nursemae

Decadron's not the only crotch-burner! Other steroids like SoluMedrol/SoluCortef can do it too. Dilute and push 'em slow on the high port. :) Ditto on IV Benadryl, it can really make people feel freaky if you push it fast and/or on a low port.Watch IV Vanco, always on a pump, always diluted right (I've seen several newer nurses over the years try putting it in 50 or 100ml bags), and if it's the first time they've ever had it run it extra slow!

Young Soldier (Gods bless Privates...) finds a training UXO (unexplored ordinance). Tries to detonate said UXO, no luck. Takes it back to camp. Tinkers with it some more. Tries again to detonate it, no luck. Dismantles it some, tinkers some more. It finally detonates, while he's holding it of course. Fortunately he had thick leather gloves on, which took a large amount of the thermal damage. One was half gone, half fused to his hand. Remarkably, he retained all his fingers but won himself a lengthy round of wound care...As he was explaining the saga during triage, he stopped at one point and said "Now that I'm saying all this it was a pretty dumb idea Ma'am..."Yes honey, yes it was.

I know there are companies that staff sitters for people of differing needs, or people who do this on their own. There are many different varieties of patient care needs - some just need a babysitter, some need help with care, some need medical care. It seems to pay quite well and many of the professional sitters I met while in one of my hospitals seemed to really like it. They have the bond you get with working long-term care, the work isn't as taxing as nursing and they make a good paycheck. I wish I had more information in how to get involved in that kind of work but your Google-Fu can probably find quite a bit. Best of luck to you, in whatever you find to do. Thank you for all the years of service you've already given, and thank you for the years of service I'm sure you're still going to give.

Hah, I hear ya. We've had a run of 'real ER' patient lately...strange! Would love to have just a little more of a mix, but hey, still can't complain too much since it means not too many of our constituents are having a Very Bad Day.

Woo, happy week to us! I'm going to go celebrate it by doing shifts and saving people from Imminent Death via ear infection and strep throat.

