kacefaceRN

Patent foramen ovale From Pubmed Health: While a baby grows in the womb, there is a normal opening between the left and right atria (upper chambers) of the heart. If this opening fails to close naturally soon after the baby is born, the hole is called patent foramen ovale (PFO). Causes, incidence, and risk factors A foramen ovale allows blood to bypass the lungs. A baby's lungs are not used when it grows in the womb, so the hole does not cause problems in an unborn infant. The opening is supposed to close soon after birth, but sometimes it does not. In about 1 out of 4 people, the opening never closes. If it does not, it is called a patent foramen ovale (PFO). The cause of a PFO is unknown. There are no known risk factors. Symptoms Infants with a patent foramen ovale and no other heart defects do not have symptoms. Signs and tests An echocardiogram can be done to diagnose a PFO. If the PFO is not easily seen, a cardiologist can perform a "bubble test." Saline solution (salt water) is injected into the body as the cardiologist watches the heart on an ultrasound (echocardiogram) monitor. If a PFO exists, tiny air bubbles will be seen moving from the right to left side of the heart. I've never seen a bubble test performed, but you learn something every day!

I just sent in my 2010 taxes (paper version) and realized I signed them kaceface, RN. Hope the IRS needs a laugh!

DC and Virginia seem to have a selection of new grad programs to choose from.

I don't think it it's fair to judge those nurses as "holier than thou" for expressing their honest opinions about their work. As they stated, they entered the field with certain expectations which were then left unfulfilled. I can understand why those nurses are frustrated. It is heartbreaking to know that an innocent child is going to get sent home with a mom who showed up in labor while high on cocaine, simply because there is not enough space in the foster care system or because child abuse "hasn't happened" yet. How upsetting is it to know that a baby is getting sent home with a father who punched a hole in the wall of the hospital because he was having an "emotional moment?" I hope his child never does anything to make his father too emotional. While I think it is admirable to be empathetic to all patients and to try to refrain from judgment, sometimes those patients are behaving in ways that you know will endanger their children. Should we respect those choices because that is what the patient wants? We will never know all that has happened in a patient's life and all the troubles they have faced that led them to the path they are on. So yes, offer support and empathy for that patient and do your best to meet their needs, but also call the social worker and get that patient involved with CPS. In the end, it is for the good of the entire family. So to answer the OP, how do you deal? Try to go home every day knowing that you were a good nurse to that family. And if it's at the point that you can't be the best nurse to that mom or dad, be a great nurse to that baby. Sometimes you'll go home and hate all of humanity and sometimes you'll meet a family that makes you proud to be a nurse. Vent to your nursing friends, treat yourself to dinner, and promise yourself that when you have a family, you will make sure your home is filled with love.

When I started my first job, I had to take a computerized clinical scenario test that sounds very similar to what you are describing. It's called the PBDS (Performance Based Development System). If I remember correctly, the test we took was something like six hours long and broken into maybe five sections. For two of the sections, they would show a brief video of a patient and then you would be expected to write what was happening, what actions you would take, and what you would communicate to/expect from the MD. There was a section on communication where you would listen to conversations between a nurse and a patient or doctor. I can't really remember what the goal of that section was-maybe you were supposed to offer a better way of communicating? Also, there was a section where it showed you a picture of things that could go wrong with IVs and we had to state the problem and how we would resolve it. I feel like there was one more section, but obviously I have tried to block this test from my memory My suggestion to you is to be detailed in your descriptions of the actions you would take and especially in what you would communicate to the MD. Use SBAR format to organize your thoughts. Don't assume that the test grader knows what you would do in that situation-you have to write down everything. Even if it's something simple like taking vital signs, write it down. Otherwise, try to relax and don't feel bad about yourself if you don't pass. One thing I found very frustrating about the test was that it was unclear exactly what the test was looking for. There is very minimal direction given. Like you said, the test is definitely geared towards nurses who have experience. As a new nurse, it will be difficult because you have not seen these scenarios in real life and you have never had the opportunity to observe how the nursing team responds to them. I did find a website where it offers some common scenarios to study. http://hrnservices.com/?PBDS%20Sample%20Exam&node=181 Hope this helps! Edit: Just found out that if you search for "PBDS" on allnurses.com, you'll be able to find many threads discussing the test.

From my personal experience, getting your license endorsed in DC is very easy, especially if you can go to the BON in person. I did something very similar-got a job offer in DC and had already signed up for the NCLEX in VA. I went ahead and took the NCLEX in VA and as soon as I had my license number, I walked right into the BON with my money and my other paperwork, waited about 30 minutes, and walked out with a DC license in-hand. Just follow the directions on the DC BON website and you should be fine!

From my experience, the cost of living in Northern VA can be considerably higher than in Richmond. You'll definitely see an increase in the cost of rent. When I lived in Richmond, the cost of gas was often 30 cents cheaper than what my family in Northern VA was paying.

You should also talk to your employer about whether you are eligible for family medical leave. I don't have any personal experience with it, but this website can hopefully provide more information: http://www.dol.gov/whd/fmla/index.htm

The starting pay for new graduates is $27.673/hr on day shift, with 10% evening and 15% night differentials when working a rotating shift. The hospital operates under a collective bargaining agreement with the union Nurses United. The current contract expires this April, so I don't know what the pay will be when the next residency program starts. If you are interested in reading the collective bargaining agreement, you can download it from the union's website: http://www.nursesunited.org/index.cfm?view=contract_page

I just graduated in December and started my job in the NICU last week. I had had no previous NICU experience, but I did my senior capstone class in pediatrics, which probably helped a little. As far as reading recommendations, if you look in the "stickies" for this page, the one that says Start Here includes a book list. Here's the link: https://allnurses.com/nicu-nursing-forum/member-recommended-neonatal-45883.html Best of luck!

I just got hired into the NICU! I look forward to meeting you both during orientation!

The PVT worked for me (I live in Virginia)! I took the NCLEX yesterday, got the good pop-up last night, and got the confirmation that I had passed this morning!

Actually, here is a link to a thread discussing some books to read: http://community.midwiferytoday.com/forums/t/312.aspx Hope that helps!

You might have more luck finding answers if you post this question to the Midwifery Today forum: http://community.midwiferytoday.com/forums/ There is a forum specifically for students and aspiring midwives. Many of the midwives who post on that site are CPMs, so they will probably have good suggestions about books to read. Good luck!

The answers that I would change are #7-10 and 12. I think #7 and 8 are tricky because you can see how certain answers would be correct. For example, a buffer can yield H+ ions. However, I think you need to look at the most basic and all-encompassing definition. For that reason, I would choose acid (#7) and base (#8) as the answers. For #9, you need to think back to basic acid-base reactions. For #10, pH, by definition, describes the concentration of H+. Bicarbonate can affect pH by decreasing the concentration of free hydrogen ions. However, it is still the concentration of H+ that is measured by pH. Similarly, #12 asks about changes in pH (or H+ concentration). pH levels can be confusing because they seem to change in the opposite way of what you'd expect. If the amount of hydrogen is decreasing, the pH increases, becoming more alkalotic. If you have .001 mol/L of H+, you have 1x10^-3 mol/L and a pH of 3. If you have .0001 mol/L of H+, you have 1x10^-4 mol/L and a pH of 4. Every 1 point increase in pH shows a 10 fold decrease in the concentration of H+. I think this link explains these concepts better than I can: http://www.visionlearning.com/library/module_viewer.php?mid=58 As for #11, I disagree with the previous poster. I think your answer is correct. The sodium-potassium pump is an active transport process that regulates the membrane potential of cells. However, it is osmosis through which sodium affects fluid balance.