geekgolightly

A coworker of mine graduated two years ago with 90k in debt. I found that to be astounding. At that high of a debt to salary ratio, I wouldn't think it wa worth it to become an RN.

I'd like to just defend all preceptors who watch what you're doing, especially while in a critical care environment. Despite the growing confidence a preceptor may have in a newly minted nurse, that preceptor, if s/he is worth their salt, will watch you like a HAWK, and for good reason. Those patients take a turn for the worse at the smallest unnoticed change. Learn to live with it, until you are almost ready to fly on your own.

I think also, because people don't understand the mechanism, when I say things like, weight gaina nd loss is regulated by hormones, they might assume that what I mean is ONE HAS NO CONTROL, JUST GO AHEAD AND BE FAT, but that assumption is wrong. There are ways to encourage loss. Looking into eating without sugars and grains is a big one. I have done this (after reading GCBC) and have lost 25 pounds in six months, without counting calories or "dieting." I eat a huge amount of fat - approx 60-65%, all clean fats, coconut, animal, nuts, EVOO. I no longer have GERD (possibly undiagnosed Celiac, but definitely related to giving up grains), I no longer have OSA, nor do I even snore. And I feel so.much.better. I can't describe how much better. The low fat high carb, standard American diet (and that includes the ADA recommendations, which are frightening) appears to be the culprit behind this jump in obesity in WW countries. Some peoples bodies regulate higher and so they appear - from the outside - to tolerate the SAD, whereas others are susecptible to insulin resistance and leptin resistance and enter a positive feedback loop which eventually destroys appetite regulation. I found a succinct 11 point conclusion from Taubes' book that might encourage people to read it. You *really* need to read the book though. The 11 Critical Conclusions of Good Calories, Bad Calories: 1. Dietary fat, whether saturated or not, does not cause heart disease. 2. Carbohydrates do, because of their effect on the hormone insulin. The more easily-digestible and refined the carbohydrates and the more fructose they contain, the greater the effect on our health, weight, and well-being. 3. Sugars--sucrose (table sugar) and high fructose corn syrup specifically--are particularly harmful. The glucose in these sugars raises insulin levels; the fructose they contain overloads the liver. 4. Refined carbohydrates, starches, and sugars are also the most likely dietary causes of cancer, Alzheimer's Disease, and the other common chronic diseases of modern times. 5. Obesity is a disorder of excess fat accumulation, not overeating and not sedentary behavior. 6. Consuming excess calories does not cause us to grow fatter any more than it causes a child to grow taller. 7. Exercise does not make us lose excess fat; it makes us hungry. 8. We get fat because of an imbalance--a disequilibrium--in the hormonal regulation of fat tissue and fat metabolism. More fat is stored in the fat tissue than is mobilized and used for fuel. We become leaner when the hormonal regulation of the fat tissue reverses this imbalance. 9. Insulin is the primary regulator of fat storage. When insulin levels are elevated, we stockpile calories as fat. When insulin levels fall, we release fat from our fat tissue and burn it for fuel. 10. By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity. By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity. 11. The fewer carbohydrates we eat, the leaner we will be.

You find it hard to believe because you don't have enough information. I hope that you read Gary Taubes' book. It's enlightening.

I have definitely heard nasty comments from coworkers, and I have spent my time calling them out on it. Because I am married to a man with a child, they all assume I am straight, and so I have heard comments from time to time and it irritates the heck out of me. Sometimes nurses can be the most judgmental of people, rather than the most accepting. I have worked in Texas, Kansas, Missouri and Pennsylvania and in PA, there was little bias. Kansas was the worst, by far.

Big fat lie - Telegraph Interview with Gary Taubes.

I really hope that before anyone else spouts off about fatties and their food that they actually research what regulates fat accumulation. Read Good Calories Bad Calories by Gary Taubes and I bet many of you will be hanging your head in shame for how woefully little you knew before. I did. Amazon.com: Good Calories, Bad Calories (9781400040780): Gary Taubes: Books

This. I am curious, too. I know that there is a matter of acuity, but I struggle often with two patients in ICU!

