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Mossback's Latest Activity

  1. Mossback

    IV questions

    It sounds like most of the issues you describe are occurring because the secondary bag isn't high enough relative to the primary bag. Bear in mind that the top of the fluid in the primary bag must be below the drip chamber of the secondary bag. When the bags are arranged with the proper height differential, simple physics prevents the fluid in the primary from backing up into the secondary. Judging from what I see in the clinical setting, this is a pretty common issue, even among experienced nurses. As far as flush volume is concerned, typical primary IV tubing requires 15 to 30 mL to fully flush the circuit. Good luck with future infusions
  2. Mossback


    All of the acute care hospitals in the Sacramento area require a BSN or MSN for new grad hires. If it is practical for you to do so, you might want to consider an RN to BSN program.
  3. Mossback

    Is 63 to old to start nursing school?

    I started pre-reqs at 55, then moved on to a second bachelor's program. I graduated with a BSN at 59, passed the NCLEX with 75 questions, and got hired at a university-affiliated hospital two months later. Two years later I went back for my master's while still working full time. Don't let anyone tell you you're too old to keep up. I work circles around coworkers who are young enough to be my grandchildren.
  4. Mossback

    265 questions is almost guaranteed if your a male.

    I passed with 75 questions and when I was a doddering 60-year-old. MENCLEX indeed!
  5. Mossback

    UC Davis MEPN 2018

    RNs and NPs have distinctly different scopes of practice. In general, RNs cannot order procedures, medications or diagnostic tests. They do not formulate medical diagnoses. Nurse practitioners can independently diagnose and care for patients. They are allowed to prescribe medications and order diagnostics. Acquisition of an NP license requires an additional one to two years of formal education, including at least 500 hours of clinical experience. Graduates of the MEPN program at Betty Irene Moore graduate with a master of science in nursing (MSN) and are eligible to sit for the registered nurse licensing exam. The program is 18 months long.
  6. Mossback

    Pt. With trach: cuffed but always deflated?

    The purpose of the cuff is not to limit airflow around the teach, but to prevent secretions from moving down the trachea and into the lungs. Unless the patient is actively bleeding, the coff is deflated following surgery and the recovery from anesthesia. An inflated cuff can collect a large amount of secretions above it that will, at some point, descend into the lungs. It can also erode the delicate mucus membranes that line the trachea. For these reasons, it is customary to deflate the cuff as soon as the patient recovers the ability to cough up and control secretions. Here's hoping all goes well with your son.
  7. Mossback

    How old is too old to become a new RN?

    There seem to be plenty of people telling you that you're too old to go into nursing. Based on my own experience, I don't think that's the case. I graduated from a BSN program at 60, passed the NCLEX, and was hired at a university-based medical center within eight weeks of getting my license. Six years later I'm still going strong, working 12-hour night shifts on a busy med/surg unit. Last year I got my master's degree in nursing while still working full time. In addition to a full nursing schedule, I'm currently working one day a week as a clinical instructor for a BSN program. I'd encourage you to go for it. The insights and perspective gained during your life will help make you a better nurse.
  8. Mossback

    Should I continue nursing school?

    I'm a part-time clinical instructor for students in a BSN program, as well as a full-time floor nurse at a busy university-based hospital. I've found that it's not uncommon for students to find clinicals an unsatisfying or even downright miserable experience. I believe this stems from a number of factors that most students experience to a greater or lesser degree. The feeling of being behind the learning curve makes clinicals stressful, as does the sensation of being constantly quizzed and scrutinized. Being on the receiving end of criticism from clinical faculty and staff nurses is often a source of anxiety for students. Dealing with patients can be challenging, particularly when they view a student nurse with some skepticism. For many students, there's also deep-seated fear of inadvertently injuring a patient. All this is by way of saying that the stress and unhappiness you're currently feeling won't necessarily translate into being unsatisfied once you graduate and are in the professional setting. I hated nursing when I was midway through my BSN, but I now feel that it's an interesting and highly rewarding career. Many of my former students report a similar evolution of their attitude towards nursing. My advice is to hang in there. You're through the worst part of your nursing education. As time goes on, you might just find that you like nursing after all.
  9. Mossback

