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lilla_fjaril

lilla_fjaril

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lilla_fjaril's Latest Activity

  1. lilla_fjaril

    Finding a preceptor

    How does everybody feel about offering to do some non-clinical work for a practice that it willing to give you some hours. I have to do placements in a variety of places so I can't insinuate I might be able to work for all of them down the line and still feel ethical. Is it unprofessional to offer myself up for a certain number of hours of answering the phones or rearranging files or assisting with a presentation, etc.?
  2. lilla_fjaril

    What if an ANP wants to add FNP or MHNP certification?

    Thanks everyone. I will take this information to heart. It may still be more cost-effective for me to get my ANP (basically free through tuition reimbursement) and then pay to complete a post-masters in FNP than it would be to switch to a more expensive school where I could get an initial FNP. St Louis University has some on-line post-masters certificates for as little as 15 credit hours and there must be other similar programs. Since I'll be one of those NPs with only about 4 years of nursing experience, I see the wisdom in completing another 500 hours of clinicals, even if I do have to pay to work for free. I was actually planning on offering myself up as a free intern to potential employers for 3-6 months. And for those of you who think no nurse without 20 years of experience has a right to try to be an NP, I encourage you to keep an open mind. There may be no substitute for experience, but an intelligent and motivated person can achieve great things. I personally have received excellent care from fledgling PAs and NPs
  3. Where I live, ANPs and PNPs are more common than FNPs because most offices/EDs specialize in kids or adults. I'm in an ANP program that'll I'll finish in 2011. There aren't any FNP programs in town. What if I want to add FNP or mental health certification to broaded my scope of practice? I know I can get a post-MSN certificate, but do you think I'll have to repeat all my 'adult health' classes? Or just coplete the coursework related to the additional scope of practice. I like the idea of working with the homeless or in an urgent care center, and that might mean being able to deal with kids and psychological problems too.
  4. lilla_fjaril

    Waiting for NP job, working as RN

    I work in the OR and one of my coworkers is an NP that chooses to work as an OR staff nurse. She said she did the continuing ed because she likes to learn and the hospital paid for it, but at the end of the day she's happy being an OR nurse and do to 15 years of experience she makes about the same amount of money as a new NP, so why change? There's no rule at my large teaching hospital about working below your license. When you think about it, an RN with acls licensing can do a lot in an emergency. Unless you're going to start prescribing meds or performing emergency trachs (a procedure not taught in FNP I assume) I don't think there's a whole lot of room for confusion of job duties, is there? And the job market for NPs is good most places, especially if you want to do primary care.
  5. lilla_fjaril

    Why do you put up with the abuse?

    Thanks guys, for your honest opinions. I've been in the OR at a big teaching hospital for a little over a year. I've calmed down some. I may go talk to HR or an EAP counselor about the best way to deal with being screamed at, so that I don't eventually snap, cuss out a surgeon, and get fired. (Our docs have mastered how to stomp and scream without using the F word so thet if anyone reports them it's all subjective as to whether they were yelling, talking sternly, etc.) And you know, I don't begrudge them getting snappy when the case takes a turn for the worse, but when the patient is totally stable and they expect everything rapid-fire from a newbie scrub just so they can go home early or squeeze in an add-on...I just want to turn and inform them that I'm not sticking myself with a Hep C needle so they can make an extra 5 grand that day. It bothers me even more to see coworkers (especially the ones who aren't evil) abused than it does to take it myself. Yesterday was grueling for a couple of my friends. Surgeons screaming at them when they didn't even do anything wrong. Nurses--preceptors even--humiliating them during the procedure and talking about how slow and stupid they are behind their backs. As the circulator in a couple different cases, I felt so helpless. I became a nurse because I don't like to see people suffer and I want to be able to help. Instead I feel like I'm forced to watch my coworkers suffer at the hands of other healthcare professionals. How messed up is that? And we've tried to talk to our manager but she just gives us the "difficult personalities/thick skin" lecture. Once or twce she's tried to tell our unit that everyone needs to be nice. Well, nothing ****** off a bunch of hostile nurses like telling them they need to be more nice, you know? Where I work is cardiac vs' non-cardiac, scrubs vs. RNs, part-time vs' full-time, old-timers vs. new nurses, etc. You gotta come prepped for battle every day! No wonder I'm so exhausted...
  6. lilla_fjaril

    Why do you put up with the abuse?

