Charmander

we take 1 - 2 patients, the rooms are paired (as much as the census allows), so sitting at one of the computers outside the room (there's 2 in a cubby with windows) you can lay eyes on each of your patients and monitors very easily. also the monitors have a feature where you can 'peek' on another room, and an actual window with an internal blind so you can lay eyes on if your in the other room (and close for privacy) works great. :)

just my thoughts.... but finish your BS in Public Health, (you're almost there anyway and getting some sort of degree is a great accomplishment) making sure you integrate any pre-req's into your curriculum (your advisor should be able to help you make things fit or get them approved) then go to an accelerated BSN program. As a previous poster alluded to, public health positions at the BS level are few and far between with most agencies requiring a MPH. Nursing right now isn't that in demand, but it is picking up. (At my hospital we went from 0 nursing positions advertised / open over the last couple years to about 27 last time I looked, about a quarter are open to new grads, which isn't too shabby...) Since people will keep having more people, and getting sick, drinking and texting while driving- nursing regardless of the job prospects right this second, is a good career choice. Things WILL change. And the opportunities are seriously huge, you could do public health nursing.... or continue to get your MPH and be really attractive to state and federal public health agencies... the RN goes a long way and not just at the bedside. all that being said, do what makes you happy and best wishes.

lifesaver = hands free double pumping bra.... La Leche League International Nursing bras, intimates, baby wear and sleepwear look for 'hands free pump bra' or 'new pump bra' this way you can multi task :) other survival tips: have a small insulated freezer pack ready to go. I also used storage bags to immediately freeze in the desired space saving flat freezer position. The pumping room had 2 super fancy pumps, so the you could only bring the tubing if you had that kind... which I did not.... The break room had a coffee maker with the hot water spout so cleaning equipment was a breeze. pre-load your pump bag with quick snacks, bottled water and wipes for the quick clean post-pump. and learn to be quick not to abuse your fellow nurses who are happy to relieve you.... unless you're always late in returning.... (make sure they have as little to do for your patients as possible... ie: take care of your pt's pain, IV fluids running out and things that will beep before you go) you being organized is the key. best of luck-

just my 2cents... but I took a PAY CUT to become a nurse.... went from flight with 15 yrs to BSN RN.... just for some perspective... :) Paramedic scope of practice varies WIDELY state to state, and region to region. I totally agree with the different thinking. This is what makes the RN / EMTP -as in one P and another RN-combo on the helicopter so great. (This is my experience.... ) Paramedics think from the outside in (scene safety, hazards, stabilizing the car, how to manage extrication...) and Nurses think from the in out (patient, comfort, more longer term care, etc.... ). The paramedic brings the ER, the nurse brings the ICU. It's a great combo. That being said, the RN's who just go and get their P-card (without any experience in the field... I know many do it and are great) don't bring the ER like a field born and raised medic does. Not saying that nurses are oblivious in the field, or paramedics can't do a crazy critical care interfacility... because they do and can and are awesome. Do what you love, do what makes you happy. Do one thing.... awesomely. so my advice for what it's worth... keep on keeping on with nursing school, you'll have many more opportunities in the long run, but don't let your EMT go either. As a RN with ICU time and your EMT, you are / will be way appealing to a flight company. even with 'just' your basic. PM me if you have questions.... best wishes what ever you choose.

high hot and a helluva lot is the HHH I know..... :)

I love my dansko's, but have found that the socks make a huge difference. I LOVE smart wool's.... if I wear cute thin socks, my feet and legs are killing me by mid shift.... How are the Alegria's??? always curious with shoes... :)

I take Ambien personally, and have had bizarre conversations with my hubby.... but that's it (as far as I know right? ) So I take it IN BED, with my alarm set and everything in the house ok. And only with my hubby home to take care of the kids. I usually take 5 mg if I NEED sleep, and half of that (as best as I can) if I just need to shut my mind off. My MD prescribed trazadone to help me sleep, since it didn't have the dependance issues, but it gave me HORRIBLE HORRIBLE nightmares so no more of that for me.... I also only take ambien a max of 3x a week for my PM shifts, with ear plugs, eye mask and fan... :) I guess like every medication we give that causes an alteration in consciousness, we need to be more aware for adverse reactions. I haven't had any reactions like those described in my patients (luckily) but will now be on the lookout. :)

I'm sure your already searching the web.... sarmc.org stlukesonline.com lots of campus' (Boise, Meridian, Wood River....) Elmore Medical Center West Valley Medical Center Mercy Medical Center there are also some long term acute care places like South West Advanced Care or something like that and Complex Care. lots of 'doc in the box' type places (Primary Health and the like) ... oh and PLENTY of bars.... :) Good luck!!

