Granolagirl17

When I lived in New Orleans my husband and I handled two therapy dogs (they were both retired search and rescue dogs). We visited LTC facilities and the pediatrics ward at my hospital where I worked as an EMT. The residents at the facilities delighted in our visits - sometimes the care staff said that was the only time they would talk - while petting our dogs and telling us about their beloved pets. Disoriented agitated residents would calm down while petting the dog. There were those who didn't want the dogs in their rooms and we knew which rooms to avoid. The pediatric ward was wonderful - the dogs came to a central area, not in the rooms - for however long we were there, the kids forgot they were attached to an IV pump or whatever was going on in their lives at the time. I also visited as a safety clown and did magic tricks, etc. I think they liked the dogs better

i understand what you are saying - didn't mean to dis non emergency transport - but having spent a couple years in both transport and running 911, there is a huge difference - i was just advising op to check out what he might be getting into - not all ems services are alike - i know a lot of emt's who thought they were going to be the siren blazin' life savin' road warriors be quickly burned out after a 12 hour shift with 30+ transports. i had many friends though who just loved their "regulars" and had wonderful rapports with their patients and couldn't imagine working 911. it probably didn't help that our non-emergent transport gigs were at the longest, maybe 5 miles door to door and often - i mean often literally across a driveway (it honestly would have been quicker to just freakin' push the patient across the driveway in the stretcher rather than load them up and drive 100 ft!) not a whole heckofalotov opportunity for assessments, there!! :chuckle

DaddyO - you are a little further out from starting than I had assumed - thought you wanted to start both programs at the very same time - so absolutely it might make sense to do the EMT training - uncle with FD?!? Man you will be in like Flynn - but depending if Fire rolls on medical calls, FR may be all you need. Yes, CNA is more applicable for traditional floor nursing but check out local hospitals to see if they have ER techs - sometimes they use CNA's in the ER - sometimes they use EMT's as the ER techs so that could be an awesome opportunity, too.

I'm an EMT and nursing student - I can tell you that no training is wasted training as far as that goes - but as far as the experience you will get - that will depend entirely on what sort of EMS system is in your area that you get involved with. In many areas, they run ALS trucks - translation - the paramedic gets all the "good calls" - the very sick and injured patient - as an EMT Basic or even EMT-IV / Intermediate, you will be driving the ambulance while the paramedic works with the patient. Yes, you get to help in the on-scene prep and assessment but the sicker and more injured they are, the less you do. Also some areas ONLY run a double paramedic truck so you will be stuck on transport EMS - take grandma to dialysis and back to her nursing home. Not much experience points there. EMT school is not a brush off school either - not as involved as nursing to be sure, but you have to do "clinicals" of a sort - ride times in the truck and sometimes in the ER - so be sure you can handle class time, study time and ride times along with nursing school times and clinicals. A lot of EMS folks work 12-hour shifts and many PRN positions require a certain number of shifts per week - its rare (but possible) to find a place that will let you volunteer on your own schedule. If you are flat new to the field but want to jump in and especially like the emergency scene, another option would be to get a First Responder class (that's about 40 hours or so depending on the program) and then hook up with a rescue squad or fire department so that you can sprint out with them on the scene - you can help with the initial assessment/interventions until EMS gets there - less time for you to commit but still the opportunity to be exposed to different situations. They are usually more forgiving and flexible with hours plus if you hook up with them, you are part of their team and get exposed to other areas of training. I'm not saying EMT/EMS isn't a good experience builder - it is but I was lucky to be one well BEFORE I started NS - remembering what it was like to be a new EMT and now a new NS I'm not sure that blending the two at the onset is the best way to go about getting your experience.

You know, its hard to look this stuff up online when you don't know how to ask/phrase the question - so I followed up on your post and started looking into diffusion of glucose into RBC's. Got me down the right track! Your response still left me wondering as to if/why/how the membrane was so different and wouldn't it need to be HUGELY permeable or fairly different in its structure if glucose could just freely diffuse in and out - what would keep other things from doig the same - or is it just a big open sac? Eventually lead me to.... GLUT1 - a glucose transporter that is found in highest levels in adults in erythrocytes and also in the endothelial cells of barrier tissues such as the blood-brain barrier. (From Wikipedia) : GLUT1 behaves as a Michaelis-Menten enzyme (whatever that is) and contains 12 membrane-spanning alpha helices, each containing 20 amino acid residues. A helical wheel analysis shows that the membrane spanning alpha helices are amphipathic, with one side being polar and the other side hydrophobic. Six of these membrane spanning helices are believed to bind together in the membrane to create a polar channel in the center through which glucose can traverse, with the hydrophobic regions on the outside of the channel adjacent to the fatty acid tails of the membrane. AHA! Victory! Now I can get some sleep! :)

Ah, I knew I should have had organic chem - my AP book was a dead end on that - have done some intense googling on it too and can ONLY get information "what it measures" = not so much the process of how it got in there the first place to be measured! Thanks tho' for some thoughts on it.