Another one to echo ordering pressors ahead of time (I message the pharmacy as soon as I hang the gtt) and be sure, even if you think you hit all of the numbers right, make sure you actually hit all of the numbers right by double checking the pump and the gtt. I have made both of these errors, too and the scrambling afterwards was enough to give me a heart attack!

If you really want it, do everything you can now to prepare such as trying to obtain a job on the LD unit as a tech, or requesting that any elective clinicals (if you do that at your school) be in LD. Also, call the hospital's HR dept and ask if they have a nurse intern program and work a summer as a nurse intern in LD. And when you're on the unit, work HARD, volunteer to do everything you can, request to observe anything unusual if all of your regular work is caught up. Be as enthusiastic and available for learning and working as is possible. I don't work LD but I work ICU and we are very picky about who we hire into our unit. Most of the people who we hire, we have already sorted out by these means.

What do you really love about NICU? I think you would do well in any ICU if you're doing well in your current area, but adult ICU is mainly geriatric ICU (unless you do trauma!).

marilynmom! I know you from mothering, yeah? I remember us talking about how stressful critical care is. I just interviewed for an ap/pp/nursery job. I complied a list of questions and I'll copy them here for you. What is the staffing ratio for mother baby? Do you cross train into nursery or labor delivery? How long is the internship/orientation? Is there classroom instruction as well as clinical? What resources are available to me to help me transition into this role? Is continuing education offered? Encourged? How is the scheduling done? Self-scheduling? How far in advance? Are there mandatory on-call requirements? How much? How often? What is the charting like? Computer? Paper? What is your management style? What is the rapport of the staff with physicians? Why do you like working here? Also, I prepared for the interview by going over these questions tht would be (and most were) directed at me: Why OB? What about this area is appealing to you? What specific nursing skills do you feel you possess that would benefit you in OB? How do you manage your patient load/prioritize/manage your time? What is your weakness in nursing? Are you willing to cross-train to other areas? (PP, Nursery, L&D, etc...) Willing to work nights/weekends/holidays? Give me an example of a conflict you've had (either with a patient, physician or a manager) and how you dealt with it? How do you deal with loss? How do you manage your stress? I am excited for you and wish you the best. I hope we both get the jobs we want.

I had my phone interview with HR and the nurse manager and I think it went really well! I am completely sold on this unit and hope I get the opportunity to join their staff. They are expanding their MFM dept and are caring for critically ill antepartum patients, which is a huge bonus for me. I can't wait to do a shadow experience with them when I move next month. I wanted to thank all of you who helped me and who post here because I have been reading all of these threads, trying to get an understanding of what AP/PP/nursery care is about. You all have been invaluable to me.

You did all you could considering your experience and your lack of help from the more experienced nurses on the floor. As an aside, I would have asked for a UA C&S, and BMP to check esp the BUN and creat (flank pain) as well as a lactate. And yes! to the liters of fluid and adding a pressor if necessary after the fluid boluses. For future reference only! I have been working MICU for two years now and sepsis is our main diagnosis. And consider a new hospital's LD unit. Find the most cohesive LD unit in your area and jump ship because it sounds like poor working conditions!

Adult Ventilation Management Online Nursing Continuing Education Course This is a very nice pdf on adult ventilation management written for nurses. You can download and read it for free, but if you want CEU hours (likely you won't as you're in AUS) you have to pay for it. Just click on the tab "Download to Read Offline" on your left hand side. After this pdf, go to LearnICU.org - Society of Critical Care Medicine and sign up (it's free) in order to listen to the ICU lectures. They have a couple on ventilatory support. Even further! There are some great podcasts by ICU Rounds ICU Rounds It has a search function on the lower right hand area of the blog. Here is a word search on "ventilation," I did for you. ICU Rounds Enjoy!