    MEPN vs ABSN

    The MEPN program at UCD hasn't launched yet, but I'm a graduate of the MS program at the Betty Irene Moore School of Nursing at UCD and have taught at SMU, so I think I can provide a little perspective. 1) MEPN stands for Masters Entry Program in Nursing. It is designed for students with a bachelor's degree in another field. No bachelor's degree in nursing will be granted. Instead, students will graduate with an MSN. As I understand it, the program will not provide a direct pathway to an NP, CRNA, or other advanced nursing specialty. 2) SMU provides students with a very good education, albeit at a high cost. However, the Betty Irene Moore School is already recognized by US News and World Report as one of the nation's best graduate schools of nursing. The MSN degree will be granted by UC Davis, which has a sterling academic reputation. I cannot imagine that having an MSN from UC Davis would in any way serve as a bar to employment. 3) If you want to become a nurse practitioner, you will need to go through an additional master's level program. One such program is currently offered at Betty Irene Moore. Before pursuing NP studies, I strongly urge you to first work for a few years as an inpatient nurse at a large hospital. In my opinion, the best NPs come from a solid background in patient care. 4) For most hospitals, there is no difference in starting job category or salary between candidates with a BSN or MSN, although some employers prefer candidates with the higher degree. An MSN will prepare you to work as a registered nurse and will set the stage for a later move up to a leadership or teaching position. It takes a couple of years to start functioning at a journeyman level as an inpatient RN. Don't expect to move up before then. Hope this helps.
  10. Mossback

    Be honest, what pt behaviors do you find annoying?

    My personal pet peeve is patients who come to the hospital, but then refuse vitals, assessment, labs, oxygen, repositioning, wound care, physical therapy, respiratory care, and the majority of medications (but almost never pain meds). Are they just drug seeking? Or are they contrary to the point of being suicidal?
  11. Mossback

    I need some really-wide-shoe ideas!

    Several styles of New Balance walking shoes are available in widths up to 6E. I have extremely wide feet and have worn the 928 style for a number of year. The soles are fairly grippy and seem to wear well. The 928s are available in black or white leather, so they can go with most colors of scrubs. The only downside of the New Balance shoes is that they're not cheap. I pay about $130 a pair for the 928s. Best of luck in your shoe hunt!
  12. Mossback

    what age did you decide to become a nurse

    I was 55 when I made the decision to become a nurse. It came after a long career in journalism and electronic media. I got my BSN at 60, and am now on track to get my master's at age 64. I only wish I'd become a nurse about 30 years earlier.
  13. My first degree was a Bachelor of Arts in Journalism. I worked for 35 years in commercial television, then went back to school and got a BSN. I'm now working full time in a med-surg unit at a university-affiliated medical center and working on my master's degree. By the time I'm done I will have spent 11 years of my adult life in higher education, making me officially over-educated.
  14. Mossback

    Older, New RN

    I attended nursing school in my mid-50s, after a long career in media. Now I'm in my 60s and working in a large university-affiliated hospital and pursuing a master's in nursing. I was a challenge to go back to school in late middle age, but in retrospect it was the best decision I ever made.
  15. Mossback

    Trying to select a program as an older male

    Whether or not you need a BSN depends largely on where you are located. In some parts of the country, ADNs can readily find hospital jobs. Elsewhere, a BSN is the minimum standard for entry to work in the acute care environment. Where I live, hospitals won't even consider new graduates with ADNs. As far as getting into nursing late in life, I starting taking pre-reqs at 55, got into a second bachelor's program at 58, and got my RN at 59. It was a huge amount of work, but was easily the best decision I ever made.
  16. Mossback

    Growing Up Unvaccinated

    Thanks for sharing your story, but was the "2 in 10 that die" comment a typo? According to the CDC, serious allergic reactions to the TDaP vaccine occur at a rate of less than once in a million doses.