Also... when you go to the simlab, take a list of those skills that you need to work on- (Pump management, IV insertion, foleys, assessments... what ever... ), the policy and procedure for that skill, and work with a preceptor or one of the educators. Go thru each skill with the p&p, practice several times, get feedback from the preceptor, hints, tips... do it until you're comfortable. Document everything. Excel spreadsheet with checks for how many times you have reviewed this.... and have the preceptor initial and provide written feedback. Be very proactive in your education.... these skills are an individual responsibility... May sound excessive, but if they are thinking of letting you go, this shows them how much you really want this job (especially since this will most likely be off the clock). You've been told what to work on, so get started right away. Also shows you take feedback and apply it to your practice. They will probably take a copy and stick it in your file. Who knows... you may be helping to develop a new-grad development program??? Good luck-

Don't forget WA state.... they do accept Excelsior for LPN's only NOT paramedics (LPN's must go thru a 200 hour preceptorship in WA before they can proceed). Even if you have extensive (say 15 years) of experience, have all your clinical hours documented (yup... all of them), get your RN then go to a university to get your BSN, or MSN for that matter, test, work for a while then test in, work and endorse... any scenario with Paramedic attached, they don't want. I will say that I felt similarly prior to completing my BSN in a traditional university. I too worked with RN's (flight program), with the same procedures, protocols and responsibilities. Nursing clinicals are different than medic clinicals. I wouldn't discount that part of the education at all. Paramedic clinicals focus more on individual skill sets and individual assessments, while nursing clinicals focus less on individual skills and more on pt assessment as a whole, then the prioritization of patients, looking forward to tomorrow and the next day as far as their treatment and therapies. Paramedic vs nursing prioritization is a bit different... though I miss the 'all of you involved in this accident- walk over here' -- fantastic!! they are all greens!! The good news is as a medic you can easily work full time and still get fantastic grades as there are many similarities and the physiology is the same.... :) (If you can swing the shifts I had a set schedule so it worked great) Best of luck to you with your career goals, but before you invest in Excelsior, be sure to contact the states you may work in to make sure they take Excelsior Paramedic-RN's....

ok, a lot has been said for it being hard.... and I'll agree it's not cake.... though I don't work a split (I'm pure nights) I have 2 kiddo's (22 mos and 4) with my husband at home and it works great for us. My husband works full time too, though not the typical 5 days a week. We also have a great hospital day care that's open weekends too. Here's how I do it... I work weekends, so the 'day' of the night, I'm in bed by 11AM which means I have time to play with the kids, get them breakfast and do some general stuff before bed time. I'm up at 430P to get ready for work, spend some time, have dinner with them and get to work. Back home, repeat (though sometimes I do go straight to bed). My last day I stay up until the little one needs a nap (noon to about 3), then I take a nap with him and am back on the day routine. If we have a conflict or overlapping schedules, we use day care or a good friend of ours for the coverage. My hubby works set days a week, which I obviously don't work those days.... It works for us. I can switch back and forth relatively easily, though do take a sleep aid.... a melatonin and herb mix... or benedryl or a lovely breakfast cocktail.... all with ear plugs and a sleep mask.... I knew I'd be working nights when we remodeled our house, so the master bedroom has massive insulation in the inner walls.... :) You have to find what works for your family, though you may need to 'suffer' a little to get your way back to days. Good luck to you-

well... the unit I work in uses the 'self schedule' concept. Kind of a pain for the scheduler, but she's awesome and works really hard at it. About 4 weeks before the next schedule comes out there's a blank schedule that we put our wishes on. Most people work the same days each week, other's don't care what days they work. If there are days you can't work, we submit a request. Day people work days, night people work nights. I'm a weekend nights person, but I can pick up day shifts if I want.... Weekends rotate, but there's usually people who want to work weekends.... We don't have call shifts. by 24's do you mean 2 shifts per week? most hospitals don't schedule floor nurses for 24 hour shifts. I used to work for the flight program and we worked 24's but that's not going to get you into CRNA school.... (neither will out patient surgery) For the most part nursing schedules are flexible.... but each unit has a core number of nurses that they have to fill per shift, regardless of peoples wishes.... Good luck!

just so you don't limit your options.... most hospitals are latex free... or have lots of non latex options for you :)

Here's a whole list!! Good luck! http://www.aacn.nche.edu/Education/pdf/APLIST.PDF

the D50 part you got... but the normal amp comes 25 gm's in 50 ml's..... (thus the 50% :) and it's usually the big blue one if you have to find it quick.... good luck, some little medic tips with the D50, aspirate before admin (sugar is really bad if it infiltrates) we normally aspirate in the beginning, the middle and the end, just looking for good blood return in the hub of the catheter. It's really thick, so use a larger vein, 18g IV would be ideal, and remember that it's basically pure sugar and metabolizes quickly so you need to follow up with complex carbs / protein after they wake up and are able, or their BG will crash again and lower. Also it's not necessary to give the entire amp, (unless the MD's are insisting) just until they wake up more. then of course recheck the BG..... :) Good luck!

