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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!

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).

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?

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...

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?

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!

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.

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!

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.

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

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!

Wow, I've never heard of that. Thanks for the info!

Just to reiterate, the nursing programs I applied to required a lab with micro... requiring it to be an on-campus class.

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.

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.

Sort of outside of the DC area but Culpeper Hospital and UVA are hiring new grads. I work for Inova and they are not hiring new grads... but that's also what they said when I was hired (as a new grad). My advice would be to not limit your search (geographically) and go for UVA - they are attached to a medical school and can offer great experience. Also, see if you can make contacts in the area. Knowing someone seems to go a long way.

I've had the same problem with Firefox. Safari worked fine. There has to be some sort of compatibility problem. Try a different web browser.

I am currently working in a psych unit with a specialization in geriatric/dementia patients. You are right, they can be very difficult to deal with. But, we have amazing docs and nurses who can pick up on the slightest issues with these patients. In fact, we often get patients from long term care with acute mental status changes or increased aggression, like you're describing. Once we get them, they go through the entire medical head to toe. Often, they have a UTI, which can be the root of the problem. Also, we've found underlying pain. If neither of those are there, the docs often switch up their drugs and that works. I would recommend that someone sees her and evaluates her. I'm sure many people would say, "that's just her!", and leave it be, but it's not safe for the patient or the staff that she's that non-compliant and aggressive. I feel your pain. I hope it works out.

bsn va $25/hr plus diff. (up to $8/hr, depending on the shift. works out to about $50-55k/yr). like: helping people dislike: catty people/attitudes/cliques

I took the review in 2010... fantastic!!! A lot of people are talking about how they heard Marlene's voice during the NCLEX but I still hear her voice as I'm working on the floor! Our reviewer was very personable and knowledgeable as well. I passed the NCLEX in 75 questions... it was well worth the money! If you can spend it, definitely do it!

Just an FYI, GMU's pass rate is higher than Shenandoah's... this year and historically: Virginia Board of Nursing Education Programs. I applied to Shenandoah but ended up getting into Mason so I went through their 2nd degree program. There are definitely problems in the program, but I would expect that there are problems in any accelerated area of education. That being said, the Professors there have been some of the best I've encountered. I still keep in touch with many of them and use them as clinical and academic resources even in my current position. I hear Shenandoah is a great school but $ and NCLEX pass rates would convince me to at least apply to Mason. I commuted 45 minutes each way to the Fairfax Campus but I recorded lectures and used that time to listen to the lectures. They were also planning on moving much of the nursing program to the Prince William campus, though I don't know it that's still the case. Also, the clinicals we had have been very impressive on my resume - Childrens, Georgetown, Sibley, NVMHI, etc. The Inova system, amongst other hospitals in the area, knows the Mason 2nd degree students well and offered many of us jobs, even in this economy. Just my 2 cents. I'm sure you'll do great at Shenandoah, but I'd at least apply to Mason, if I were you. What could it hurt? $20k, 12 months and a reputation for academic excellence in the healthcare community... you can't beat that.

In addition to the above, a lot of time is spent "checking in" and talking with patients and families.

Pay differs a lot. Depending on the hospital/system you go with, there are shift differentials and it can even differ by floor. There are also some much cheaper places to live. You just have to search. Is there a specific area you're looking into?

There are a lot of opinions of this one the site and you'll hear good and bad about both programs. I went through GMU's 2nd degree program and the good is that you are done in 12 months. I am finding that I was well prepared regardless of anything positive/negative within the program. They really have some excellent, dedicated professors and, what I'd describe as an intense but thorough program. Hospital experience may not affect your chances of getting into the program but will absolutely help you through. I would strongly recommend you consider doing something (paid tech, volunteer, etc.) in a hospital but plenty of people went through having never set foot in one. You have plenty of time to decide so, good luck!

Hey AddieRN and others - I'm a new nurse and have been working a few temp jobs until I got into med/psych inpatient. Now, I've been offered a pt hospice case management position. I'm looking for info on HCR. Most of the hospice nurses on this site seem to really enjoy their jobs but I'm wondering if all of you are employed by local companies or larger organizations like HCR. Is there any info you could give me on the company? I know they are run differently in their own parts of the country but there may be some similarities. Thanks!