Hello Jeager! I figure I'll throw my $0.02 here. I have been in the military healthcare system for 11 of my 13 years of nursing - 7 years active duty AF (3 of those years serving at an Army hospital) and 3 years of civil service at Army hospitals. These answers are related to what I feel I can answer to from personal experience. :) Some of these things are hard to answer because a lot of the 'worth' of military vs. civilian nursing is based on personal issues. Yes, the financials come into play but each individual rates the importance of home/family life, individual freedoms, etc. Often you're not really going to know until you're in the situation, I think. In the military there are leadership courses you go to (Head Nurse course (Army), Nursing Services Management (AF)) which help add to the leadership you've already learned in your BSN program. I have known several people in the military who were nurse managers of a clinic/unit after only a few years of experience. While I was made a charge nurse in about 6 months during my stint in a civilian hospital I think part of that were the circumstances on my unit as well as the fact that I had considerable charge experience in other facilities already. I don't believe it's common to find such young (experience wise) nurses in management in the civ world. With that being said, once you have gone into that track it is harder to get out in subsequent assignments unless you are going to a very large facility and want to do floor work, or are going to advanced practice. I have found a significantly higher level of professionalism on the military side. As with any place there are going to be individuals who don't seem to have a professional bone in their body but in the whole there has been no comparison in my military/civilian experiences. Nurses are a vital part of the health care team in either setting, and your personal experience credit is given its due as well. In the military you hold 2 professions - first and foremost you are a military officer which has its own accord of duty and professionalism. On top of that you have the professionalism of your clinical career. This is always a possibility. The needs of the military are the priority over your personal desires. However, they have a vested interest in meshing their needs with people's wants. This is where it is important to be honest and direct about your professional goals so they can hopefully mesh. The other important part is to realize that there are few 'wasted' opportunities. When I was first in the service I was frustrated that I was moved around so much (within the facility, not around the world). After I had a little perspective I was very thankful for the varied experiences I had. It has made me a far better nurse to have the 'breadth and depth' I have. That being said, if you are tagged with a specialty identifier (L&D, ICU, ER, etc.) there is a much better chance that you can remain in that lane of practice...actually it can be difficult sometimes to break out if you decide you want to do something totally different! However, if CRNA is your goal then being 'stuck' in critical care would be to your benefit. I have no answer for this one... This is really one of those personality questions. Obviously there are monetary rewards. You will gain experience on a deployment that you can't get anywhere else, even if you were in a large urban trauma center. However, there are many deployments you can go on which won't see 'action'. If you go somewhere like Qatar or Diego Garcia it will be like a rather short vacation with clinic hours. If you get deployed to Germany for a year that will be a long vacation. If you deploy for a year with a Combat Support Hospital to a hot spot...well that will be totally different. How it balances out will be a truly personal choice. Is the money, clinical experience, importance of your work and camaraderie worth the lost time with your family, the long hours, sometimes spartan quarters and the forever memory of what you've seen? No one is going to be able to tell you that except yourself. When you take into account base pay, housing, insurance, etc. there is little comparison to the civilian world after the first few years. I started out making a bit less than my civ. counterparts when I was a 2Lt, but once you've been in for a short while the pay and benefits far outstrips the pay you'd receive in the civilian world as a staff nurse. I can't speak much for CRNAs or providers although I know several of my docs took home less money after they got out because of the unknown costs of working private practice, paying for malpractice insurance, paying for health insurance, etc. Each place is individual, and you're a salaried employee. There were times when I had a cush job with fewer hours and got paid to go to lunch and the gym. There were other times when I worked almost 60 hour weeks because things went to crap downrange and our patient census tripled in 24 hours. I would say there's no comparison. Yes, you move but I don't think it's like travel nursing at all. There you can pick and choose assignments, they can be a few weeks or extended up to a year. In the military you can move, yes, but you will be there for 3-5 years at a time unless it's a short remote assignment to Korea, Turkey, etc. You can move within a facility though; that's not to say you have to work in the same unit for all of those years. Medics are the health care workers that really take the brunt of danger in the military. As a nurse you're much more removed most of the time. I would say, given the length of deployment and the areas of deployment, that the Army will always be the more dangerous of the two when it comes to deployment. I'm not sure what kind of experience you're talking about, so I'm not sure how to answer this. As an Armyfied Air Force nurse I worked in 5 different specialties in 7 years (L&D, Family Practice, Med/Surg, Ortho trauma and nurse manager of an Ortho Clinic). I know several nurses in both branches that have also experienced that variety. However, I've also known many nurses that have pretty much stayed in one lane of experience for many years. It kind of depends what you want, and what they have to offer. While I think the AF has improved since I have been in, you will still promote faster in the Army and they promote more of O4 and above. I have seen similar levels of clinical professionalism. I think the Army has a higher level of military professionalism in the medical setting, if that makes sense. While the medical field is lax compared to line units in both the Army and AF, there is a stricter sense of military bearing in Army hospitals. I think on-base life in the Army has improved a lot over the past decade or so but in general the housing and accommodations on base will be nicer on AF bases. While you can volunteer for a year-long deployment in the AF, most are still 4 or 6 months while the Army typically deploys for a year at a time. I haven't heard of any of my friends/coworkers in the Army deploying anywhere but Iraq or Afghanistan in quite some time while the AF still has deployment locations in Kuwait, Qatar, Kyrgyzstan, etc. I don't know the numbers, although I know they fluctuate depending on the needs of the AF/Army. Each one has CRNA programs (I think they both still have to go through USUHS). Each has tuition assistance if you want to continue schooling while on active duty. Both have programs where your active duty job is to be a graduate student at a civilian university and you continue to get your rank pay while they pay for all your school expenses. Both branches offer many amazing programs, but I have no clue on percentages of availability. Things may be changing now with the trend toward combining health care facilities, but I believe the Army still has more facilities overall where you can get the critical care experience necessary to do the CRNA program. Not that I can think of right now. Work out a lot! :) I'm not sure how far along you are in your studies. You can cram the ROTC program in in a couple of years provided you can handle the increased credit hours on top of nursing school. I personally think ROTC is better than doing a direct commission because I feel it gives you a much better understanding of what it's going to mean to be a military nurse, especially if you didn't grow up with the experience of living in a military household or something similar. You come out with an understanding of some military history, dress & ceremonies, military rating, etc. You'll understand more why being a military nurse entails some of the things it does and the training it does. While ROTC isn't a guarantee of commissioning (I have known people who were released from their contract after 4 years of the ROTC program rather than being commissioned) I think it offers a better chance. With the current financial situation in our country more and more people are turning to the military as an option so it has become much more difficult to get in than it used to be. Since a BSN is the base requirement for any of the Nurse Corps I don't imagine that will give you any special leverage in either situation. As far as I know those are your only 2 options when it comes to nursing - either direct commission after at least 12 months of experience or ROTC...unless you're prior service and can go the OTC/OCS route, which it doesn't sound like you are. :)I don't know if this blathering on has helped you, but I hope there's something useful in there!

