ibnathan

I would like to see advanced nursing education changed. The first year would be devoted to clinical sciences such as bio, genetics, gross anatomy, and pharm. During the later part of first year start going through the ten systems and clinical application. Then the last 2 years full time clinical residency. Or instead of requiring a BSN make the requirement a BS in biology or biochemistry. I agree nursing does need to have more science in it's curriculum.

I am not 100% sure but the cardiothoracic surgeons use it on almost all of their open heart patients. It's usual concentration is 2 grams of (2 amps) epinephrine and 2 grams of calcium chloride in 250 mls of NS. Just look at the positive effects and actions and uses of both drugs and then combine them. It's funny though that particular drug is mixed either by anesthesia or ICU nurses, pharmacy won't mix it.

In our facility our max dose for Levophed is 30mcg/min. Just like the other posters have stated once you start to go beyond the max dose it is pointless. I once had a patient on Levo, Neo, Vaso, Epical, and Dopamine and within hours there extremities were modeled all over and expired shortly thereafter.

Epical is usually used by our cardiac surgeons after a cabg. The mixture is 2 grams of Epi and 2 to 4 grams of calcium chloride. Vasopressin is a good drug to use as well. Generally once you hit two vasopressor your prognosis is poor.

When I worked the ICU we used Levophed as our first line in the septic patient along with boluses of Albumin. Neosynephrine was usually used as a second line agent. Remeber levophed works on beta and alpha receptors. Actually it only mildly stimulates beta receptors. It stimulates alpha receptors much more. Neo on the other hand is a purely alpha-agonist drug. This is my opinion clinically levophed was much more potent than neo. I always though neo was a rather weak vasopressor. Actually in one of the doc's pharm book I was looking stated that neo should be used first then levo, because levo was deemed more potent. Epical and vasopressin are good vasopressor too.

I was making 26.50 when I left the ICU. I now make and this is starting wage 42.02 an hour. I think one reason is the perceived danger and enviroment that we work in. Really though it isn't as dangerous as the outside. I have my own personal alarm so if I hit the office and guards will know exactly where I am at. If I work on one of the yards I have at least one or two guards at all times in the office. To answer your question the state of California has a pretty big pocket book compared to any of the hospitals. Also they came under federal receivership which rose the wages to attract and retain good nurses.

Sweet 10+K a month. We start at 7285 and top out around 8400 a month.

I worked in one of the local hospitals in Bakersfield CA. It's funny in Kern County (Bakersfield is largest city in Kern County) we have the greatest shortage of nurses in Cali. ,but we are the lowest paid in the state. Our cost of living isn't as high as other parts of Cali but it is getting close to southern cal. One of the reasons why I left ICU was because I felt that out licenses were on the line to much. I loved it but the hospital would not back its nurses. So my friend who started in the ICU with me went to the CDCR he loved it and told me to come out and take a look at it. Since the CDCR raised there wages condsiderably there is a 3000+ waiting list.

I just got hired on at the California Department of Corrections and Rehabilitation. My starting pay is 42.02 an hour. I just left the ICU were I was only getting paid 26.50 an hour plus shift differential.

It may be a inferior wall MI with RV infarct. But all in all we need a pressure, the patient needs perfusing pressure. A. Start Levophed or Dopamine as well a a 250cc bolus of albumin or NS B. Watch patients pressure and heart rate and any funky arrythmias C. Call Cath Lab team Stat! B. Insert IABP stat and I qoute, " The goal of the IAB in such a disease stat (such as cardiogenic shock) is to decrease or "optimize" preload by ensuring a filling pressure high enough to obtain the highest CO on the Starling curve but not so high as to cause pulmonary congestion." (Counterpulsation Applied, An introduction to Intra-Aortic Balloon Pumping). Again the importance is to agressively treat BP and HR stabilize patient for cath lab. The patient also needs an A-line, and a Swan-Ganz for hemodynamics. Oh I forgot he needs to pray.

Well it definitely sounds like a cardiac output issue. The patient is going into cardiogenic shock/ Heart failure. I agree with everyone that Dopamine should not be used at all you would have a real chance of causing arrythmias. I actually seen levophed used in this type of situation, yes it does have some beta 1 effects but it is very mild compared to dopamine plus it will start giving you a pressure that will start to perfuse. It is a catch 22 though. On one hand levophed will clamp you down and start giving u a pressure, and on the other it is going to increase the workload/ afterload that the heart has to do. It will also increase myocardial oxygen demand. What they should have done immediately is start to TCP until Cath lab is ready. Maybe when the patient goes to the cath lab if he is still hemodynamically compromised they would insert a IABP.

Hell NO! New grads should be paid at a min. of $25-30 an hour. An experience nurse with 10-20 years of hospital experience 45-60 an hour PERIOD. This is why nursing is behind in pay, we self sacrafice ourselves for our patients, and in doing so we sometimes lower the standard and let hospitals determine what were worth. I love what I do but nurses should not stand for any kind of pay that is demeaning. No offense but I believe the pay is low because the majority of nurses are women. As more men come into this profession I hope and I believe that the standard of pay will rise. Don't settle for less.

Congrats!

Yeah I had OB, Peds, Meds that I have never heard of, Priority and Delegation, and Pysch. How many questions did you have tabymac.

Wow! I just took mine today and I got 107 questions then it just shut off. The board just got out transcripts two weeks ago and every who took the test after the board got our transcripts new within 3 days whether they passed or failed. The was one person in our class who took there boards in early Jan. and it took a month to find out because they did not have out transcripts. Hopefully we all passed.