Okay, I'm with you on the development of RBC's - they are generally speaking, just big SACS that carry around heme molecules. And yes, they use glucose but anaerobically so as to spare the O2 that they carry (and by default since they don't have any mitochodria to perform aerobic respiration). But still - how did the glucose GET INTO THE CELL WALL - its still a barrier membrane and insulin needs to be there to let it in, doesn't it? Are you suggesting that by losing the other organelles that this changes the permeability of the RBC membrane allowing glucose to come in as it will? (Pity my instructors - they routinely get three page emails from me after a lecture - on a good day its only one or two questions - my norm is usually about 10!!)

I'm not sure if this is a "med savvy" or more correctly "lab savvy" but it seems to fit here best - I guess I'll see if it gets moved... My question is about HgA1c - not what it measures - I understand what I've been told that sugar in the bloodstream can become attached to the hemoglobin in red blood cells (glycosylation) - my question for the brainiacs out there is....how does the sugar GET attached to the hemaglobin? RBC's are cells with cell membranes and if you are diabetic and don't have the insulin there to play "gatekeeper" and let the glucose in, how the heck does it so freely get into the RBC's in the first place? What am I missing?

Southernurse, you are going to love WSCC! :loveya: I'm a non-traditional student returning to school - I have a previous degree and one year's master's degree program experience - went to college both in US and in Canada - so I've been around the block a time or two on college campuses and I'm am HIGHLY impressed with this school. I took my pre-req's of AP and Micro here and was blown away by the caliber of instructors at this small community college - fully as qualified, passionate and knowledgeable as the bigger state universities I've come from. The nursing school is phenominal. I had a choice of several programs in the area - with my previous degree, in fact I could have gone straight into a Master's program in nursing in Knoxville. I checked around and BY FAR the reputation of WSCC graduates is stellar - time and time again I've heard from floor nurses and hiring officials that they LOVE having a WSCC graduate apply/work with them. Our instructors team teach - each in her own specialty/background. We actually DO clinicals - I've read on this board how some folks only have computer sim's for say, OB - I can't even imagine that! We start IV's, we do it all - from being assigned patients to rotating through surgery, ER, ICU, etc. Our school's NCLEX pass rate is one of the highest - we are well prepared when we get out of here. The instructors are approachable and receptive - I've not run into the horror stories like instructors I've read about on this site - yelling, disrespectful, trying to "weed out" students - our instructors WANT us to pass and do what they can to assist. Is everything perfect? Well, no - I don't like our schools "improved" online class program - the old one worked much better, in my opinion (that was a college wide change, not nursing school change). So far all but one of our instructors are at the minimum "good" platform instructors - many of them are truly EXCELLENT and we actually ENJOY and look forward to their lectures. (The one whose strength does not lie in platform lecturing is wonderful one on one - can't expect everyone to be strong in every area). The biggest beef I hear other students express is the amount of material covered - I guess since we cover the same NCLEX material in 4 semesters as the BSN programs cover in 4 years - you have to expect a rather concentrated program - it can sometimes feel more like the information is being "presented to us" rather than "being taught to us" - there is a fair amount of learning on your own that is expected to occur - I don't know how the school can get around that given the time constraints of an ADN program. Again, though - if I get confused or need clarification, the instructors are approachable and easy to reach out and contact via email, phone or office hours. Hope that helps - welcome aboard and enjoy the program!

