suetje

Good for you! you should always take on a challenge! Can you get a job in an ICU so that you have some of the necessary knowledge to pass the CCRN? that would be best.

I teach and make jokes of this to the RNs I teach.." It's OK Mom! You are a fighter! You are only 102!" We are a terrible death-defying society. Even trying to discuss this topic is almost forbidden. I encourage all to have an extremely specific living will (no CPR, no defibrillator, no vent, no dialysis etc) but people shake their heads and say "I don't want to talk about it." After 30+ years in a major academic medical center SICU...I have seen untold suffering. And what about if the dying person cannot communicate? How much are they suffering? Ridiculous! My Dad gasped for breath for 15 hours before dying...his morphine was inadequate. I asked for them to turn it up. The nurses refused. What can we do to stop this????

There are marvelous institutions out there (I work in one!!!) and you should move either to another unit or hospital! There are great people out there, great teachers and mentors. You deserve to have good ones!

Unfortunately, I think it is. We have to be so much more skilled, have so much more critical skills...and no more pay. It is equivalent to paying a company vice president the same as the office workers! are you kidding? I always say, "If they or their family was really sick, I dare say they'd want the BEST, not just a pill-pusher!

I believe the only clinical trial of the "wearable kidney" were in Europe. And yes, this is a working prototype but nanotechnology could make this much smaller. Not sure what you'd do with the ultrafiltrate tho!!!

You really owe it to yourself to just practice for a while as a nurse. You may find a CNS program to be quite a handful without any background experience in the real world of nursing. You surely can get a job in L & D without a Masters! The problem with schools today is that they push students to go for an advanced degree BEFORE THEY EVEN HAVE REAL WORLD EXPERIENCE!!!!! How can you make decision, patient assessments without just doing it every day? Just be a simple good RN first!

The fact that you have done 2 semesters in a neuro unit is fabulous and probably you have learned a lot more than you thought you did! So you already are ahead of the game! If you want to learn more, you could always get a book on Neuro nursing, from a company like Elsevier or just look around. Neuro is a specialized unit, but very cool and exciting too! Just by working there you will learn, so don't fret! Rome wasn't built in a day and you will gain info every day! So go for it!

I agree with Julie A. The "standards" to raise nursing practice are all great, but what really IS the value of a DNP? It should reflect skills with clinical practice yet I hear the students I work with tell me, 'The nurses that teach us with Doctorates are clueless. I'd rather have an MSN be my clinical educator because they often have been at the bedside." Just because you have a doctorate does not make youa clinical expert. And yes, I also think NPs and PAs are an asset to all of us. I thought about getting my PA because I was more interested in the hands on type thing. But there is a fine line between NP's and PAs and in our Academic institution they do the same thing.

Absolutely positively to the point! I see it in my ICU too. And the Attendings are often the problem. We all know it is going to happen, but the comment from them is 'Well, good news! The white count is down" Ridiculous! And WHY are healthcare dollars out of sight? This is a big reason. Until someone (Medicare/ Medicaid) scrutinizes the practice of these physicians, and insists they talk with the families and really tell them the truth, it will keep going on.

I agree with iluvivit. Saline is the only thing to run "with" blood, and clearly, the MD did not want the pt to get fluid overload the pt, so she slowed the rate of the infusion while blood was running. You also could have started another line as well. So you are OK! And that night RN II should be chastized for demeaning a bright new nurse such as yourself!! Shame on HER!!!

@traumaRus- yes I am called an educator. Fine. The 'pseudo CNS' means I do that job as well as educator because we have no CNS and it dovetals into the whole mentor educator role. I suggesated to the Director I could be called something other than CNS, su7ch as you suggest, but she also can'yt think out of the box.

I agree that the DNP ius a worthy goal, but for us bedside expert clinicians, it is a title for....WHAT? Any of us that read academic journal articles can understand research, I think. So shouldn't there be a ladder, if you will, to check off levels of clinical expertise, or clinical knowledge that ensures the clinician is REALLY a high level nursing practicioner? The key word here is practicioner. Although I do not have a DNP, I am an advaced practice clinician...and no. My Master's is in business, not nursing (I was burned out of nursing and the intitial theory classes borred me to death!) Now, I am sorry I did not complete that nursing degree, because even though I practice as an educator and as the pseudo CNS, I have been told, " You have the clinical background but so not have the intials." Does that make sense???? At least the staff I taught and mentors is a top notch group that really learned how to clinically and critically think!

Trust me, in our large teaching hospital, a lot of the patients in MICU are frequent flyers like quads that come in for repeated pneumonias, CF patients with issues, and those chronic medical patients that keep having problems. SICU is fresh people form OR, generally with NO VRE or MRSA (no gowning every time your turn around!!!) and more stimulation I think. I have been in SICU for about 30 years (yup- old!) but it is always challenging and not boring.

Anyone have an answer for why the so-called standard for setting the minimum UF on a dialysis machine seems to always be taught as 300? this would be when you are not taking any fluid off. There does not seem to be any documentation why this seems to be the minimum you should always set. I am thinking it is because: - may increase backfiltration - may screw up the machine pressures otherwise - the machines have this as the lowest spec for UF Anyone with any info let me know. We are lookin to write some policies and need standards. Thanks!!

O!M!G! You are doing a GREAT job of quality assurance and your institution does not appreciate it? Geez! I would suggest to your Manager 1st you initiate a QA program for CRRT. Note the errors you have witnessed, and keep writing those incident reports. I did at my institution and found many errors. We also had a couple of incidents with the citrate that led to a hospital-wide review of what to do and not to do with it, and how to make sure it is in the right place!!!! Can't believe you are still using the Prisma machines (not the Prismaflex?) They were shut down by the FDA because the scales were inaccurate, and people bypassed the balance alarms leading to hypotensive pts with too much fluid off! That AND the P-Flex I think are less than user friendly, and I wonder about the scales. They claim to have fixed the scales since that. We had a number of adverse events with it! You might want to look at other, (what I, in bias) would consider safer options for CRRT. What if you didn't have to empty drain bags? What if you could hang your whole shift of fluids one time? It is a reality and they are #1 in the US. http://www.nxstage.com. Trust me. Thousands of happy costomers laterI know it is true...and safer than Prisma!