RN 2005

Thank you so much for responding! We actually did try to reach the surgeon but we only got the doctor covering for him and she did not have access to his chart and did not know the specifics of his case. One of the downsides of weekends.....She said it was an issue for his primary doctor, which was really not a big help......He was in PACU for 3 hours due to blood pressure issues and his respirations were not up to par. The bleeding has since stopped, but I am so glad you posted because I never even thought about his initial injury as the cause......That may have an implication. (He fell down a hill while skateboarding....don't ask!!) I really appreciate your response...You provided excellent advice!!!

Hey! Quick question for you OR nurses! I am wondering when a patient is having surgery do they place foleys for everyone? My husband had an internal fixation for a tibial spiral fracture and the surgery was 2 hours long.....followed by 3 hours in recovery....Would they have placed a foley? He has hematuria 4 days post surgery and I have no idea why.....Any info or input would be helpful! Thx!

For some reason this article brought so much of this tragedy home to me...God bless each and every doctor and nurse who was forced to make these horrifying choices........ New Orleans' Health System Faces Crisis Sep 18, 5:55 PM (ET) By DAVID CRARY NEW ORLEANS (AP) - This city's health care facilities have been shattered to an extent unmatched in U.S. history, and its hospital system faces grave challenges as residents begin returning, the vice president of the national hospital accreditation organization said Sunday. The official, Joe Cappiello, said several hospitals were probably damaged beyond repair by Hurricane Katrina, while some may try to rush back into business before conditions are safe. Others, while rebuilding, may lose doctors and nurses to communities elsewhere. He also recounted harrowing details of how doctors and nurses felt compelled - against the fundamentals of their training - to make triage-style choices during the flood. They were forced to aid some patients at the expense of others with less chance of survival. "Essentially the health care infrastructure of New Orleans is gone - it no longer exists," said Cappiello, who just completed a three-day mission to the city along with a colleague from the Illinois-based Joint Commission on Accreditation of Healthcare Organizations. Although the city has more than a dozen hospitals, none have resumed normal operations. Officials at Children's Hospital, which Mayor Ray Nagin had hoped would be ready when residents are allowed to return to the Uptown neighborhood this week, said they may need 10 more days to prepare. Nagin's plan is to start repopulating the city neighborhood by neighborhood, starting Monday with the Algiers section, across the Mississippi River from downtown New Orleans. Over the next week and a half, the Garden District and the French Quarter, the city's historic heart, are due to open to residents and businesses. All are areas that didn't flood, but Coast Guard Vice Adm. Thad Allen, head of the federal government's hurricane response, has urged Nagin not to rush people back in. He didn't want to set a timeline on Sunday, but he said the information he was getting from administrators at the U.S. Centers for Disease Control and Prevention and the Environmental Protection Agency suggested it still wasn't safe enough. Cappiello expressed concern that some hospitals, desperate to get back into business for competitive as well as public-service reasons, might move too quickly, before all mold and contaminants from the flooding are removed. "I hope there's someone looking at all the health care assets and making sound decisions as the mayor faces overwhelming political pressure to let people back in," Cappiello said. "The federal government needs to go in there and make sure the hospitals are a safe environment before they're reopened." Many local doctors and nurses are without paychecks, he said: "There's a nationwide shortage of nurses. People will try to recruit them and many may never come back." He cited Charity Hospital, where floodwaters continue to be pumped out, as one that seemed beyond repair. The hospitals seemed to have been well-prepared for Katrina's howling winds, but not for the disastrous flooding that followed, Cappiello said. That foiled plans to evacuate critically ill patients and knocked out backup generators that would keep air conditioning and lifesaving equipment on. At Memorial Medical Center, doctors and staff worked valiantly during the worst of the flood to evacuate more than 200 patients by boat and helicopter, but 45 patients - most of them critically ill - died at the hospital. "We're going to hear of a thousand more acts of heroism," Cappiello said. "But the bottom line is that having a response plan that relies on heroism is not tenable." At a couple of hospitals, he said, officials ordered a lockdown of pharmaceutical supplies, wanting to protect them from looters when their hospitals emptied. They later learned that staff were unable to gain access to the drugs to aid ailing patients after flooding thwarted evacuation plans. "Doctors and nurses who stayed behind were scrambling to find drugs for their critically ill patients," he said. "They had to make choices that we ordinarily don't make in America, to help those with the greatest chance of survival. ... That's not the way we practice medicine." Cappiello also said he had heard unconfirmed reports that some doctors may have euthanized some critically ill patients who could not be evacuated, rather than leaving them to die from the flooding or from neglect. "There was a whisper about that when we were down there," he said. "It may prove to have some viability to it. Sometimes horrible decisions like that have to be made." The flooded areas of New Orleans continued shrinking, but crews were still searching by boat on Sunday for the dead. The state Department of Health and Hospitals said the hurricane death toll in Louisiana had risen to 646. The toll across the Gulf Coast was 883, and that number was still expected to rise. --- Associated Press Writer Cain Burdeau in New Orleans contributed to this report.