    *rant following* Surgeons who swear, throw instruments on the floor, scream at you for giving them what they asked for instead of giving them what they wanted? Backstabbing sabotaging coworkers who systematically run off new orientees so they can keep making overtime? Managers who give you a few shifts of cardiac scrub training and then put you out on your own in a ruptured TAA, even though you've never seen one before? I know why senior nurses stay. They're the ones actually treated like human beings by surgeons and coworkers. I already started NP school, so I don't plan on hanging around the requisite 5+ years that it takes to become uber-proficient in the OR. I'm already a darn good circulator, but even if I wasn't, that still doesn't make it okay to belittle me and scream at me in public. Newer nurses/techs...why do you do it? Is cleaning up poop really worse than being treated like it? I don't need a pep talk. I don't need a lecture about thick skin. I'm not 'overly sensitive' because I object to being treated like dog doo. Don't tell me things are rough all over because I have new grad friends on many floors and none of them are being abused by their co-nurses. I was treated better as a student nurse in the ICU/on the floor. Heck, I was treated better as a registrar in the ED. Basically where I work is hell (going on a little over a year now) and I'm staying just long enough to get my ACLS and CNOR. And then I'm splitting. Will my evil co-nurses snicker amongst themselves how I couldn't hack it? I'm sure they will. But where I'm from, the weak one is the one who sticks around and lets herself be treated like a b#tch. I just wanna know what the heck motivates everybody else. And if your OR isn't chock-full of arrogant sacks of crap...well, it'd be nice to know places like that exist. LF
  7. lilla_fjaril

    OR Pet peeves

    Ohh my god, so nitpicky but I work in CT and the thoracic surgeons are forever pulling tonsil sponges off on my sponge sticks to use them as ring forceps. They don't even tell me. They just drop the sponge on my mayo for me to discover when I turn back around. And I ALWAYS keep both an empty and a loaded sponge stick on the mayo at all times, just so I have both available in case my hands are tied up loading a stapler or something. And also they like to ask for things not on their DPC, like a harmonic scalpel or ostene or local anesthetic or whatever. But if I can't produce this for them in a nanosecond, they do a work-around while the circulator is getting the item. Then, as soon as she opens it up they don't want it. So. Much. Waste. And being treated like I'm subhuman when I circulate. We have cardiac surgeons who never say the circulator's name. It's just my job to guess from the slight change in inflection (while I'm charting, fetching, pager managing, phone-answering) that they're talking to me and not the scrub or fellow or anesthesia or perfusionist. The same docs punctuate every request with "and be quick about it." Oh, so it's not okay to get your gortex graft on the way back from a smoke break? Thanks for clearing that up." I'm only 10 months in the OR but I plan to leave Award-Winning Teaching Hospital as soon as they pay for my CNOR. If I'm going to get treated like absolute scum every day I might as well be a travel nurse and make bank. I've worked a lot of jobs but never experienced abuse like I see it inflicted daily in the OR.
  8. lilla_fjaril

    Career change advice

    On working in school: Sure, it's better not to work if you can afford it, but I actually worked part-time in a hospital that provided tuition reimbursement while completing one of the accelerated 1 year BSN programs. I went to school 35 hours a week, studied about 10-15 hours a week, and worked 16 hours on the weekend. I graduated with a 3.9 GPA and I don't feel like working was a major detriment to my education (to my social life, yes, but what's one year?) So on that note it comes down to you--you know how much you can take on and still be successful. You also know if you're the kind of person who will 'freak out' if you get all B+'s instead of all A's. On the cost: Don't forget to figure in that year of nursing salary ($45,000+) that you can make if you graduate in a year from an accelerated program. An ADN will take 2 years, and may have a long waiting list for clinicals. Plus, most hospitals will pay back at least $10,000 in loans. Once I figure in my tuition reimbursement and loan repayment, my accelerated BSN will have cost me about $4000. On job possibilities. I live in a major metro area that sadly only pays 20/hr to start. We're saturated with nursing schools and most of the ADN nurses I know start out in a nursing home. A couple magnet teaching hospitals in the area won't even consider you without a BSN. (I'm not saying that is right, just how it is where I am.) Check with some HR recruiters in your area before you make any definite decisions. Good luck :)
  9. lilla_fjaril

