TSchmitt

The interaction between coumadin and cranberry juice has nothing to do with vitamin K, actually cranberry juice has the opposite effect of vitamin k when mixed with coumadin. It is thought to potentiate bleeding in two ways, by competing with receptor sites where coumadin is cleared in the liver and by altering the clotting factors, such as cox1. The result is that coumadin stays in the system longer thus potentiating its effects. Evidence is not clear exactly how coumadin and cranberry juice interact, but is not as simple as introducing extra vitamin k to the diet. Too much cranberry juice with coumadin increases the risk of bleeding, not like too much vitamin k in the diet will counteract coumadin and increase the risk of clotting. They have two different effects on the body.

Yes, this nurse does have a bit of personality disorder. Her approach is punity and does little to build her coworkers confidence. Her superior attitude makes it difficult to work with her. She did not assess first to find out if there was a knowledge or skill deficit on your part she just went strait to the judgmental aspect of her personality. This is what is known as eating our young (you don't have to be younger or have less experience for it to happen to you). Make sure you keep track of these incidents and then talk to your manager. Nurses with this kind of attitude, no matter how good their skills are, should not be put into the role of a mentor or orientating other nurses (not that she was doing that with you). Your manager needs to be made aware that this individual has poor people skills so that she never gets asked to be put in that position. We all make little mistakes. Patients tend to do fine until 5 minutes before shift change and then it looks like you dropped the ball. Did you learn anything from the experience? Do you now know to check both ends of the dressing? If you learned something and grew, you are a good nurse.

Don't ever dismiss salaries in nursing as a consideration. If the profession is to advance so must the salaries. The best and the brightest do not work for free, they can not afford to. Advanced education requires a six figure investment now (tuition and lost income while doing it) and there needs to be a pay off. I am looking at NP schools as well and the pressure I am receiving to just apply to medical school makes me really reconsider. You have to love what you do if you are going to spend years in secondary education to get there and then decades doing it for sure. When nurses say you should not be doing it for the money they are really putting down the profession saying what we do is not valued. To heck with that. Patients come to the hospital for nursing care, not doctor care. Otherwise they would be doing open heart surgery at your local mall. Nurses are the back bone of the healthcare system and there is a culture of keeping nurses in their place to keep costs down and profits high; unfortunately alot of this comes from nurses with advanced degrees. Nurses deserve their share of the pie, since they do a significant amount of the work. Get some real life experience as a nurse before you apply to a NP school.

Jogirl: Yes,there are indeed programs that will pay up to 85% of your federal student loans for nurses, and other healthcare professionals. These require you to spend 2-3 years at a federally designated underserved area: inner city clinic, Native American Reservation, Nursing Home provider. Usually these are inner city areas or isolated areas. The program pays 30% of your loan per year for the first 2 years. If you extend your contract for a third year you may qualify for an additional 25% paid off your loan. Unfortunately this program is drastically underfunded, a budget of less than 20 million for the whole country. Pitiful. However, if you are willing to go to underserved areas, like Indian Reservations, funds are available from other resources. Then there is always the military. Yes you can get your loans paid off or almost paid off, but not by working at a local hospital and having any kind of 'normal' life. There is a price to pay whether it is isolation in the bush or serving in the military. Nothing for free. Hope this helps. Tim [email protected]