whatdayoftheweekisit

In school now and have 2 small children and a supportive husband. It is doable but beyond comprehension for difficulty...not just the material but I am talking about making the family life work! My 3-year-old is missing me and acting out a little bit because he doesn't understand. I am dedicating about 80-90 hours a week right now between lecture and studying. Be sure you can totally afford to be without your income...plan ahead! As someone suggested - shadow early if you can. When you do start working as a nurse try to be on day shift. You will have more opportunity for networking and caring for post-op patients which puts your face out there to the anesthesia team. Get to know at least one M.D. that you would feel comfortable asking for a letter of recommendation. Not all schools require one from an M.D. but some do. Keep in mind that not only do you have to have (usually at least 2) years of ICU experience or more but that taking the CCRN and GRE are a lot to prepare for as well. I would continually bounce things off your spouse to make sure he knows what this commitment would entail and make sure that he is well informed ;-) I have no regrets so far...just have to get back to the books now!

Best advice I ever received concerning my admission to anesthesia school...."The only people that are truly happy about your success are your mother and your spouse!" I think this is more of a quip than reality but it has a ring of truth to it!

To Mymy - very high 900's to 1000 at least on Gre is the minimal expected standard. 4 ppl interviewed me. Was pretty non-threatening but also intense...just study and know your stuff.To Shannon - good luck on getting a transfer. Advice...try to gain as much experience as you can while in ICU...volunteer for classes and acquire new skills. Make good impressions on ALL supervisory staff because letters of reccomendation are very important to get in. You will need a letter from an MD...form a relationship with one now if you can by letting them know your goal. IMO...don't broadcast your ultimate goal to lateral staff. Out of all the APN degrees ppl are touchy about this one. I told a few people I was striving for grad school and when they would ask....depending on how well I knew them, I would sometimes say, "I am still undecided"....don't get discouraged while getting your ducks in a row....ie: preparing for applications to programs. It took me a total of 2 years between testing...gaining appropriate experience (I was an ER nurse) and getting apps submitted. Good luck :-)

I work at MVH. Interview was here...classes will be here (you have to travel to Texas twice once you're in...2 weeks each time). You can email/message me anytime if you have questions. Good luck on CCRN. It was definitely a lot easier for me than the GRE.

I used the study guides...verbal wasn't a problem for me but everyone is different. I hired a private math tutor who had taken the GRE. I just researched math tutors on google and talked to a few. I had like six one hour sessions with him about geometry and we just worked through my GRE practice book with him giving me more of the same types of questions and explaining things to me. I went from a 450 (without math tutor) to a 620 with math tutor. Good luck!

Hey there...I live in Dayton also. I interviewed with Texas Wesleyan in November and just got my acceptance call a couple of weeks ago ;-) I think they interviewed 12-15 people and there were quite a few more applicants than what they interviewed. From what I've seen and heard, there really are no problems getting the minimum number of people around to do the clinical at MVH. Know your stuff for the interview. Very cardiac focused. Know your pressor drug-classes and receptor sites. Basic vent setting info...be able to talk about hemodynamic monitoring. There were a few things I didn't know/couldn't articulate well in the interview so be prepared to let them know that you aren't familiar with a concept or have only vague knowledge of it. Good luck!

Any way you can switch shifts? Sometimes it helps to go to night shift - away from the crooked manager and away from this territorial, rotten individual. You only have a few options... 1. Switch shifts and make it clear you don't want any more trouble. 2. Stay on your shift and fight - document everything - talk to HR - talk to administration. 3. Leave the unit/hospital. Sometimes we just don't fit into a certain unit for some reason. If there is a lot of laziness in general going on there...the nurses and techs that are currently there find a gung-ho, hard-working newcomer to be a threat. They get jealous for whatever reason instead of picking up the pace and doing their own jobs. They don't want anyone making them look bad. It sounds like you all may need an open-forum staff meeting with director, manager and HR there to mediate. Maybe getting it all out on the table and revisiting why you all do what you do would help? Good luck but don't let it eat you.