    Upward Mobility in the OR

    You know, I'm a new nurse in the OR and I got that song and dance about how I would be stuck there because I'd lose my clinical skills, but I really think it's just a matter of how you sell yourself. I want to be an NP down the line so I'll eventually change to a floor or unit. Where I work, OR nurses put in foleys, prep, apply dressings, do quick patient assessments, and interact w/ patient and family, just like they do on the floor. Sure, you probably won't do IVs and you won't give a lot of meds, but that just means you might need to do a little studying and take an IV therapy course. And you can always practice your assessment skills on friends and family or volunteer at a homeless shelter doing blood pressures, etc. In the OR you can become an expert on sterile technique, an expert on multi-tasking, an expert on anatomy (if you scrub), an expert on dealing with difficult people, an expert on prioritizing (nothing says prioritize like 5 people all screaming at you to do something for them simultaneously), an expert on high-tech medical devices, an expert on debugging computer problems, etc. Depending on where you work, you also might learn about SWANS, arterial lines, chest tubes, balloon pumps--stuff that might scare the crap out of an inexperienced floor nurse. And when your patient asks you about their upcoming Nissen fundoplication or thymectomy you'll know enough about surgical terms and procedures to at least interact with them in a professional manner. There will always be people who disagree with the idea of starting in a specialty area. In the end, you have to do what is right for you. Good luck!
  10. lilla_fjaril

    C&C Clogs (Scandanavian Company)

    Try Birkenstock--Superbirki. Cheaper than those 'specialty nursing shoes' and sooooo comfortable :) If you've got high arches you may need to pop an arch support over the cork insole. My feet don't get hot during the day, my toes don't rub, and my shoes can be washed off with a hose or run through a dishwasher (so they say but that's kind of gross to me, though I did put them through the dishwasher at the end of my shifts when I used to work as a chef.) function, not fashion, that's my motto
  11. lilla_fjaril

    relatively new and stressed

    One more suggestion: massages! :) You think you can't afford them but really at this mst stressful time in your career you can't afford to skimp on taking care of yourself! And if all else fails, consider temporary meds just to get you through the internship period. My PCP will not give benzos to healthcare professionals, a position which I highly respect. She did offer me an antidepressant in nursing school but as my problem was more nerves--specifically sweating and shaking--than depression I declined. I ended up with a prescription for low-dose propranolol which many classical musicians take prior to performances to steady the fingers. It was just what I needed to get me through my first few IV starts. It doesn't do anything for your emotional anxiety--just slows down the old SNS, makes the job feel more like a job and less like being chased by a hungry shark on a deserted beach. I got a refill to get me through my first few weeks of scrub training. Maybe it's placebo effect but I notice a real difference in my performance. Hang in there! You can do it!
  12. lilla_fjaril

    Shoes?

    Danskos are expensive...and most are so tall! (i have klutz tendencies) I wear Birkinstocks. I think the style is Pro-birkie or something. Costs about 70 bucks. Very wide toe box, non-slip bottoms. I also have high arches so I put a pair of orthotic insoles inside. I do 12's and my feet never hurt at the end of the day. i worked as a chef and wore Birkinstocks there too :)
  13. lilla_fjaril

    Timeout univercal protocol

    I suggest you google it. A single search brings up a lot of info.
  14. lilla_fjaril