My first thought is - you don't seem clear on what you want to do - which is absolutely fine - heck, figuring out what you want to do is what college is all about - but perhaps you'd benefit from talking to your college advisor - they often have aptitude/interest tests that might help clarify your direction. Second, I don't know of anyone who took Anatomy and said "Dang! I just love these Latin terms - gosh darn it now I want to be a nurse!" I think the terms are boring even for the instructors! Will you remember every term.... likely not, but the knowledge base helps a lot in making sense of medical jargon. Even so, you can tell a physician that a patient complains of a stiff neck and he'll get it just as well as saying the patient c/o "nuchal rigidity" Third, don't base your decision to become or not become a nurse on how much Anatomy interests you or is fun. It has a LOT to do with the instructor. At my community college, my instructor is a biochemist - and he brought Anatomy and Physiology (AP) to life and made it so applicable to what I would see as a nurse and how medications might affect a system, etc. Even within the faculty, though, there are other instructors who just present the material and just "teach to the test" - I would have hated AP with them. A good knowledge of AP, nutrition, microbiology etc is vital to being a safe, competent nurse - but nursing includes much more - social work, counselor, teacher, caregiver, detective, advocate...etc etc. So don't base the decision on one pre-req class. I'd say until you research it more, keep those business classes - there's a lot to say about savvy business oriented nurses, too - those classes won't hurt. Good luck in your decision process!

Hmmmm.....well, I have a lucky rabbit's foot that you can buy for $500. It will provide you true love, cure arthritis and gout, bring money and fortune and guarantee the health of your family. And get rid of wrinkles, too. Do you believe me? No? Where is YOUR research data to prove that MY intervention does not work? Those who put forward interventions have the burden of proof, and I believe that if these interventions were sound, there would be a plethora of reproducible, verifiable studies out there that would recommend them and endorse them. Where are they? Is it a conspiracy theory or something? I looked up Therapeutic Touch in peer reviewed scientific journals and did not find support for the intervention. The articles I was pointed to by my nursing instructor who DOES approve of Th. T were NOT PEER REVIEWED articles/studies and were small number case studies without double blind, control groups, etc. We don't have any trouble reproducing double blind studies of pharmacology or studies proving efficacy of surgical interventions, but I haven't seen a lot of convincing proof that copper/magnetic/Egyptian runes are good solid therapy. But honestly, I'm open - please send links to journal articles! Heck, I'll be the first to buy the bracelets if they work!!

I have learned that sometimes, no matter what you try, you will actually have to (gasp!) wait to be seen in an ER, especially if you come in with a non-lifethreatening condition... (a dog bite from your dog that happened three days ago and you don't want to have to "wait" to see your regular doctor) Ranting and raving about the fact that "I was here first!" does nothing to sway the triage nurse (although at first she will try to explain why the person arriving by EMS with an active MI had priority) And it doesn't help to call 911 from the payphone down the hall from the ER in the hospital.... And it still doesn't help to call 911 from the payphone a block away from the corner grocery store - and if you do, don't be dumb enough to explain that you just left the ER and you want to go back in a stretcher so you don't have to wait - especially when you are wearing the triage bracelet from said ER and the 911 is hospital based - that was the only 1 of 2 times I know of that the paramedic got the "all clear" to NOT transport the patient.... And it even still doesn't help to call 911 from your home, 30 minutes later (especially when you are still wearing the triage bracelet from the ER and as luck would have it, the same paramedic and partner show up at your home - that would be 2 of 2 that permission to decline transport was issued)

TJ, thanks for the bump. This is a great thread. I almost walked out of nursing school in the first two weeks because of the whole "Nursing Diagnosis" "Magnetic Unruffling/Therapeutic Touch" thing. That was not what I signed up for!! Show me the science (or new word "Evidence Based Practice") I agree that nurses do so much today and the responsibilities are enormous - so I understand that there needs to be a way to describe what we do and the way we do it (ie we are not just little monkeys that pop pills in our patient's mouths) but I think that in the quest to prove the worth or role of the nurse, the garbledegook of some of this theory stuff has backfired. EMS had a similar struggle in the past 30 or so years - pushing for respect and acknowledgement that we are not just ambulance drivers (well, we do drive 'em but we also intubate, push first line drugs, pace, etc). It seems to me (in my second semester ADN studies) that some in nursing have pushed so hard for "we are different, we are important" that they have gone off the deep end. If you want respect from the medical community, leave the magnetic unruffling to the back pages of The Enquirer (NEW! Copper / Magnet Bracelet! With Egyptian Runes! Cure Arthritis and Bring Love and Money!) and develop the skills of understanding the nuances of ABG's, etc. I'm writing my danged old student 12 page plan of care. And I read the plan of care for my patients that are in the hospital in the real world. You know what they were/are? Risk of fall r/t..... Risk of impaired gas exchange r/t..... Each EXACTLY the same. So much for using the theory of acknowledging the "holistic person"....BUT the actual CARE that the patients received from their nurses WAS individualized. I don't think reading about FN made a whit of difference on HOW these nurses cared for their patients - unless you counted the fact that they had to create a POC and spend time on that paperwork rather than delivering the care to their patient.