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Psych, Stepdown, Research
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vwde specializes in Psych, Stepdown, Research.

vwde's Latest Activity

  1. vwde

    Renal Pathophysiology

    GREAT explanation Guttercat! Thanks so much! I actually asked my boss yesterday too and she gave me some of the same information you just gave me, but not so much detail. I LOVE pathophys, and yes, renal pathophys has definitely been the most difficult for me!
  2. vwde

    blood draw from PICC

    At my facility, the policy is to stop the heparin gtt for 5 minutes, flush (10 cc), waste (10 cc), sample (10 cc syringe, but usually only take 4-5 cc), and flush (10 cc).
  3. vwde

    Renal Pathophysiology

    So, I've been researching this, and I currently work on a tele floor where a good portion (50% or so) of our pts are ckd/aki pts. I'm fuzzy on renal labs to some extent and wanted to know if there's a good delineation between dehydration and actual kidney disease. Or, is it that you would suspect dehydration as a cause of aki, rule it out with volume repletion, and continue BMPs/CMPs to reassess daily? I guess what I'm asking is, I routinely get pt's w/ decreased GFRs, elevated BUNs, etc. I usually look for minimally abnormal GFR/BUN, combined w/ evidence of hemoconcentration to decipher dehydration on my own. Is there a cheat sheet for dehydration? Or are there just too many variables to look at to diagnose dehydration vs. some other form of aki?
  4. so, so, soooooo agree. I just did some more HCAPS training yesterday, and I could just about puke from all of the scripting they want. What about the fluid overload I just caught, or the SVT we just controlled? Where's that survey? As a side note, I'm a BSN and I work in a hospital with ADNs and LPNs. Let me tell you, these nurses are some of the best I've seen. And I've been in those "highly ranked" hospitals. Talk about misinformation...
  5. vwde

    Transfusion Reaction

    That's what I meant. I understand that the IV can stay in, but do you have to replace the entire drip set with a new one, or can you clear it of blood and use it?
  6. vwde

    Transfusion Reaction

    So, I know what to look for as far as reactions during transfusion of PRBCs, FFP, etc. I'm also aware that you always want to stop the infusion and start a "new" line of NS at KVO. I think I understand that you can't use your existing line due to the microscopic infiltrates/anaphylactic "offenders", right? I'm just thinking of timeliness in an emergency, but it seems like you shouldn't use the existing line... right? I've not yet seen a reaction, but I'm sure it's only a matter of time. Thanks in advance for the input. Love this site!
  7. vwde

    Counseling/psych after Psych NP?

    I'm looking into a Psych NP program in my area that allows dual certification in NP/CNS with about 6 more credits. The CNS part gives you counseling education and allows you to reimburse for counseling.
  8. vwde

    Pregnancy and... the floor?

    So, I'm 31, ready for babies, and on the floor. I'm still a new nurse (nearly a year), but we're thinking of pregnancy in the next 3-6 mos. Any opinions on being pregnant on the floor? I know the norms, i.e.: swollen feet, stressed, tired, etc., but what do you think about coming into contact w/ drugs (possibly carcinogenic), bacteria, etc.? We're lucky, in that we're not exactly financially bound to my floor position but I just want to know what other people have done or thought. Thanks for the replies!
  9. vwde

    Am I ever going to get this?

    I am soooooo glad other people feel this way too. I know we all say it, but it just also seems like no one else could possibly feel this anxious and nervous as a new nurse. I'm almost a year old (still a babe as well), but about 3 mos into my second job. I cried the whole way home the other night for my first time. I think I'm going to need to go to the dentist to get a bite guard. My jaw is constantly hurting and I, too, have permanent frown lines. I also have grown more grey hairs in the past 2 mos then in the first 31 years. I feel like quitting, because at this point it's hard to find anything redeeming in a job w/ such a demanding pace and huge responsibility. But, when I look at my patients and think, they're going through what my Mom went through, and my situation couldn't possibly be worse, I double check the IV meds I've just hung, and take a few minutes to talk w/ them. At that point, I don't care so much about being behind. I guess there is a redeeming quality about being a nurse, when my patients hug me at the end of my shift and thank me for... I don't really know what... but they thank me anyway. I'm glad to hear other people feel the same way, and thank the Gods of Nursing for this site.
  10. vwde

    Tuition Assistance in Virginia Hospitals

    The hospitals I've worked in just give a blanket TA amount to employees. Many times, it just has to "be related" to your job. I haven't seen one that won't pay for nursing.
  11. vwde

    Georgetown Online FNP

    Oh, I knew it was new, but not that new. Thanks for the info.
  12. vwde

    Georgetown Online FNP

    Does anyone know much about the strength of the program? I've looked around allnurses, but haven't found anyone who is actually in it, or who has had experience with it. I know it's expensive, and I know Georgetown's reputation. I'd just like to know that it's a worthwhile program - since it's online - and I'd love to actually talk to someone in it or someone who has graduated from it. Thanks in advance and I love this site!
  13. Wow, I've never heard of that. Thanks for the info!
  14. Just to reiterate, the nursing programs I applied to required a lab with micro... requiring it to be an on-campus class.
  15. vwde

    anyone leave high paying 1st career?

    I left a job that payed almost double what I'm now making as a nurse. I got into an accelerated BSN program and didn't work for the year I was in it. I don't have kids, but know plenty of people who did in that program, and they definitely had a hard enough time juggling school and kids without a job. I agree with other posters that this is your decision, but I would always go for the higher degree. I know there are people in my hospital system that are sort of being "grandfathered" into higher positions, but for the most part, you need a minimum of a BSN to get further than base level. I would definitely go with option 2. Also, many hospitals in my area offer scholarships in exchange for working with them upon graduation. HRSA is also offering scholarships to nursing students. I've seen people have the entire accelerated BSN program paid for by these routes.
  16. vwde

    Advice needed on which job to take...

    The only problem I see with the surgery center, as a fellow new nurse, is that it is not considered an "acute care facility"... is it? That's the big stumbling block where I live. I took a hospital job initially, over others because it seems like almost any other job in nursing wants you to have "a minimum of 1 year in an acute care facility". I feel like that will open many more doors later. However, if it's on par with a hospital, in the eyes of future employers, I would definitely take the surg center job.