Hello all! I've just recently left military nursing and am experiencing civilian nursing for the first time. I moved here and started on an Oncology floor almost 2 months ago. I've not worked Oncology before, although I did a lot of it during my clinical rotations since it was an area of interest. Needless to say, I don't remember a WHOLE lot since that was 10 years ago! :) I got 6 shifts of orientation because the PBDS said I was good to go. Now, I am used to not getting much orientation in a new place, because that was par for the course in the military. However, my main concern is the utter lack of chemo training I've received! It seemed that I remembered from OHSU that you didn't do much with chemo until you were trained/certified. Here, only 2 or 3 of the nurses are chemo certified - one of which is the Nurse Manager, who doesn't really work on the floor. I've heard the typical sort of response - "It's been like that since before I got here, I didn't get training, my preceptor didn't get training, you just learn it". To me, this is some pretty scary ****! I am reading furiously, I'm putting in my application to join ONS and I've used their site to look up the listed trainers. Unfortunately none are within 3 hours of me, but since I plan to be here a couple years, it will be worth it. Hopefully I can get some sort of reimbursement from the hosptial, but who knows? It seems overall that many people have a rather lax attitude about all this...but IT'S CHEMO! Ack. I hear talk of a training class sometime in the next few months, but who knows? Any advice or resources you could pass along would be GREATLY appreciated. I have to say for the first time in 10 years of nursing this is the first thing I've run into that truly scares me. And it's not the chemo itself that scares me so much, it is my desire to do right by my patients. Thanks for your time!

Hello! I have only been working on the Onc floor for 2 months now, on nights, but so far I've been pretty darn busy! We give a lot of chemo and blood products 24 hours a day, nights are no exception. I give a LOT of medication - antibiotics, antiemetics, steroids, and oodles of PRN analgesics. I have had few nights so far where any of us got to take much of a break! From reading the previous comments, I'd say it must depend on where you are! :)

Hello all! I have recently moved and started working on a local Oncology unit. I was pretty shocked to learn that they don't use ANY type of holistic/alternative integration! Of course, part of this probably comes from my past experience in Portland OR (a pretty alterna-friendly place!) to now being in a small city in Texas, where I'm already a 'freak'. :) Do any of you have tips on integrating a more holistic mentality to the floor? I can do my own teaching, and energy work, but there's got to be a way to get the ball rolling to make things better for ALL our patients!

Hello all! I'll chime in my $0.02 here... For me, my military nursing experience was a LOT of things. VERY rewarding, busy, frustrating, busy, diverse, busy...you see the trend. I have NO idea where that quote on the first page came from (the not touching patients one), but I call BS. In only 7 years of service, I had such a diverse experience that it has made me far more well-rounded than I think any civilian setting could give me. I started in L&D/Postpartum/Nursery, then on to a Family Practice Clinic (which I really did not like much at all), finally to MedSurg, then mostly Orthopedic and GenSurg trauma related to the war, then finally ER. I made wonderful friends and had the opportunity of a lifetime when I got stationed in Germany. Sure, I didn't travel as much as I thought I'd be able to because of all the work hours, but I was ok with that. I took great pride in caring for my fellow service members. I went through the ROTC program on scholarship, so I was fortunate enough to come out with a degree and no debt! The majority of nurses are Direct Commission though, so have less 'militarized' experience. There is a vast difference between the medical military and the "regular" military lifestyle, but that can be OK. I have just returned from overseas and now have almost 2 months of experience under my belt in the private sector. I don't know what it's like in other areas or facilities, but I have noticed a VAST difference in the level of work ethic and professionalism. In the military you fulfill two professions - an Officer and a Nurse. I now really appreciate the relationship I had with the rest of my teammates - providers, nurses and support staff! To be honest, if I could have stayed in clinical nursing I probably would still be in uniform, and am currently in the process of pursuing a Reserve assignment when one opens in my area. Unfortunately I felt very pigeonholed by my assignment personnel when it was time for me to move, and many small things added up to the big decision to separate from service. The military isn't for everyone, but it was an amazing experience for me.

I was GS in Germany, but it was pretty different for me since I separated from Active Duty while over there and just stayed at the same hospital! They will only relocate if it is a critical need/shortage job...I know at LRMC the only civ nurses that got Stateside Hire status (which gets you the megabucks housing allowance!) were Cardiac Cath Lab nurses, Onc nurses and I think a Trauma Coordinator position. You get some COLA, but it's nothing compared to what it was when I was in! It does help offset costs some, just not as much. I'm not sure if that was much help, now that I go back and look at it! Sheesh.