pererau

I'm not living in Washington anymore, so I can't guarantee that anything I say applies anymore, but I didn't know anything about the residency program at Franciscan when I was applying for jobs. I just applied and when they interviewed me, they put me in a residency. For Legacy, I filled out a huge packet of information and got it back to them... turns out I was 2 days past the deadline and would have to wait 3 months. For Providence, I worked there as a CNA and I know at the time they didn't hire new grads into the ER, but they did have residency programs for other floors. I have heard that since then, they have had a few new grad residents in the ER, but I don't know any details on it. I loved the residency at Franciscan, as the didactic was detailed and specifically tailored to the ER. I learned more in those 3 months than in the whole of nursing school. That was a couple years ago, though, and I don't know what it is like now. I still have lots of friends over there, so if you want to email me at pererau at gmail then I'll try to connect you to someone who at least can give you some details.

My Davis and my Gahart both say 1 minute, and I've never had a problem with that speed. Has anybody else?

Why not? 1 D 2 D - I really hate this type of question, because in the real world we would be doing D and B at the same time, and I could see a pretty reasonable argument for either, but in the end, absent standing orders, the RN does not have the authority to start a normal saline bolus, and typed and crossed blood is always safer for the patient than o neg. 3 B 4 D 5 A - wild guess here.

The total care was the idea of the (at the time) new nursing bigwig who wanted to achieve magnet status and decided that the best way to do it was to fake staff to patient ratio numbers by firing LPNs and CNAs and using only RNs. It ended up working out well for me (a CNA at the time) as it pushed me to apply to the ER, where I fell in love and have called my home ever since, but I feel bad for the nurses on the floor as they now have to do the butt wiping and bed changing in addition to the critical thinking skills that they are getting paid big bucks for (don't get me wrong - nurses aren't above wiping a few butts, but when you go to school to be educated to assess and implement procedures and become knowledgable on meds and the like, it is a waste of money to have the nurse doing menial tasks that can be done by anyone). I also feel bad for the patients who instead of having several team members available to help them have one overworked nurse who comes by when possible. That is why when I graduated from nursing school, I didn't even apply to St. Pete's. (That and they don't have an ER residency program and my eyes were fixed on the ER prize) Overall it is a good hospital, and I think that eventually the thinking will come around and the stupid nursedoeseverything policy will change.

If it is the rush of the hospital you are looking for, you may be disappointed, because most hospitals around here are doing away with LPNs in favor of RNs. That said, Group Health hires a lot of LPNs for their clinics and urgent care centers. Good luck.

I am very seriously considering a move to California. I've tried to research the subject of how best to get a license in CA, and in fact, I've already paid to have Nursys verify my license. My concern is that I have read at various places that it is better to wait until you are actually in CA and get a temp license because if you submit the application packet, and then go to CA before it is approved there is no way except to start over. So my question is this: Should I just go ahead and send in my application packet so that I get a CA license, or should I wait until I have a sure thing and stop by Sacramento to pick the license up? And if I do submit the application from my current state and then get an offer for a job, what are the steps to get a license at that point? I know this theme has been posted to death, but I'm still a little confused, so any help would be appreciated.

I worked there several years ago as a CNA. I was on the TCU (transitional care unit) side, and I don't know if anything has changed in the past few years, but for a nursing home, I found it to be nice. That said, I'm certainly not a nursing home fan, so I would never want to work there again, but I have had experience in three different nursing homes either as a CNA or RN student, and MJCC is the best of the three.

I got my CNA training many years ago at the Puget Sound Healthcare Center in Olympia and it was free. Also, I was employed as a CNA while working at the Providence Health System and going to nursing school and they helped me with a reasonable chunk of the cost. I'm not sure about anywhere else.

