VandyNurse714

So, I'm here at work, and I was just reading up on my patient in her chart. I came across this little one-liner, and I just had to share! "Mrs. X has IPF and aortic stenosis. We need her old records, will get from son. She has periodic breathing, not a good sign.":lol2: Ha! Share yours!

Yeah, it is horrible to thrive on others' sickness, but I am an adrenaline junkie as they say. Of course I don't enjoy others being sick, but I love my job...unfortunately my having a job requires someone else to be quite ill...but then I get to try to make them better! I suppose it's all in how you look at it...

Remember to really communicate with your preceptor. Tell her what you are feeling in a very professional manner. Preceptors are there to teach you and help you learn, and if you don't feel that is what you are getting, she needs to be aware of that. She may not even realize you feel this way. Tell her your goals as well as the specifics of what you feel you need to learn. Make a list if you have to. Do you have an orientation book with a list of things you need to checked off on? Also, the critical thinking part of nursing is a slower learning process. You are introduced to critical thinking while in nursing school, but you are really put to the test while you are out in the working world. You may not even realize it, but you probably already possess these skills. You may have just not have to use them enough yet. I will say that I am incredibly surprised and proud of myself whenever I see myself noticing little things about my patients...like when a patient begins to "just look funny" or isn't acting "right"...then, you put your critical thinking cap on and figure out why! You'll do great...just keep your head up, your thinking cap on, and the lines of communication wide open! :)

I agree that you should definitely do the CNA thing, as mentioned by others in this thread. I will say that nursing school can be quite difficult for some, and extremely time-consuming for all. Try not to overload yourself too much because it may burn you out before you begin. Go for your dream, but be very practical in your planning. I know many people who work full-time as a CNA and go to school part-time. Working and going to school both full-time would be almost impossible depending on the type of school you go to. More power to ya, and thanks for serving! I wish you all the best!

That sounds like so much fun...I work in the MICU now, but I would someday LOVE to work in the CVICU...can't wait!!

Ok, so in nursing school, you gotta pay your dues. You do those things because if you really, really love nursing, you'll put up with that stuff to get there. When you become a nurse, you do still have to deal with all those things you don't enjoy quite so much. But part of being a fine nurse is learning how to deal with those things with finesse and with a sense of humor...putting yourself and your patients at ease. We are a very special group of people who deal with the "gross" things in life on a daily basis because we love taking care of people...this means the good, the bad, and the downright ugly! :) And someone before mentioned it, but you will have to put in about 1-2 years in the ICU before becoming a CRNA. I work in an ICU, and I deal with puke, poop, and baths everytime I work. There are jobs where you won't have to deal with that stuff as much, but like the book says, "Everybody Poops."

Worked at a pediatric office for two years...the docs HATED the tympanic thermometers. They are never right. I use digital thermometers with nice accuracy as long as they are held in the proper position. Rectally, of course, is the most accurate. Orally is the second most accurate way, but you have to make sure the person hasn't had anything to drink in a while. You also have to make sure the person holds it firmly under the tongue until it beeps. Or, you can do what I do sometimes, and you can place it waay back in the mouth buccally with the mouth all the way closed.

Tridil is right on. Obese patients sometimes are natural CO2 retainers because of the physical weight of their chest wall (see Pickwickian syndrome or Obesity Hypoventilation Syndrome). I have had more than a couple patients like this. They are like COPD-ers in that they rely on a drop in pO2 to breathe as opposed to a rise in pCO2 like the rest of us. Their bodies are used to the increased pCO2 because of constant shallowing breathing and subsequent hypoventilation. Anyway, my guess is that she was already a little more hypercapneic than usual from the surgery, and that combined with the high flow oxygen and narcotic allowed for a nice, steady increase in her pCO2 to a level that was high enough to make her loopy. The fact that her pCO2 was so high doesn't surprise me because remember, people like this (much like COPD patients) are used to being slightly hypercapneic. It would take more of a bump for them to show any signs or symptoms of the increase. So, you did nothing wrong. That was not something one would easily catch unless they were quite familiar with the situation.

