diveRN

Just read this a 1/2 hour ago. Linky

Ditto on the above post. PACU is it's own critical care area. In 99% of cases, they have direct and immediate access to MDs if a pt frumps. No OR, PACU, ICU, or ED. Our RATT (Rapid Assessment and Treatment Team) responds only to floor requests.

Strongly consider your nursing degree because the paramedic scope is pretty narrow. If you get burned out, you won't have many options as a medic. With an RN degree and license, you can take an accelerated medic program, some agencies will often allow you to challenge the didactic portion, and then all you have to do is your clinical time. Here, medics have to do 400 precepted clinical hours. I had considered going this route to have something outside the hospital to do, but 400 unpaid hours would take me several years to recoup at a medic's pay. It didn't make any financial sense for me to proceed. I've recently dropped a few resumes for local CCTRN positions. Would get me out of the hospital now and again and pays pretty well comparatively.

Our better monitor techs / WCs will: - Answer call lights & direct appropriate staff. (CNA vs RT vs RN) - Screen calls/visitors - Verify orders and diets with me daily and enter them in the computer appropriately - Page MDs then let me know when they're on the phone - Thin charts regularly and make sure they're stuffed daily with blank order sets and prog note sheets. - Let's me know within a short time of ANY conduction changes or abnormal VS not caused by artifact or activity. (And knows how to tell the difference) - Enters work orders / requests for me related to hospital services like housekeeping following a DC or transfer, biomed, plant ops, etc, etc. - Keeps the coffee pot filled with good coffee.

I recently had a Cardiac Interventionist go off the hook at me when a pt stopped making urine for better than 3 hours in spite of a liter of saline over 12 hours to flush the kidneys out. The doc went off on me. He has a history of doing this, mostly with women though. "Why did you wake me up at this hour for that? Get me a nurse who knows what they're doing..." After I explained that I was concerned about ARF secondary to the contrast media, he continued to read me the riot act for waking him up. My final reply was, "with all due respect Dr. P________, if you didn't want to be woken up at all hours, perhaps podiatry would be a better specialty." I hung up without orders and called the house supervisor. Yes, there was a meeting the next morning in the Critical Care Director's office. Our director waved the P & P in front of him and pretty much told him the same thing... sans the podiatry comment. I didn't say a word the whole time. Arrogant MDs make good pt care tough.

Yeah. That. ^^^ almost exactly. Our class is 4 hours and we orient to the assessment and machines for a shift. The only difference where I'm at is that most of the HD RNs are pretty good at looking after the pt if they're compliant, relatively stable, and not too needy.

Who says you have to be home all the time?

One of our RN educators is 71 and she's still going strong. She's something of an icon/legend in local EMS and acute care circles. Was my plan to retire at 55. Doable, but I've got to bust me orifice a bit more than I have been lately. At my current pace, it'll be more like 65. I'm 39 now.

Many of our discharge and case managers are LVNs. In fact, it's pretty much the only position in our hospital that uses an LVN. We just don't have them around. Agree with prior post - arranges for health care needs post discharge such as home O2, medical equipment (liaison with suppliers/insurance), follow up care, STR, LTR, SNF, interfacility transfers and the like. Very administrative in nature, not much if any, bedside care. Requires solid communication and organizational skills.

Our pumps have electronic labels for the Guardrails drugs so it makes it easier to look at when you have 8 channels infusing something... We also label at the pt.

Procrit is usually refrigerated. I've found that pts don't complain AS much about the ouch factor if you let it warm up to room temp before administration. I usually take out the procrit about 30 minutes before I give it. There are only a few drugs off the top of my head I can think of where this helps... EPO and Octreotide.

The ones I know of are in the Central Valley, specifically from Madera (Valley Children's) north to Sutter Roseville and a few in between.

Yeah, where? I know of several. Just depends on where you want to be.

Congrats on your acceptance. I have a CS background, was actually my field of study in college and my second career. I don't miss the computer bidness at all. It is THE most dog-eat-dog profession I know of. By comparison, nursing is pretty kick back, if not boring at times. Nursing is my third career, so I'll leave it just to when I was in pools and hot tubs. Way back. I miss: being outside at work. When it was hot, I'd jump into a client's pool to cool off. Having a good tan. I don't miss: Working in the sun from daybreak to sunset 6 days a week from May 1 to Labor day. I miss: Making obscene money in spring and summer for relatively easy work. I don't miss: Draining a significant chunk of my savings account every winter because the phone never rang. Doing collections. I miss: Having winters off and being able to kick it 4 or 5 days a week. I don't miss: Having to lay people off every year. I miss: Being my own boss. I don't miss: Being my own boss.

Even if it's one antibiotic, I always set up a NS rider to which the abx is piggybacked. Even if the pt is fluid compromised, an extra 10 or 20 cc of fluid isn't going to hurt them. We run PIVs at 10cc tko and 20 on central lines per policy). I would rather have them get +/- 20cc of NS than lose one port in a central line or have an IV clot off on a pt who is a difficult stick. Since most of our ICU pts are on IV protonix and some sort of abx, so we often have at least two med infusions to do in 24 hours. Running a TKO for a 1/2 hour to an hour buys time until you can get back to it and lock it. We keep 100cc NS bags just for this.