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NoviceToExpert

NoviceToExpert

CCRN-CMC-CSC: CTICU, MICU, SICU, TRAUMA
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NoviceToExpert has 2 years experience and specializes in CCRN-CMC-CSC: CTICU, MICU, SICU, TRAUMA.

NoviceToExpert's Latest Activity

  1. NoviceToExpert

    Anyone else studying for CCRN exam?

    Dennison's CD for practice test questions is invaluable... and the book itself is an excellent reference... I keep mine in my locker... Yes, it's dense, but you should not expect to learn everything in it for the CCRN... use it to supplement your identified weaker areas... Ed Woodruff's review is good as well... as is the AACN review. Good luck!
  2. NoviceToExpert

    Csc/cmc

    Hey Xigirs, I sent you a private message. M
  3. NoviceToExpert

    Csc/cmc

    Hey Xigris... Are you able to maintain CCRN-CMC-CSC through your clinical hours as a CRNA? I see on the AACN website nurse anesthesia was counted... but I know a lot of CRNAs let their CCRN and subspecialties lapse because maybe they didn't know better... I had intended to keep mine as a CRNA but when I come up for renewal I'll have already qualified for my first three year round after anesthesia school... I'm planning ahead already for the renewal after... The hospital I plan to work after anesthesia school has CRNA Cardiovascular team...
  4. NoviceToExpert

    Csc/cmc

    Yupp... totally serious... Congrats again!
  5. NoviceToExpert

    Csc/cmc

    By the way, Intra-aortic... I just found out from AACN that there are only 129 (including you and me) nurses nationwide that hold both the CMC and CSC credentials simultaneously... something to be proud of for sure... Congrats!
  6. NoviceToExpert

    Am I the only one??

    I had read an anesthetist post some advice on the topic of being the goat...he said that one particular MDA suggested that he "think of everyone [who acts in an abusive fashion] as mildly retarded...!!!" This way it helps diffuse the assault and may even allow you to keep your mental teflon suit in tact...letting everything roll off your back... easier said than done, but I like the quote... and I've found that it actually does help... so KEEP GOING!!! One day at a time!!! Anesthesia school, like nursing school, is but a brief moment in the big scheme of your career... it will pass... :anbd: Of course, after I start my program I will probably be scrambling to get back to this post to listen to my own inexperienced advice if I have any similar experience... I hope it's your program and I don't encounter this... geeezzz... I heard about a couple of programs near me that were like this and didn't bother to apply... luckily I got into my first choice where all students I've spoken with who are in or who have recently completed the program have only good things to say...
  7. NoviceToExpert

    Has anyone taken the ecco course from AACN?

    ECCO can be very informative... However, the modules, if you do them carefully, take much longer than specified... My issue with ECCO (aside from typos here and there and the occassional miskeyed answer) is that it is completely non-printer friendly. If you want to print any of the information you have to print screen it rather than print page... in other words, you have to scroll down on the text and reprint the screen shown in order to capture all the text... it wastes a lot of paper and a lot of ink... I found that to get through the modules at my pace it was better to mute the sound and scroll the text and read myself rather than listen to the voiceover... In general I thought it was worthwhile, but feel I could have gotten a lot more out of it in a lot less time if it was formatted differently.
  8. NoviceToExpert

    Csc/cmc

    :ancong!: That's just awesome, Jake. It's a great feeling, isn't it?!!! ps... if you look on AACNs website for proper use of subspecialty initials... they want them hyphenated after the CCRN... as in CCRN-CMC-CSC... just so you're "in the know"... How great... Congratulations again! Good Good Good for you! Yipeeeeeeeeeee
  9. NoviceToExpert

    Please help, orientation problems

    The CMC and the CSC are cardiac subspecialty certifications... they stand for, respectively, cardiac medicine certification and cardiac surgery certification. They are separate examinations that have different criteria for eligibility. You can find information on AACN.org for all of this. There are presently under 500 CMCs in the United States and under 700 CSCs in the United States. I believe for those taking the subspecialty examinations in this area of expertise the pass rate is about 80%. You must be CCRN certified to take these exams and also meet the clinical practice criteria as well. Thanks for asking!
  10. NoviceToExpert

