay difference. If you are interviewing with a public school, ask about benefits. Because I work for a state university, I am considered a state employee and therefore eligible for the teacher's retirement program in my state as well as significant contribution from the school towards medical benefits. One of the other things to consider is that you will probably be working the school year, meaning you will have time off in the summer and on holidays. You may also be able to work PRN at the ER to keep up with your clinical skills. I agree with the previous poster who recommended at least going to the interview to feel it out, but also see your orientation through. You don't want to burn bridges that you may have to cross again later.

Not only have I been a Scott and White patient since birth, I used to work in the ER a few years ago. It's a great teaching hospital and the nurses I worked with that came out of the internship program liked it. They remodeled/added onto the hospital right before I left 2 years ago and have a very nice new ER as well as critical care units. With 2 local nursing schools (Temple College and University of Mary Hardin-Baylor), you'll also have lots of interaction with nursing students.

Come to Texas. There's definately a shortage here. I currently have 3 open nursing positions that have been open for 2 months that I can't fill.