penthes

I'm currently working in a SICU that does a lot of head trauma. The TBI protocol states that we level the A-line transducer at the external auditory meatus. I follow the protocol and we treat with hypothermia, 3% saline, Mannitol, and pressors. Sometimes we drain CSF and sometimes we only monitor with the Camino. I previously worked in a NICU that required we level it at the phlebostatic axis. I had understood this to be the proper place to measure MAP. I'm not sure if you can find any research or textbook that will tell you to measure MAP anywhere else. I would think that an accurate MAP would be important since CPP=MAP-ICP. I follow the policy of the facility where I now work, but do not agree with it. Penthes

I wouldn't want to deal with some of the patients that the nurses in our ER deal with. You catch people at their worst, most of the time. I'm an ICU nurse and wouldn't trade it for anything. It was only a couple of weeks ago that one of those "gruff" 30+ year experienced nurses was telling me the story of a terminally ill patient's husband who stopped to take time to bring this nurse flowers for her kind care! She had tears in her eyes as she related the story, and it had happened many, many years ago. Keep in mind that attitude is something that you determine to have. It can be shaped into a habit by consistent reinforcement. This applies not only to bad attitude, but good as well. Both types are contagious, too, but you can develop in yourself a natural immunity to one by clinging firmly to the other. Best of luck and study hard!

Sorry to hear of your bad experience. As a charge nurse on a newly formed, 12 bed neuro ICU unit, I have quite a bit of experience with travel nurses. Our facility, like many others is cutting back drastically on the number of travel nurses it hires. I am suffering the pain of losing some excellent nurses due to contracts no longer being renewed. I can fairly say that I will miss most of them greatly. I have always tried to be equitable in making the assignments and making sure that every nurse on the unit had as much support as could be provided. I hope that you will continue to pursue your nursing career and give it a try again. Maybe some day you will turn up in my unit and we can laugh about the bad old days!

I don't think the CNA course will help you much with A&P. You need 2 good semesters of Biology for healthcare majors. Then be prepared to MEMORIZE a ton of information in A&P. If I can do it at 40 years of age, you can certainly do it! I actually went straight into my BSN program with no healthcare experience at all. I worked full time in an unrelated field while doing it. I took all of my prerequisites at the local community college, which also has an excellent ADN program of its own. You need to get the basics down, and get into a good study group. Form one of your own if you can't find one. I find that 3 to 5 people is optimal.

I really can relate to your situation. I am a guy, and not really knowing your full situation, can't address everything. I decided to go into nursing and being the main bread winner of the family had a hard time. I worked full time but my wife was able to keep the kids. If you have any way of providing child care without cost, that is about the only way you can do it. I worked full time and went to school. I was thankful that the nursing school let me take half load for several semesters. They were fairly flexible about it. Clinicals were hard. Often I had to work 8 hours, catch a nap and then to 8 or even 12 hours of clinicals. Sleep was very short, and my wife took the brunt of child rearing for most of the time. It was the most stressful time of my life, and was stressful for everyone else, too. So, about the only advice I can offer is to find a way to care for the children with little or no cost, and be prepared to be very tired for a couple of years. It was worth it to me, but it took me a year to recover from it fully. Best of luck.

Many hospitals offer "nurse tech" programs for nursing students. If you start out in nursing school, after the first semester you can apply as a Tech. They are very flexible in their hours to work with your classes and clinicals. Our hospital gives tuition reimbursement as well, when you graduate and commit to work for them. Phlebotomy or CNA jobs would require some schooling and possibly a commitment of their own. You can work as a "nurse aide" (patient care associate or whatever the title) and train on the job until you have completed pre-reqs and the first semester of nursing school. All you would need is your Healthcare CPR certification. Hospitals also have a high demand for sitters and transporters. These require the CPR and very little else. Of course the advantage of the Phlebotomy or CNA position is that they would pay a bit more to start. Best of luck, I hope it all works out well for you.

I started out in a night shift even though I didn't want to. After 16 months, I got a transfer to days. There are plenty of jobs, but you must be willing to get that initial year or two of experience wherever they will hire you. Usually at a hospital working the night shift. Good luck to you.

You can't beat critical care for learning new things. The internship they gave me at our hospital was fabulous. I am still learning new things every day, too.

our hospital offers different hours for different departments. Many are 8 hour shifts, usually 7-3, 3-11, 11-7. Critical care is 12 hours from 7-7. Most nurses start out on the night shift. We have a different rotation of days in CC. We work 3 on, 2 off, 2 on, 3 off, 2 on, 2 off then repeat. That's a 2 week rotation that gives us 3 day weekends every other week. I started on nights and after 16 months went to days. Some hospitals offer weekend only shifts; you work either 2 16's or 3 12's. Procedures can include pulling central IV lines, inserting IVs, removing sutures and such. We assist with quite a few bedside procedures in ICU as well. Good luck, and do your research to decide if you want to become a nurse. I love my job and can't think of anything I'd rather do.

Review your ACLS meds, cardiac iv drips and such. We use a lot of Epi, Neo, Levo, Cardene and such. See if there are any of the shortcuts to figuring drips that you want to learn; drip factors and such. Re-familiarize yourself with the basics of ECG interpretation. You might also want to get some copies of the department's nursing notes to preview, they will probably be quite different than what the OR uses.