    Please help, orientation problems

    I have some things to add... since I was in your shoes... I lived through one heinous orientation... My second week I was told, "As long as I'm your preceptor...you're going to be my b*tch!!!" It went downhill from there...and the comments stayed the same... I could have actually sued her and the hospital for a clear cut hostile work environment. I finally, after a year and a half, left my unit and went to another ICU. I put up with it but cried many nights, hated going into work, wanted to quit all the time. I knew it wasn't me. In the last six months, 7 day-shift nurses have left the unit. I snagged another critical care job in our hospital on a unit where a day-shift slot only becomes available every three years...yet there's a "nursing shortage" down the hall on my old unit... administration hasn't ever questioned this... go figure... I was afraid I'd lose my job if I reported her... I found many errors on my orientation (like autotransfusions running directly without a filter...) We have an error reporting system that is anonymous... I was told if I reported anything "they" would find out who did and it would be the quickest way for me to lose my job. I was told perform MRSA swabbing "very lightly" so my preceptor wouldn't "have to wear plastic all day..." I was told "You can't multitask... but don't worry, you'll never be able to because men CAN'T multitask..." I took a scholarship from the hospital and wanted to fulfill my contract, although I could have had it null and voided because of the experience had I engaged an attorney...I probably could have retired on that. But I didn't want to take that route. I can't say I recommend sticking it out in a toxic environment. I can say you are not the only one having a terrible first nursing experience. I plugged away and dealt with it. In under two years I had my CCRN, and then my CSC and my CMC and I am now the only nurse in the hospital who is CCRN-CMC-CSC. I am going to get the last laugh because I just found out two days ago that I was accepted to anesthesia school at one of the country's top programs. "Ciaoskis" former preceptor!:chuckle "I'll be seeing you layta!" You are not alone in your experience. My issue was this... it is hard to get anywhere being in the position of putting anyone else down. I felt that if I tried to interview for another job I would have to say "why" in an interview... and then I would have to disclose my situation... and in doing so, I thought it would just make me look bad...leaving the interviewer to worry if it were me or if it were really the hospital (maybe I'd be seen as a complainer or problem)...so I figured I'd wait and then have my experience and a clear cut transfer/exit strategy after being off orientation. Then when I got off orientation everything changed. I still had problems with her... but they were minimized because I had my own patients and developed strong alliances with other supportive nurses who served as my resource. Then I started working my schedule opposite hers so I could minimize my contact with her. That made a huge difference. Because of the poor quality of my orientation and my strong desire to learn I did a lot of the orienation myself. Make a list of all your equipment and manufacturers of such... we use Edwards swans and arterial line sets, we use Datascope IABPs, we use NxStage CRRT, we use Atrium chest tube set-ups. Go to all the manufacturer's websites. Example: edwards.com, atriummed.org, datascope.com, nxstage.com...These companies all have inservice audiovisual training via the web... go to pacep.org, atriumuniversity.com... You will learn more from the manufacturers than any preceptor. A lot of nurses do things the way they were taught because that's how "we always did it." However, you will find a lot of manufacturer's recommendations are different. I do it the way the manufacturer recommends. Soon I had the sane nurses asking me about equipment. I was teaching them. I made a habit of everytime I opened a piece of equipment, whether an autotransfusion pack or an ETT hollister, of putting the manufacturer's pamphlet in my scrub pocket, keepin it in my bag with other resources and taking it to and from work with me. I'd read them thoroughly at home. You'll find no one on the unit has ever read them... and chances are you will learn something about the device that is unknown to other nurses on the unit. It all comes down to how good you want to be. You are in a terrible position. That resonates with me because I was in the same position. If you want this bad enough and are not going to another unit or hospital...you will need to take responsibility to educate yourself to make up for the inadequacies of your hospital's culture. You'll end up a better nurse in the end. Finally, in January, JCAHO is requiring that there be in place, at all accredited facilities, a disciplinary plan for toxic behavior among healthcare team members whether horizontal violence among or between nurses or anyone else up and down the medical food chain. You can find this on JCAHO's website. You may want to float this by the CEO of the hospital... maybe they don't know about it yet. They will not have a choice in compliance if they want to keep their JCAHO status. Enforcing it is another story... but at least you can make sure the hospital is ramping up to deal with it. Best of luck to you. You have my support whatever you decide. But if you stay...just know this orientation process is going to be, in the scheme of things, a very short time during a hopefully long and successful career...I chose to get the experience I needed and then moved on. You may move on earlier... but ABSOLUTELY DO NOT let a nasty nurse or toxic unit pollute your enthusiasm for the art and craft of nursing and/or critical care itself. Know it is not the norm, and when ready, seek out another unit... despite what they tell you... it is NOT the same everywhere!!!!
  11. NoviceToExpert

    accepted SRNAs

    GPA 3.93, GPA 4.0, GPA 3.88 No GREs, waived because of GPA 1.5 years CTICU Now MICU/SICU/Trauma unit CCRN-CMC-CSC
  12. NoviceToExpert

    Thomas Jefferson Univ. interview

    :ancong!:
  13. NoviceToExpert

    UPenn Interview

    :ancong!:
  14. NoviceToExpert

    How do you spell relief?P A S S E D B O A R D S

    :dncgbby: :ancong!:
  15. NoviceToExpert

    Anyone else studying for CCRN exam?

    Hey ghillbert... I wrote a little more of what I thought of the CMC and CSC certification exams on the CSC/CMC thread... if you can't find it let me know or if you have other questions after finding that thread let me know... pm me... I follow your posts and you will obviously have no problem passing either... I can tell you what study materials I used... you should definitely go take them! There are less than 500 CMCs in the country and less than 600 CSCs. I believe the pass rate for CCRNs taking these exams is somewhere around 80%.
  16. NoviceToExpert

    Mean Arterial Pressure

    I agree with all posts on here... but remember, it all depends on pt Dx... if you are talking about certain myopathies and diastolic dysfunction the picture changes, if you are talking about CABG pts, you have to worry about grafts with high pressures... what if you titrate to your MAP and your systolic goes out of range based on that pt's particular hemodynamics?... Sometimes it's a problem keeping both parameters above the prescribed low end if one rise too high, especially as your circulating volume changes in relation to your preload and/or SVR treatment... then, in addition, there is the issue of watching trends in parameters... widening or decreasing pulse pressures (maybe if you are only watching your MAP you won't notice these if the MAP remains fairly stable)... pulsus paradoxus, tamponade, etc. etc... You have to keep an eye on all three parameters SBP, DBP and MAP and consider those in relation to the pt's condition to guide your assessment, titration and plan. Watching these trends all will help you catch difficulties early. I commonly have orders that specify for titration to both SBP and MAP as mentioned above in another post... I sometimes have order sets on stent pt's to watch SBP and MAP and when I call the physician because the MAP is under 60 for a certain time interval I get asked what the pressure is and am told "don't bother me with the MAP if the SBP is over 100," (go figure....this physician didn't even know the order set he signed... he's an invasive cardiologist, so what does he care about the kidneys?...not like he gave his pt contrast or anything and the kidney perfusion is important...argh!)...then there is titrating to the AUG on an IABP...I wouldn't go by one parameter across the board of the pt conditions we handle on our unit... it is all case specific...and I try to keep in mind that generalizing may get me and my pt into trouble...
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