LilGirl - this is what my facility calls "immediate bedding"...except, the triage nurse doesn't triage at the bedside, the primary nurse receiving the patient does. Our triage tech takes the patient to the room. Hooks them up to the monitor/starts VS. If not needed back at triage, they may start an EKG or a line or something. If triage is busy, then it's right back out front. The nurse should remain at triage. We cannot immediate bed patients if the section in which the patient is to go to does not have an available provider/nurse to see the patient immediately. ie: nurse with a level 1 patient or nurse unavailable since they're in ICU transporting a patient.

Hmmm...the best way we avoid "stat" nonsense orders is to have already had a bed rqstd upstairs and the second the resident whips their measley orders off their order set we can say, "sorry...these will have to be implemented upstairs since this patient has a clean and ready bed...admin doesn't want us to hold patients in the ED." Gotta play the game!

It is important to understand that an encode is a courtesy by EMS - not a requirement. That being said, by not encoding, EMS certainly isn't on the fast track to having a good working relationship with the ED. I do agree that lengthy reports over the radio are basically pointless and a waste of time. Only need to know enough over the radio to make an appropriate bed assignment. Everthing else should be done at bedside.

Had a guy with vibrator stuck in rectum - sedated to remove with some forceps - wanted to die laughing when my ER doc hit the "on" button in there with the forceps and started the thing vibrating. Lots of cussing ensued. Same ER doc writes on his charts as a "plan" for drunks - Metabolize to Freedon.... Admitting doc jokingly told one of our new grads that someone's admitting diagnosis was Acute on Chronic Poor Protoplasm Syndrome - I got a copy of the orders 20 minutes later for the bed request and she actually wrote that! He was an ETOH intox...

Your documenting of the facts only...no bias...will likely not be what gets this guy fired. Whoever he is, he won't know that this had anything to do with you. If anything, his anger may be piqued at the triage nurse. Welcome to nursing! There is drama no matter where you go...and even if you try to avoid it like the plague. In my facility there is no private area in triage to look at a member. Just for your own future reference, make sure you document the patient's complaint/symptoms AND the fact that the member was not visualized in triage due to privacy contraints.

Clinically, there would be no less preparation for the ER coming out of an Associate program than say a Bachelor's program. A new grad in the ER is a new grad...doesn't really matter what alphabet soup is behind their name. I have seen some new grads do ok in the ER and some that get a couple weeks of orientation and then shipped off to med-surg as it becomes abundantly apparent that the ER is not where they should start. It sounds like you have emergency experience as an EMT...I think that definitely helps. No matter what, you should be given a lengthy orientation if you are in fact hired in an ER as a new grad. And no matter how long that orientation is, you should not expect to be running three or four trauma rooms on your first day of orientation. The vast majority of RNs in practice have Associate degrees. The number of BSNs is rising but clinically there is no difference.

Hey Tabitha, Boswell described a great two-tiered system. This is an ideal way for triage to work but if you have only one nurse then the primary assessment or rapid triage has to be performed by the RN on all patients. The RN should be able to see the front door with patients coming in...good communication with the treatment area is key as far as knowing what beds are open. Anyone requiring immediate bedding go back immediately. The triage RN must, however, document how the patient arrived/appeared...the treatment nurse does the comprehensive triage though. A lot of our comprehensive (non-sensitive) triage questions are asked at our front desk where the nurse is still able to see the door...after a brief history is obtained, the patient has VS taken by a tech in our triage area - nurse documents triage plus ESI level and tech may document VS.

Sounds like you need the QMP or ESP process....using the ESI five-level acuity system, all 4s and 5s in our ED are QMP eligible. The ED phsyican provides the MSE - if no EMC (emergency medical condition) exists, then the patient is visited by registration. They are given the choice to pay their co-pay if they want to stay and see the physician for tx anyways - or a lump sum if they have no insurance. If they can't/won't pay then they are let go with a not that states that the patient chose not to be treated by the phsyician. Perfectly legal and cost-effective. We have a list of QMP exclusions - basically old people, babies...and a list of medical complaints that are no brainer emergencies anyways.