You rock!! Congratulations nurse!!!!

I think as nurses we have a morbid sense of humor that helps us deal with stressful situations. It makes horrible situations easier to cope with. So true........It is difficult for others to understand sometimes, but all I can say is it must be a coping mechanism..... :imbar I have been laughing for 5 minutes after reading the post by gr8rnpjt

I just quit my first job after 5 weeks.......I feel your pain. I was already used to the 12 hour shifts and I actually love that part of the deal, but the rest was just not the right fit for me....I think at our age we understand a bit more about what we can and cannot do....I knew right away I was in the wrong place and did something about it and so did you. I am second guessing myself now too because once again I am wondering about my future but that is OK.....I worked too hard for my license to risk losing it because they were short staffed and felt you should learn independence by figuring it out yourself. This is a hard time in our lives....Don't be hard on yourself but instead try to focus on what you may want to do. For me the hospital is still the best route, but this time I will find a department with a much longer preceptorship. Why one gives 6 weeks and the other gives 6 months I will never figure out!!! Push on and find your niche!!!! Don't let this get you down....I understand..... :wink2:

Thanks Happy! I am going to try to transfer......I have put in the forms and am just waiting now. I really think I want to stay with critical care. I am thinking ICU.....They have a great precepting program, 6 months. And my friends who went there say they really precept. They are there in the room with you the whole time. I want to be able to learn more about my patients - to understand and apply what I have learned in school. I also want the pts. to know that I am "there for them" - I like that "bond". I missed that so much in the ER...I guess I just like more continuity......Does that make sense?! Anyway, your kind words mean alot! It is just nice to know someone else understands! Good luck to you too.....I hope whatever you do you enjoy your new career as a nurse :)

Hi.........Your post hit a cord with me. I also started in the ER and just this week I talked to my manager and decided to get out. She said if I did not like it after 5 weeks I probably would never like it?!?! and I worked too hard in school to be unhappy. I had days when I felt so good about my accomplishments but I always felt like the staff and my preceptor expected more. I hated feeling like I was not "up to par". This whole experience has really taken a toll on me....I am just laying low for awhile and hoping to get my confidence back, but I really feel like I got kicked around pretty badly. When I think about it though, how was I supposed to know how to do the ER basics if I was never shown? It was trial by fire for me. I need to learn by watching....I thought that was what precepting was about. Yes, I can stumble through things on my own without being shown how to do it but all that does is create frustration and self doubt. Sorry about my little rant here....I just wanted to let you know I understand...........Only you can decide what to do.....I personally think I could have probably stayed and been happy in a year or two but life is just too short for me to do that to myself. By the way, for all the ER nurses that do their jobs every day.......I have nothing but respect for what you do!!!!! I truly admire your stamina and we are all lucky to have you all working so hard in the ER's!!!

Trish, I am in EXACTLY the same position as you are! I could have written this post! We have worked so hard for this! No good advice to give to you........Just wanted to let you know that you are not alone in your feelings!

I understand completely how you feel. Just knowing where supplies are when you need them IS important in the ER....I am hanging in there on my orientation also but it is a struggle and I really wonder if they possibly remember what it is like to be a new grad. I am glad you posted again.... I have wondered if I was the only one just doing all I can to escape at the end of my shift doing less damage to the patients then what they came in with!