Hey there don't worry! Me and my friend are taking our boards Monday. Many of my other classmates have taken there boards alreadly all but one has passed and she had 75 questions. One of the girls in my class had 96 questions, another 110, and another took the full 265 questions and passed. The way we were explained in our 3 day NCLEX review class was that 15 of the questions that you recieve are test questions and do not really count. They are new type of questions that the boards are trying out. Secondly, we were told that we are not graded by percentage like we were at school. It is a grid line, if you answer the first question you start on the line, answer a second question you move up the line. The line is considered to be basic nursing knowledge. The lady who was doing our NCLEX review said that theortically you can miss 25 out of 75 questions or 1/3 of the test as long as your above that line. Hope this helps I will be going through the same thing that you are going through right now in a few days. Nathan

I will be starting my orientation Jan. 15th. My starting pay will be $24.75 an hr. After my 14 wk orientation I will be eligible for overtime, overtime at my hospital for the first 4hrs. it is regular time then double time after that. Also after orientation I will be on the night shift 7pm-7am there is a 10% shift differential for nights and if I work weekends which I probably will have too as a new grad it will be another 10%. I will probably work 4 days a wk and every once in awhile 5 days a wk. I have worked the night shift before for 2 1/2 years it can be vary taxing on your body and family life. Good Luck Focker!

Thanks Trauma just got back from graduation ceremonies time to party!::balloons: I know that our instructor was saying that when she went to go on an interview for a position at a MD medical group they offered her $35.00 an hour. She makes $45-50 dollars an hour per diem as an RN. She laughed and walked out I think for the schooling and responsibility that NP's have they should make anywere from $65-85 an hour. Just my thoughts.

Yes you can be a NP and work as an RN. Both of my instructors at my college are Acute Care Nurse Practioners. Here in Bakersfield it is the good ol' boys Doctor Club they are really resistant to most of the mid-level practioners. Plus the pay is better as a PRN RN than as a NP. Now in the bigger metro centers ACNP can make alot more money plus hospitals are more willing to use NP's. The one thing that I thought was interesting was even though that they are ACNP's practicing as an RN, they are held responsible at the NP level of knowledge. Hope that helps! PS. I am graduating from my Nursing Program today! ;)

I'll be working as an R.N in an ICU. For instance my sister just graduated optomety school in Chicago with 180,000 dollars of school loan debt. Her first job she will make around 80,000 a year, even in there graduation ceremony the Doctor who spoke to the class said and I qoute " don't worry about your huge loans you will be able to pay them off in time." The point is some people have to have loans to get by,nursing school is stressful enough, especially with all the bullsh!t that is involved in the nursing process. Thats cool if you paid your way through college and more power too you, but I know that in long term the loans helped me get out of a horrible job and help me get into a new career with limitless opportunities. If the government doesn't help me out with my school loans then I will become a traveling nurse and pay them off that way.

The "opportunity cost" of not working dwarfed my tuition expenses. Exactly quickbeam, especially if you have a family and not 18yrs and Mommy and Daddy will pay for everything. Also there are government programs and some hospitals will help pay a percentage of your loans off.

Hey you have to do what is best. I was a manager a local retail supermarket making about 50K a year working six days a week with overtime. After they started to downsize I lost my position and took a 15-20K a year loss. I decided to go back to school and get my nursing degree and I will be graduating in 12 days. Yeah!. I have approx. 60,000 in school debt. Now let me say this it is not the schooling that costs, it is the outside expenses that are very expensive such as health care, car payments, grocery, gas, rent, unexpected expenses etc. I've been going to school for 5 years break up that 60000 grand and it really isn't that bad. I expect to make that my first year without overtime. (60,000). Long term it is an investment in yourself, oh did I mention I am married and have a kid, it is expensive but do it. If I were to work 4 days one week and then alternate working 5 days the next I would make close to 100,000 dollars my first year. Anyways good luck!

Wow! I can't believe you only got 6wks of orientation. I will be graduating in Dec. and starting orientation in the middle of Jan. The hospital that I will be going to work for has 14wks of orientation. The orientation program consists of the ECCO program from the AACN which we will meet once a week. We will get ACLS training, 3 days a week on the floor with a preceptor. The first 10 wks will be on days and the last 4 wks will be on nights. After that we will be required to work nights shifts for at least 9 months, but up to a year. I have a friend in the ICU and he said that all the nurses on both shifts are really helpful. Also the critical care clinical instructor for the hospital will be working with us on skills in the hospitals skills lab aside from what we learn on the floor. I would really confront the management and if they can't meet what they promised you I would resign and find another hospital to work for. Remember its your license and you patients safety at risk. Good Luck!

I will be graduating in December and I live in Bakersfield Calif. which is approx. 2 hours away from LA. Starting wage for new grad RNs is $23-26 hr. If you work an extra day a week equals out to about $500 a day or 25,000 extra a yr. Cost of living is decent and it is cheaper than L.A. but is beginning to climb. The recruiter at the hospital that I will be working at said that they have numerous RNs that make 150,000-200,000 a year. Personally, after my orientation I will probably work 4 days one week and then 5 the next. Also I have a friend who got a job offer in the San Diego area as a new grad and they offered her $34 dollars, and in San Francisco the starting rate for new grad can go as high as $40 hr. Shoot! Travel RNs make a killing $40-$50 an hr plus double time the 4th shift or after 8 hrs depending on their contract. Plus living expenses paid, car payment paid for, cell phone, electric bill, it is sick, and that is why someday I will travel.Good Luck!

I was going to say go for it, but if you are going to get pregnant then I would go to tele instead of med-surg. I myself am graduating in Dec. and I will be going straight into ICU. In tele you will learn alot more than a straight up med-surg unit. You'll know cardiac drugs and cardiac dysrhythmias, code management and a whole lot more. Good Luck! your almost done and may the force be with you.