Usually depends on where you work, also usually follows Benner's novice to expert model of the nurse, clinical education, and professional development such as degrees, working on degrees, unit education, projects, volunteer work etc. Each level requires more and more of the competencies. As far as I know, most new grads start out as RNI's, (I think the VA may start BSN's at II's?) then after orientation / about 6 months you can move up the ladder. (and get paid more... :) There should be some sort of hand book or other information to look at.

Do the BSN, try for a fast-track, or just suck it up.... I have a BS that took me about 10 years (work and life... pesky...) and my fast track BSN program was 16 months (spring, summer, fall, spring) . Check out the link, best of luck!! http://www.aacn.nche.edu/IDS/pdf/BACDOC.pdf

We have a handy-dandy screw down to crush-crusher.... have no idea what it's called, but it works really well and is quiet. Every patient has one in their room. I've never noticed it wasn't clean when I went to use it- I assume it's new for each patient. I also worked with a Nurse who carried a pair of small pliers in his pocket for quick crushing in the bag. Worked great- sometimes it's the simplest things... :) I do tend to make sure the pills are crushed super fine for KO tubes and mix in warm water to be sure they are dissolved...

Absolutely. I don't shout it from the doorway, or say it in any way to be snide or obnoxious, however I have had several instances where the care my family or myself have received has been less than ideal and upon the staff finding out my health care experience it has SIGNIFICANTLY improved. Usually you can slip it into casual conversation like, 'I hear you there, I'm a nurse too and ..... ', or 'would you like me to call you, or can I refill the water if I write it down, I don't want to mess up your I&O's ...' I also firmly believe that everyone who is hospitalized should have some sort of advocate there with them who knows how to navigate the health care system. Too often the patient falls into the role of the patient and sits by passively assuming that the care providers know what is best for them, or have intimate knowledge of their medical history. I have 'fired' nurses and residents, but it's my family they are taking care of, this is not a rehearsal for the 'real' patient. I don't claim to know their job, but many aspects of health care are universal. I also will always fill out the comment card for those excellent nurses and aids, I've even dropped an email to the manager letting her know the excellent care. I think dropping the RN card so to speak is all in the delivery, as are so many things in life...

YAY!! This all means your a smart nurse!! Sounds like you understand the gravity and seriousness of your role and you respect that you are caring for another human being. Honestly, I have always thought someone entering any healthcare field should feel nervous and concerned about their performance for the first few several years, better that you know there's more you don't know than be the new person who is so over-confident they don't realize what they don't know. Which in the ICU makes all the difference. :) Hang in there!! Sounds like your in a supportive place!!

Burn Unit all the way. Oh holy cow those are some of the most compassionate, professional and smart nurses I have ever worked with (it was in medic school, literally ages ago...) You will learn so much about meds, patient assessment, wound care, family dynamics, compassionate care, collaboration and the list goes on. You will get your IV skills as you go, but this is one of those amazing opportunities you shouldn't let pass.... good luck!!

Congrats on both the baby and the sweet new job! Check on the FMLA regulations for your state and hospital. Sometimes you have to have worked for the hospital for a year before you qualify for FMLA (the holding of your position for a period of time while you have family issues). Short term disability, maternity leave and all that is important to get figured out too. It's a lot... and was somewhat confusing for me when I did it. I was just a few weeks short of qualifying for FMLA, but my manager held my spot for me (it would have been more difficult to hire and train someone new for my position). Remember too that your not the first nurse to have a baby, there are policies (most likely... ) and people to help you out. Good luck!!

um yes please?!?!?! I have been looking for this option too....

hubby - shot no problem 3 year old - nasal mist... no problem 15 month old - shot no problem me - shot no problem :) were Hini'd up in my house...

You are correct on Apollo... The Boise program is in the candidate phase of NLN accreditation for their Practical nurse offerings only and are not listed as an accredited school of nursing for any of their programs (http://www.nlnac.org), although in Arizona they are in the process for associates RN. CCNE accreditation would not apply as that is for BS and Graduate schools. Apollo is an accredited technical school, approved by the Idaho Board of Nursing for the Associates program (http://www.ibn.idaho.gov/publications.htm schools of nursing). Just FYI on Excelsior, many states, Idaho included are looking to no longer allow graduates of the Excelsior program become licensed RN's. They have been talking about this for a while.... who knows if or when it will happen. I don't mean to rain on your parade... but it would be terrible to do all the work and pay all the loads of money to not be allowed to become licensed in this state... I would suggest contacting the Board of Nursing to see when they plan on no longer accepting Excelsior, and if it's within your timeline, getting it done before??? Or apply to BSU, ISU, CWI, CSI though that doesn't help your drive.... best wishes to you in your nursing career...