I honesty don't know what CRNA schools think of what college you went to, but my guess would be that they would look at all the details keeping the "big picture" in mind. Meaning, where you go to school is an important detail, but it may or may not be a make-or-break factor, depending on the school. From a person who went a private university in Nashville that is very known for it's nursing program, I would say to you...you get what you give. I have a TON of student loan debt. If you or your parents can afford going to an expensive university that has a good nursing reputation, then by all means, attend that University. Do not, however, make the mistake that most people make when assuming good nursing school always produce good nurses. Nursing is a dynamic career choice. You will get out of it what you put into it. Colleges do their very, very best to prepare you for the nursing world, but no college will ever be able to teach you everything you need to know. You will learn most everything when you enter the workforce after college. So, if I were you and couldn't afford it, I would consider attending a more expensive school for my upper level nursing courses or not at all. I received a very, very good education, but honestly, I kick myself all the time for the insane amount of money I spent for it. Especially when I look around me and realize my fellow nurses are doing just as well. I may know a thing or two more than them sometimes, but I do believe I would have known those little "extras" anyway just because I am an overachiever and very diligent in my studies. I enjoy learning about nursing, and I read all the time. I really made it a point to LEARN while I was in college, not just cram to remember stuff on the tests. And remember, a "C" nurse from a community college could definitely turn out to be a better nurse than an "A" nurse from UAB, Vanderbilt, or wherever. It's about hard work, practice, desire to learn, and a real love for the art of nursing.

Ok, I have about a MILLION scrubs...because I spent a lot of time buying the WRONG scrubs... There is already some sound advice in the posts above mine, but here's my opinion. I don't care for allheart scrubs. Scrubs fit strangely, and the ones I've purchased online make me look unkempt and dumpy, not professional and intelligent. The material is not super nice, either. Really find a type/brand that fits you best, and invest in them. You really WILL have those scrubs a long time. Buy pants that you can bend, sit, stretch, and squat in. Don't buy see-thru material. As for tops, buy LONG tops. There is nothing more unprofessional to me than a nurse whose belly button or God forbid her butt crack shows when she's (or he's!) in certain positions. Nursing requirements movement, and the scrubs should allow for that. Make sure you have LOTS of pockets, as you will need them. Urbane scrubs make cute sets, but I find the shirts are too short with only one pocket on the chest of all places. I like their pants, though. I really like Landau's scrub tops because they fit nicely, wash nicely (with little wrinkles), and they have 4 pockets!! I never run out of room for all my nurse goodies. And though you didn't inquire about them, shoes are very important as well. Maybe not right now while you are in school, but you will need to get good ones later on. All my friends with high arches really like Danskos (you have to sort of break them in, though). I, however, have long, narrow, FLAT feet. I have only found one shoe that I've liked, and that is a Merrill (spell?) shoe. My feet NEVER, EVER hurt...even after a 14-hour shift. That is huge for me. Anyway, hope that helps. :)

We don't titrate vaso in our unit, either. It is also running at 0.04 units/hr. I would ask the doctor at what point would he or she prefer turning the vaso off. I feel more comfortable with levo, so I would rather get the vaso weaned completely off (while simultaneously weaning levo bit by bit) then coming down solely on the levo. I would venture to say that patient would tolerate weaning something at this point with MAP in the 70s and 80s, CVP 12-15, and HR in 150s. That HR concerns me as well.

Then how come you see patients with 2, 3, 4 chest tubes? What you (Ready4CRNA) said about the pleural space makes sense, of course...but now my brain's a-wandering...

Then how come you see patients with 2, 3, 4 chest tubes? What you (Ready4CRNA) said about the pleural space makes sense, of course...but now my brain's a-wandering...

I work in an ICU, and we use feet all the time for IVs as well as for peripheral sticks. We never need an MD order. We do not, however, stick a patient with diabetes, for obvious reasons. I've started an IV in my own foot before (practice, no one else would let me), and it really wasn't that painful. If the nurses are having that much trouble with access, even after trying for the feet, we speak to the MDs about the possibility of a central line. But, like I said before, I work in an ICU.