I am considering a job offer in Sacramento at Mercy General Hospital in the ER. This offer is somewhat coming out of the blue, and I need some help with anyone who lives in Sacramento. Is there anything about the MGH ER that I need to know before I run blindly into it? The hospital itself seems to be in a fairly nice neighborhood, but it seems expensive. Where are the best places in Sacramento to live to be safe (two young children) and fairly quiet? Some important things for us: we don't want an ancient house, we want sidewalks in the neighborhood. Near a mall would be great. Near Costco even greater. We don't want to go too far from the Hospital. Preferably somewhere that we can find a 3 bedroom house to rent in the 12-1600 range. What kind of heat is it in the summer? It is hard to tell based on the humidity graphs we have found. If anybody has any suggestions or ideas for getting by in Sacramento, please get back to me ASAP, as I will probably accept this offer baring anything unforeseen. The other thing I need help with is what I need to do ahead of time if I am going to get a walk-through Cali license. I have already paid the money for the national licensure web page to verify my current license, but what else needs to be done prior to heading down there?

The headache comes because Morphine produces vasodilation. This is why we give Morphine for chest pain patients. The vasodilation is great to reduce constriction due to angina, but it causes headaches due to the vasodilation. These are usually transitory in my experience.

Try the Franciscan Health System (Tacoma area), the Providence Health System (Everett and Olympia) or the Legacy Health System (Vancouver and Portland area). All three have residency programs.

I graduated in late 2007 and it took less than a month to find a good ER residency position. I don't buy the BS that you have to do floor nursing before going to the ER, but don't try to go into the ER except through a good residency program. I think trying to work on the floor would have ripped my soul clean out of my body.

Do you feel better now? Having worked the floor and ER as a CNA and now the ER as an RN, I have seen both sides of the picture, and I agree with you in principle, though I wouldn't take it quite so far. Working in the ER is worlds different than the floor and, I have to say, considerably more difficult. Honestly, ER nurses should be making more money, but unions will never allow that. With that said, from the other side of the coin, the floor nurses are not just sitting around smoking cigars and playing poker. One thing that a lot of ER nurses don't realize is that the floor nurses have 4, 5, or 6 (or even more at night) patients, many of whom are the crazies that we sent their way an hour ago, and while they don't have as much hands-on drama, they do have a load of paperwork and red tape hoops to jump through that makes their jobs pure misery. They want to know about the CT results and bedsores, because they have 3 double-sided forms to fill out for every little problem so that the hospital can get reimbursed/accredited/not sued. I've come to terms with the fact that there will never be the perfect transfer. Every time I take a patient up to the floor, either they find something that I didn't do, or I sit and wait in the room for 10 minutes only to find that the assignment was changed or the nurse didn't think to get an IV pole or a tele unit, or they tried to put my female in with a male roommate or some stupid business that keeps me away from my other patients in the ER. One day I'm going to take a patient to the floor and the nurse will be right there ready to go with all the supplies needed and magically I will have had time to do all the I&Os and skin assessments and fall risk scores and I will have detailed information about all the labs and radiology reports and will be able to quote, from the top of my head, the patient's meds and allergies and last 10 blood pressures. Until that day comes, we just do the best we can and try to remember that although we are busy with some of the people that even Jerry Springer wont accept, they are busy with the paperwork and guidelines created by even crazier people in the joint commission.

One thing that I have found is important in starting IVs is confidence. It is kind of a vicious circle, because when you miss, your confidence goes down, and when your confidence goes down, you are more likely to miss. You have to trick yourself into thinking you are going to get it, because I've found that when I go in with no confidence, I create a self-fulfilling prophecy.

You are a patient advocate. That means that it is your responsibility to advocate for the well-being of the patient. This means ensuring the patients get the proper treatments and medications and respect. The patient will sometimes have you believe that this means that you are to get them more dilaudid, inapropriate radiology tests, and the like. Don't fall for that trap. Advocating for the patient sometimes means pleading with the doc for more meds, but sometimes it means teaching the patient that the drugs they want are not appropriate for their condition, or explaining why an MRI isn't appropriate for a sore throat. Also, remember that advocating for patients also means advocating for patients that are still in the waiting room. If you fall for the idea that you have to do everything that your patient wants, then you are delaying the care of the patients that are yet to be seen. What I do: I try to respect everyone and make sure that they are comfortable, but I do not let them order me around, and I do not bend the golden rule of the ER (sickest goes first) on the whim of a patient. Good luck