Manurse715

With the changes in the financial aspects of healthcare that Obama is instigating, what will the trends be in CRNA salaries? Will hospitals and anesthesia groups seek to employ more CRNA's vs MD's as the cost is less?

I went to a Preview Day at Union's campus. They said they didn't really care about the GRE, which I thought was weird. They said they look at your last 60 hrs GPA and what you made in Anatomy, physiology, micro and stats. I really liked the environment there in Jackson and the feel the campus had. I don't know it I'll get in, but I'll try.

COD 123, thanks for that info. aCRNAhopeful, Here's what I'm reading: Calcium played a major role in the initiation of sliding the filiments (actin and myosin) in the cardiac contraction. It is both a trigger for contraction and a regulatory factor for the process. The higher the concentration of Ca with in the sarcoplamic reticulum the greater the tension or functional inotropic force the heart can generate. from "aacn clincal reference for critical care nursing" Mosby 4th ed. Remember that Ca channel blocker slow conduction, decreases myocardial contractility, and causes some vaso-relaxation-decreased afterload and SVR that it stands to reason that giving a patient Calcium would do the opposite.

Using a central line. The patient seemed to improve after giving the CaGluconate and other stuff we did.

This week I had and immediate post op emergent aortic valve replacement. He came back on Epi, Dopamine, Levophed and insulin drips. We started amniodarone soon after. Amongst other interventions we gave an amp of calcium gluconate. So what the difference between Cagluconate vs CaCl when addressing blood pressure?

How is the public transportation system in OK? Lol. Public transportation in Tulsa is for poor people. No one who doesn't have to uses it. Honestly. Down here in the South things are different. There's not as much of a need for it really. Most folks own 2-3 cars.

This info is for TULSA ~$18-19.00/hr I got a $7,000 sign on bonus paid out over the 2 year commitment at the going tax rate of (lame) 60%. But it's more than nothing. ~If your paying more than $600 for a one bed room you're in a "nicer" apartment. Less than that and well I wouldn't want to live there. ~ Tulsa is no Cali. Things are different around here. I come from Texas, Dallas/Fort Worth in particular. Tulsa was a one horse town, I thought at first. Having lived here 6 years its' just the right size. You have one of everything (shopping entertainment ect...). Tulsa is very much a small business, entrepreneur, conservative, family oriented place. It is growing A LOT. They say we are in a recession....but it's not in Tulsa. They're building stuff everywhere. I think you will be very pleasantly surprised by Tulsa. Home go for $85-120/square foot to buy, renting is very affordable, gas is $2.09 today and milk is $2.88, movies are $6.50. Dallas is a short 4 hours away with the MEGA shopping and international airport. Overall, and this is coming from a Texas Boy, Tulsa is a great place to live.

I work in Tulsa. As you may know, the economy in Tulsa is doing better than most of the US. I got hired in the ICU as a new grad in 2007. Starting pay for no experience with a BSN was $18-19.00 I work night/weekends, and have my CCRN which is a little extra. I will take home about 26-28 bucks an hour after taxes and insurance.

I see. That sounds about right. Sounds like you have a good group of ICU RN's with you too. I saw that you sight 7 years as your length of experience. I made the assumption that this was 7 years of ICU experience. My mistake. I took my CCRN about a year and a half after my orientation was finished.

That's fair. I know in my setting of practice there are many who are very negative and tear people down just to build themselves up. I didn't know if this malevolence presented its self in your location, and if it contributed to reservation of taking the test. Generally, I am not afraid to try for something. I really don't think you'll pass if you don't know your stuff. And it does show you know things. It also **i feel that is the most important thing** shows that you're committed to learning and expanding your capacity to care for critically ill patients. Which it sounds like you are. What I was trying to communicate is that when people (including yourself) tell you you can't look them back in the eye and call them a lier. :chuckle

geekgolightly Gave a host of reasons why she shouldn't take her CCRN. Mostly, they were rooted in lack of self confidence. The AACN clearly lists the minimal requirements to take your CCRN. Once these are met, a balanced assessment of personal readiness will appropriately recognize both limitations AND qualifications of a potential CCRN candidate. I usually side with The Little Engine That Could.