    relatively new and stressed

    Hi Ames! I'm at 5.5 months in the OR at a top ten hospital and I'm right there with you. I did an externship in the ICU where I was treated well and enjoyed the teamwork, but the lure of the OR overcame me and I signed on for a 9 month internship there instead. I'm sticking it out for at least another year because I want to travel and I think periop traveling would be really cool. I bet you're like me, you've always known you were hardworking and smart, people have always told you you were hardworking and smart, you've always been successful at jobs and liked by coworkers because of your good attitude. Then comes the OR where people prefer a hellbitch that can fix the bronchoscope and find the big berthas over a clueless newbie who really wishes she could help. It sucks to be us! my favorite is my manager, who is always asking 'Do you like working here?' I mean, what kind of masochist likes a job where everyone thinks she is a big dummy and they whisper about all the stupid things she does but the never offer to help her out so she'll do fewer stupid things in the future, a job where she is two-steps behind all day and being barked at from all directions and blamed for basically anything that goes wrong. My program started with 5 interns and one has quit and another is on the bubble. As the interns are all hardworking, smart, and kind people, I'm really trying to get them to stay. I'm hoping enough nice people will water down the power of the evil ones. My recommendations-- 1. Go to three 12-hour shifts if you can. That's just 13 or 14 days a month :) 2. Yoga. Running. Reading. Lying in the sun. Drinking. Whatever it is that takes the edge off for you. 3. Befriend the med students and surgical interns. They feel exactly like you do! The other day I handed a sterile gown to an intern in line to get gloved. He looked at me all 'deer in headlights' because he wasn't sure how to open it. Sure I could've enjoyed a laugh at his expense. But instead we walked away from the crowd and I helped him. Then I found a Bonney forcep for a med student wanting to practice suturing. Bingo--instant allies. 4. Tell your manager how you feel. Our floor started up an intern support meeting which meets once or twice a month. All the nurse interns from diff services get together and mostly vent. But our manager and our educator attend so at least they know what's going on. 5. Stick it out for your year and then consider a smaller OR. For me, the top ten name will help me land a good travel job (I hope) so it's worth it. But I've observed in smaller ORs and people seem nicer. 6. Take advantage of tuition reimbursement. Start a BSN or MSN. Just the thought of the opportunities you might have in the future can make the present bearable. 7. Realize that surgeons aren't better than you, or smarter than you. They're just people that spent 15 years studying the same thing (and then expect you to know everything after 6 months.) 8. Report anything that crosses the line. Cursing, throwing instruments, making a fuss big enough to risk patient safety, etc. Most big hospitals are university affiliated and the university will have a code of conduct in place. Maybe nothing will happen if you report it, but at least the MD knows you're not a complete pushover...and if he crosses the line repeatedly there will be a papertrail to show that you made management aware and they didn't fix the problem.
  15. lilla_fjaril

    Opening bypass cannulas

    Some of the bypass cannulas are two feet long and unpredictably floppy. Ever since I contaminated one trying to drop it and realized those suckers cost 35.00 each, my new plan has been to wait until the scrub nurse has everything else set up and then open them so she can grab them. Some scrubs have no problems with this. Some are raging beotches that say ' you know, you really need to learn to open better. you won't always have time to stand around waiting for me.' Etc. I asked a couple of our perfusionists for recommendations and both said they would always recommend having the scrub grab the longest pump pieces because of the danger of contamination. What does everyone else do? And a side note. Why are so many OR nurses cold, catty, backstabbing, two-faced, condescending, snarky, impatient witches? As a new grad OR intern I've been laughed at, mocked, marginalized, ignored, etc. till I could scream. And don't give me any BS about having thick skin. My skin is thick. And I don't use that as an excuse to treat other people like total crap! And I take notes, take the DPCs home to study, watch surgeries on CTSnet, read cardiothoracic textbooks and keep all of the inserts from valves and grafts and read that stuff too. I keep a positive attitude even when I feel like crying. Anesthesia providers are nice and polite. Perfusionists are nice and polite. Surgical fellows are nice and polite. Surgical assistants are nice and polite. It seems to be ONLY the STs and other nurses who treat us newbies like crap. And that makes me sad!
  16. lilla_fjaril

    Brand Spanking New OR Nurse

    Take heart. I was a superstar in nursing school and I, too, am a complete OR retard. Any stupid thing that can be done--I've done it...twice, maybe three times. I now categorize the surgeons as 'thinks I'm a complete moron' or 'might not yet think I'm a complete moron.' The other day, after 6 weeks of being precepted in circulating CABGs and valve replacements I was left alone to do a pacemaker lead extraction. I had only seen two prior, both done by different doctors. EVERYTHING the surgeon asked for I was like "Huh? What? What's it look like?" and my scrub tech who couldn't help me took more than a wee bit of pleasure in my suffering. After twice being asked for something I had never heard of, I finally went to my charge nurse and told her I needed someone with me who knew the equipment. At the end of the case the surgeon thanked everyone by name except for me and I felt like total crap. The next day I circ'd a CABG/valve replacement by myself and things went a little smoother. I was nervous, and managed to contaminate a small mayo set-up during opening when a robnel wrapper ripped on me, but I told the scrub nurse ASAP and she was cool about it. The thing that sucks is, if everyone knows it takes a year to be a decent OR nurse, why is there so much grumbling, laughing, eye-rolling, whispered comments, etc. by the senior staff. Sometimes I feel like they want us orientees to fail...and that sucks