This is interesting........Especially the comment by the President Elect of the AMA......I see pros and cons, but it sure does help to raise the profile of nursing......Rock on NP's! :) Coming to a mall near you: Medical care in a jiffy By MARTIGA LOHN Associated Press Published on: 06/23/05 MINNEAPOLIS-When Ann Theisen's 6-year-old daughter, Hannah, had a sore throat, she didn't take the little girl to the family doctor. Instead, she went to the Cub Foods store down the street from her house, lured by the prospect of faster treatment at a MinuteClinic tucked into a corner of the supermarket. Within about 15 minutes-no appointment necessary-they were seen and had the results of a rapid strep test: negative. JANET HOSTETTER/AP (ENLARGE) Andy Duppler, 16, awaits his turn at a MinuteClinic in Maple Grove, Minn. JANET HOSTETTER/AP (ENLARGE) Ann Theisen, right, takes a break in shopping to check her daughter Hannah, 6, center, into medical care with nurse practitioner Sheryl Barthalow at a MinuteClinic at Cub Foods. "It's the convenience factor," Theisen said. MinuteClinic, based in Minneapolis, is on the leading edge of a new kind of clinic that offers swift treatment for simple illnesses. MinuteClinic operates in 22 locations in the Twin Cities and Baltimore, most of them in Target, Cub Foods and CVS Pharmacy stores. The company has big plans to open more than 80 clinics in 12 major metropolitan areas east of the Rockies by year's end, and to push westward next year. "The demand for this is so amazingly consistent," said chief executive Michael Howe, the former Arby's head who joined the company earlier this month. "It's really something we've all been looking for-making health care a little more convenient and affordable for everyone." At the quick-service clinics, nurse practitioners diagnose and treat strep throat, pink eye, bronchitis and other common ailments. Howe and other MinuteClinic executives say their business is to health care what ATMs are to banks-making ordinary transactions easier while freeing up traditional providers for more complicated cases. It is a low-tech, low-cost innovation that could catch on, said Matt Eyring of Innosight, a consulting company that tracks health care trends. The average MinuteClinic visit does not require an appointment and costs the patient less than $50, Howe said. The cost can be shaved down to the same co-payment as a doctor visit under several major health insurance plans. "This is something that makes medicine much more available to consumers," Eyring said. "This kind of service will spread." MinuteClinic was founded five years ago. Its competitors include MediMin, which operates in the Cleveland area, FastCare in Louisville, Ky., and QuickClinic in Akron, Ohio. Howe would not disclose MinuteClinic's annual sales or profit. Each clinic treats an average of 30 to 35 patients a day, he said. More than three-quarters of those who visit the clinics have health insurance. Major plans-including Blue Cross Blue Shield, UnitedHealth Group and Medicare-include MinuteClinics in their networks in the Twin Cities. Some employers have lowered insurance co-payments for MinuteClinic visits because they cost less than traditional doctor visits, Howe said. And some companies-including Best Buy, Carlson Cos. and Guidant Corp.-host MinuteClinic operations at their corporate locations in the Twin Cities. The American Medical Association and the American Hospital Association are wary of the trend. What is best for patients, they say, is an ongoing relationship with a doctor. "We don't want to see nursing care substituted for physician care," said Dr. Edward Hill, president-elect of the AMA. "This type of clinic might not lend itself very well for continuity." But Mai Pham, a senior researcher at the nonpartisan Center for Studying Health System Change, said the clinics could provide a better alternative for patients who might otherwise go to an emergency room for care or skip it altogether. "It's clearly meeting a market need, but there's also concerns about why it is there is such a need," Pham said. Howe said MinuteClinics limit their work to common illnesses and are quick to send patients to emergency rooms or back to their primary doctors if other symptoms turn up. The clinics also pass records on to patients' doctors and help those who do not have a physician find one. Strep tests are the most common procedure performed at the clinics. That's what Theisen, a nurse who lives in the Minneapolis surburb of Maple Grove, wanted for her daughter in a hurry. "If we would have gone to our doctor, it would take an hour longer," she said. The trip to the MinuteClinic cost Theisen an insurance co-payment-the same amount she would have paid to see their regular doctor. "I grocery-shopped while I was waiting," she said. -- Associated Press writer Xiao Zhang contributed to this report.

I have a classmate who had all 265 questions and she passed.... I am so sorry you have to suffer through the wait but I wanted to let you know that there is hope. She was in agony too waiting for the results but she is now a RN!!

Hi.... Just graduated from there and it is a great program...I transferred in pre-reqs from 2 prior colleges and they took them all. Some of my classes were 7 years old and they took them anyway. As you are going through the program they will average in all of your grades together (those from other schools and those from NGCSU). One tip for you.....When I originally applied they told me that if it comes down to 2 equally qualified applicants, the one who applied to the program first will be selected. I do not know if that is still how it is done but I would look into it. I applied in November! Good luck!

Julie, Sending good thoughts your way! I was in your position last week and I passed......I took the complete opposite route and hardly studied at all....I just could not handle the pressure! You sound very prepared....My one piece of advice.....When you are considering the answers on the questions, (especially prioritizing ones!!) think about each possible answer and mull over if you have ever heard anything about it.....This is hard to explain but several times on the exam the more I looked, the more I remembered and that helped me to pull long lost tidbits out of my brain! It is all there in your head already!! All you have to do is stay calm and focused enough to apply it.....I am sure you will do great!! P.S. I took advantage of the free ear plugs at the testing center and was really glad I did!

Darn it!! I took the Sylvia Rayfield review and I am wracking my brain to remember......I know she said High = Dry and Low = something else but I cannot remember what..... :angryfire Basically she said if the alarm on the vent is "High" the line is "Dry" somewhere meaning you need to look for some form of blockage etc. I just do not remember what Low stood for...I have already loaned my books out otherwise I would look it up for you! Good luck on the test.... :)