Albumin is expensive and while it is DUH logical for us to sit there and say "Dude, no oncotic pressure, low albumin, gross 3rd spacing, increased vascular permeability...give albumin..." Research suggests that colloids may not be any more effective in fluid resuscitation than isotonic crystalloids. Surgery will make you 3rd space and then it should start coming back in a 2-3 days. Why they let her wallow around in pre-renal for three days seems foolish. Is she a DNR? I bet the White Coats might have gotten DNR confused with Do Not Treat.

dittos on the previous. If the K is high R2 dehydration Crt and BUN are up too then you very well could see your K come down as your kidney kick it up a notch. But no, isn't directly effected by dilutional situations like Na Alb or H&H are.

Whatever. You should take it. I've been in the ICU 2 years with many pundits of my capacities (mainly biased dayshifters). I studied daily. And passed it.

I got a 103! I hope I get an intvw

I'm looking at Vigileo online right now. It says it is calibrated to account for vascular tone according to its algorithms. Many of our pt population have been smoking cigarettes and shooting up since they were 12. With a helping of uncontrolled DM and HTN. Are the algorithms taking co-mobidities into account?

I kinda agree with the previous poster. Yes having your dreams crushed sucks, but it isn't failure. Maybe you have the tools to be a great ICU RN and a great CRNA. But maybe you don't. ? We don't know. But if you go to the floor and never get back to ICU or CRNA school be good at what you do do and always try hard. That being said, (lol) I got fired from my first RN job in the ICU within two months of orientation. The worse thing I did was give 2 units SQ insulin when the pt was on an insulin drip. (they said I wasn't safe) I did some LAME home health care for a Dr I knew personally and a few months later got into an other ICU at a different hospital, worked my rear off, read everything I could about all my pt's cases, and asked lots of questions. Less than 2 years later I'm CCRN certified and am quite competent. Don't give up yet.

man, i hate "those families." i had a end stage hiv pt who had been estranged from his family for decades for his homosexual life style. his partner of many years was at bedside in the day and his "family" at night. the man was incapacitated and on the vent. one day the "family" brought a notary to witness the pt "sign" a check so the family could cash it. i didn't see which "family" member took the hand of the pt to "sign" the check since it was on days and i work nights. crap like that ****** me off.

Get "Pass CCRN!" from amazon.com. It has a DVD with 1000+ questions. I used it. I passed. Try it!

Thanks for your opinion. My statements come not from my victim cries but from multiple mouths of multiple women who objectively speak to my circumstances. I never have played the gender card when raising issues to my superiors. Generalizations are usually full of inaccuracies. Personal experience, well that's a bit more authentic. Some of both men and women are able to be objective about gender rolls and ICU capacities. Some aren't. I've encountered more of the latter. The opposition I've encountered has motivated me to engage in independent studies and subsequent acquisition of my CCRN. So I try to use the "nay-sayers" to improve my capacities and tools of my personal practice which leads to safer and improved quality of care for ICU patients. That's what we all really want....right?

Fact. Truth. Strongly confirmed through extensive evidenced based practice. lol. I personally have met with some strong bias when it comes to gender differences as it relates to my perceived competency and skill. To the original post: I hope I'm not old when I'm 36. If you change your attitude I'll bet you can get a position. I work with a lady now who has just finished her orientation in our 33 bed EverythingbutNeuro ICU. She was in the corporate front office of QT (very popular gas station in Ok) for 20 years before deciding to "try something new." So it can be done. Also, as a 24 year old dude sometimes it's challenging to work with nurses who are 10-20 years my senior. I have been raised to respect my elders, even if they have less ICU experience. The challenge comes from communicating across the Generational Chasm. If and when you start to work ICU NEVER EVER be intimidated or scared to ask questions about EVERYTHING, even if its from a young whippersnaper like me . At the end of the day we're all on the same team. Good LUCK and don't take No for an answer.

"None. Does clinical in nursing school count? lol" no. :chuckle

I will contribute that this maybe because many nurses don't know the significance of the numbers that are produced.

You manager is a moron. Unless you aren't a good nurse. Which is sound like you are since you try hard to learn more and seek out new opportunities. Clearly she/he (probably a she) is more interest in fulfilling her bottom line and has no interest in your career success. Nursing is a great field but you HAVE to serve your OWN self interest in regards to your career. If you're not ready for ICU after some time in a step down, why do they hire new grads? If you're not ready for ICU why does she want you to do charge? Trying to guilt trip you into staying where you are is very insulting. I would NOT work for this individual ONE MORE DAY. Put in your transfer.